Reason for hand flapping and toe walking besides autism?

[Singingmom]

My just turned five year old has been walking on his toes for quite some time. When I brought it up to his pedi, she said lots of kids toe walk, and just to encourage him to walk on his whole foot. So, that's what we've been doing.

 

But, in the past several months, I have been noticing a lot of hand flapping...especially when he is excited about something. Sometimes it is accompanied by jumping up and down, sometimes not.

 

He is an emotional kid, no flat affect at all...more on the dramatic side. He gets amped up very easily....and can be very argumentative. He needs to have his way....and is bossy/ parentql. He is constantly telling his brothers to behave, etc. He does show empathy, and seems to read/ understant people's emotions. He is very verbal. He asks a lot of questions, but he seems to think I am omniscient. For example, if he sees a little girl walk into a restaurant where we are eating, he will say, "Mom, what is her name?" When I say, "I don't know" he will say, "come on, Mom, just tell me!"! W have a frustrating conversation like that pretty much every day. I don't know if this is normal for his age or not?

 

He can play with kids pretty well, but has a harder time with larger group activities. For example, his Cubbie group at church did a Christmas mini concert. He dressed up like a shepherd and stood in front of the church, but while most of the kids sang and did hand motions, he just stood there, looking around, staring into audience. He never sang while he was up there, but when everyone would clap at the end of the song, he would take a bow!

 

He doesn't like to wear clothes, he strips down to his undies evey time we come home. He also was very, very slow to potty train ( he was about 4 1/2 before he was fairly reliable. He is also a bit hyper....it's hard for him to stay still for very long.

 

So, sorry for the rambling, but does anyone have any insight? My pedi said when I took him in for his five year old appointment that she saw his quirks, and understands why I am concerned, but that she is not terribly concerned yet. She told me to get him into a tumbling class ( which I have enrolled him in) and as many social situations as I can.

 

I would love to hear if anyone has had a similar situations with a dc, and what your findings have been.

 

TIA!

[BMW]

Our pediatrician didn't diagnose our son for years because he had lots of eye contact and was very verbal... he hand flaps and I saw him doing it just the other day (he is 12 now). When we moved and changed pediatricians my son was diagnosed with aspergers...

 

His clothing sounds like sensory issues, which is common with autistic spectrum...

 

At this point, from what you've shared, I would just keep noting things. Does he get hung up on rules or patterns? My son would only enter and exit the car from a certain door and would sit there, helpless, calling, "Mom! Mom!" instead of scooting over and getting out the other side... Or if he got scraped in the front yard, he would decide he could not play in the front yard ever again...

 

Hope you get more answers... my son was not diagnosed until close to 7 years old because he wasn't as severe on the autistic spectrum and my pediatrician was a bit old school.... just keep notes and keep communicating with your pediatrician. If you have more concerns and it is dismissed, perhaps seek a second opinion?

[Veritaserum]

Dd5 used to flap her hands as a coping mechanism for her sensory processing issues. Your son's dislike of clothing could indicate an aversion to certain kinds of touch. His hyperactivity could be a sensory seeking behavior. Dd could NOT function in a group of kids (like at church) until we did occupational therapy. Check out sensory processing disorder and see what you think.

[sbgrace]

I'd have a PT look at the toe walking if at all possible. If you're insured they often cover at least an assessment type evaluation if they don't cover therapy itself. It could be a sensory issue but I'd want to make sure there isn't anything physical going on.

 

Some non-spectrum kids hand flap when excited. This is probably less common (in non spectrum) the older a child is. My spectrum child didn't hand flap when excited until he was quite a bit older than typical kids would do it.

 

It sounds like there are very likely sensory issues and an Occupational Therapist can sometimes be a big help with that as can many widely available books. Check into this for sure. Kids (and adults) can have sensory issues without being on the autism spectrum.

 

You're also describing a child who seems intense and that exists on and off the spectrum. My spectrum child is very emotionally intense (positive emotions included) but so is my friend's neurotypical son. Spectrum kids don't need to be flat affect I'm saying. Reading emotions well from facial expressions, though, would be less common on the spectrum.

