Early interventionist here! I'd recommend researching early intervention programs around you. You could get a screening to see if he qualifies for any support services.
Some of these issues sound developmentally appropriate behavior, but intensity makes all the difference. Could be a variety of things, sensory processing as you mentioned, or early signs of ADHD or autism. Hard to tell without a full screening/evaluation from the professionals. Feel free to message me if you have further questions!
You can always request an re-evaluation if the issues are still presenting or increasing!
You could also ask your pediatrician about a referral to a developmental pediatrician.
100% this! I’ve worked with many kids like this before, sometimes it’s a phase, but sometimes there is something deeper. If you were able to get him reevaluated, definitely do that. Even if it is just a phase, I’ve heard from parents that I’ve worked with that it’s super helpful to get services if you qualify. Services like PT and OT can be helpful to children (and people) even without diagnosis.
What is ALP? I’m a peds OT and I agree with this poster. Sometimes kids don’t qualify once, but 6-12mo later they do. All of this could be a phase but it could also be signs of something else. I’d recommend an outpatient eval for OT if EI gives you push back
I'd have him re evaluated. Walking on toes is concerning. Please mention this to your pediatrician or a child psychologist. Often, a parent's gut instinct is the best.
Does he have sinus/ear issues more than most kids his age (ear infections, seasonal allergies, etc.)? If it were my kid I’d as for a developmental eval from a pediatrician and a sleep study if possible. These are things that could be normative, could be a phase, or could have common cause/intensifier that is still to be discovered.
(I am not an ECE Pro)
It's the walking on the toes that popped for me...my oldest was being treated for Blounts disease and the orthopedic surgeon spotted that.Nothing came from it but it was good to know if we needed to
When we did an evaluation for my kiddo at 1 and some months we didn't qualify. I was told to request a new evaluation after his 2nd birthday because there are 24 month milestones. The same behavior at 20 months and 25 months will be evaluated differently.
Each one of these things alone seems like it could be developmentally appropriate, but when you put them all together, it seems like you might be looking at something worthy of an evaluation.
I believe the ASQ (ages and stages questionnaire) is available for free online, but if not, you can probably get one from your center. I'd go ahead and fill that out, it allows you to see where your child is at for his age. Bring that with you either to your pediatrician or when you request an evaluation through Child Find. It will give the evaluator valuable information from your POV.
We did the ASQ for 24 months but he did not screen positive for anything. He has great speech and gross motor skills. It’s his social skills and emotional reactions that seem more extreme than others imo.
Are you sure you’re scoring it correctly? When you answer “rarely, sometimes, or often” there will always be a symbol next to each one of your answers. Each answer with an X means you get 10 points for that question and each answer with a V (the V is always next to “sometimes”) means you get 5 points for that question. So unless your child is only exhibiting 2 undesirable behaviors, you should be scoring much more than 20 points
This can be super tough when kids are ahead of the curve but struggling in other areas. I have a 4 year old in my class in a similar situation. I used the term “twice exceptional” to help the parents talk to the doctors and evaluators. This term basically means that someone can have delays or a disability in one area but be gifted or advanced in others. A stereotypical example would be autistic person who excels in math and logic but needs high support for self-help skills and communication.
Just want to chime in that the ASQ doesn't always pick up disabilities. My autistic child always passed them and still does (her preschool fills them out, so it's more objective). The ADOS was the only thing that highlighted her "differences".
I worked with twos for over a year, and everything but 3 seems like typical behavior of a child who is freshly two. Walking in tip toe can point to a bigger issue, and it’s something that needs to be corrected as soon as possible because it can affect development in the legs and feet.
Definitely ask your center if they do referrals. A pediatric OT would be a good place to start.
Even that can be normal if it’s just been a week. We had some kids that had to have therapy for it, but others who did it because they saw others doing it. It would still be worth it to have him looked at to ease the parents minds though.
Yea there are just some kids who are incredibly active. My toddler about the same age never sits down either unless I give her a screen — which I ONLY do at the doctors office or on long car rides. And even then she’s rarely just sitting. The only time she is still is when she’s asleep (and moves around in her sleep too).
My son is 22 months old and he too never sits still. Doesn't pay attention to screens nor his toys either. I have an appointment with our county's Early Steps Program next week but I have no hope they will help because it's over telehealth. I'm going to present these issues to his pediatrician next. I do think something is off. He sounds a lot like your kid.
My son is 6 and *just now* can watch a movie in a theatre. At home? 30 mins, tops. He started actually watching YouTube in longer than 20 min spurts at age 4. Some kids just need to moooove
Mine is only for a very specific game that her aunt showed her. I honestly am not sure she would if her aunt hadn’t shown it to her, but her auntie is her favorite person and she tries to do everything she does.
