The newly-ish minted four-year-old Mr. Man needs an evaluation…another one. This one, however, is more annoying. My son attended a private preschool two mornings a week this past year. It’s a play-based program, and truly good in terms of quality. I don’t want to rail on about the virtues of this school and the comparisons between private and public. But, fundamentally this school hires and keeps qualified teachers, which is fairly uncommon outside of the public sector. I don’t have hard data about that, but given my experience running private nonprofit special education programs (albeit a vastly different population), it’s probably a profoundly safe bet.
Little Man’s teacher team is good; generally I have no complaints. But, after his mid-year conference, I saw the play for the remaining part of the year. My husband and I assumed we would hear polite niceties about his stubborn, rigid nature. We walked out puzzled. My son has been very sweet and compliant. He’s chatty and funny, but seems to struggle with processing information. His teacher highlighted a few examples of his behavior…his confusion about where and how to get into line well after all of his peers complied…repeatedly asking questions that he seems to already know the answers to (like the name of a common fruit)…sitting with his back to the book during story time, and confused when an adult addresses it. For those familiar with Mr. Man’s story, these behaviors are…odd. My son doesn’t have a processing issue (though I get why his teachers think so). His memory is stunning, and he usually picks-up a routine within one or two renditions…provided he agrees with said routine. At the time I had to sit on this one for a few days because it simply didn’t make sense.
Little Man had a speech delay; not uttering words until two-and-a-half years…not that you’d know it because the kid won’t shut his hole for the life of him. The speech therapists called it “motor planning,” and it would be unclear if it completely resolves or if other traces present themselves. As of his end of year conference, I suspect other traces have become uncloaked, but it’s hard to know for sure. I’m not necessarily concerned; whatever is going on leaves him fairly high functioning. But, I’m left with the distinct taste that I will need to document things because my son does not have a processing thing. My concern is that he’s found behaviors meeting his attention seeking needs, and his education will become a process of him turning into a type of learner he isn’t.
Overwhelmingly my concern with this process and the selection of the right evaluator is that the final product accurately document his behaviors…their motivations and note appropriate interventions. While I don’t think his deal is processing, I can most certainly see features of autism. I don’t know if he ultimately meets the criteria for a type of spectrum diagnosis, but there are pretty obvious pieces to his quirks that are.
I’m not remotely a specialist with autism. The spectrum kids I enrolled came to my school because their behaviors were vastly more concerning than their autistic presentations. Regardless, I’ve done well with the kids I’ve met possessing such a profile. I’ve mentioned in other posts that I’m an exceptional disciplinarian. The core strength of my approach and personality is that I’m remarkably consistent in response to behavior and my personal affect. I’m also black and white with my interventions and communication. Kids generally know what to expect from me at all times, even if they don’t much care for me or my way of navigating their educational experience. While I’m quite rigid, direct…and frankly blunt pretty much all of the time, I provide a stabilizing force for kids who generally feel unsafe in life and internally chaotic.
Little Man is the recipient of my behavioral training and instincts…with a bit more yelling…okay, significantly more yelling. Actually, to me “yelling” is more losing control and reacting emotionally. In that context I seldom yell, but I’m certainly loud and tolerate very little. I’ve been on the receiving end of plenty of stink-eyes from other mothers, but I refuse to beg my kid to behave appropriately. This is not to say that I would judge others for a different parenting style, but for my family the expectation is that my kids won’t be dicks…I’m moderately successful on that front as I’m sloping into the tail end of a day with an unnapping Warrior Queen and a sickly Mr. Man.
But, all kidding aside, my son does quite well with my approach. When I’m with both kids alone, they consistently behave the best for me. Out in public or in school without my influence, my son is sweet and probably the most polite four-year-old you could possibly meet…I don’t even think I’m kidding about that as so many others have noticed and said something. Warrior Queen is too, but this post is about her dearest big brother. The problem with school…and probably my son is that one of the most effective interventions for him when he is doing his stubborn shtick thing is to be quite direct and set a limit. His school doesn’t really do that, especially issue time-outs. Here is another complicating issue, he doesn’t tantrum or overtly misbehave. He manipulates his environment and the people around him. My son learned very quickly in his school that there is no downside to refusing a routine if he pretends he simply doesn’t understand the expectations. I’ve seen it; it’s very convincing so I don’t fault his teachers for falling for it. That said, I sent them a lengthy email explaining his behavior profile after the first conference because I was concerned their chosen interventions would exasperate the problem. Sure enough my predictions came to complete fruition. As a parent I find this annoying. As an educator with a history as an effective boss of teachers, I get it; but it’s still annoying.