 

As far as autism stuff you mentioned a few things that I think might be flags but not enough that I'm at all certain you've got any reason for concern.

 

However, at five this stuff should be able to be ruled out or in definitively by an expert in autism screening. If it is spectrum stuff the earlier you intervene the better in my opinion (for the child, for family functioning) so I'm pained that the pediatrician seems to be for a wait and see approach. Further, spectrum kids as a rule aren't going to pick up things socially from being given increased social opportunities. That's not the approach I'd take if I suspected spectrum stuff in a child. So all that to say I would not trust your pediatrician's judgement on this because her thoughts and recommendations lead me to believe she doesn't have a real understanding of the area.

 

You might try this questionnaire. It's not diagnostic but it might tell you if there is reason to look into formal assessment. FWIW, my son is diagnosed on the spectrum and he always scored mild pdd on that assessment. His twin is neurotypical but had sensory issues. He always scored no pdd no matter how "liberally" I answered the questions for him. So I like the assessment even though, of course, it's not diagnostic.

 

You might just have an intense kid with sensory issues!

Edited December 30, 2011 by sbgrace

[ChristineW]

My just turned five year old has been walking on his toes for quite some time. When I brought it up to his pedi, she said lots of kids toe walk, and just to encourage him to walk on his whole foot. So, that's what we've been doing.

 

But, in the past several months, I have been noticing a lot of hand flapping...especially when he is excited about something. Sometimes it is accompanied by jumping up and down, sometimes not.

 

He is an emotional kid, no flat affect at all...more on the dramatic side. He gets amped up very easily....and can be very argumentative. He needs to have his way....and is bossy/ parentql. He is constantly telling his brothers to behave, etc. He does show empathy, and seems to read/ understant people's emotions. He is very verbal. He asks a lot of questions, but he seems to think I am omniscient. For example, if he sees a little girl walk into a restaurant where we are eating, he will say, "Mom, what is her name?" When I say, "I don't know" he will say, "come on, Mom, just tell me!"! W have a frustrating conversation like that pretty much every day. I don't know if this is normal for his age or not?

 

He can play with kids pretty well, but has a harder time with larger group activities. For example, his Cubbie group at church did a Christmas mini concert. He dressed up like a shepherd and stood in front of the church, but while most of the kids sang and did hand motions, he just stood there, looking around, staring into audience. He never sang while he was up there, but when everyone would clap at the end of the song, he would take a bow!

 

He doesn't like to wear clothes, he strips down to his undies evey time we come home. He also was very, very slow to potty train ( he was about 4 1/2 before he was fairly reliable. He is also a bit hyper....it's hard for him to stay still for very long.

 

So, sorry for the rambling, but does anyone have any insight? My pedi said when I took him in for his five year old appointment that she saw his quirks, and understands why I am concerned, but that she is not terribly concerned yet. She told me to get him into a tumbling class ( which I have enrolled him in) and as many social situations as I can.

 

I would love to hear if anyone has had a similar situations with a dc, and what your findings have been.

 

TIA!

 

Not your exact situation but DD toe walks--the ligaments in her calves are weak (I'm supposed to help her practice point and flex and rub oil on her feet). She also has sensory processing disorder particularly in her vestibular system--some mild issues with tactile sense and clothes as well). Enrolling her in gymnastics and tai kwan do and gymnastics has been very helpful. Her OT is scheduled right after TKD and the difference between days when she's gone to class and when she hasn't is dramatic.

 

Have you considered evaluation by a PT or OT? Many OTs are trained in Sensory Processing Disorder and can work with you and your son to make him more comfortable in his skin. Though to be honest my newly 6 year old boy isn't a big fan of clothes either so again it could be age appropriate. Trust your mommy gut and ask for a referral from your pediatrician for an OT evaluation. I did it for my DD about 4 months ago, and it was sooo worth it. The OT was able to eliminate some concerns and helped me focus on areas where I could help my daughter.

 

Christine

[Singingmom]

I did do that questionnaire last night, and he came out non- pdd, I think it's called?