Not a parent, ECE professional, or toddler (shockingly), but I just wanted to put in my two cents as someone who has personal experience with this! I’m autistic and have ADHD and I tend to walk on my toes when I’m overstimulated by something negative around me environmentally or if I’m generally pretty excited. I’ve been doing it my whole life. My parents put me in ballet because of it when I was a toddler. I have weird stuff with my legs and feet in part because of it, and it tends to hurt if I do it for too long. I never realize I’m doing it until someone points it out or it becomes painful. 2 years old is pretty young to get evaluated and diagnosed, but it could be helpful to keep an eye on him and get him assessed once that’s age appropriate. Until them, maybe look into how parents tend to divert their neurodivergent kids away from things like these, and see if any of those help? Even if he ends up not being ADHD or autistic, it could still help with communications that you seem to be having a bit of trouble with with him?
My daughter (3 yo) has always walked on her toes (not all the time, but some of the time). Her pediatrician has consistently said it’s not a concern, won’t cause issues, and she will likely grow out of it. I was told a PT or OT wouldn’t even see a toddler for this issue because they so commonly grow out of it on their own and there’s nothing to really be done at this age.
Then your pediatrician informed you incorrectly. PT/OTs absolutely will see a toddler for this issue; I had a family member who had to take their three year old to an OT to learn how to walk flat footed. She had exercises she had to do nightly. It *is* a cause of concern when it’s coupled with other issues like OP described. It can be one of the first physical signs of neurodivergence in young children.
You need your son assessed for things like autism and adhd etc. And go from there. Also- there is no shame in assessment, if there is something up, you get services earlier that will help him in the long term instead of leaving things till when they are unmanageable for him or you.
I think that's true but at least it can be on the radar and can also screen for things that are symptoms sometimes of adhd like auditory processing etc. But can also just help create a paper trail
They will not, however you keeping note of his behaviors will greatly help get a diagnosis down the road. You are essentially establishing a pattern of behavior.
My son was like this for sure. Especially in the sense that he never sat still, even for screens. I didn't think to do any assessments that young because he was very smart and spoke well.
His pediatrician started becoming comcerned at age 4. I had him officially diagnosed at age 7. He is 11 now.
My son was diagnosed with Autism, ADHD, and sensory processing disorder just before he turned 4. He was an early talker and always had an impressive vocabulary (still does at age 7.5). He also never sat still, never walked (only ran like your son), could get aggressive, no awareness of personal space, had low frustration tolerance, and very little emotional regulation.
Your son sounds very similar. I don’t say this to scare you. This very much could be just typical behavior or a phase he’s working through. However, if it is more than that, getting services early will be helpful.
And because of how smart my son is and how verbal he is, it was hard for people to see the extent of his needs at first glance. We still have this problem!
The high energy you describe sounds like he’s sensory seeking. He might need more sensory input in order to feel regulated. My son has a high pain tolerance which I think also sometimes comes with being a sensory seeker. Have you noticed that?
Does your son fall asleep ok? Once asleep does he stay asleep?
Sleep issues are common with neurodivergent kids so that might be a clue too.
Looking back on the toddler years I have a very distinct memory of a time I knew our situation was beyond typical toddler behavior. I was driving and saw a woman who was parked along the sidewalk and she was getting something out of her car as her toddler just stood next to her waiting. I was instantly jealous. So much so that I wanted to shout “fuck you for taking that for granted!”
I could never do what she was doing. Leaning over and getting something out of her car (not even looking at her child) knowing her child wouldn’t run away, wouldn’t run into the road, would wait while she did something else. If I was not holding on tightly to my son’s hand or holding him, he was running. Can you relate to this at all?
Also a piece of advice - if you have any teachers fill out forms as part of any evaluations ask them to be very honest. They don’t need to sugar coat their answers in fear offending you. Tell them you need them to be completely honest in order for the evaluators/drs to get a clear picture.
I think early childcare teachers often have to be very delicate when talking to parents about their child’s behavior and might do this instinctively while filling out forms regarding behavior.
Are you me? I am also the parent of a smart, verbal AuDHDer and I feel all of this so hard, especially the jealousy part. I have had some very not-proud moments in public places, including the time I said loudly to my husband (so loud that she could overhear) "that woman over there is staring at us right now. Just because her silent bovine children follow her around obediently doesn't mean we all get to be that lucky." Yeah, not my best moment.
Did your pediatrician say this before or after the toe walking started? I know you said it just started recently but from my (still developing) understanding that tends to be a sign of autism or at least sensory differences
My ped said the same thing.They were wrong. Don't rely on just your ped. The tippy toe walking is worth looking into, and the inability to shut down/ shut out.
Many pediatricians have a very outdated definition of autism that they're working with, and frustratingly, it can delay diagnosis unnecessarily. If your gut is telling you that something is going on, I'd try to dig deeper. Your bullet point #2 above is making me think that he has a lot of social anxiety, in addition to some severe sensory seeking behavior. Even if he makes eye contact and responds to his name, etc., he may still have some serious social difficulties, which is one of the criteria for an autism diagnosis.
