Tuesday, February 26, 2013

No News is Good News

I guess I have developed a bit of a pattern here of only posting when things are more difficult. Oops! I haven't meant to. I guess it's just that those are the times I need help to "cope" and I find journaling helpful.

E is still panicking about Primary school, but has stopped worrying so much about me staying in the car park. I don't know if I have even spoken about that before? I should read my own blog for once! We seem to have effectively closed the door on the 'waiting in the car park' discussion by refusing to answer the question after answering it once. It took a few hundred "I've already answered this question" responses, but now it is done.
He is not sleeping very well worrying about he next step in his educational career. We are doing what we can to help him with the help of our psychologist. Husband face and I have an appointment tomorrow at the clinic where they observed us. Hopefully they have some more insight for us.
I really want to get him out of his hot, heavy jumper with a hood as I know he is struggling with the heat at school. It is his security blanket and removing it results in waves of panic.

Mostly I think we are doing really well. The kids are fighting a lot and I am not managing to not yell (follow that train of thought?) but I am making a concerted effort to be more relaxed within myself which is helping.

Peace out




Wednesday, February 20, 2013

I have been meaning to update here for a while now. So much has happened!

E is going so beautifully at school. They actually can't believe there is anything "wrong" with him which is of course making us doubt it ourselves! He plays, interacts, chats, helps, tidies, whatever. He spends much of his time with the hood of his jumper up though which is getting a bit hard for him, I can tell. He really feels the heat so he says he doesn't like playing outside there much.
He brings homes wonderful drawings and paintings. He doesn't talk much about his day there, but he generally seems relaxed when I pick him up.

At home we are struggling a bit. He asks over and over about school when he is not there. He asks specifically this exact question "will you wait in the car park?" He asks probably 100-200 times a day. I mostly ignore him and change the subject, but some times I say I will wait for him as I haven't seen the harm until now. I wonder if he keeps asking because he knows I am lying. I am feeling awful about it, but fortunately have an appointment with his psychologist in the morning so will ask how to tackle it.
It was put to me in a way which has made me get a little deeper in to his questioning. If he keeps asking the same question, then what is he really saying? What does he really want to know? what is he really unsure of? All he says is that he wants me to wait in the carpark so it 'doesn't take me too long to get there' to pick him up. I am some times late for things, but usually on time. Is he afraid I will forget him? Or be so late that he will be left alone there?
I don't know.
It has escalated now in to anxiety about going to Primary school (big school) next year. It will be the first year of mandatory schooling. He was awake for what felt like hours last night sobbing about it, and again this afternoon. Another reason I am glad to see the psych tomorrow.

We also see the OT tomorrow. It is a new OT. He has had an assessment with them which was mostly really positive, but there are a few things they suggested we work on. But again, what is anxiety, what is sensory, what is both? What causes what?

And last but not least we had an assessment with the child and adolescent mental health clinic. It was very intimidating (think us in front of a one way mirror, behind which sat a number of psychiatrists observing us!) He handled it well though and to be honest I feel guilty for taking the spot of someone who probably needs the help a lot more than we do. Nevertheless, they want to help us with what WE want help with, and we want help with teaching him to reduce anxiety.

So all in all, things are reasonable! I am tired. A gastro bug has swept through our house like wildfire. Combine that with a very anxious 4 year old and a rambunctious 2 year old and that makes for one exhausted Me.


And on that note, I am off to sleep.




Tuesday, January 29, 2013

Day One

We survived day one. The school are so fabulous. He was fretting all of last night and this morning, and screamed his arse off when we left, but apparently he settled down and had a wonderful day. The director was so pleased, she had tears in her eyes.

I suspect next week will be harder, but all in all, I am starting to get a really good feeling about this year x

Monday, January 28, 2013

Communication is Key

This is an email I sent to E's preschool teacher. The director of the school called me soon after to say how useful it was so I am glad. E starts tomorrow. He is very upset and clingy today, tearing up off and on. I am trying to keep strong!

Dear teacher,

I wanted to write to you about our son, who will be in your class this year.

E has PDD-NOS (pervasive development disorder-not otherwise specified), and high anxiety.

I thought I would give you as much information as I could so that you are as well equipped as possible to manage E.

He is a kind-hearted, sensitive boy, but is easily overwhelmed and not well versed in social protocol. We think in part this is due to the PDD-NOS, but the anxiety seems to really get in the way of him having the opportunity to develop much needed social skills.

