Morphing Symptoms and ID questions

Junebug060609

I know it's common for signs/stims to morph over time with ASD.  Been noticing that  a lot lately with my DS. 

It started this spring with his hand motions.  He used to do a wrist twisting motion, sometimes with a contorted face and marching feet.  Now he jumps and flaps.  Kind of curious if this is a common switch and why it might've happened.   Maybe because he got good at jumping?  Possibly he saw another kid at school doing it (He attends a pre-school in the local school system during the school year.  I don't know the other attendees dx, but I'm sure there are others with an autism dx or that would have stereotypic movement for other reasons).  Lately he's been adding grunting to the jumping and flapping. 

I guess the reason for my post is that there seems to be an uptick in the frequency of his doing this lately.  Ok, that and that this evening for the first time he dropped to the ground and sat there in a parking lot and watched the stroller wheels move.  He's fixated on wheels before, in fact I suspect it's part of the reason he loves watching Thomas, but never in public (its usually just when he's really tired before bed at home).  Granted he was tired at the time, but it was different that he stopped what he was doing in a novel location to do it. 

I'm curious if those of you with older kids might know if it is common for almost 3 year olds to have changes like this, or if its just kind of a crapshoot when it happens and we're just along for the ride.  I'm assuming it's the crapshoot, lol

I'm also wondering...and it's killing me that I'm even asking this...but I'm wondering how we would go about finding if DS might have an intellectual disability.  Does anyone know?  I'm guessing that at his age it's a waiting game and that they'd do testing before kindie.  He gives mixed signals on if he might have one or not, at least to my uneducated eye.  He's shown an ability to point to the correct letters/shapes/colors/numbers when asked.  Doesn't always get it right, but if he's focused and the field isn't too big (maybe 2-4 options) he pics right.  He sometimes will point to things in books when asked.  He's done maybe a half dozen signs, but he's more miss than hit with doing them.  He can follow single step directions decently, but multi-step I often lose him on.  He has said about 50 words, but I only hear maybe a half dozen of them a day (2-3 words per day, sometimes heard more than once).  He sometimes spontaneously says appropriate things unprompted.  For example he'll climb up onto the big bed and say, "My did it!" or at one time he fell down outside playing and blurted out, "I fell down!" clear as day.  Now that I'm writing all this out I feel a little better about the ID thing.  I'm not saying I think he's a genius or anything, but putting this down in words has reminded me of how far he's come in the last year.  Kind of makes me wonder if the uptick might be related to his ABA, maybe something is going on developmentally? 

Oh and one last question...dark circles under his eyes...what's up with that???  I don't think it's lack of nighttime sleep.  I'm blessed with a good sleeper.  He goes down at 830 and will sleep thru until 7am when I wake him (we have a video monitor on him).  Naps are more miss than hit lately, so I do know that by afternoon he's tired...but the circles were there this morning. 

Junebug060609

sorry that was so long!

hopecounts

IME stims are a bit like the moles in whack a mole. They pop up, go away/.are targeted for extinction, then are replaced by something else or show back up again later.

And yes as bandwith increases with age the stims typically increase/change as their physical and mental capabiities increase and require/allow more stims.

We're currently reextinguishing DD's hair twirling that had basically become non-existent but has creeped back up over the past couple months. As has her mouthing.

My guess is the stress of summer (change in routine, multiple providers with only 2 remaining the same, less structure, it being light later messing with her sleep, etc) has her more anxious which is causing her to stim more in response. I'm hoping when we get settled into our normal routine again when school starts that some of it will reduce again as she settles back in.
But in the mean time we are addressing the behaviors with ABA and it's helping.

Junebug060609

Playing with hair is a stim?  I guess it is by definition, isn't it?  It's a thing on my side of the family.  My dad, my brother and myself all do it when we are relaxing (ie watching TV...or just now I was doing it while reading your post). 

That bit you included about their bandwidth increasing and allowing/requiring more stims...that might be what's going on with DS.  He does seem to be moving forward.  Has made some big steps in his ABA goals (goals are things like coming when called, stopping when asked to stop [he's a runner], responding to his name). 

hopecounts

Yep, technically a stim but definitely falls under the intensity makes a difference category. We actually were leaving it alone as it is not a SIB stim as long as it isn't excessive and her twirling was minor enough it seemed better to leave it be since as you point out lots of people do it so it was a reasonable way for her to self regulate as long as it didn't become a problem or interfere with her ability to interact and focus. It's just gotten excessive and to the point that she is knotting her hair unintentionally at times so we need to address it. It sounds like he is making good progress and as his brain matured so will some of his quirks. At almost 3 he is roughly developmentally around 18 months most likely so like any 18 month old you are going to start seeing new and challenging behaviors (pre-cursor to the terrible 2s) they might just be a little different then an NT kids.