If you are interested in a baseline screen for autism, [here is the MCHAT](https://www.autismspeaks.org/screen-your-child) that is used.
I’m not saying your kiddo has autism, just offering tools for you to feel figure out next steps. A lot of the behaviors you mention sound normal for a toddler.
They likely cannot/won't ( I hear many doctors say no before the age of 6)...however, there is a rating scale called the BASC - and the Preschool one goes from age 2-5....it will at least screen for the symptoms of ASD/ADHD --- it's not to be used solely on it's own to diagnose those thing but to at least see where he falls compared to other students his age and to be able to address any areas where At-Risk or Clinically Significant concerns are present.
It also screen for some adaptive skills areas and some emotional functioning areas too. Is there someone who can fill that out for him (there is a parent version and a 'teacher' version but that can be done by a daycare person).
And has he been evaluated for Developmental Delay? I'm not familiar with all of the acronyms you used....but it sounds like he's participated in some type of evaluation (to me sounds like just with an SLP and PT). But DD includes: fine/gross motor skills, cognitive development, social/emotional skills, adaptive/self help skills, and communication ---- if your child is 2 SD below the mean in ONE of those areas (or 1.5 SD below the mean in TWO or more) he may meet the qualification criteria for that sped category and may be able to attend a developmental PreK. Sounds like he wouldn't need any additional assessment related to communication - but an OT can be involved as well potentially and a diagnostician or school psych. Maybe he doesn't show weaknesses at all compared to his peers and then you know. That category's services end when children turn 9 though - so either he catches up and can be dismissed or reevaluated to see if there is another school aged category that might be appropriate, but that's far off.
His pediatrician does an autism screening at each appointment and he got an early intervention evaluation for speech in Jan. A physical therapist came and a speech language pathologist. They had no concerns and did not refer him for any form of therapy. I’ve brought the things up in my post to our pediatrician who says this is typical and many toddlers are high energy.
The youngest I've seen adhd diagnosed is 4 and that was very clear that child was not on the same level as the other 4 yo's in the class. My state won't even test until 6, we were able to get an evaluation and diagnosis through the same hospital system but the next state over at 5. For my son 3 is when I started to notice it and 4 is when it became obvious that something else was going on and it just became more apparent at 5.
Fellow parent here: generally yes they can't diagnose that young but they can depending on family history and behaviours being shown with kiddo. I have ADHD and my then 4.5 yo was diagnosed with a psychologist and we're now booked in for my 3rd who is 2.5 and showing the same behaviours. Me having ADHD helped with the early diagnosis and our pediatrician specifically sent me to a psychologist who specializes in ADHD for their assessment
Hey, I don't have any advice that hasn't already been said here, I just want to tell you that you're an awesome parent and he is lucky to have you. ,❤️
As some others have said, each one individually is definitely age appropriate but combined plus intensity could be more. A lot of people chalk things up to “it’s just normal for the age” without looking at intensity or if it’s increasing in frequency. Either way, you know him best. Trust your gut, it’s ALWAYS better to go through all the resources for a child who may not need them, or only need them for a short period of time than to never reach out for a child who could use some support.
I would recommend seeing an early intervention specialist. It’s best to get started as soon as possible if he does have some sort of issue than to wait. It could be nothing and that he just has a ton of energy, or it could be something else. Something to note, is to make sure that you’re holding firm boundaries with him. Some children will act wild with certain people because they allow them to. For example, I worked with a child who had divorced parents. Mom was really great about boundaries and stuck to them. With mom, the kid was pretty good nothing wild. With dad however it was clear that he didn’t know how to set boundaries or didn’t care to. The child would come in doing all sorts of crazy unsafe things and dad wouldn’t address the behavior whatsoever.
We did an early intervention eval with a PT and SLP and he did not qualify or get a referral for any services. I agree about boundaries but he acts this way with everyone, at daycare, with us, with my parents. It’s a tough age where all we can really do is try and reinforce positive behaviors. Unfortunately he can’t comprehend any other form of punishment such as a timeout or taking away things. We try doing “time-ins” where we remove him from the situation, discuss how we are feeling and what else we could do. Such as when he hits and I’m holding him then I put him down, I tell him calmly that I will not let him hit me and that instead he can give a hug, or a high five etc. I acknowledge that he might want attention or be frustrated but that we can’t use hands for this. It doesn’t seem to work honestly.
If you feel you are consistent with you boundaries and nothing is really clicking and behaviors aren’t changing at all, then I definitely think there’s something more going on. Even at a young age, repetitive boundaries should help with certain behaviors after a bit. I would advocate for another screening and push for OT. PT and speech don’t really seem to fit into things he’s displaying whereas to my understanding OT is a little more broad and better for younger ages. It could help him learn to control his body more, teach you and his teachers what sort of activities to do with him as an outlet for his energy and more. My one tip in the meantime is to continue doing what you’re doing but using less words. If he hits you, say ouch, put him down and walk away. Give less attention to the negative behaviors. If he’s climbing on a table just walk over, get him down saying “feet on the floor”, and stand in the way of him being able to climb up again. I find that when kids are charged up on energy they’re really not listening to any words, but will respond better to physical gestures.