There are various other pieces of more heaps of annoying to this story, but that’s more of a vent for friends because ultimately it doesn’t matter. Mr. Man certainly has something going on from at least a couple of angles. While I’m not concerned about his future, it’s something that will require documentation because I know with certainty that no one in education will take my word for it. This school is a snapshot of what I know to be true…because I’ve seen it from the other side. It takes training to really work with a family system. I have a whole mess of educational certifications, but I’m also a licensed social worker trained to work with families because I interned and worked for an agency that pushes such things as its primary belief system. Often places…entities…bureaucracies…whatever make the family friendly claim. It’s been scant occasions I’ve seen it in practice, especially in the public sector. Perhaps it’s an anecdotal comment, but I sure know a whole mess of people who would agree from all spheres of the educational process. If a kid is typical, perhaps a parent wouldn’t notice. My son is delightfully odd in probably one of the most spectacular ways, but that means I need to be aware of how his oddities bump up against conformity. I will need to teach him when to go along, and when to stand out. I will also need to reinforce honesty because I can easily see how his manipulation can turn to a darker character as he grows.
With everything going on I finally managed to get this evaluation process business underway. It won’t happen until early December, which is fine. Public schools don’t usually know what to do with spectrum profiles, so we are paying for an independent evaluation from a psychologist recommended by my son’s pediatrician. Fortunately, she will take our insurance though I’m still not sure what it will cost. Part of insurance is that there is a negotiated rate for such things, so whatever it is should be manageable…should as the operative term.
The psychologist asked for a background of Little Man, all through an email exchange which makes this entire thing significantly easier. But, upon receiving her request I was left wondering what information she wanted to know for this initial contact. I don’t know if I arrived at an answer. I just sort of wrote, and tried to be as brief as possible…which ended up not all that brief, yet I feel I left significant issues glaringly unmentioned. I suppose that’s what the first intake meeting is for.
I haven’t had occasion to speak much of evaluations through the totality of my children’s lives, but it seems that my last reflection on some kind of intervention process was one of my most well received posts. Below is the behavioral background email I sent to the psychologist who will be responsible for my son’s assessment (note I removed his name for privacy reasons)…my apologies for some of the repetition:
Thank you for getting back to me. Your timeline is fine. I’m not particularly concerned about Little Man to the point of immediacy. Next year he will be in his school program (pre-K) longer, so having some time for him to adjust works on our end. But, longer is three mornings a week (T, W, R). We are at this point because his school recommended he be evaluated. He definitely has his shtick, but I don’t agree with his school’s take on what’s happening. I’ll explain a bit more, but my read is that he is presenting with spectrum characteristics, and they think he has a processing issue. I don’t know that he would meet the criteria for a diagnosis, but certainly some of his behaviors are similar to what I’ve seen from spectrum kids. I should note, however, that my experience is with at-risk adolescents. The autistic kids I’ve worked with were referred to my school because that piece was secondary to their behavioral issues. I am by no means an expert in the realm, but there are commonalities I’ve seen. Regardless, my son is high functioning, so I want to make sure that whatever documentation we have regarding his profile is accurate. My concern with going through our town is that Mr. Man has some unique presentations, and my experience is that public schools are generally not as well versed in spectrum behaviors.
I’m not sure what information you would like up front, and some of it is a bit involved to explain…especially for someone inherently long-winded like myself. But, I suppose the more important notes are from a couple of fronts. I’m not sure what is relevant where, which I suppose is part of the issue. On the one front my son didn’t speak until 2.5 years (with early intervention)…not that you would know that to speak to him. He’ll talk to you about whatever you never wanted to discuss until far beyond your eyes glazing over. He’s generally a curious kid. I don’t have much familiarity about four-year-olds, but he seems to be curious about things my friends’ kids don’t even consider. His latest obsession is the body. I’ve bought some of picture encyclopedias. Right now he is fixated on the skeletal system, particularly red blood cells and marrow. This fixation doesn’t seem quite as intense as “defibrillators” or “compost, recycling, trash,” but I’ve been fooled before. And, I can honestly say that I know extraordinarily little about bone marrow…I always assumed it produced white blood cells, but I digress. I can’t predict what he will decide to tell you about when you meet him, but it will likely be something quite entertaining…unless he’s continuing to ask you about it when you are using the restroom. I suspect that won’t be an issue for you. 🙂 In any case, this is part of the other front. He can’t really let things go…routine or otherwise, but he doesn’t tantrum or seem to get anxious about disruptions. He’s actually a pretty mellow, easy going kid. He will organize and sort all kinds of things and have trouble switching gears to something else until he’s finished, but if his sister wrecks his work before he finishes, he just moves on without issue. He usually doesn’t even react most of the time. That might not be terribly unusual, but I find it interesting. As rigid as he is, he’s not terribly anxious or nervous. Never had separation anxiety or anything.
