sensory integration dysfunction v. bipolar v. adhd
- Thread starter whatamess
- Start date
smallworld
Moderator
Absolutely to both questions.
Out of curiosity, what symptoms are you seeing that point to mania?
Out of curiosity, what symptoms are you seeing that point to mania?
whatamess
New Member
Here's a description from one of my other posts:
"My view of my difficult child's mood and subsequent behavior always bring the term 'manic' to my mind. For my difficult child...he cannot sit still (goes way beyond his normal adhd), his whole entire body will move constantly, for hours. Legs moving, kicking, stomping; arms flailing, poking, slapping, hitting, throwing; bumping into people, crashing into furniture; voice-loud whoops, yells, shouting in sibs ears, using words he knows are inappropriate. Bothering our cat and hamster to a degree different than usual. Ripping paper, stealing sibs toys, bothering sibs by entering their room and throwing their stuff around. He's been in this state for about 20 hours now and it is exhausting. Does this sound manic to you? "
"My view of my difficult child's mood and subsequent behavior always bring the term 'manic' to my mind. For my difficult child...he cannot sit still (goes way beyond his normal adhd), his whole entire body will move constantly, for hours. Legs moving, kicking, stomping; arms flailing, poking, slapping, hitting, throwing; bumping into people, crashing into furniture; voice-loud whoops, yells, shouting in sibs ears, using words he knows are inappropriate. Bothering our cat and hamster to a degree different than usual. Ripping paper, stealing sibs toys, bothering sibs by entering their room and throwing their stuff around. He's been in this state for about 20 hours now and it is exhausting. Does this sound manic to you? "
smallworld
Moderator
It doesn't necessarily constitute a manic episode, but only a psychiatrist would know for sure.
Here's a link to an excellent article on diagnosing bipolar disorder in children and adolescents by researchers at the National Institute of Mental Health in Bethesda, MD:
http://intramural.nimh.nih.gov/research/pubs/leibenluft01.pdf
Here's a link to an excellent article on diagnosing bipolar disorder in children and adolescents by researchers at the National Institute of Mental Health in Bethesda, MD:
http://intramural.nimh.nih.gov/research/pubs/leibenluft01.pdf
Marguerite
Active Member
Yes.
Your description above - it could be any one of a number of disorders. We an't diagnose here, neither can we un-diagnose. I would hope that anyone diagnosing BiPolar (BP) would have a lot more basis for it.
Marg
gcvmom
Here we go again!
My difficult child 2 behaves very similarly when he's not stable. His current diagnosis is Mood Disorder-not otherwise specified.
I don't know if medications can help sensory issues, but I do know that his sensory issues improved once he was properly medicated for the mood disorder. And FWIW, he initially looked like he had ADHD, which then got much worse over time (several years) to the point that ADHD medications didn't work anymore. Which is another reason why we suspect the mood disorder diagnosis is accurate. Because he does respond appropriately, or as expected for this disorder to the medications that he takes.
Hope you can figure out what your child needs best soon. It's very frustrating for the entire family when things are so out of control, the affected child included.
I don't know if medications can help sensory issues, but I do know that his sensory issues improved once he was properly medicated for the mood disorder. And FWIW, he initially looked like he had ADHD, which then got much worse over time (several years) to the point that ADHD medications didn't work anymore. Which is another reason why we suspect the mood disorder diagnosis is accurate. Because he does respond appropriately, or as expected for this disorder to the medications that he takes.
Hope you can figure out what your child needs best soon. It's very frustrating for the entire family when things are so out of control, the affected child included.
BusynMember
Well-Known Member
Reminds me on my son when he was little. He was like that all the time, especially with the inappropriate noises and bouncing around. He has high functioning autism. It looks a lot like mania, as adults know mania. With interventions, he has calmed down a lot and no longer seems "Manic." When a child seems overly hyer, makes weird noises, looks for sensory satisfaction (bouncing, running, shouting, touching everything, rolling on the ground), and doesn't seem depressed (but may melt down easily) you may want to see a neuropsychologist (not a psychiatrist) to check out ALL disorders. But it could be high functioning autism. It looks a lot like extreme ADHD or mania, without the kid ever coming down. Anxiety is high with it. My son was misdiagnosed with bipolar, and the consequence was very heavy medication routine that was unnecessary and a delay in Pervasive Developmental Disorder (PDD) interventions. Be careful as they mimic each other. You seem unsure, as you should be. Don't take the first diagnosis. as gospel and be careful about giving him heavy duty medication. They WILL calm him down--my son was sedated. But, unless it really is bipolar, it's not going to help in the long run.