 

So, several of you have mentioned sensory issues. He doesn't have a problem being touched; but cries bloody murder if he is hurt....he seems not to have a lot of pain tolerance....which is a lot like me :) . He is a picky eater. I have to cut the tags out of his clothes. Noises and smells don't seem to bother him unusually, though. Can sensory issues cause toe walking and flapping?

 

I agree with the last poster about not waiting too long to get this figured out. That is my instinct. My husband, however, is concerned that our son will have a label placed on him that may or may not be accurate, which he will be forced to bear the rest of his life. Dh is especially worried that if we have to place our child in public school sometime in the future, that he will be made to go into a special Ed classroom, and will never be able to mainstream. Dh was a high school special Ed teacher for a while in an inner city area, and he will lay himself over railroad tracks before allowing our child to be subjected to that sort of setting.

 

So, how much of a concern was it to you to have a label placed on your child. Does it follow a child on his "records" for the rest of his life?

 

That is the only thing keeping us from pursuing a specialist's opinion.

[Veritaserum]

Sensory issues are not universal (all kinds of touch, for example). Dd could not tolerate anything wet or damp--especially her hands--but she loved the feel of dry dirt or sand. She refused to wear clothes that feel tight or stiff (like jeans) but likes loose knit dresses and leggings. She hated being bumped but loved to snuggle.

 

Dd was most sensitive to unexpected sounds like water moving through pipes in the walls or the random noises of children in a group. She hand flapped, rocked, and cried tears of terror. A toilet flushing two floors away would send her scampering to me in a panic.

 

The things you mention make me think sensory processing. I was very worried before she started therapy. Now I'm just relieved that we figured out what she needed in order to function. :)

[dirty ethel rackham]

A diagnosis of sensory processing disorder is not about a label to limit a child but a means for getting appropriate therapies so that the child can function normally in the world. I have never heard of kids with SPD being put in special classrooms, unless there were other issues making inclusion impossible. I do not think sensory processing needs to be a life-long issue. Ds15 suffered greatly from it from toddlerhood through early elementary. We got intensive therapy and he is now considered neurotypical. While he will always have strong likes and dislikes, they no longer inhibit his interaction with the world. Even if this "label" did follow the child forever, wouldn't it be better to get the needed therapy so that the world would not be such a difficult and stressful place for the child? Knowing how my child suffered due to his "faulty wiring" - I could not make him live with that if I had a solution for it.

[katilac]

I don't see how a school would know a dx unless it was submitted to them? If it goes 'on the record' at some point in order for the child to get accommodations or such, then yes, that will probably follow them around. But if you test on your own, and the child is not even in school yet, I don't see how that would follow him.

 

Very few pediatricians are trained in childhood development. I would go for a complete evaluation, and I wouldn't wait until my pedi was concerned. I believe in specialists. I bring my kids to medical professionals for medical concerns, and to developmental professionals for developmental concerns.

 

I don't think that it's typical in that age range to frequently ask questions like you mention, or to be persistent about them. I also don't think that "lots" of kids toe walk, at least not to a noticeable extent. One of my dds tip-toed pretty often at that age, just like she skipped and hopped pretty often, but she didn't toe walk, if that makes sense.

 

Lots of the things you mention seem like mild sensory or maturity issues, but, taken altogether, I would want an evaluation. Getting an evaluation doesn't mean agreeing with it or accepting their recommendations, and it doesn't mean submitting it to a school some day. Unless you get the eval through the public school system itself, they will have no way of knowing about it. Given your dh's concerns, I would go through my insurance or pay for a private eval.

[Singingmom]

Thank you, Ellen!

 

What you wrote about your experience makes me very,very hopeful. How encouraging to hear that your son has been able to work through these difficulties so that they are no longer negatively impacting his life!

 

Of course I want my son to get every bit of help that we can possibly provide, as soon as possible; and I think I have my husband on board, after reading off a checklist of symptoms for SPD tonight. My son has quite a few. I am going to print out the checklist on SPD and will take it to my pedi, and ask for a referral to a......what? Occupational therapist? A pediatrician with a specialty in diagnosing these kinds of problems? Could anyone give me any guidance on what to ask for?

 

Will there be any push to enroll him in the public school system, or are the

services for SPD all independent of the school system?

