need opinions on my 4 year old please

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Hi. I'm new here. I have had questions about my daughter for a while now. She has a corn allergy and chemical sensitivity and these things seem to make her behavioral symptoms worse but after getting better about avoiding them, she is still having issues I can't seem to help her with.

Please bear with me, I'm going to try and list everything that is going on.

Extreme sensitivity to texture of foods, smell, touch, taste, sound. (Though sometimes she likes to have very loud music!) Seems to have a hard time making eye contact sometimes. Difficulty following instructions. Difficulty transitioning between activities. Certain activities become so frustrating for her they result in a meltdown. We walk on eggshells around here, trying to avoid meltdowns (last longer than an hour sometimes!). Difficulty telling us what she wants or needs (sometimes its like she can't use her words and it comes out as a whiny noise or one word which she will yell at us). Very easily overstimulated and can't calm down on her own. She has had bouts of self harming behaviors. She often licks herself or chews on her lips. Every few weeks she will have a rash under her bottom lip from licking and chewing and rubbing.

She also has frequent nightmares, confusional arousal, has had night terrors in the past. She doesn't respond when unfamiliar people talk to her, she has to be prompted by her dad or myself and even then its one word responses. She doesn't have too much contact with other kids, except her younger brother, but when she does, she doesn't seem to understand how to play with them. She gets too close, tries to hold hands when its clear they don't want to, chases or tickles them and doesn't seem to notice if they don't want to play the same game. Sometimes she will meet a kid that wants to play the same way.

Also, when things around the house get tense or noisy, she starts bouncing around and making her own noises with her mouth or her voice. She sings and rhymes (with real words or made up sounds) a lot. She often likes to play by crashing and jumping and running around and making lots of noise vocally while she is doing it.

She has gotten so many toys over the years and doesn't really play with most of them. And if she does, she doesn't use them for what they are meant for. Occasionally she will use them how they were meant to be used. She does well with duplos and drawing and putting together train tracks.

She has some areas she does really well, like her artistic ability. She draws so well! She also has a very good long term memory she can remember routes really well and has an excellent sense of direction. She is really good at noticing patterns and making up her own.

As for her trouble areas, I used to thing it was all related to her allergies. Then I thought it was related to parenting issues, but now I am seeing there are some things that just don't seem to fit into either category.

Sorry if this post is really scattered. I'm hoping I can get some opinions on here. Does this sound like an ASD? Or something else?
We have a psychological evaluation set up for later this month.

To me it sounds a lot like ASD, but I am not a doctor or anything. I think it bears looking into. Sometimes they can be sensory seeking or sensory aversive in different things and this can switch over time. Your child may need the loud noises in some sense.

Thanks for your response!
Yes, it seems like it helps her to have some measure of control over the noise and action going on so she makes her own. I could be completely wrong, but that's my theory.

Ask the psychiatrist if it is ok for her to try taking melatonin. You can buy the stuff off the counter but its always best to ask a pro on things.

Melatonin is commonly known as a hormone that triggers one's sleep cycle. When you feel drowsy with sleep that's the melatonin kicking in. However, what is important about this is that it has a much more critical function while you sleep. In the brain, there is a structure called the blood-brain barrier. Think of it as a super-tight membrane that acts as a filter. It only allows blood cells in, nothing bigger (like bacteria or or other harmful things).

By doing so, it also prevents things larger than blood cells from getting out. The brain consumes most of our resources and it produces a lot of waste. Almost none of it can leave the brain. Except when you sleep. When you're asleep the blood brain barrier 'relaxes' and allows the waste to be cleared out of the brain. Literally, the weariness you feel after being awake so long is the result of all the 'crap' your brain produced while awake. If you don't sleep you start to get toxicity levels of it affecting your brain functions...you begin to by hyper-sensitive to things.. hallucinate.. moods go wild, etc,etc. It takes nearly 6 hours for a full 'cleaning cycle'.

There are people that when they sleep they don't produce enough melatonin to cause the blood brain barrier to relax enough to allow all the brain crap to be washed out. Its almost like when someone is allowed only to sleep 2 hours a day for an extended period of time...there's just not enough 'rest' (ergo, not enough time to clean the crap out) so day after day the person functions at a level where the brain crap isnt critically toxic but toxic enough to mess up his functioning.

It is very hard to read melatonin levels unless they take your blood while you're asleep (usually only hospitals can do this when you're staying overnight) so most doctors dont even consider this as a possibility and prescribe drugs to counter the effects rather than treat the cause.

But again, consult your psychiatrist and primary doctor on this. Who knows, it might help her or it may not even be 'it'. Asking doesn't hurt

It sounds like it could be ASD. For what it is worth, my daughter was diagnosed just before she turned 2. For reasons completely unrelated to GF/CF diet, we reduced her milk intake drastically, and then eliminated milk, and a lot of her symptoms decreased and some went away (self injurious behavior). Your suspicions that it could be allergies can still be true. If she does have autism, her symptoms could be exacerbated by her allergies.

Regardless, she does sound like she has major sensory issues. You could try reading "The Out of Sync Child" because whether or not she is diagnosed, I think you will find it illuminating and helpful.

Again this is not from a professional and I do hope its not that but it does sound like she is on the autism spectrum.