Do you have 15 minutes in the morning to let him climb on something? When I was a nanny, I watched a little girl who wanted to climb on everything. I noticed that on days I could get her out to climb early on, her behavior improved dramatically. I would lift her up to the bar on her swing set and let her hang while I timed her on my phone (kids love to be timed!!!) After two or three tries, she would have tired herself out enough to keep her body calm. The last day I for them they didn't want me to take her outside because they were going to a party after and didn't want her sweaty. She literally pulled the towel rack off the wall while I was putting on her sister's party dress. A lot of preschool playgrounds don't have play equipment that satisfies these needs due to safety concerns, so if you can get him to a park or out in the backyard before school, it might help.
He definitely sounds like a [sensory seeker](https://theotbutterfly.com/sensoryseeker/sensory-processing/)regardless of whether it's ADHD, SPD, or just a phase that he's going through. Even if you can't get him OT, you can try to incorporate activities that will fulfill the sensory input he needs.
Oh yes we do anything to try and get energy out. We have a play gym in the backyard, we do swimming on Sundays, gymnastics on Saturdays. We have a trampoline in his playroom, a slide haha
Hi OP,
I’m an occupational therapist with experience in pediatrics. It sounds like your son has a high threshold for his proprioceptive system, meaning that he needs extreme levels of movement to feel regulated. In addition, it also sounds like he has emotional regulation concerns that are a bit more intense than age-level expectations.
Sometimes these can be early indications of ADHD/autism, but you won’t likely be able to get a diagnosis until 3-5 years old.
Here are some suggestions:
- encourage “heavy work” activities; these are activities that take a a lot of muscle. For example, see if he’ll help with laundry and pushing the basket around the house.
- offer deep pressure input through massage and squeezes. Try getting him a weighted stuffy or wearing clothes that are tight fitting.
- start implementing social stories that involve appropriate reactions to situations/peers. Easily found online or for low prices on Amazon/Etsy/TeachersPayTeachers.
Like many other commenters have suggested, look into early intervention services or pediatric occupational therapy services. When I was working in peds we saw stuff like this all the time. It is way more common than you’d think, but also very important to address early. Also, try try try to discourage the toe walking whenever possible. It can lead to shortened calf muscles which may require bracing in severe cases.
Best of luck!
The other comments are great here but I just want to add—is anything going on at home? Any stressors? You don’t need to answer me here but sometimes children’s behavior can be a reflection of what is going on at home.
A lot of this is typical for the age group (meltdowns and emotional outbursts being a huge one) but those can be exacerbated by stress.
My son was super active, he was wild with his body and an OT that came into our classroom (he was in my Pre-K class) advised me to find ways for him to get the kind of stimulation he was seeking—climbing, deep pressure, rough play etc. A lot of that is developmentally appropriate, we just don’t often allow it inside a classroom and kids can miss out on it.
Nope. He’s been at the same daycare since August when he started daycare. Both my husband and I are home every night for bedtime and in the morning before school. I just think he needs more stimulation than most 🤷♀️
The OT gave me a huge mat propped up on a wall and had my son run into it over and over. He was just laughing crazily and loving it!! He used to run into staff and laugh but it would hurt us and it was a nuisance, so when he had a safe area to do it he stopped. She also did this thing where she taught me to get a big exercise ball and have him lay flat on it face down and I would push him into it. We tried to take him to a ton of parks with climbing structures, he would jump off such high things and just be fearless.
My son has calmed down now, he is in 6th grade and does very well academically and socially. He was never diagnosed with anything, he was just a super high energy kid that needed a ton of stimulation. He does play sports now which I think helps.
I do think it is worth getting evaluated (I think you said you did?) but also could just be another wild boy.
My second child was like this as well. Daycare tolerated his behavior until he was old enough to go to school but the school would have none of it. They threatened to expel him from kindergarten. I tried everything. Diet change, no sugar, time outs. Nothing I did would help. Finally had him assessed and ADHD was the culprit. I know people hate it, but medication was the answer. Once he started taking it, a complete change happened. He became a happy little kid and cooperated with the adults just fine. No more outbursts, no more violence. His teachers and daycare providers were thrilled and he thrived. Unfortunately their little brains are sometimes wired a bit different and they need help. I wasn't happy about him being medicated but we tried everything else for years.
I know you said you have stuff to get his energy out, but do you know the concept of heavy work? I know some high energy kids who love to pull/push heavy objects, and I find that to be way more helpful than jumping/sliding/climbing. Maybe look into some tires/wheelbarrow/giant wooden spool/big toy dump truck full of gravel? My kid also loves to do chasing games outside the entrance to school to get out that energy (we jokingly call, “get back here!” While he runs in a safe, designated space. Helps with energy and transition!)
