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BF's DD...immature or something else?

Before I met my BF's DD (13 years old), he (and BM) had told me upfront that she was very immature for her age. I've only been around her three times but we had her for spring break this last week and after spending extended time with her, I think that there is something other than just immaturity going on. 

She is very sweet and she listens fairly well, even though I have to tell her multiple times to do things and have to say her name and ask her if she heard me.  However, she talks and acts like she is 6 years old.  She mimicks things that I do and say, and rarely says anything that is not a repeat of something someone else had just said.  If you try to hold a conversation with her, any questions are answered with an uncomfortable "I don't know" or "I don't remember".   I took her shopping at the mall and that was when I really saw the difference between her and other teenagers. While trying on clothes, she wanted the sales woman to come look at all of her outfits, giggled and laughed while the sales woman told her she looked like a little model, and acted like the sales woman was her best friend. I was really happy that she was having a good time and was laughing, but I couldn't recall ever caring what a sales person thought when I was a teenager or preteen and I didn't see any other teens acting that way. 

Throughout the week we had some problems with her hygiene, she wouldn't brush her hair, she didn't wash her face or put on her lotion for what appears to be eczema.  BF was helping her get ready for bed one night and asked where her toothbrush was at and she said she didn't have one.  So she had not brushed her teeth for 4 days.  I felt awful and super guilty that she didn't have what she needed (tooth brush) but I had asked her many times if she needed anything and she never said she did.  She just chewed a lot of gum I guess (I found gum wrappers everywhere). He gave her a toothbrush and also some floss but she didn't know how to floss her teeth so he had to floss her teeth for her. She was on her period at the beginning of the week and we had to remind her to change her sanitary pad because she could not remember, she also was made a mess of her toilet and left used pads on the ground.   

The most troubling thing was BF was getting ready to take her back home but had to do a work event in a park so he took her with him.  In the middle of the event, she peed her pants in front of everyone.  He was mortified but I'm not sure that she was.  He asked her why she didn't tell him she needed to go (the bathroom was 40 feet away), and she just said she didn't know.  I told him to ask her if it burned when she peed or if she felt like she still had to go after she went, thinking that she may not have cleaned herself well enough and maybe had an infection, but she said no. 

 We live in a different state so we do not see her but once a month.  I expressed my concern to BF that there may be something other than just immaturity going on and he said even if there was, her mom would deny it and nothing would change and so his efforts would be futile, especially since he sees his DD so rarely.     

So, my question is, does this sound like normal immaturity or does it sound like something else is going on?   I do not have any children so I'm not sure what is normal and what isn't, I just gage from what I remember as a teenager and this doesn't seem normal to me.     

Re: BF's DD...immature or something else?

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    It does seem like there is more going on.  I suspect two things - that he knows something and is keeping it quiet or knows something but is in denial and not doing anything about it.......
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    I don't want to be alarmist, and I certainly would defer to Auntie on this stuff, but I would consider the whole picture of your SD.  Is there any possibility of abuse?  I am probably wrong, but some of what you have written raises the hair on the back of my neck.
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    Is she receiving any supports at school?  I'd hope that with this level of impairment/immaturity that some teacher has requested an evaluation somewhere along the line.
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    Thank you all for answering!! And also for being so nice! Really, it is very appreciated.  I had a chance to do a little internet research and I think you are spot on, Auntie. 

    I had suspected abuse at first as well, with the wetting of the pants, but with the bigger picture and after doing some research today, I think there is some undiagnosed delay as Auntie said.  

    As far as school goes, I don't think she is getting anything in way of support.  They live in a small remote town and I can't imagine the small school has the resources or much experience with ASD.  She makes good grades (A's and B's), but she did have a bully incident earlier in the school year.  She didn't say anything about it to either parent but the school alerted BM and suspended the kid.  I can't imagine what else she's had to endure that no one knows about.  Which breaks my heart because she is really a sweet girl.

    I think the lack of recognition of social heirarchy is interesting.  I don't think she has many friends.  When she was at our house, there was some texting but I think it was mainly with her mom and her aunt.  I didn't hear any conversations with any girlfirends the entire time she was there.  BF did say that she would cling to me when she met me as her new friend and she definitely did.  I saw her staring at me out of the corner of my eye several times and she repeated things I said after I said them (Me: "I'll be right back, I'm going to go to the bathroom"; Her "You're going to the bathroom?") and mimicked my mannerisms and actions, even getting on the floor and sitting next to me while I was working out.  When I laughed, she laughed, even though she had no idea what I was laughing about.   

    She's very quiet and sweet, very shy (will not order food at restaurants) does what she's told after you are specific and remind her (like putting dishes in the dishwasher), and doesn't complain about anything (like not having a toothbrush) nor does she talk much.  She is very emotional, like I told her it was cold outside and asked if she brought any other clothes and shoes besides capris and flip flops and she started tearing up and said she didn't know.

    Some comments that my BF has made in the past are starting to tip me off that he probably knows something is going on, but to be honest, I didn't know anything about ASD until it was brought to my attention today so I imagine he probably doesn't either. He was pretty upset about his DD not knowing how to floss and not brushing her teeth and especially when she wet her pants, but has said he thinks its how BM is treating her, that her delay in maturity is environmental.   I have urged him very strongly to tell BM about all that went on and he said it wouldn't matter, nothing would change, but said he would talk to her.  BM certainly does cater to their DD's every whim.  She's able to eat whatever she wants and do whatever she wants at her moms and her mom picks up after her every move and doesn't make her do anything she doesn't want to do.

    If they did get a diagnosis, what kind of treatment would be available?  He is out of town for the rest of the week, but I'd really like to get some information together for him and figure out some way to approach him with it.      

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    Thanks Auntie.  I spoke with BF briefly this morning and he said that they took DD to a counselor a few years back but the counselor found nothing wrong with her.  He's said that he will talk to her mom about taking her back to a counselor, but I'm not sure that's what needs to happen first.  I suggested he or BM take their DD to her doc and be 100% candid about DD's behavior.  We both think that BM probably would not be upfront with the doc as she sees nothing wrong with their DD.  I told him we can take her when we have her this summer if her mom doesn't and he thought that was a good idea.  I haven't broached the possibility of ASD with him , just have said I'm really upset about what I saw last week and I think that something is wrong, which is true, but I'm not really sure how to go about talking to him about specifics since its a sensitive subject.     

    Edit: We just talked a little more and he said that she does have friends at school.  He has seen girls around town call out to her (like at Walmart) and his DD and the girls have been friendly.  I've seen it too but it was a brief encounter.  When he reminded me, I did remember she talked a little more like a teenager, but it was more of how I imagined her mom or someone older would interact.  Hard to explain, just the way she talked I guess.  He isn't worried about her social behavior even though I am still on the fence.  I told him about the mall interaction with the sales woman and he thinks its because her mom treats her like a buddy and she doesn't understand the difference between an adult friend and a kid friend so she treats them the same.  I'm standing my ground on the doc though, the mimicking and pants peeing episode tells me there IS something wrong, even if its not ASD. 

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