E is very attached to me, his Mother. He has always called his father and I by our first names, however, he knows that we are his "Mum" and "Dad." He has a two year old sister named M.
E spends little time away from me and is usually by my side. We have been working hard to get him to enjoy spending time away from me or on his own, but this is still a cause of great distress for him at times. He will stay happily with his Aunties and with his Nanny and Poppy, but has never successfully stayed with others.
He has a tendency to call other children "Sam" if he does not know them well. Sam is a friend of his, and therefore all friends are Sams!

E is very fearful. He can worry a lot about hurting himself, or about dying (drowning in particular.) He will ask us a lot of questions about something or a situation he is afraid of, but tends to panic and melt down if he is scared and I am not around.

His expressive language is advanced, but he rarely talks when meeting new people.
We assume his receptive language is fine, but were unable to test that during a speech therapy assessment. He was very aggravated, upset and uncooperative, so the session ran too far over time.
He does have a few speech idiosyncrasies, but they are quite random. For instance, he calls wisdom teeth "wizard teeth", power lines "power lions", and a crotch a "crutz." He seems to genuinely not understand that he is using the wrong word in these instances, and there are many other examples.
I will attach a copy of the speech therapist's comments and findings.

E does not like to be touched or hugged, but does touch other people. The Occupational Therapist we were seeing last year suggested that he had a poor ability to judge where his body is in space (poor proprioception.) He often bounces, crashes, tackles etc., and can play too roughly with others (if he can overcome his fear of actually talking to them!)

E is very particular about his clothing and is very prone to taking his clothes off (shirt in particular, but would be too embarrassed to go nude in public!) He regularly complains that he is hot, especially when feeling overwhelmed by noisy or crowded environments.
He does not like wearing a shirt once it has had water etc. dropped on it. I will pack extra t-shirts for him.

E is toilet trained (bar overnight), but is extremely self-conscious about going to the bathroom. We had a lot of trouble getting him to be able to poo on the toilet. He would hold it in for up to a week and eventually stretched himself to the point of foecal incontinence. Fortunately, this is no longer a typical problem, but I imagine he will be extremely reluctant to use the childrens' toilets. He may also try and urinate outside, somewhere private, to avoid having to use the toilet. I would love for him to be able to use the childrens' toilets, but it may be necessary for him to use the staff toilet if it is obvious he needs to go but is refusing.

A "meltdown" for E can be either quite explosive, or internalised.
At home he tends to scream, kick, cry etc. (basically have a tantrum), but it can last up to 90 minutes. Fortunately, it is not that common for this to happen away from home these days. Instead, you may find he tries to "hide" either under furniture or blankets/cushions, or if there is nothing available, he will pull his shirt over his head and curl up in a ball. He will often suck his shirt, fingers or sleeves to soothe himself. He some times flaps his arms.
To be honest, we have not managed to find any one, foolproof strategy for dealing with an explosive meltdown.
Where possible, we try to distract him or get his attention in another way. He is particularly interested in bugs and spiders, and likes the bugs encased in resin at the preschool.
If he is overwhelmed by his environment, we try and remove him. Where possible, we take him outdoors or to an empty room/quiet space where he can not hurt himself. Trying to hold him, or touching him at all, generally intensifies his reaction. If he is not too distressed, but clearly wants to "hide", we allow it where possible. It is a way he has learned to regulate himself.

E is a collector and a hoarder, and will hide things away. He also has a tendency to line things up. He becomes quite attached to random objects and can be quite possessive of them. A few days will pass, and he will have forgotten the once important spoon or seashell and will move on to something else. We try very hard to get him to share, but he can be quite ruthless about 'his' things and gets upset when people move them or touch them. This is obviously something we are really working on improving. We are trying to stress the importance of not taking things that don't belong to him, but we often find items missing from our rooms or the kitchen, only to discover them later, stashed in an old bag or box with other "treasures."

Unfortunately, many social niceties confound E. For instance he does not seem to know that when one is greeted with a friendly "hello", it is polite to respond. We model good manners and always prompt him, but he rarely says "thank you", "please", "hello" or "goodbye."

He is a real stickler for the rules and gets upset when others break them. He just needs to know exactly what they are.

