Tuesday, August 17, 2010

The danger of a diagnosis

When you have a diagnosis, you are faced with a difficult situation on occasion that may not be obvious to others. I mean, everyone can tell that, because of an autism diagnosis, one can expect tantrums, communication difficulties, sensory processing issues, and being uncomfortable in social situations. But what about the specific situations are true in the "normal" or "neurotypical" population as well?

Every once in a while, we have to ask ourselves if we are dealing with an "autistic behavior" or if we are just dealing with a 3 year old. In many cases, they seem to be one and the same thing (well, in our case, they ARE the same thing).

Tonight was an example. Rachel has been giving us a lot of trouble at dinnertime for as long as I can remember now. She refuses to eat most nights, unless we pick the exact food she wants on that night. And there are only 2-3 meals she'll eat, so that's pretty pathetic.

Tonight's dinner was chicken nuggets. This is NOT one of the things she'll eat, but we do put it to her anyway when it comes up in the rotation. We've been working with her to make contact with the chicken (or other food item) when they are served to her. Touching it is the big thing. She will now touch almost any food we give her. Kissing it is the next step. We've gotten there with the chicken. We have been determined to get her to eat her food for a while, and if she doesn't eat her dinner, there's no dessert. But that hasn't been doing much good. Tonight, we went a bit further. Rachel did eventually eat 2 pieces (very small) of chicken, but we had to force her (literally). One of us would get her to open her mouth and we would shove in the piece of meat. On the good side, she didn't do anything to spit it out, but she did scream. And she did get the reward -- 2 pieces of chicken led to 2 M&Ms (and her fruit of choice [banana]).

So, here's the question. Are we having this problem because she's autistic, or are we having this problem because she's a 3-year old and quite stubborn (just like her mother)? I have made a request for an IEP meeting for her when school starts to update her annual goals (they are really not quite right any more as she's advanced, per her ESY teacher) and I'm going to try to add working with her on new foods, at least getting her to try them. If the problem is autism, it will hopefully help in this matter. If it's a stubborn 3-year old, we'll just have to deal.


  1. We struggled with the same issue - what was just typical naughty behavior and what was the autism. Sometimes it is a little of both. There is no easy way to answer this. As my son now approaches 13, it is becoming much easier to make the determination since most teenagers don't throw pre-school like temper tantrums at the mall because they didn't get to ride the elevator at Sears. Still with a 3 year old, it soooo hard to tell the difference.

  2. If you figure it out, let me know! It's a constant guessing game in my house...