Could my 7 year old son have SPD?

by Emma
(England)

Hi

I have been concerned about my son who is now 7 on and off since he was about 2 as he has always shown a lot of autistic like traits. However, something has never added up as I understand that autism is primarily a problem with communication and social interaction. My son actually has excellent verbal and non verbal communication and pretty good social skills. He does struggle though with large group situations which I'll come to later. I have looked at the DSM 1V criteria for autism and try as I might I struggle to tick even a couple of the criteria, let alone 6! I have voiced my concerns often at nursery, then school but, until now, they have been reluctant to take it further. He has been labelled naughty, my parenting skills have been called into question and have been told he'll "grow out of it." However, his new teacher has taken my concerns seriously and agrees with me that there are definitely issues. He is very behind with his schoolwork which has prompted the school to take action. Now he is 7, the difference between him and his peers is more obvious. Most of them have calmed down and he seems very immature in comparison.

He has been observed by a lady from the ASD team in school. Her main finding was that he has "major issues with sensory integration" and has recommended that he be assessed by an occupational therapist. I did ask her if she thought he was autistic and all she would say was that there was a lot to suggest that he isn't but wouldn't commit herself any more than that as, clearly, further assessment is required. However, I googled "Sensory Integration" and wound up here! I never actually knew that you could have sensory problems and not be autistic and autism was previously the only explanation I could think of for my son's behaviour. I can now see that many of his traits could possibly be explained away by sensory problems. His main issues are as follows:


Very poor attention span, easily distracted by outside noises eg. lawnmower. Now affecting his learning. Particularly behind in numeracy and literacy.

Very hyperactive. Has trouble remaining still or waiting for even the shortest time. Insists on having a car or toy to fiddle with when we go out “in case it’s boring”, although he hasn’t seemed quite so reliant on this recently. Has always been like this but has become much more noticeable recently as his peers have matured and calmed down.

Poor fine motor skills, his handwriting is appalling!!

Poor sleeper. This has developed over the last year and is getting worse. Sometimes plays noisily in his room until 11pm. Previously a good sleeper.

Sensory issues: Particularly noise, light/dark, touch. Has improved a lot with age e.g. will now go on a bouncy castle, play in a sunny park or go into a disco when he wouldn’t previously, but still causes the following issues:-

Will not join in with certain large group games such as football or party games. Often acts strangely by humming and playing alone with a car (or imaginary car). Says he doesn’t join in because it’s too noisy and he’s scared of getting hurt. He also does this when waiting in the playground before school - the other kids are either running around playing tag or football or waiting in line with their parents - he can do neither!!!

Often finds the playground too noisy and teacher sometimes finds him in the toilets.

Often finds socialising in the playground difficult as he cannot play the noisy and boisterous games most of the boys play. Tends to play with girls and younger children, presumably as he prefers the gentler, role play games they tend to play.

Dislikes having his hair cut, having his clothes tucked in or cycle helmet being put on.

Occasionally refuses to go into dark places. Avoids bright sunshine, will always sit in the shade.

Dislikes sitting on the floor. Eg. on holiday he really wanted to watch a magic show. All the kids were sitting on the hard ballroom floor but he seemed unable. He asked me to get him a chair to sit on and he sat there at the side happily enjoying the show. He has problems sitting on the floor at school and will get up, wander around, or perch on the edge of a table instead of sitting in the circle with the other kids.

NB. If his desire to do an activity is stronger than his fear of the noise, dark etc, he will go into the noisiest soft play centre or swimming pool, darkest cinema or play in a noisy playground if engrossed in a game. Even went to an airshow with no problems!

Obsessions:
Has always been hugely interested in cars, trains, planes etc, and anything electrical or mechanical. Makes electrical appliances out of cereal boxes, bits of string and lego, and will “plug them in” around the house. Pays incredible attention to detail where these interests are concerned e.g. if drawing a house will include aerials, telephone lines, satellite dishes etc, immediately noticed when a new street light was installed in our road and mentioned it several times! He also loves science (is an enthusiasic member of the school science club), arts & crafts, lego, making things.

I realise the obsessions could be an autistic trait but I wouldn't say his interest was "abnormal" or "restrictive" as described in the autism criteria as the play is very imaginative and extends to other characters and situations. He prefers to play the games at home with his sister rather than alone. He does have other interests outside of his main ones such as cycling and swimming and enjoys going out and about seeing new things.

“OCD-like” behaviour.
School have mentioned that he has certain rituals he likes to follow such as placing his water bottle away from the others, putting it back if moved (although apparently he recently stopped this), and sitting on the carpet at the end of the day with all his bags instead of leaving them on the table as instructed. He tells me it’s because he is worried these things will go missing. I have never noticed anything like this at home although in the past he used to get very upset if I parked the car in a different space or moved things around his room. This no longer seems to be an issue – in fact I recently had a major clear out in his bedroom, he responded quite positively and certainly wasn’t upset. Generally, he is not routine driven.

Humming. Has done this since he was very young but seems to have got worse and he now does it a lot of the time. Also makes lots of car and other silly noises. Worse if excited or stressed. Doesn’t seem to know he’s doing it and blames his cars!

Diarreah. Has had this from birth. Initially told it was “toddler diarreah” but he didn’t grow out of it. Have had many investigations but all inconclusive. Once told it could be “squash drinking syndrome” but it makes little difference.

Hurting his sister
Has become more of a problem recently, although we did have major problems when she was a small baby and he was 3, but things improved a lot when she was old enough to play with him. Its become a particular problem at school drop off, possibly since he stopped taking a car to fiddle with in the playground. Keeps subtly poking, prodding, pinching and fiddling with her hair. He has also bitten her a few times recently at home. He knows its wrong and is actually very fond of her (he keeps saying how “cute” she is) but seems unable to help himself. It’s almost as though he gets a “kick” out of seeing her distressed. Will also “overhug” her when saying goodbye to her and I sometimes have to pull him off. Has also starting pinching me occasionally.

Craves attention
Behaviour improves dramatically if he is with me alone, eg. will be helpful in supermarket instead of disruptive when his sister is present.

On the plus side.....

As well as the good communication skills mentioned previously, he comes across as very happy, smiley, friendly, sociable & lively, has great imaginative play, can concentrate well if interested in activity, interacts well individually and in small groups, has a few close, longstanding friendships (mainly with girls), very interested in world around him (asks lots of questions), understands & uses sarcasm, good sense of humour, affectionate, emotional.

So, does SPD sound like a possibility here?? I also wonder if he could have ADHD, as I believe they are very closely linked and a lot of people with SPD also have ADHD. Also, is it usual for the symptoms to improve with age or only be present in certain situations i.e. the fact that he will tolerate the noise if its an activity he's interested in.

I know its not a good idea to try and self diagnose using the internet and that most of you are not doctors! However, I have to do something during the VERY long wait for appointments so would be grateful to hear from anyone who can identify with what I've written. Also, apologies for the length of this post but I needed to get as much info in as I could. Many thanks in advance.