I suggest you get a copy of The Out of Sync Child - ASD or not, your daughter seems like she probably has sensory issues.

I can definitely relate, my son is 4 years old and he does a lot of the things you described of your daughter (minus self injury and long meltdowns and I wouldn't call him an artist lol).

When he was 3 years old we went through local services, originally for speech therapy because he didn't speak and then we were given a resource teacher to help us. She did a great job teaching us how to transition between tasks and how to deal with different scenarios. He also did the physiological test but he was a 'very rare case' and couldn't actually finish it. He gave up midway through and there was no getting him back at that point. Eventually after doing the ADOS test (a 6 month wait) he was then diagnosed with ASD in December by his pediatrician. He has the same issues with food sensitivities and his pediatrician got us referred to a dietitian to help with that.

It definitely sounds like a possibility.

She also sounds like she is extremely right-brained.

Language is (usually) a left brain function. Speaking from experience, try to avoid the temptation of ever talking "for her" as it can disropt the speech/language ability level she currently has. Instead, allow her extra time and encourage others to do so as well.

And consider getting speech therapy for her. (Kids like her can often go under the radar for speech services because they do speak, but then can later develop more social issues and depression/anxiety because the role communication plays in modern functioning.)

I just want to thank everyone for their responses. I'm learning a lot here and its also nice to know there are others who understand or can relate to the things I've described.

Interesting comment about the speech. Lately I have trying extra hard to be more patient and let her try and get all of her words out before I start to answer her, and also trying not to speak for her. She gets really mad and frustrated when we ask her to use her words and try to ask for what she needs/wants. I don't want to push her too hard, but also want to encourage her to keep trying to use words when she needs something.

Her psych evaluation is on the 27th. I have no idea what to expect. Will they be able to tell me what they think is going on with her or will there be more waiting? I don't know. I feel like we should have done this a year ago!

This sounds like it was written about my son when he was 4 years old

My daughter had her evaluation today and although they still have to review everything, the unofficial diagnosis is disruptive behavior disorder. Has anyone else had that diagnosis for themself or their children?

I'm not sure...... I still feel like there is more to it than that. But either way, they are going to recommend therapies so hopefully other issues can be observed and addressed. I just want things to get easier for my little girl.

This does not sound like what you described. As far as I knew Disruptive Behavior Disorders were basically ODD, and Conduct Disorder. This has to do with non-compliance and aggression in a very specific way (not for the same reasons as ASD). These are traits that may have overlap with ASD (or ADHD or a number of other things) but ODD and CD would not involve the sensory/social components unless they were doing a dual diagnosis type thing. They do not involve any of the sensory/social things you listed or any of that. Did they mention it was a co-morbid or a sole diagnosis?

If I am wrong, hopefully someone else will post, but this does not sound like a good diagnosis to me. I don't know much about this category, but I am wondering how they are explaining the other things that you described. Does your daughter even have "disruptive" behaviors?

^ Thinking the same thing. Didn't want to say anything because I don't know a lot about ODD and such, and also because the little I do know leads be to think it's kind of a bs diagnosis.

I really hope they get the diagnosis right!
From the (little) I have read about this the treatments would be very different for a Disruptive Behavior Disorder and and ASD.

Good luck to you and your little one as you navigate this.

I wouldn't take a behavior disorder diagnosis, at least not from your first consultation. First, she is only four. Second, you've already noticed that how she acts changes when she eats differently, so the behavior seems like a response to something outside of her control, not something she chooses. Third, what about the way she is drawn to patterns? BUT I am no expert on behavior disorders and readily admit having a prejudice against those types of diagnosis, just based on what I've seen and read over the years.

It can't hurt to hear what their therapy suggestions are, but I would be skeptical. VERY skeptical. If your daughter really is ASD and they called it wrong, the kinds of therapy they might use could be highly counterproductive and actually harmful to your daughter.

Can I ask something? I know you are concerned about her and rightly so, but how do you feel about your day to day life with her? Do you feel you mostly "get" her and know how to keep her issues down to a minimum? Do you feel like you are at your wits end trying to manage her? Or is it somewhere in the middle?

My son was very difficult at 4, no question, but while I was interested in absorbing information and improving the way I handled his issues, and had my moments of desperation, he was overall in my eyes growing and changing and developing in all the most important ways, and we were having a great time together. I think it would have been useful at that point in time to know he was ASD so I could have avoided a few mistakes I was making in my parenting, but nothing essential got missed for him by not knowing. And we had, in fact, visited a psychologist because the preschool asked us to (they thought he had a behavioral problem), and the psychologist thought he was lovely and amazing and within the range of normal. The fact that he was going to need "something" didn't really come into sharp focus until he was in elementary school, and by that age he was also MUCH easier to diagnose.

Personal opinion: labels are kind of a heavy thing to put on a four year old if you do not have to. And ASD is much more obvious in a 6 year old than in a 4 year old.

What our pediatrician said after we asked about sensory integration disorder: who needs labels at this age if you are tuning into your child? He told me to pay attention to my child - not what anyone else or any book is saying - and I would figure out what he needs. And he was right. It may get more complicated later when you aren't in charge of all your child's learning and development, but there is a lot to be said simply for paying attention to your child.