Junebug060609

hopecounts said:

Yep, technically a stim but definitely falls under the intensity makes a difference category. We actually were leaving it alone as it is not a SIB stim as long as it isn't excessive and her twirling was minor enough it seemed better to leave it be since as you point out lots of people do it so it was a reasonable way for her to self regulate as long as it didn't become a problem or interfere with her ability to interact and focus. It's just gotten excessive and to the point that she is knotting her hair unintentionally at times so we need to address it. It sounds like he is making good progress and as his brain matured so will some of his quirks. At almost 3 he is roughly developmentally around 18 months most likely so like any 18 month old you are going to start seeing new and challenging behaviors (pre-cursor to the terrible 2s) they might just be a little different then an NT kids.

Oh, we've been seeing them.  Boy has been seeing what he can get away with and throwing some awesome toddler-esqe tantrums. 

Junebug060609

-auntie- said:

Junebug060609 said:

I know it's common for signs/stims to morph over time with ASD.  Been noticing that  a lot lately with my DS. 

It's what stims do.

It started this spring with his hand motions.  He used to do a wrist twisting motion, sometimes with a contorted face and marching feet.  Now he jumps and flaps.  Kind of curious if this is a common switch and why it might've happened.   Maybe because he got good at jumping? 

That a very real possibility. It takes a certain amount of gross motor skill to jump, he may have just gotten to a place where he can. Or he may have just realized that jumping is pleasurable for him. 

Stereotypic movements are pleasurable for the person doing them. Jumping, flapping, etc. can provide deep joint compressions that many seek as a way to settle. You might be able to redirect this behavior somewhat by offering joint compressions in some more socially appropriate manner- climbing, a mini-tramp of Willbarger (brushing).

It's nice to hear it's pleasurable for him.  Never seemed to bother him (would be smiling afterwards), but he sometimes has a face contortion that can look almost painful, so I've wondered.  At his age the jumping isn't such a big deal, but the grunting and flapping is beginning to be.  For the climbing are you talking things like having a playground/swingset?  I'm not familiar with Willbarger. 

 Possibly he saw another kid at school doing it (He attends a pre-school in the local school system during the school year.  I don't know the other attendees dx, but I'm sure there are others with an autism dx or that would have stereotypic movement for other reasons).  Lately he's been adding grunting to the jumping and flapping. 

Yeah. Um. No. Kids on spectrum don't tend to imitate one another. If they did, we could put them all in a class with NT peers and ditch the ABA, Floortime,DIR, ESDM and Social Thinking. Hell, getting my kid to notice what peers were doing and accept that they were setting the bar behaviorally took several years of social skills instruction twice weekly.

Hehe, I suppose you're right.  He does sometimes pick up on what we're doing and learns from that.  Sometimes.  Other times I can do the same thing will him 400 times and it doesn't seem like it registers...until he lets me know he's been listening all along (ie when he started pointing and could point to shapes and such I'd been telling him about all this time)

I guess the reason for my post is that there seems to be an uptick in the frequency of his doing this lately.  

Like @hopecounts said. It's the increase in bandwidth. He's probably doing more because he's more aware of his environment and has a greater ability to be bored or anxious which are two of the common triggers.

Probably bored.  He tends to do them more when he's stircrazy and/or tired. 

Ok, that and that this evening for the first time he dropped to the ground and sat there in a parking lot and watched the stroller wheels move.  He's fixated on wheels before, in fact I suspect it's part of the reason he loves watching Thomas, but never in public (its usually just when he's really tired before bed at home).  Granted he was tired at the time, but it was different that he stopped what he was doing in a novel location to do it. 

It almost sounds like you're more concerned he took the show on the road than that he's stimming. How to handle stims is a bit controversial. Some people, including adults on spectrum, feel they should have the right to stim "as needed" and where ever they like. And they always bring up the NTs twirling their hair or fiddling with their pens. But it's one of those frequency, duration, intensity situations. 