Hopefully, see a neuropsychologist. Did he have any speech delays or speech issues? Can he make strong eye contact with strangers? Does he understand how to interact with his same age peers? Does he talk way too loud...lol (this was a big one for mine). Ever cover his ears or freak out in a crowd where there is too much stimuli?
I have bipolar/mood disorder spectrum. I was a very sad and upset child, but I did not act like that and my layman's opinion is that he is sensory seeking, not exhibing mania. My mania as a child was non-stop talking and a feeling of extreme happiness, as if I was infallible. When I was depressed, I cried and was fearful of strange things, such as bandages. I would never have blurted a swear word at my parents. Although everyone is different, I didn't bounce around.
Good luck, whatever you decide to do.
Hopefully, see a neuropsychologist. Did he have any speech delays or speech issues? Can he make strong eye contact with strangers? Does he understand how to interact with his same age peers? Does he talk way too loud...lol (this was a big one for mine). Ever cover his ears or freak out in a crowd where there is too much stimuli?
I have bipolar/mood disorder spectrum. I was a very sad and upset child, but I did not act like that and my layman's opinion is that he is sensory seeking, not exhibing mania. My mania as a child was non-stop talking and a feeling of extreme happiness, as if I was infallible. When I was depressed, I cried and was fearful of strange things, such as bandages. I would never have blurted a swear word at my parents. Although everyone is different, I didn't bounce around.
Good luck, whatever you decide to do.
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M
ML
Guest
I agree with MWM. Manster who is also hf autism/aspergers would act like this a lot, especially when he was younger. by the way he was initially diagnosis as adhd/Generalized Anxiety Disorder (GAD),social anxiety and separation anxiety with a throat clearning tic. Now we believe he has AS/ADHD and possibly Tourette's Syndrome.
whatamess
New Member
Well difficult child does have an Autism Spectrum Disorders (ASD) diagnosis, as well as ADHD and we know he has sensory issues. But these 'episodes' are distinct in intensity for him. We have our normal Autism Spectrum Disorders (ASD)/adhd issues and then some days, as described above, he seems so 'high' he is unreachable. When he was little he was just never stopped moving, now that he's older he's still like that but definitely more unhappy in an irritable way and then the 'high' periods.
With the knowledge that he has sensory issues, has he been fully examined for these by an Occupational Therapist (OT) trained in all aspects of sensory integration? This can help you figure out exactly what his sensory needs are and try to provide them in a way that doesn't send the entire family such intense distress.
The Occupational Therapist (OT) NEEDS to teach you brushing therapy with joint compressions. It is AMAZING, but it MUST be taught by an Occupational Therapist (OT). If you brush certain areas you cause big problems, even problems with his digestion and other bodily functions. So don't try to figure it out on your own.
This therapy will need to be done every hour or two for a while. NOT forever. After you get into it you back off and do it less and less often. If you cannot do it every couple of hours, don't just skip it totally. Do it as often as you possibly can. It will just take longer to show some of the results.
This should be mandatory for every child who is suspected of adhd, autism, bipolar, any mental illness/developmental problem. It is non-invasive, requires just about 2 minutes every couple of hours, involves no medicine and scary side effects. This therapy also is proven to REWIRE THE BRAIN. It actually teaches the brain how to handle sensory input. It creates new pathways so that the brain learns how to handle sensory information in a better, more functional way. I cannot begin to rave about this enough.
My youngest was a wildman for a while. Only at home or with his dad and I. MUCH worse with his dad if they were out and about. (I did things that husband saw as babying thank you. Opening the baby carrots so he could munch, involving him in picking which bag of whatever to buy, letting him ride in the cart, even leaving with-o finishing the shopping trip if he got wild on me - those kinds of things.)
I set up an appointment with a private Occupational Therapist (OT) for evaluation. Later that day I had an appointment with my older child's psychiatrist to see if we were looking at possible aspergers/Pervasive Developmental Disorder (PDD) or some other problem. thank you was getting wilder as he got older. He would seem almost frantic at times. He also was growing increasingly unable to handle anything that involved loud noises. The Occupational Therapist (OT) taught me brushing therapy. She said he clearly had Sensory Integration Disorder (SID). As he got older we expected him to handle situations with more and more sensory stimulation. His poor brain just couldn't cope with it. She even recommended that if he seemed really overstimulated by school then keeping him home the next day would help. (He missed 6-9 days of school per quarter due to this. School understood and he still had the highest grades in his grade, not just his class.)