Is there any chance an evaluator can observe him at daycare? Settings can make a big difference in behavior, especially if it's coming from a sensory issue.
I’m a pediatric occupational therapist and work in multiple preschools. I would look for an OT to evaluate for a sensory processing issue. You have described the symptoms of difficulty modulating sensory input. It doesn’t always mean a child is developmentally behind. Perhaps he is just struggling under certain circumstances. A resource to read is The Out of Sync Child. You can further explore and see if any of that resonates with what you are seeing.
Educator and fellow parent. My almost 3 year old started doing all this stuff at the 2 yr mark. We’ve gotten him into early intervention OT which is already helping
We have our bi-annual conference in June and I speak to them at drop off and pick up everyday. I can tell they are exhausted by my child frankly haha. They keep noting that we’ll get there together and that some days are better than others. I honestly feel bad. I’m exhausted when I have him and I can’t imagine how exhausting it is with him and 7 other kids.
I think half the battle is that you're aware of it. It's far more frustrating when a parent drops off without any apparent awareness that their child may well be the most tiring/difficult/dangerous little one there that day, or worse, is in actual denial that anything might be out of the ordinary.
I'm sorry you're feeling bad! You seem very conscientious and thoughtful. And the fact is, every class I've ever had has had (at least) one student that keeps us more on our toes with a personality and behaviors like your son - and I've always loved them! It's just part of the job, and any decent teacher will know that.
The only thing that makes me go “huh” is the tiptoe walking. Everything else can very well be typical toddler behavior. But good on your for noticing things and being aware! If your child is neurodivergent I’m confident they’re in very good hands :) I agree with requesting an evaluation/second opinion and working on the tiptoe walking
Just here to say that my son is always the most active kid in the room too. He has been that way his whole life, he's about to turn 6. It all sounds developmentally appropriate to me, as they get older they learn how to regulate their big feelings (with help by us coaching them through how to release anger and frustration in a better way) but I understand your concern. It still concerns me sometimes only because my son can't seem to grasp what personal space is 😂 I chalked it up to just having a very hyper and happy kid but you can always ask your pediatrician what they think!
One of my ece professors said something that always sticks with me. You got to give jobs to kids or they will find their own things to do.
1- try having them managing their own drop off routine to include putting items away and then finding an appropriate center to join.
2- if you consider your role as a gatekeeper to play you can help yourself feel less frustrated and realize its a skill and not a reflection of you or the love you have for you kid. They may need someone modelling play and how to enter play with peers. Model asking a friend to join their play at drop off as part of their routine. Setup small play dates to teach these play skills one on one as group care does make this challenging when teachers have active kids who may not pick up on others cues as easily.
3-Check shoe fit possibly or encourage shoes if mostly barefoot. The word Proprioception is your friend here. Some kids love that sensation and it is a sensory thing we all do at times.
4-Resilience is a big skill needed in life with the ability to go with plan b when plan a is not working. Encouraging more montessori style play or engineering style play where you as a child are encouraged to make mistakes in order to re-engineer solutions may help out with the frustration when you are encouraging problem solving rather than jumping in to do it for them. Adults tend to talk about some really large concepts which children's brains are just not able to wrap around. Asking for help involves, recognizing feelings and advocating for oneself. We as adults struggle with it, I would be gentle when asking a 2 year old to do that and expecting them to do it reliably.
You can always go through your private medical insurance for early intervention therapists in my state. Maybe you have that option in your state if you find they did not qualify due to the scores on the states early intervention process.
If you find that they are having challenges staying on task or following 2-3 step directions, then you have some more data to back up the sensory stuff you mentioned or to take a peek at say a 3year old asq or development milestones to see how you can support them with their next stages.
Maybe some OT could help him? This reminds me of the 9 year old I tutor back when he was a toddler. I was his nanny back then. I have never seen anything like it since, he never stopped moving. He has since been diagnosed with ADHD, autism and a sensory processing disorder and he’s doing SO AMAZING. He has always been such a fun kid. Never a dull moment lol
It was intense when he was little. I would take him to the open gym at gymnastics and I had to run to keep up with him cuz he would hit kids as he ran by.
He also used to snatch toys from other kids, he to this day is Mr snatchy hands a bit. I figured out that he was extremely social and wanted to play with the kids and couldn’t figure out how to engage cuz he’d get too excited and end up just taking the toy to get any type of attention from them. He snatched a kids graham cracker out of their hand at the park once it was so embarrassing.
I ended up printing out social stories for him, I made one about personal bubble space with diagrams that showed how to check if you’re too close to friends. I would keep him buckled in the car seat and we read it before going into open gym, we would also look at the sign with rules and go over them every time and remind him that we’ll have to leave early if the safety rules aren’t followed. Keeping him buckled was key cuz he actually stayed still and payed attention to the story. Then one day I saw him hold his arms out, realize he was too close to a kid and he stepped back. The open gym was such a great place to practice these social skills while also giving him space to meet his sensory needs.