His attention span is pretty limited, as with many preschoolers I suppose! However, he is far happier playing outside and being active than being inside with a book or activity. The OT has suggested that his fine motor skills are not where they should be, but we feel this is more a result of where his interests lie than a physical problem. I have noticed he has a tendency to either press too soft or too hard with the pencil, but I don't know how remarkable that is in a four year old!

E does tend to give "messy" play a go, but can be very sensitive about stuff getting stuck to his hands or face in particular. We find the best way of coping with a messy activity is to have a packet of wipes, tissues, washer or tap nearby, so that at any point he is able to wash his hands. We have been working hard at home this past year on his tactile sensitivities, and he has made dramatic improvements. He used to need to wipe his mouth after every bite of food, but that has improved a lot as well. We have also been working on trying to get him to stop blowing raspberries or making repetitive vocal sounds. We encourage him at those times to try and whistle instead or to at least be very quiet if he must make sounds. It often helps to distract him and break the cycle.

We have been working with a psychologist over the last couple of months. He said he is available to discuss E's needs if required, and I shall attach his contact details to the end of this email.

We have been in contact with a clinical psychologist at a child and adolescent mental health service. We are due to have E assessed there soon, hopefully within the next six weeks.
We are hoping to re-visit with the speech therapist in order to test E's receptive language. We will pass on any results we obtain.
We are also meeting next week with a new Occupational Therapist and again will pass on any relevant information she gives us.

If you have any questions, please don't hesitate to contact us at any time.

I hope I have not included too much irrelevant information, but I thought it best to give more info than not enough.

Kind regards

Saturday, January 26, 2013

Counting Down

I am becoming increasingly uneasy as we count down towards the day E starts school. He is so scared and so upset. We know that he is anxious about being hurt while he is there and not having me with him, but I'm not sure how to ease those fears.

We have a worry doll that I have tried to get him to use. We read the story of Silly Billy who worries so much until he gets a special worry doll to carry his worries for him, but he can't seem to make the connection or see the point in doing it himself.

We have been reading a book that the school sent us, about the preschool day. It is a very good idea. It has photos from the school as well, for instance, "Mum and Dad will help you put your lunch in the big fridge" with a picture of a girl putting her lunch in the school fridge. I noticed that a paediatric dentist's website had a similar thing in the form of a slide show. The book seems to just upset him more some times, but I know there are parts he finds reassuring so we are keeping it up.

Husband face has taken the day off work so he can take him there. I'm not sure if M and I will go too. I have tried to make an appointment to see the psychologist again before we go so I could ask him, but he is on leave. I am trying to be confident.

We had such a shock last year when we attempted to send him to a different preschool. We knew then that he was "clingy" and an anxious child, but everybody assured us that he would be fine, that it was normal and so on. I did believe that would be the case. I believed the first few weeks would be tricky, but we would get there in the end and he would be ok.
He lasted two days.
After the first day, he barely stopped sobbing for the rest of week, slept on top of me, even crying in his sleep.
When I picked him up on the second day. I was shocked. He was being walked back from the toilet with his teacher. He had his head in his t-shirt, sucking it, arms pulled in too, curling himself up as he staggered back. She said he needed to poo but wouldn't go. She said she wasn't sure if she should hold him on the toilet until he went. I am so glad she didn't. He had wet himself a few times and was in wet pants after being changed twice. I don't think that is the school's fault; I just don't think they could get them off him. He wouldn't eat or drink. He went to the toilet as soon as we left and could find a public loo. Then he ate and drank, and then he cried himself to sleep. I got about 2 hours sleep over the next two nights as I couldn't get him off my lap, and he was having nightmares, screaming and crying all night.
I didn't know what to do. Was this normal? People assured me it was and that he would be OK, but I couldn't do it to him after that second night! I called to speak to them and agreed with me that they didn't think he was ready, and that he was too distressed.
It took about six months from that point for him to be able to be more than about a metre away from me. Even when he was riding his scooter, I had to walk beside him or he would tear up and come running back to me. We saw a Paediatrician who diagnosed him with severe Seperation Anxiety Disorder and suggested we think about home schooling him. We saw a psychologist for a few months who tried her darnedest but made little difference. We then went to OT, which he was so anxious about attending, he would vomit and shake uncontrollably. We got a second opinion from another Paediatrician who diagnosed the PDD-NOS and anxiety. Then more OT. Then a new psych. Fast forward and here we are again, about to start preschool.