 

I am so grateful for this information....it feels like such a relief to finally have some understanding of what's going on with my son....and the hope that something can be done about it!

[katilac]

I did do that questionnaire last night, and he came out non- pdd, I think it's called?

 

pdd-nos, maybe? pervasive development disorder, not otherwise specified?

[Singingmom]

Maybe that's what it was. Maybe I'll go back and re-take it and see if I can print it out and show it to our pediatrician, too. you talked about getting a complete evaluation.....is there something specific I should ask for, in the way of a specific sort of evaluation , in case my dr. is not completely up on all this?

[katilac]

Maybe that's what it was. Maybe I'll go back and re-take it and see if I can print it out and show it to our pediatrician, too. you talked about getting a complete evaluation.....is there something specific I should ask for, in the way of a specific sort of evaluation , in case my dr. is not completely up on all this?

 

The wording may vary, but I would want a developmental evaluation, which means several different experts looking at the OVERALL picture: speech, vision, hearing, motor skills, social skills, and so on. Don't let him refer you to someone who will only look at one piece of the picture - for example, don't be satisfied with an appointment with an orthopedist to check out the toe walking. It's fine to do something like that ALSO, but insist on a developmental evaluation.

 

You may or may not need a referral. You might look at your insurance first, to see the type of wording used and what might be covered. If you do need a referral, either for insurance purposes or b/c the evaluators require it, think about what you are going to say to your pedi if she tries to shrug you off. Practice the actual words so you aren't caught stuttering in surprise, kwim? "I am not comfortable with waiting. He is showing specific signs of possible issues, and he needs an evaluation now." Printing the questionnaire is a good idea.

 

One reason you don't want to wait is that it sometimes takes months to even get an appointment. Then, if you decide certain services might be helpful, it can be additional months before those are scheduled. Again, remember that you don't *have* to start any kind of services or therapy; they may not even recommend any. But if you are able to pinpoint specific issues, it's easier to work on solutions even at home.

 

You might also call early intervention and ask if they have a list of places that do private evaluations. Teachers may be able to help as well (with names, I mean).

[thescrappyhomeschooler]

PMing you.

[grace'smom]

I haven't read the other replies but he sounds like my daughter who has sensory problems. It may simply be a matter of sensory issues. My daughter has gotten much better as she's gotten older but I don't think the issue ever really "goes away." They just learn how to cope. She doesn't hand flap anymore but she wrings her hands when she's under a constant level of stress (mostly in the summer when our routine is out of whack)...

 

What helps my daughter most is allowing her very liberal amounts of heavy physical activity.

 

Definitely get an evaluation if it continues to worry you. Sometimes you just have to go over your doctor. I had to do that in order to get my daughter's food allergies diagnosed and we have a great pediatrician.

[NotSoObvious]

Yes! ADHD and sensory issues. Toe-walking is actually more common than most people think. Just talk to a PT if it is concerning. Hand flapping is my dd's way of relieving really bad anxiety or excitement, but she only does it when she's experiencing extreme emotions.

[Pippen]

I did do that questionnaire last night, and he came out non- pdd, I think it's called?

 

.

 

FYI, the screening checklist at childbrain isn't accurate for kids who are very verbal. Kids who are very verbal tend to fly under the radar on Autism checklists but it's important to sort out being verbal from being verbally appropriate. Things to watch for speech-wise in more verbal kids:

 

Memorizing large chunks of language--quotes from movies, books, etc.

 

Not answering questions appropriately---this might be echoing back your question instead of answers, using a standard answer ie "How was your day?" "Yes", changing the subject instead of answering, answering with a movie or book quote.

 

Avoiding the harder WH questions--ie not asking or answering why and/or how questions.

 

Having trouble following multi-step instructions

 

"Stuttering" over the beginning of sentences--ie restarting the sentence multiple as if the train of thought had been lost.

 

Not handling back-and-forth (reciprocal) conversations well, even though a lot of "talk" might be going on.

 

Talk that's not typical or really seems off for the age--ie sitting down with a group of kids and trying to tell them about air conditioner brands.

 

Obviously any one of these isn't going to point definitively at Autism or any other speech/language issue, but these are the kinds of clues to be looking for in a more verbal child.