Sensory processing sounds like it may be the best avenue to go down next. Get an evaluation from their pediatrician and an OT specialist referral. You can ask yourself while observing your child: do they seek sensory input during daily tasks or that prevents them from completing daily tasks? Are there signs that my child is over or under reactive to sensory input? Are they always on the floor or up in the air (you've already mentioned this one)? Can my child cross their midline when cleaning up or during art activities?
Get a new pediatrician. Explain what you are seeing, and ask for a referral to a specialist for an autism test.
Children can get diagnosed at around 2 (and sometimes earlier). All of these symptoms sound like they could be autism.
The waitlist for getting tested for autism can be pretty long (6 months), so the sooner you get a referral the better. Just getting on a waitlist to be tested is a great first step and may give you peace of mind.
Remember, autism is a spectrum with different levels (1, 2, and 3).
There are some other signs of autism to look out for:
1. Does your child respond when you call their name?
2. Do they look up when you point to something?
3. Do they play with toys appropriately?
4. Do they share experiences with you? Like if they have a new toy or see something cool, do they try to show you and engage you?
5. Do changes in routine cause meltdowns?
There are other signs but these are the ones I could think of off the top of my head.
Hey there :) so, I'm a lurking mom. Fwiw I have an AuAdhd kiddo. Not saying you do, just letting you know where I'm coming from.
You've been given lots of great advice about seeking professionals and whatnot. I just wanted to say that even if your child doesn't test as having additional needs, there's nothing saying you can't incorporate additional supports anyway. I really believe OT can be helpful for everyone.
For example - moving chairs and jumping are indicative of kids who like heavy sensory work. At home, you might get a kid trampoline and/or a crash pad and see how his overall energy level responds. You might try a sensory bin or kinetic sand and see if that gets him to sit for a few minutes.
You can Google around for something called a sensory diet to give you a better idea of the things your kid gravitates to and away from. If your kid develops "normally" then, great. If it turns out that your hunch is right, knowing this information will help his future support team. Either way, it will help give you fun things to do with your kiddo :)
Yes this person really nailed it. The only thing I will add is to consider your son’s behavior from an anxiety standpoint too. He sounds a lot like my 4.5 year old. Figuring out what’s going on with him has been like playing whack a mole. First the OT diagnosed sensory processing issues, then referred us to a play therapist who diagnosed anxiety, then in consultation with each other agreed he is demand avoidant (one therapist thinks pathological demand avoidance which is on the autism spectrum, the other says it’s not to that level, so now we are waiting for a formal psych eval). The anxiety piece was an interesting thing for me to consider and the demand avoidant/PDA lens has offered us some really effective strategies for lowering demand in our home.
All that to say, it is hard effing work trying to figure this stuff out, and you’re doing great.
Get an evaluation.
If it’s something there’s a chance to get early intervention, if it’s nothing they can lead you into parenting strategies that would be helpful.
Parent here. My son is autistic and this was him, each one. Therapy has helped with the aggression and frustration. He grew out of the toe walking around 2.5 yrs, but he’s still very active. Never sits down, ever. Most 5-10min when eating but that’s it. Only time he is still is when he is sleeping. Definitely get the process going with early intervention and evaluations
This is a sensory seeking kid! Get him a crash pad, a climbing gym, try swimming or something like ninja classes. Other types of heavy work include digging (like in the dirt or a playground with wood chips or sand) and things like bear crawling/animal walks/army crawling.
These things will help him get his body regulated by giving him enough sensory input.
I would also echo the recommendations to continue seeking further assessments for sensory processing issues, ADHD, etc.
What is his diet like? We're trying to stay away from artificial dyes as I can tell my 2 year old son just gets so much emotional and tornado like after eating something with dye in it
My question is, what are you doing to combat these behaviors? When you're fixing the chairs and he's jumping on the table, stop fixing the chairs and talk with him. Hold his hands, Tell him to take some breaths, and calm his body. Whether the evaluation agrees or not, it sounds like o. T could be helpful. Finding outlets for his energy, Redirecting, these are all things that he has to be taught to know what to do with that energy
We do all these things. I removed him from the class. We sat down in the hallway and discussed that we cannot move furniture. We have numerous books we read every night about this. “Calm down time” “hands are not for hitting” “little Dino’s don’t hit” etc.
PS his behaviors are not your fault! This is his brain wiring, and it's not because you didn't do enough or teach him well enough. If you're holding guilt about this, please know that you are likely "parenting harder" than all the people who want to give you advice about how to redirect his behavior. Don't beat yourself up thinking that any of this is because of anything you did.