The Occupational Therapist (OT) had him cut out a circle with a pair of scissors (somehithing he could not do well). He said he hated himself because he couldn't do it 'right'. I was floored - I had not heard him say that before! Then she had him cut out another shape. She did just the very gentle joint compressions of his shoulders and neck. He actually started to cut straighter. And he said it wasn't so hard after all, he actually could do it "right"! The transformation in him was immediate, unprompted, and stunning! I got teary right there because I didn't know he felt that way and this gave such a huge improvement.
Our school would not allow a teacher to do this therapy. Had to be the part time Occupational Therapist (OT) who could not come into the class every couple of hours to do this. So he didn't get it at school - frustrating the teacher hugely because she saw the difference in him when I did it.
BUT - this shows the amazing results you can get from this therapy.
in my opinion this is the thing you should try first. Call TODAY and get an appointment with a private Occupational Therapist (OT). If insurance doesn't cover it, find a way to pay for it yourself. School OTs will only focus on how it impacts academics. So they might not even be familiar with brushing.
After he has had a couple of weeks of brushing see how he is. Continue with the mood and behavior charts. They are so helpful!
If this and providing OK sources for the sensory diet he needs doesn't help THEN I would be worrying about other causes for the problems.FWIW, the psychiatrist who evaluated thank you after the Occupational Therapist (OT) evaluation said that he would NOT give a diagnosis to him. Chances were that we were seeing the Sensory Integration Disorder (SID) problems. IF things didn't change in a few months or a year to come back to him. We never have needed to for thank you.
Many hugs!
ps. Get a copy of The Out of Sync Child by Carol Kranowitz. It is an excellent resource. Also get a copy of The Out of Sync Child Has Fun by the same author. These will help you understand the problems and get the right help for them.
The Occupational Therapist (OT) NEEDS to teach you brushing therapy with joint compressions. It is AMAZING, but it MUST be taught by an Occupational Therapist (OT). If you brush certain areas you cause big problems, even problems with his digestion and other bodily functions. So don't try to figure it out on your own.
This therapy will need to be done every hour or two for a while. NOT forever. After you get into it you back off and do it less and less often. If you cannot do it every couple of hours, don't just skip it totally. Do it as often as you possibly can. It will just take longer to show some of the results.
This should be mandatory for every child who is suspected of adhd, autism, bipolar, any mental illness/developmental problem. It is non-invasive, requires just about 2 minutes every couple of hours, involves no medicine and scary side effects. This therapy also is proven to REWIRE THE BRAIN. It actually teaches the brain how to handle sensory input. It creates new pathways so that the brain learns how to handle sensory information in a better, more functional way. I cannot begin to rave about this enough.
My youngest was a wildman for a while. Only at home or with his dad and I. MUCH worse with his dad if they were out and about. (I did things that husband saw as babying thank you. Opening the baby carrots so he could munch, involving him in picking which bag of whatever to buy, letting him ride in the cart, even leaving with-o finishing the shopping trip if he got wild on me - those kinds of things.)
I set up an appointment with a private Occupational Therapist (OT) for evaluation. Later that day I had an appointment with my older child's psychiatrist to see if we were looking at possible aspergers/Pervasive Developmental Disorder (PDD) or some other problem. thank you was getting wilder as he got older. He would seem almost frantic at times. He also was growing increasingly unable to handle anything that involved loud noises. The Occupational Therapist (OT) taught me brushing therapy. She said he clearly had Sensory Integration Disorder (SID). As he got older we expected him to handle situations with more and more sensory stimulation. His poor brain just couldn't cope with it. She even recommended that if he seemed really overstimulated by school then keeping him home the next day would help. (He missed 6-9 days of school per quarter due to this. School understood and he still had the highest grades in his grade, not just his class.)
The Occupational Therapist (OT) had him cut out a circle with a pair of scissors (somehithing he could not do well). He said he hated himself because he couldn't do it 'right'. I was floored - I had not heard him say that before! Then she had him cut out another shape. She did just the very gentle joint compressions of his shoulders and neck. He actually started to cut straighter. And he said it wasn't so hard after all, he actually could do it "right"! The transformation in him was immediate, unprompted, and stunning! I got teary right there because I didn't know he felt that way and this gave such a huge improvement.