His school reports that he still does parallel play instead of interacting with peers. He interacts with his sister (two years), and I’ve seen him play and interact with peers, but it’s always been with regard to more gross motor play (i.e., tag or chase) than with something involving objects. I’m not sure if this behavior would be linked to the same mechanism that prompted the delay or if it’s more of the spectrum commonalities. He’s definitely interested in peers, but he seems much more interested in independent creative play than interacting with peers…generally speaking. He becomes quite caught up in the stories in his head. Sometimes he’s vocalizes it, but often he is just playing. To this day he has yet to play with an object how it is designed. For example, he loves building things, but it’s usually with something other than blocks designed for such an activity. And, often he’s building mechanical things like an air conditioner or something having to do with pipes. Incidentally, the air conditioner he built from large Lego-like blocks did not remotely resemble one.
My son is highly empathic…eerily so, and has been since at least 9 months. He has an extreme need to control people and his environment, and uses his ability to read people as a manipulation. In school it’s usually attention seeking in nature. I don’t think they realize it, and their assumption that he has a processing issue has fed into what I mentioned above. I warned them that the interventions they were proposing would likely exacerbate the behaviors they were concerned about. They decided to ignore me, so here we are… Little Man has an incredible memory, and usually picks-up new routines (that he agrees with) within a couple of renditions. So, for him to not understand where to stand in line or how to sit facing the teacher during story/circle time despite MANY one-on-one interventions is…odd. My husband and I will give Mr. Man multi-step instructions using big words, and he’s never had any trouble understanding what needs to be done. Personally, I think he’s getting lost in the group, and has found a way to get his needs met. That’s probably an issue in and of itself. I’m an excellent disciplinarian…for better or worse. I’m very consistent and black and white. My son responds quite well to that approach. His school doesn’t believe in things like time-out, and it seems like any kind of negative consequence is off the table. Those interventions are quite effective with him, and if he understands a caregiver won’t go with that approach, he’ll exploit that. It’s not even just a school issue. It’s happened in some of his other relationships with caregivers as well, but it presents differently. Those aren’t the only interventions I use (counting down before transitions or explaining expectations before an activity, for example, are also effective…among other things).
Finally (long-winded…), and this is something on his pediatrician’s radar, Mr. Man sleeps on a mattress on the floor of his walk in closet…like a Little Man cave of sorts. It doesn’t seem to be an anxiety thing, more of a control/fort-like thing. He still takes 2-3 hour naps daily. They are easily disrupted when life is exciting, but he might miss a nap every few months. Regardless if he misses the nap, we can’t get him to settle before 10 at night. When things are exciting in his life, it’s exceptionally hard to get him to settle…he’ll keep coming to our door. When times are more low-key, then he’ll bother us a bit, but mostly play in his room until he’s ready to go to sleep. Naps are no trouble at all. As of this week I can FINALLY get him to wear pull-ups. He has virtually no interest in toilet training. Once he started using the potty as school, he virtually stopped at home. I don’t know if this piece is linked to the speech delay. I wasn’t at the appointment, but his doctor brought up speaking to the psychologist for the above issues. In terms of waking in the morning, my son is up in the 6.30-7.30 realm…7.30 is unusual, but isn’t unheard of.
In any case, that is a fairly extensive snapshot of the behaviors we are seeing and are reported to others…different parties have different concerns.
I probably wrote an overkill of information to the psychologist considering our first appointment will be for collecting background information, but for me it’s hard to know how to communicate or trust what I see at home. For the duration of Little Man’s life (more so than Warrior Queen), I’ve been on the receiving end of a healthy dose of nay-saying. I have almost always been correct in my observations and assessments…ultimately interventions, but find myself in a constant state of second guessing, especially when something about him is not up to developmental snuff. But, as I wrote this psychologist I felt a bit more confident…like maybe I’m not crazy. So, I provided my letter because I don’t know a single parent raising their kid(s) who can’t do the same. Maybe I can assign a fancy word or two, or structure things to have a more report feel to it; but mostly I simply know my kid. And, that’s the point…probably the only one.