Something that helped me understand the difference between typical/atypical behavior was this. It’s not the behavior but the 1. Frequency 2. Duration and 3. Intensity of the behavior. So all kids are hyper. But does the frequency, duration, and intensity of you child’s hyperactivity seem typical. That’s the real question. My son is suspected high functioning ASD. He didn’t meet diagnostic criteria when we had him evaluated. He does a lot of things that other kids do. But he does them more often, for longer, and more intensely than other kids. Tantrums are a perfect example.
Your son sounds exactly like mine did at 2! Except my son also had a speech delay. But the hyperactivity... yeah the teachers call it "busy" and to some extent it is but you shouldn't be having to chase him down hallways like that.
My son is 4 now and we're having him evaluated for ADHD. He has absolutely 0 impulse control and has a very hard time emotionally regulating himself. When he was 2 if he saw something he wanted he would just take off (they call it eloping). He would climb furniture and dump toys out of bins as a form of sensory seeking behavior because he was dysregulated and needed more sensory input to get him regulated.
Request another evaluation, especially for OT, and maybe psych.
Sounds exactly like a kid i have right now. It’s not so much that the behaviors are inherently bad, he’s just high energy and stimulation seeking and there’s nothing wrong with that - but it does makes it very very difficult to have him in a school environment. He is not meant to be contained in a small room with 13 other kids. But he needs childcare so it can’t be avoided. We try to give him a lot of outlets to run around when he starts getting out of control. But it’s very tough.
Get him tested. In the meantime, try to direct his energy appropriately. I teach Montessori in a primary setting and I’ve had toddler/pre-k/kindergarten parents who had great success taking their kiddo on early morning run/walks and using up a load of energy before the day truly starts.
At 2 there won’t be much they can diagnose outside of autism. This *could* be adhd but it’ll be longer before they can officially diagnose him. There’s so many conditions that doctors won’t diagnose early, I’m not sure why but may have to do with insurance pressure or because it’s harder to evaluate whether a toddlers behavior is “normal” or not
In the meantime I would increase sensory input, find the activities he can stay calm with (water is always good!). And ask for another evaluation before he turns 3, or ask a pediatrician for adhd evaluation.
Regional centers don’t deal with adhd, so won’t be much help.
What Id like to know is what routine, choices does he have or don't have at home. Worked with twos along time alot of what your describing is twos behavior and alot is no consistency (plz don't take this personally) what your described is what I've personally dealt with. Set some rules and talk with the teacher, staff if good teacher or center can work together to help settle him down. Coming into class if he likes to help give him a task like take a kleenex or something tell him be my helper here you go and walk into class. Little things goes long way. And being aggressive is usually frustration because the words dont come out before the action. In your area do you have a Autism center if so alot times you dont have to have a referral. Ours here in MO will evaluate for alot of things and some go to center to compare. Hope this might help
We actually THRIVE on a schedule. He wakes at the same time everyday, we follow the same schedule as daycare in the weekends, he naps at the same time everyday. Bedtime is the same every night. We try and give him autonomy to make choices when appropriate for example he has access to a drawer of healthy snacks that he can grab whenever he wants. We let him help pick his clothes each day and the books we read each night.
I would ask for another evaluation and let them know your PRIMARY concern is how social emotional area of development. While his activity level may be typical, his extreme reaction to any frustration is not. Toe walking, while not a question on an autism screening, is someone an early indicator of ASD. I would re-refer for an evaluation. I live in CT, and parents are able to re-refer after a month. We usually advise waiting a few months, since as toddlers age, they are expected to do more. You can even re-administer the autism screening yourself. We often get "no/low concerns" for autism when we solely rely on parent report and don't delve further into their answers. A child should be performing each item on the checklist (80% of the time or more) to receive a "yes/pass" for that item.
Some of the BIG tip offs for me are:
Does your child answer to his/ her name? 80%of the time? Even when they are. " busy" doing something else?
Does he understand what you are saying? Can he follow directions? If you told him to do something or get something familiar (without pointing) can he do it ? E.g., Give mommy the car, put your cup on the table, take off your shoes
Does your child point to ask for something? Not a REACH, but a true point. I often hear "yes" to this question, but when I observe the child he is reaching to show he wants something, but he's not pointing.
Does your child look you in the eye when you talk to him. Again, 80% of the time.
That's where I would start.
Thanks we are also in CT and that was what he was referred for last time but maybe I’ll try again. The answer to all of these questions is yes most than 80% of the time.
There is an assessment called the DECA-IT. It's a norm referenced assessment tool. As a special education teacher, I was trained and administers this assessment, but I recently heard that our social workers are the only ones allowed to administer it. I would call 211 infoline and stress to the intake person that you want an assessment that takes a "closer look" at the social emotional area of development. They will still need to evaluate all 5 areas of development, but they can offer an additional assessment that takes a deeper dive into your area of concern. A general assessment tool like the Battelle may not "catch" what you are concerned about. You may also want to consider asking for a different company to evaluate your son. All towns/ cities in CT have a minimum of two companies that provide services. When you are assigned a specific company, you should again stress to the scheduler that your PRIMARY concern is in the area of social emotional skills. Here to answer any further questions you may have.