Our school would not allow a teacher to do this therapy. Had to be the part time Occupational Therapist (OT) who could not come into the class every couple of hours to do this. So he didn't get it at school - frustrating the teacher hugely because she saw the difference in him when I did it.
BUT - this shows the amazing results you can get from this therapy.
in my opinion this is the thing you should try first. Call TODAY and get an appointment with a private Occupational Therapist (OT). If insurance doesn't cover it, find a way to pay for it yourself. School OTs will only focus on how it impacts academics. So they might not even be familiar with brushing.
After he has had a couple of weeks of brushing see how he is. Continue with the mood and behavior charts. They are so helpful!
If this and providing OK sources for the sensory diet he needs doesn't help THEN I would be worrying about other causes for the problems.FWIW, the psychiatrist who evaluated thank you after the Occupational Therapist (OT) evaluation said that he would NOT give a diagnosis to him. Chances were that we were seeing the Sensory Integration Disorder (SID) problems. IF things didn't change in a few months or a year to come back to him. We never have needed to for thank you.
Many hugs!
ps. Get a copy of The Out of Sync Child by Carol Kranowitz. It is an excellent resource. Also get a copy of The Out of Sync Child Has Fun by the same author. These will help you understand the problems and get the right help for them.
tiredmommy
Well-Known Member
My difficult child (Duckie) has "looked" like four possible disorders: Early Onset Bi-Polar (EOBP), High-Functioning Autism (HFA), anxiety and sensory dysfunction. The last is the only one I'm sure of and she seems to grown out of the symptoms of the first two, for the most part. She's improved greatly over the last few years as her sensory functioning seems to be maturing a bit. But she definitely had red flags for bipolar disorder & autism. She still gets quite revved up when over-stimulated: loud, irritable. She seems crackly somehow, if that makes sense.
whatamess
New Member
difficult child's shorter lived 'manic' moments seem to be triggered by excitement. Picture an 11 year sitting at the window waiting for his in-home therapist to arrive. He's conversational, talking about what game they will play when he arrives. The therapist's car pulls up and difficult child goes into a mental tailspin wherein he locks the door and runs up to his room to hide under the blankets, he comes down minutes later and is literally bouncing off people and walls, making strange noises, really uncontrollable and loss of language. Imagine this has been happening every week for the last 3 years with the same therapist. I have tried breaking this 'habit' through sheer bribery...candy, game time, money. It is out of his control completely.
BusynMember
Well-Known Member
I have to add my .02. I seem unable to shut up...lol...maybe because both me and my poor son were so badly diagnosed. Your son's meltdown before therapy sounds like Autism Spectrum Disorders (ASD) to me. The kids do not do well in "different" places. Autism Spectrum Disorders (ASD) kids can regress and lose language. They all have various language problems anyway. Sometimes, under stress, they can't talk at all. My son, if stressed, with bow his head and stay silent, yet he has an amazing vocabulary. Socially he has oodles of problems. The hiding and strange noises and bouncing off the walls again sounds like Autism Spectrum Disorders (ASD) to me, not bipolar. No, I'm not an expert.
An Occupational Therapist (OT) can help sensory issues. A speech therapist can pinpoint language problems. NEITHER are capable of diagnosing the full disorder. They only know their own field.
My son acted like he was shot out of a rocket all day and all night long. He couldn't sit still. He bounced. He babbled nonstop before he spoke. He broke things while examining them (it wasn't malcious). He would have meltdowns if he had to transition from one thing to another or sometimes when he was told "no." He didn't do "no" well. He is sixteen and doing "no" much better.
