All About Our Strong Willed Child – Part II

In my last post I started telling you all a little bit about Connor. Today I am going to finish where I left off and let you all know where we are at today.

In late August of this year we had our first appointment at The Melmed Center. The Melmed Center is a place where families can take their children to be evaluated for behavioral, educational, and developmental difficulties. We were referred to The Melmed center by Connor’s pediatrician. They usually book appointments 6-9 months out but due to a cancellation they were able to see us 1 week after I made the appointment!

The evaluation was about 3 hours long and the doctor looked at several different areas of his development. She spent a lot of time getting to know Connor and speaking with him first to build a relationship with him. Connor warmed right up to Dr. Pe Benito which didn’t surprise me at all. She was making a lot of notes while speaking with him and I couldn’t help but wonder what she thought about my sweet boy. She spent a lot of time playing pretend with him, asking him to draw, having him identify different objects in picture books, and administering a few exams. On the Autism Rating Scale he scored 23.5 which corresponds to no symptoms of Autism Spectrum Disorder. (Thank you Jesus!) On the Peabody Picture Vocabulary Test he scored a 106 which is age equivalent of 3 years, 8 months (at the time of the test he was 3 years, 2 months).

Towards the middle to end of the evaluation Connor started to get frustrated. He was getting hungry and definitely ready for a nap. He slammed the office door open and closed several times, threw toys across the office, and started to hit me when I would try to punish him or ask him to sit and wait for us to finish. As hard as it was to manage this behavior and finish with the doctor, it was kind of a relief for her to see what I have been trying to explain to so many different medical professionals.

We left the office with some answers:

-there is no concern for Autism Spectrum Disorder

-he is strong willed with impulsive & aggressive behavior

-has difficulty with emotional regulation

-experiences sensory overstimulation

-externalizes anxiety with aggressive acts

-emotionally and socially delayed

Having some of our concerns verified is such a bittersweet feeling. I am glad that this wasn’t “all in my head” like I was starting to believe. I’m also glad to know that there are doctors who deal with this kind of behavior in children. But it is very heartbreaking for me to know that a lot of his difficult behavior comes from anxiety. Anxiety?! In my 3 year old? What does he have to feel anxious about? As Connor’s mom my ultimate goal is to keep him safe and happy. So naturally I feel an extreme amount of guilt and ask myself over and over “What did I do wrong? What should I have done differently? Does he have too much ‘screen time’?” Thankfully Dr. Pe Benito told me that this is due to his temperament that he was born with and not something I “did wrong”. The hard part of this for me to accept is this will be a really long journey for us. It’s not like he was diagnosed with an ear infection and we give him 10 days of antibiotics and he’ll be fine. This is going to be several years of trial and error and a lot of learning what works for Connor.

Due to Connor’s mild sensory hypersensitivities and tactile-seeking behaviors, occupational therapy was recommended. Unfortunately, our insurance didn’t cover occupational therapy and the out of pocket expense would be $150 per hour. I was really frustrated by this but decided to work on some of the other things the doctor suggested and figure out how to get Connor seen by an occupational therapist in a few months.

My wonderful friend Erin told me about the Early Childhood Department within our local school district. They have a special education preschool program for children with developmental delays. If a child is eligible for the preschool program they can receive different therapies in the preschool setting. Oh, did I mention this is a free program?! I was so grateful for her passing on this information and quickly got Connor an appointment.

The first appointment was in early October. This was a very quick screening. They did a physical exam, had me fill out tons of paperwork, and did some quick playing with Connor. From the short amount of time they spent with him they were able to see he needed a full evaluation to determine eligibility for the preschool program.

In November we went in for Connor’s full evaluation. This was another 3 hour appointment but this time it was with a special education teacher, a child psychologist, an occupational therapist, and a speech language pathologist. This appointment was much more play based and Connor did great! The psychologist worked with Connor to to evaluate his cognitive, adaptive, and social emotional development. Connor was able to match shapes and different objects by color, shape, size, and function. He was able to count to 13 accurately. His cognitive development presented as age appropriate. Ratings for social-emotional development showed that Connor has difficulties in the area of aggression and is at risk for depression, hyperactivity, and withdrawal. The speech language pathologist administered her own tests through play that showed that Connor’s receptive and expressive language are all within the average range for children his age. He does, however, have difficulty with articulation and scored in the delayed range. This can make it difficult for an unfamiliar listener to understand what he is saying. The occupational therapist worked with Connor to evaluate his fine motor skills and sensory development. At one point in her evaluation she had Connor sitting at a table and asked him to organize objects based on category. There were several items covering the table, music playing softly in the background, other teachers talking, and the psychologist walked into the room. Connor got up from his chair and ran a few laps around the table. He sat down, let out a big sigh, and was able to complete the task. This type of behavior is so common for us. I get frustrated with him when I ask him to complete a task (get dressed, clean up his toys, walk beside me in the store, etc.) and he seems to completely ignore what I am asking him to do. The occupational therapist explained to me that a lot of times this behavior is diagnosed as hyperactivity but is actually due to sensory processing delays. Based on all of her information she agreed that Connor would benefit from occupational therapy in a preschool setting.

We had a meeting at the beginning of this month to get Connor registered for preschool. We were able to meet his teacher, the speech pathologist, and occupational therapist who will all work with Connor. He was very excited to see his new classroom and can’t wait to play on the big playground! I continue to struggle with accepting all of this information but I pray to God daily for peace and guidance. I have faith that this school is what Connor needs to help him learn to cope in stressful situations and I can’t wait to see him grow, learn, and overcome these challenges.

Please pray for Connor as we start this new adventure!

Thanks for reading.

-Renae