That's kind of the situation.  I know he stims, we see it all the time at home as does his school.  I guess some of my concern is that he's getting to an age where things aren't socially acceptable.  Up until now he was a quirky toddler, KWIM?  It stirs up worries about how he'll be treated.  And if I'm being honest, the spinning wheel thing was hard to see...he's never done it that blatantly before.

Stimming can be very off-putting to others who can react viscerally. One writer I know holds stims to the standard of "if my kid was 25 and standing on Times Square doing it, would people cross the street to avoid him?" A lot of people take a masturbation approach- preventing obvious stimming in public and redirecting it to a private place like his bedroom explaining that other people don't like to watch him.

Most of the time I'm pretty nonchalant with my reaction to his stims.  Kind of a 'it is part of who he is' take on it.  He was a flapping, grunting, jumping, running ball of energy when I took him to a kids museum on Saturday, for example, and I took that a lot more in stride.  He was REALLY excited there.  We got some looks, and that was kind of hard, but he was really enjoying it...especially when he tried to climb into the 'excavation pit' (it was a dino display and they had a fossil excavation pit for the kids.  one of his visual stims is the sit in the sandbox and watch sand fall in front of his face...so he tried to climb into the pit and I had to pull him out). 

I'm curious if those of you with older kids might know if it is common for almost 3 year olds to have changes like this, or if its just kind of a crapshoot when it happens and we're just along for the ride.  I'm assuming it's the crapshoot, lol

Stims change all the time. You can address the antecedent sometimes- is he stimming because he's bored, upset, tired, needs to get some physical movement?

You can redirect a stim to a less stigmatizing activity that provides similar physical feedback- jumping can be replaced by a climbing wall, for instance.

As he gets older, you'll need to be aware of the possibility of him developing tics. These can sometimes seem like stims, but they are not voluntary in nature, thought most people can temporarily supress them. They're handled entirely differently- you don't bring attention to them by mentioning or redirecting.

Pretty sure most of his stims at home are boredom/tiredness related.  Sometimes excitement (if Thomas comes on).  Tics are years down the road, no?

I'm also wondering...and it's killing me that I'm even asking this...but I'm wondering how we would go about finding if DS might have an intellectual disability.  Does anyone know?  I'm guessing that at his age it's a waiting game and that they'd do testing before kindie.  He gives mixed signals on if he might have one or not, at least to my uneducated eye.  He's shown an ability to point to the correct letters/shapes/colors/numbers when asked.  Doesn't always get it right, but if he's focused and the field isn't too big (maybe 2-4 options) he pics right.  He sometimes will point to things in books when asked.  He's done maybe a half dozen signs, but he's more miss than hit with doing them.  He can follow single step directions decently, but multi-step I often lose him on.  He has said about 50 words, but I only hear maybe a half dozen of them a day (2-3 words per day, sometimes heard more than once).  He sometimes spontaneously says appropriate things unprompted.  For example he'll climb up onto the big bed and say, "My did it!" or at one time he fell down outside playing and blurted out, "I fell down!" clear as day.  Now that I'm writing all this out I feel a little better about the ID thing.  I'm not saying I think he's a genius or anything, but putting this down in words has reminded me of how far he's come in the last year.  Kind of makes me wonder if the uptick might be related to his ABA, maybe something is going on developmentally? 

It's probaby ABA in conjuction with some developmental maturity. 

IQ testing isn't very reliable at this age. It's likely the school district will do something closer to his transition to kindie. 

Kind of what I figured on both counts.

Oh and one last question...dark circles under his eyes...what's up with that???  I don't think it's lack of nighttime sleep.  I'm blessed with a good sleeper.  He goes down at 830 and will sleep thru until 7am when I wake him (we have a video monitor on him).  Naps are more miss than hit lately, so I do know that by afternoon he's tired...but the circles were there this morning. 

Circles can be from any number of things. Sometimes they're just genetic. Allergies are the classic culprit, rubbing or scratching them, mild dehydration can make them look worse, too. If he's not napping, the just over 10 hours he gets at night might not be enough sleep. 

I guess i'll keep an eye out and see if there is a pattern to it.  The days he doesn't nap he's for sure on a sleep deficit. 

hopecounts

Wilburger protocol. https://www.youtube.com/watch?v=t9LSbINc-y0 https://www.ot-innovations.com/content/view/55/46/