I still think the neuropsychologist is a good idea. I'm not convinced, since I have bipolar myself, that this is bipolar. That just wasn't what happened to me, and I"m certainly not all the people in the world, but to me it sounds more like Autism Spectrum Disorders (ASD). I'm not going to claim expert status. I'm simply giving you what I've observed since I had to live with a serious mood/anxiety disorder that surfaced very early (I do NOT have Autism Spectrum Disorders (ASD)) and my son has Autism Spectrum Disorders (ASD) (he does NOT have bipolar). It is very confusing to diagnose. Before I did the heavy medication bit, I'd see the neuropsychologist. My son is still obese from his years of medication-taking and he HATES medications. His autism therapist offered him medications because he admitted he has trouble concentrated which, by the way, is as common for Autism Spectrum Disorders (ASD) as it is for ADHD. But he said "I don't want medication" very firmly, and since he's sixteen and well behaved, I didn't push it. He also admitted he gets "sad" sometimes "but it's not too bad, it goes away." He didn't want medicine for that either. He did not like the way medication made him feel and it didn't help him because he has Autism Spectrum Disorders (ASD) not bipolar. Now if *I* skip my medications one day, I am not pleasant to be around (part of that being that my medication has withdrawal symtpoms).
It is very hard to diagnose a young child. Be very careful and, as much as we love to trust our professionals, question, question, question until your child is doing well.
Take care
An Occupational Therapist (OT) can help sensory issues. A speech therapist can pinpoint language problems. NEITHER are capable of diagnosing the full disorder. They only know their own field.
My son acted like he was shot out of a rocket all day and all night long. He couldn't sit still. He bounced. He babbled nonstop before he spoke. He broke things while examining them (it wasn't malcious). He would have meltdowns if he had to transition from one thing to another or sometimes when he was told "no." He didn't do "no" well. He is sixteen and doing "no" much better.
I still think the neuropsychologist is a good idea. I'm not convinced, since I have bipolar myself, that this is bipolar. That just wasn't what happened to me, and I"m certainly not all the people in the world, but to me it sounds more like Autism Spectrum Disorders (ASD). I'm not going to claim expert status. I'm simply giving you what I've observed since I had to live with a serious mood/anxiety disorder that surfaced very early (I do NOT have Autism Spectrum Disorders (ASD)) and my son has Autism Spectrum Disorders (ASD) (he does NOT have bipolar). It is very confusing to diagnose. Before I did the heavy medication bit, I'd see the neuropsychologist. My son is still obese from his years of medication-taking and he HATES medications. His autism therapist offered him medications because he admitted he has trouble concentrated which, by the way, is as common for Autism Spectrum Disorders (ASD) as it is for ADHD. But he said "I don't want medication" very firmly, and since he's sixteen and well behaved, I didn't push it. He also admitted he gets "sad" sometimes "but it's not too bad, it goes away." He didn't want medicine for that either. He did not like the way medication made him feel and it didn't help him because he has Autism Spectrum Disorders (ASD) not bipolar. Now if *I* skip my medications one day, I am not pleasant to be around (part of that being that my medication has withdrawal symtpoms).
It is very hard to diagnose a young child. Be very careful and, as much as we love to trust our professionals, question, question, question until your child is doing well.
Take care
smallworld
Moderator
Obviously, we're not doctors and can't diagnose over the internet, but I agree with MWM that what you describe doesn't sound like mania associated with BiPolar (BP), especially because it happens every week at the same time from the same trigger. By its very nature, the mood swings associated with BiPolar (BP) are very unpredictible. And there is no loss of coherent language from a manic episode. In fact, my son is overly verbal when he's manic or hypomanic.
It sounds a lot like Autism Spectrum Disorders (ASD) to me also, although I must say that my difficult child has not show the loss of language and hiding, but he is very high functioning, and sometimes disturbingly verbal (he spoke nonstop from the day he learned to speak until he was 8, Nonstop. He even babbled in his sleep!)
Does your son do this for any other visitor or professional? Do you stay and see what the therapist does with him for the entire session or leave them alone? I would suggest telling your son you will stay with him for the entire session and then see if he acts differently over the next few sessions. I don't have a clue if anything is going on that could cause this, and I do not mean to imply that anything improper is going on. I just wonder if something that goes on in the therapy sessions is upsetting him to the point that he cannot cope.
If you are there for the entire sessions and the behavior does not subside, then the neuropsychologist is an excellent step to find out what exactly is going on. I would call NOW to get the referral process started so you can get scheduled. Often there is a substantial wait and this will keep the process from being delayed. I just think you should try to find out what, if anything, the therapist is doing during her sessions with difficult child that could trigger this behavior.
On the off chance something is going on during the sessions with the therapist, a child with AS might be UNABLE to verbalize what the problem is. To you or anyone. It might leave him feeling trapped and alone. It is just a base that needs to be covered, NOT an implication of wrongdoing on the therapists part.