[Mommyof4ks]

I don't know about the hand flapping, but the toe walking could just be a tight Achilles tendon. My youngest has that, so he either walks on his toes or the inside of his foot to compensate. We just saw a podiatrist who can help. My son's foot problems were caused by medications that affect the nerves, but there are many reasons for that condition.

[RoundAbout]

I don't know about the hand flapping, but the toe walking could just be a tight Achilles tendon.

 

:iagree:

 

My son went through some extensive evaluations for his toe-walking. I guess my ped is overly cautious. We were referred to both a orthopedic doctor and a neurologist. It turns out he just has as a tight Achilles on one side and a very slight leg length discrepancy.

 

The first thing the doctors checked for was muscular dystrophy since its usually first diagnosed in boys around age 4 and toe walking can be a sign. Also cerebral palsy. SPD or autism was never brought up but my son, although a little quirky, pretty clearly didn't have any of the signs of either so I guess the neuro ruled it out right away.

 

I would make sure they rule potential physiological causes first. It was a relief to find out that there was a physical reason for it, and thankfully one that is not too serious.

[Denisemomof4]

Dd5 used to flap her hands as a coping mechanism for her sensory processing issues. Your son's dislike of clothing could indicate an aversion to certain kinds of touch. His hyperactivity could be a sensory seeking behavior. Dd could NOT function in a group of kids (like at church) until we did occupational therapy. Check out sensory processing disorder and see what you think.

 

:iagree:

 

my two hand flappers also have sensory issues.

[EKS]

 

So, how much of a concern was it to you to have a label placed on your child. Does it follow a child on his "records" for the rest of his life?

 

That is the only thing keeping us from pursuing a specialist's opinion.

 

This is a very important question, especially with an autism diagnosis.

 

Back when my son was misdiagnosed with Asperger's syndrome, I looked into this. I don't know if this is still true, but back then (6 or so years ago) an autism diagnosis could make a person ineligible for individual health insurance. I have also heard of cases where a person's autism was used as an excuse by insurance companies to deny payment for various things that weren't even related to the autism (like the flu). Also, I believe that you can't go into the military if there is an autism diagnosis in your past.

 

As for following a child on his records, as far as I can tell, it hasn't followed my son. The person who diagnosed him was not his primary doctor nor was he associated with his primary clinic. So it is not in the main records. I believe that our old insurance company knows about the diagnosis because the psychologist sent a claim to them--before I knew about the diagnosis. I never would have had him send the claim in had I known what the diagnosis was for precisely this reason. He has since been "undiagnosed" and so if we were to need individual insurance again, I could probably show that the first diagnosis was wrong. In my dealings with medical and psychological professionals since, I have told them up front that if they suspect something on the autism spectrum, they are free to tell me, but that I *don't* want it officially diagnosed without my authorization.

[Laurie4b]

The wording may vary, but I would want a developmental evaluation, which means several different experts looking at the OVERALL picture: speech, vision, hearing, motor skills, social skills, and so on. Don't let him refer you to someone who will only look at one piece of the picture - for example, don't be satisfied with an appointment with an orthopedist to check out the toe walking. It's fine to do something like that ALSO, but insist on a developmental evaluation.

 

You may or may not need a referral. You might look at your insurance first, to see the type of wording used and what might be covered. If you do need a referral, either for insurance purposes or b/c the evaluators require it, think about what you are going to say to your pedi if she tries to shrug you off. Practice the actual words so you aren't caught stuttering in surprise, kwim? "I am not comfortable with waiting. He is showing specific signs of possible issues, and he needs an evaluation now." Printing the questionnaire is a good idea.

 

One reason you don't want to wait is that it sometimes takes months to even get an appointment. Then, if you decide certain services might be helpful, it can be additional months before those are scheduled. Again, remember that you don't *have* to start any kind of services or therapy; they may not even recommend any. But if you are able to pinpoint specific issues, it's easier to work on solutions even at home.

 

You might also call early intervention and ask if they have a list of places that do private evaluations. Teachers may be able to help as well (with names, I mean).