I feel much more prepared in many ways, but I am also terrified. Those two days did so much damage last year. Intellectually, I know that if it hadn't been two days of preschool, it would have been something else. He had been working up towards that level of anxiety and whatnot as he was getting older so it would have happened anyway, and we can manage him better now than ever before.
But can the school? Can his teacher? Will the same thing happen again? The clinical psychologist at Redbank House said, over the phone, that she wasn't sure he could cope with preschool at this stage. But, the psychologist we have seen 4 or 5 times now thinks he will get there "in his own time", but that it will be tough.

I simply do not have enough faith in myself to say everything is going to go a certain way. The uncertainty is terrifying for all of us, but I am trying not to get trapped in to dreading everything or expecting the worse. There's a delicate balance to be attained, and some days I am there, and other days I am wobbling along like Mr Plod.

Look... (I am talking to myself here!).. We have done our orientation visits. He is familiar with the school and the majority of staff members. The fact that he is worried about how long it will take to pick him up proves that he has accepted that he will have to go, irregardless. I will write an email to his teacher to suggest strategies for managing him. They have his paed report and OT reports. They have his diagnosis. Deep breaths.

I am losing way too much sleep over this and if I am tired, I will be more obviously stressed during the day when he is awake. So the plan is to focus on being both well-rested (for myself) and organised (for E), as I know that will help.

Clothes are being labelled, rest bags are being sewn, and butterflies are cavorting in my stomach.

Wish us luck, please!!!!!!

Friday, January 18, 2013

Action Stations

We had a phone call from a clinical psychologist at Redbank House. It is a child and adolescent mental health clinic. Our GP and Paediatrician referred us there to help us deal with E's anxiety. She was very good to talk to. She said they do a comprehensive assessment, diagnoses, then sit down with us an formulate a plan for treatment, if required. She can't give us a particular time or date, but she said she is hoping it will begin within the next five weeks. This is very good news as they are real experts, and the waiting list is usually very long.

We have also seen the psychologist again. We talked to him about E's increasingly stereotypical autistic behaviors, like hoarding and grouping items, lining them up and so on. He said for a lot of PDD kids, it's a form of play, so needs the same restrictions as you would give for any other activity. For example, there are only certain places he can do it, he needs to pack away afterwards. He said to give him plenty of tins and boxes and hidey holes (which we have done already), but to make sure he keeps them in his room and can only have one box out at a time.
We also talked to him about starting preschool in 2 short weeks. He suggested husband face should take him, and that E and I should have as much time apart as possible between now and then. He said we need to continue taking him unless the school say they can not deal with him. I am really stressed about it, but trying not to show it. I am still reminding myself that it's not preschool he hates, it's change, but it is good for him in the long run.

Otherwise, things are going reasonably well. He is generally a pleasure to be around, but he is often stressed and anxious, or obsessing over something. I wish we had a way of being able to get him to really relax. The most relaxed he ever is is when he is with my Mum's dogs. We are definitely getting dogs when the kids are a bit older!

M has just turned two and is becoming increasingly challenging. It can be a difficult age, but also an exciting one, as she is so interested in everything and enthusiastic about so many different things.

I really am very lucky.




Monday, January 14, 2013

Blah!

We have had a bad day with E. It is now 3am and he has just gone back to sleep after a night terror/tantrum/ear piercing screaming episode. He has been difficult all day; extremely argumentative, aggressive, heaps of vocal stimming (i.e. screeching or screaming) which he has not really been doing much of lately. Husband face and I discussed how well he had been doing since we started being stricter with his diet, and really limiting the amount of crap food he was eating, mainly lollies and chocolate. A day or two ago, I made a packet cake. It's not something I usually make, but I wanted to try out a particular technique and didn't want to waste perfectly good butter etc if it didn't turn out, so I bought the 79c cake mix. Well, the cake did turn out and E really liked it and had a fair whack of it today. The thing was full of food additives; some harmless, some not so harmless.
I have wondered many, many times in the past about whether or not food additives are a problem for E. He is certainly sensitive to many common allergens, and suffers hayfever and eczema as a result, but I have never seen such terrifying behaviour that seemed to obviously be a response to a particular food.
Maybe it was just a bad day for him anyway, followed by a bad night.
But I am going to get back to avoiding the processed shit anyway. Just in case.