I am sorry things are so difficult. I do NOT mean to imply you are not doing what you can. I am sorry if my post implied that I did. Many parents who come here do not know what an Occupational Therapist (OT) is or that they might play a role in helping a child with AS. I was one of those people. I had to have several people here give me the advice I gave you before I took that step. Sorry if Iimplied anything that upset you. I was very doubtful that an Occupational Therapist (OT) could help my kids and she did, in fact, help them tremendously. She kept him from being diagnosed with Pervasive Developmental Disorder (PDD) or AS. Many of his adaptive behaviors looked like his bro with Aspergers. I will always wonder if Wiz had had Occupational Therapist (OT) for Sensory Integration Disorder (SID) as a toddler if maybe he would have developed differently. So I wanted to make sure this was checked out for your difficult child, NOT to imply you didn't do everything you could do for him.
Does your son do this for any other visitor or professional? Do you stay and see what the therapist does with him for the entire session or leave them alone? I would suggest telling your son you will stay with him for the entire session and then see if he acts differently over the next few sessions. I don't have a clue if anything is going on that could cause this, and I do not mean to imply that anything improper is going on. I just wonder if something that goes on in the therapy sessions is upsetting him to the point that he cannot cope.
If you are there for the entire sessions and the behavior does not subside, then the neuropsychologist is an excellent step to find out what exactly is going on. I would call NOW to get the referral process started so you can get scheduled. Often there is a substantial wait and this will keep the process from being delayed. I just think you should try to find out what, if anything, the therapist is doing during her sessions with difficult child that could trigger this behavior.
On the off chance something is going on during the sessions with the therapist, a child with AS might be UNABLE to verbalize what the problem is. To you or anyone. It might leave him feeling trapped and alone. It is just a base that needs to be covered, NOT an implication of wrongdoing on the therapists part.
I am sorry things are so difficult. I do NOT mean to imply you are not doing what you can. I am sorry if my post implied that I did. Many parents who come here do not know what an Occupational Therapist (OT) is or that they might play a role in helping a child with AS. I was one of those people. I had to have several people here give me the advice I gave you before I took that step. Sorry if Iimplied anything that upset you. I was very doubtful that an Occupational Therapist (OT) could help my kids and she did, in fact, help them tremendously. She kept him from being diagnosed with Pervasive Developmental Disorder (PDD) or AS. Many of his adaptive behaviors looked like his bro with Aspergers. I will always wonder if Wiz had had Occupational Therapist (OT) for Sensory Integration Disorder (SID) as a toddler if maybe he would have developed differently. So I wanted to make sure this was checked out for your difficult child, NOT to imply you didn't do everything you could do for him.
BusynMember
Well-Known Member
Sus, don't feel bad, hon. My kid had Occupational Therapist (OT) and speech from infancy. Yes, you can have speech in infancy. It has to do with how they move their tongue...not quite sure. We didn't adopt L. until he was two so I missed that part 
. It has helped him a lot, but I still think Wiz is higher functioning, at least academically. Your son is doing great!!!!
And L., my son, is going to take driver's ed soon!!!!
Help????
. It has helped him a lot, but I still think Wiz is higher functioning, at least academically. Your son is doing great!!!!And L., my son, is going to take driver's ed soon!!!!
Help????
whatamess
New Member
Susiestar, I am not offended at all by your's or anyone else's posts. I am GRATEFUL to have your input. I know you guys aren't professionals, but you have the everyday life experience living day to day with your difficult child's-I think you guys have more insight than professionals.
As far as the therapist, he comes into our home and I stay in the same room or very close by for virtually every session. This scenario plays out with all people who come to our home (including grandma). We can't get a neuropsychologist evaluation or even see a therapist because difficult child will not interact/speak (we've tried). Every time we've gone to our lastest psychiatrist (probably 10x's), difficult child hides in his shirt and refuses to speak.
As far as the therapist, he comes into our home and I stay in the same room or very close by for virtually every session. This scenario plays out with all people who come to our home (including grandma). We can't get a neuropsychologist evaluation or even see a therapist because difficult child will not interact/speak (we've tried). Every time we've gone to our lastest psychiatrist (probably 10x's), difficult child hides in his shirt and refuses to speak.
smallworld
Moderator
Is he on any medications at all? Perhaps if his anxiety were addressed, he might be able to engage in the world better.