:iagree: I would worry a lot less about labels than losing precious time in early intervention, which can make such a huge difference in a child's potential. The school won't have any records except those you choose to give them. However, you would likely find that you would want your child to receive supportive services, once you found out what those are like. Things have likely changed a lot since dh worked in special education if that is his take on things. Working in an inner city, self-contained classroom would be a far cry from the suppportive services kids on the autism spectrum would receive. And children only receive services that parents agree to.

 

If a diagnosis changes and a child no longer meets the criteria for it, that goes on "the record" as well. This "record" that "follows a child" is primarily medical. The school records really don't go anywhere. Colleges ask for transcripts. They would only want the special needs records if an incoming student was requesting special accommodations. Employers don't get them,etc. The military is the one place where what is in old records might matter that I can think of.

 

If your child has a significant difference, he will get labeled; there is no choice about that. Parents tend to way overestimate the negative effect of a label and underestimate the ability of the average child or adult to notice that something is different, and well.. label it. When there is no "official" label, both other children and other adults will use unkind labels such as "stupid", or "weird," or "bad." Labels such as 'SPD", "Aspbergers" etc. do much more to help people supportively interact with a person. So your choice isn't to label or not to label; it's about which kind of label your child gets.

 

Once you know what is going on with your child, you are in full control of what you share and with whom you share that info.

[KungFuPanda]

Are your child's physical milestones on track? Can he keep up with his peers on the playground?

[Paige]

My DS is intense and emotional and hand flaps. He has flapped his hands when excited since he was an infant. He's 10 now and still does it whenever he's excited. He is a quirky kid, but not aspergers or on the spectrum as far as anyone can tell. He's been evaluated twice and both psychiatrists said he definitely does not fit any of those. He has anxiety and OCD. My neuro-typical niece (13) and nephew (7) also hand flap and my MIL says that one of her children did so as well. I think it is just a quirk in DH's family tree. They don't toe walk, however. My DD toe walks and that is an expression of her cerebral palsy. I would get that looked at- habitual toe walking can cause a lot of tendon, hip, ankle, and knee problems even if it isn't caused from CP or something similar.

[angela in ohio]

My dd hand flaps, but she does not have ASD. She has intermittent tics, and that is one of them. She is high strung, but not diagnosable. :D

 

If you think there are other symptoms, I would have him evaluated, but the toe walking and hand flapping themselves don't have to be part of ASD.

[gardenmom5]

it does sound like he at the very least has sensory issues (seeker, and defensive with clothes). I would have him evaulated, as the toe walking can lead to shortened calf muscles/tendons and it can require surgery to correct. if all your dr is saying is "encourage" him to walk on his whole foot - I'd be running for another dr to do an eval.

[Singingmom]

Are your child's physical milestones on track? Can he keep up with his peers on the playground?

 

Good question, Kung Fu Panda. He will run around and play and engage, and enjoy himself with other kids. He loves to swing. But, he is afraid of heights and gets freaked out at even the suggestion to climb something or go down a slide.

 

Also, my pedi asked me if he knew how to skip yet. To be honest, it hadn't occurred to me to teach him how to skip....but since she asked we've been working on it. He can't really do it yet, but is giving it a good try.

[gardenmom5]

another thought I had about the toe-walking is if he does have sensory issues (and stripping off and being picky about clothes) is he doens't like the "feeling" of standing on his feet.

[Slipper]

This may have already been asked, but how sensitive are his feet? Does he walk barefoot in grass, pavement, sand, gravel, etc?

 

My oldest has autism and is like a cat at touching new 'foot experiences'. :) She will touch gingerly with her feet until she is comfortable with the feel. She was a toe walker for quite a while. She was suspected of having cp in addition to autism.

 

I know several people who hand flap as a means of excitement.

 

The sensory issues would throw up a flag, but considering that he seems to do well, I'd think more along the lines of aspergers. We suspect our middle daughter to have aspergers, but haven't sought any type of diagnosis (not necessary at this point). She has a lot of sensory issues - no tags, hates seams in her socks, etc. She is also very literal. It takes a lot of explaining for her to get common sense stuff. Intellectually, she is very, very bright. She's also very artistic. But emotionally, she is a bit less mature than her peers.

