Sensory Integration Problems? Dyspraxia?

S has always been very shy, sensitive, emotionally immature, clingy (less so now) and anxious, with low self-esteem and poor social skills (improving) etc

At birth, he had an initial apgar score of 3, requiring resuscitation. That rose to 6 at 4 minutes, and 8 at 8 minutes. He had a large & prominent cephal-haematoma on top of his head, which took 2 months to go down. I’m not sure whether that is relevant or not. But he would certainly have been lacking oxygen during his first few minutes of life. Consequently, I worried about him having some signs of ‘brain damage’. But he achieved his early milestones right on cue - smiling, sitting, walking, talking etc. I leaned back and relaxed a little.

He was exceptionally “clingy” though. As a toddler, his tantrums would last for a long long time. Even now when he becomes upset (as he often does), he will take a long time to recover.Until he was at school, washing his hair was a major trauma. He appeared terrified. I can’t describe how upset he became. I would only wash his hair once a month because of it. And yet, he wore a cap everywhere – day and night. The hair washing has improved over time, although he tolerates it now, he still doesn’t like it. He will still wear his cap when we’re away from home eg on holiday. He will often ask me to play with his hair, and will lay there, not moving, for as long as I am prepared to do it. He just loves me doing it!

At the age of 4 (almost 5) at school, he had to participate in sports day. Just to run a simple short race. Off he went. Slowly and awkwardly. All the others had finished before he’d reached halfway. The crowd were making lots of “aahhh” noises. He couldn’t cope, and just stopped, started crying and shouting for me. The school never made him run again – in future years he never left his teacher’s side. Sports are still difficult. He still looks awkward, and is slower than the others, but he does participate in team sports at school. Swimming still makes him very anxious – he just can’t swim very well. His teachers put the pressure on, and he dreads it.

He was very late to do some things, for example, dress himself (6 or 7), tie shoelaces (10, and still a problem even now), be dry at night (8), fasten buttons etc. He has difficulty using scissors, knife & fork, and looks very awkward when doing any physical activity. In previous years, teachers have described him as having poor co-ordination and motor skills. His handwriting is still scruffy. He is left-handed, which doesn’t help either, but his grip is very awkward, making his hand curl right around and over the top of the pen/pencil (which also means he smudges his writing as his hand moves across). He appears to hardly move his fingers as he writes - most of the movement is in his hand muscles. Teachers have to help him with some practical tasks at school.

He can over-react to certain sounds, including sounds that others don’t notice at all. He dislikes the sound of me gently rubbing my fingers for instance.

He is an extremely fussy eater. He eats a very restrictive diet, and will gag on foods. He eats no meat, no fruit, no veg. In the past, that was a major issue. It still could be, but I just go with the flow now. He takes multi-vitamins & minerals daily, and mostly eats bread and dairy products. When asked if he gags on other foods because of the smell, taste, look or texture - he just says “all of them really”.

He smells almost everything, and also does a lot of licking of his palms. Until now, I’ve considered these to be either complex tics, or compulsions. Maybe they are, but maybe they’re neither. He will often have the bottom hem of his T-shirt in his mouth - walking around in public, showing his belly to everyone! Previously it’s been the collars or sleeves of his clothes in his mouth. He licks his hands and fingers because “I don’t like them being dry. I hate the feeling of certain textures when they’re dry -even the feeling of my fingers against my palms - that’s why I lick them”. When he is concentrating and performing some activity, whether it’s when writing or playing music - his mouth moves around whilst all pursed up.

Sometimes I get a little irritable because I so often have to repeat what I say, because he misunderstands rather than doesn’t hear it. He can sit through a 1.5 hour lesson learning a new maths skill, then come home and not have a clue what to do in his homework. He will not understand the instructions, let alone know how to do it. As a result, he gets very anxious and panics. This is a boy who is attending an academically selective school - he is talented and intelligent. He often misunderstand words, and thinks we’ve said a similar sounding word - which is often absurd.

S also has a problem getting organised, and is forever losing things - resulting in a crazy last minute panic as we should be leaving for school. I try to remind him the night before, but it doesn’t always work like that! He gets very upset if things aren’t right, or he can’t find something. He writes down his instructions for homework, but will often still not understand what he has to do. He tries so hard to do everything “right”, to please others. He is very compliant and passive.

He is getting more used to playing with friends of his own age, but still loves to play with younger children. He appears more confident with younger children, and enjoys taking the lead. Even now, when with children his own age or older, he will go along with everything they say or want, and would giggle at them constantly. Happily, his confidence is growing, albeit slowly. He would rather, and often does, walk past a school mate in the shops, rather than say hello. He avoids eye contact with others, and finds conversation difficult.

He is fearful of the dark, fearful of heights, fearful of new situations. It was a long long time before he used a garden swing, and dislikes the more gregarious boyish activities of climbing and the like. He still has a light on in his room at night. He much prefers routine and being home. He’s always had a strict bedtime routine, repeating the same words in the same order etc. If I say them out of order, then I am made to repeat them.

He loves to sit closely to family, snuggled up, almost on top of us! Everyone (family) knows that when he sits down next to you, you’re going to get very close!

He’s coping pretty well, other than the anxiety. He is slowly gaining in self-esteem etc. Sports are less of a trauma. He’s 12 now - I should have done something long ago, but just didn’t know. I feel I’ve let him down, in not recognising this over the years. I knew something wasn’t right – but so many people just wrote it off as me being over-protective, him being a “nervous” child. But that doesn’t excuse me. I am so proud of him - that in spite of those difficulties (which I have failed to understand and appreciate), he has done, and is doing, so well.

S tics - but Tourette Syndrome is not the main issue for him, all these other things are. Is this a boy with sensory integration dysfunction or dyspraxia? The more I learn, the more I believe that’s the case. We’ve yet to discuss this with the medics, but school are aware of his difficulties with fine motor skills.