 

I would explore a possible physical problem for the toe walking, read The Out of Sync Child and look into aspergers.

 

Good luck :)

[Singingmom]

This may have already been asked, but how sensitive are his feet? Does he walk barefoot in grass, pavement, sand, gravel, etc?

 

My oldest has autism and is like a cat at touching new 'foot experiences'. :) She will touch gingerly with her feet until she is comfortable with the feel. She was a toe walker for quite a while. She was suspected of having cp in addition to autism.

 

I know several people who hand flap as a means of excitement.

 

The sensory issues would throw up a flag, but considering that he seems to do well, I'd think more along the lines of aspergers. We suspect our middle daughter to have aspergers, but haven't sought any type of diagnosis (not necessary at this point). She has a lot of sensory issues - no tags, hates seams in her socks, etc. She is also very literal. It takes a lot of explaining for her to get common sense stuff. Intellectually, she is very, very bright. She's also very artistic. But emotionally, she is a bit less mature than her peers.

 

I would explore a possible physical problem for the toe walking, read The Out of Sync Child and look into aspergers.

 

Good luck :)

 

Thanks :) . He doesn't seem to have much of an issue with walking on different types of surfaces/grass.

 

The doctor said that he was tight, and to work on flexing his feet, but didn't seem to think he needed a specialist yet for that either. I will definitely revisit the physical aspect when we go in again.

 

I will get the Out Of Synch book....several people on this board and another one I visit have suggested it.

 

As far as Aspergers goes, my doctor said she definitely did not think it could be that, because although he is smart, he is not displaying the unusual level of brilliance/genius that Aspies do. At first I was a little offended at the implication:tongue_smilie: , but I have to admit, I agree. He is not displaying genius characteristics, but I would say he is most definitely very bright. Others have always commented on this, too, ( including pedi). But, he doesn't lecture on things that should be way over a 5 year old's head. He does love vocabulary,and is always asking what words mean, and using some impressive words correctly.

Edited December 30, 2011 by Singingmom

[sbgrace]

I mentioned this upthread but your pediatrician does not know autism.

 

Aspie's don't need to be genius. They must have at least normal/average intelligence and no history of a speech delay to qualify for that diagnosis.

 

Again, I would not rely on this doctor's advice re: autism based on what you've shared here. Further, the fact that he/she is speaking with such authority in an area they clearly (imo) don't know much about would put me off on the person's advice generally. You can't tell when it's an informed medical opinion vs. whatever this advice falls under. I guess if he/she has been a good doctor on medical matters in the past a person trust them regarding actual medical illness information!

Edited December 30, 2011 by sbgrace

[Slipper]

:iagree: Aspie's don't necessarily need to be a genius to receive a diagnosis. That's a myth along the lines that kids with autism have a special "talent" that is genius - autistic savant type thing. :)

 

I would encourage you to see a psychiatrist/psychologist, or at least get another opinion. This isn't a slam on your pediatrician by the way. Pediatricians are supposed to diagnose ear infections and strep, etc. They aren't really qualified to diagnose autism. My pediatrician (whom I adore) has often made statements that turned out to not be true after a referral to a specialist.

 

All the best. :)

[Laurie4b]

Good question, Kung Fu Panda. He will run around and play and engage, and enjoy himself with other kids. He loves to swing. But, he is afraid of heights and gets freaked out at even the suggestion to climb something or go down a slide.

 

Also, my pedi asked me if he knew how to skip yet. To be honest, it hadn't occurred to me to teach him how to skip....but since she asked we've been working on it. He can't really do it yet, but is giving it a good try.

 

The fear of heights could be related to vestibular issues (one of the sensory processing areas). The vestibular system senses where your body is in space and is reactive to gravity. My ds with vestibular issues sought out extra vestibular input because what he got from the environment wasn't enough to keep him in a state of equilibrium. Your son may be getting "too much" vestibular stimulation and be an avoider. (too much or too little doesn't depend on the stimulation in the environment but how the body processes that stimulation.)

[Laurie4b]

Sensory processing issues are diagnosed and treated by occupational therapists. You want a therapy center with rooms that have a LOT of stimulation stuff in them. It should look like a big, soft gym or playground. Go check it out before you start with someone. Also, find out if the OT is certified or at least how much experience she's had in treating sensory processing issues.

 

For the rest, I would strongly encourage a developmental pediatrician or a neuropsychologist. You have toe walking, hand flapping, and sensory processing issues in play. Getting to an OT will at least give you a start on treating the sensory issues, but you don't want to have that triad of symptoms without a complete evaluation as soon as possible. You should also consider asking your questions on the special needs board.

[Rhonda in TX]

My friend's DS did that. He doesn't have autism, but he does have ADD. He wasn't hyper, but his hand flapping was related to that.

[Laurie4b]

I mentioned this upthread but your pediatrician does not know autism.

 

!

 

:iagree: There are ample reasons for referral from just what you've mentioned here and your child is 5. The years for early intervention are passing and she's taking a "wait and see" approach. She may be a good doc in other ways, but I would just tell her what you want in terms of referrals, not wait for her affirmation. Be assertive, pushy even.

[dirty ethel rackham]

Also, the OT should come up with a plan for what you do at home. One half-hour appointment a week is not going to create significant neurological change without a comprehensive plan to implement at home. We did not go the OT route, but used a neurodevelopmentalist at NACD (nacd.org).

[thescrappyhomeschooler]

I mentioned this upthread but your pediatrician does not know autism.

 

Aspie's don't need to be genius. They must have at least normal/average intelligence and no history of a speech delay to qualify for that diagnosis.

 

Again, I would not rely on this doctor's advice re: autism based on what you've shared here. Further, the fact that he/she is speaking with such authority in an area they clearly (imo) don't know much about would put me off on the person's advice generally. You can't tell when it's an informed medical opinion vs. whatever this advice falls under. I guess if he/she has been a good doctor on medical matters in the past a person trust them regarding actual medical illness information!

 

:iagree:

[TechWife]

I would worry a lot less about labels than losing precious time in early intervention, which can make such a huge difference in a child's potential.

 

:iagree:

[Singingmom]

I just want to thank all of you who have taken the time to reply and give me some good information. Clearly, I don't know much of anything about ASD, or or SPD....or any D, really! And, it sounds like my doctor, although a good basic pedi, doesn't really understand much about these things, either. I will definitely push for an evaluation, whether she thinks it is warranted or not. Hopefully, she is right, and there is not much to be worried about. But, if there are neurological issues going on where he would benefit from earlier intervention, then I want to know that and get the ball rolling ASAP!

 

You guys have dispelled my fears, and gotten my husband on board with a more assertive approach, too! Thank you so very much again! I hope I will have some good news to share in the future about the progress my son is making.

[Night Elf]

And, it sounds like my doctor, although a good basic pedi, doesn't really understand much about these things, either.

 

It's a matter of training I guess. My son wasn't diagnosed with Aspergers until he was 9 years old. He had 2 pediatricians that suggested he would outgrow his quirkiness. I had one psychologist tell me he was gifted with asynchronos development. BTW, gifted but not genius. I knew something wasn't right but they all patted me on the head and sent me on my way. It wasn't until my son pulled out the hair on the crown of his head that a pediatrician took my concerns seriously. After asking some questions, he asked me if I had ever heard of ASD. He said as a general physician, he couldn't diagnose any mental issue but that he saw enough to suggest the referral. Oh, the hair pulling thing was one of my son's tics. Hand-flapping was another. They come and go and have been all sorts of things.

 

Oh, and I'm not suggesting your son has ASD. I'm just agreeing that you shouldn't allow your pediatrician to decide to disagree with your request. I missed the early intervention window and can't find any help now that he's a teenager. I let those doctors continue to pat me on my head and now I'm paying for it. We're on our own.

[Barbara H]

http://www.allina.com/ahs/ski.nsf/page/10982-GS10839SKRIKKToeWalking.pdf/$FILE/10982-GS10839SKRIKKToeWalking.pdf

 

This explains some other reasons for toe walking. Tight heel cords over time can become a problem so depending on how much of the time the child is toe walking I would really want a physical therapy assessment. If has other physical problems I would also want a doctor to rule out problems such as cerebral palsy.