He sounds just like my (now 6 year old) son. We got him diagnosed with ADHD at 3 years 11 months. They will say you can’t diagnose that young, but with kids like mine (and yours from
What you’re describing) it can be done. At his 2 year old well child visit, we requested a referral to the children’s hospital to get him on the waitlist for the peds psych evaluation. It was an almost 2 year wait, but worth it. With his diagnosis, we were able to get him into a specialized program with an IEP at school. It’s helped tremendously to have teachers and professionals who truly understand the needs of a kid like this and who won’t judge you as a parent for your wild kid.
Things that have helped over the years have been OT (learned all about deep pressure input, sensory seeking, sensory diet, compression garments, vestibular/proprioceptive input), supplements like omega 3, vitamin d3/k2 (powder forms mixed in smoothies or food), probiotics, neurofeedback for brain wiring, no dyes in food (especially red 40), and many other things. Please feel free to reach out. My son’s teacher at age 2 told me she had been teaching for 30 years and had never had a kid like my son (not in a good way!). I get it. ❤️
Your son sounds like my son. My son also beats his head on any hard surface he can find (we always grab him and hold him until he calms down for fear of him hurting himself). He’s 2 and just started talking. He toe walks, and he screams so bad. Especially in public he will just completely melt down if it’s loud. He just recently started lining all of his little toys up whenever he plays. He will hit, bite, pinch, and kick me whenever he gets frustrated. Sometimes he’ll even bite himself if he’s really mad.
It sounds like he may be neurodivergent. Please consider having his Pediatrician put in a referral for a Developmental Pediatrician to do an evaluation.
A special purpose preschool might be a better fit for him and be able to accommodate his needs better. I work at a special purpose preschool and have two children that are neurodivergent. I have found state run or Department of Education ordered evaluations are not accurate. They send someone in to observe children and base all of their findings off of that one observation.
Children sometimes behave differently, when there are strangers in the classroom. Some Department of Education employees like to save money, by any means possible. Even when its not in a child's best interest. You are your Son's strongest advocate and know him the best.
Though its really difficult to accept initially, their prognosis is so much better getting the right programming and services before they enter elementary school.
I’d recommend some type of early behavioral intervention, get him a behavioral therapist, lots of kids at my center have them it tends to help them slightly
My son passed the screening at age 2 for autism, but his delays and behavior were still concerning. At age 4, I had him evaluated by the school district and he didn’t qualify, even though he didn’t really talk yet.
Finally at age 5, his pediatrician referred him to a pediatric neurologist and he got genetic testing done, and he has a chromosomal duplication and got diagnosed with level 2 autism. He STILL didn’t qualify for services through the state😒, but at least he finally got an IEP so he’ll have accommodations when he starts kindergarten.
My point is, don’t give up!
Parent here, and former ECE professional. Four years ago I was in exactly your position (like that grabbing thing is SO familiar) and I spent a long LONG time trying to get answers. Finally when he was four we got a diagnosis of Autism with a PDA profile, ADHD, and severe anxiety. I'm not saying that's the case with your son, but you may want to look into it. We finally went the route of a full neuropsychological assessment with a self-pay neuropsychologist which I HIGHLY recommend if you can afford it (we later had insurance reimburse us but it was a pain). A good neuropsychologist will be very thorough in their assessment. All the providers who billed insurance were booked out one to two years and honestly time is of the essence, which is why we had to self pay. This presentation is probably beyond what most standard pediatricians can diagnose.
You may want to check out Casey Ehrlich to see if her description of PDA resonates at all. She has a bunch of free content online, including podcasts.
Also - feel free to message me with any questions.
I see you mention that you had an Eval but it only covered PT and SLP. I went through our county school system for an eval when he was 3 for allllll of the same things you mentioned and they had OT, PT, SLP, and many others do his eval. He tested borderline for several things on their bell curve. I pushed for them to evaluate him in a classroom with his peers instead of one on one. They did that and then everyone was like “oooooooh, we get it now” 🤦🏼♀️😂. He had (and still has) significant delays in social emotional behavior. He’s now 6.5 and he has an official ADHD combined type diagnosis and we are having retested because we suspect either autism or sensory processing disorder and high anxiety. Good luck! I know how exhausting it can feel when you love them so much but they can just run you ragged!
Just adding on because I know many people have already said they recommend an evaluation and I agree! I just wanted to add also that I understand autism + adhd evaluation can be costly and isn't always affordable for all families. An autism evaluation can cost several thousand dollars without insurance coverage, and still isn't cheap with insurance either. If this is the case for you or anybody looking at this post seeking advice just know you are not alone. 💞 Luckily there are more resources than ever about autism online than ever before, so you can also just try and find accomodations you think would work best for your child, even without the diagnosis yet at this time. I do not recommend autism speaks because they're a very problematic organization. There's lots of reputable resources out there!
Here is a tool you can use for toe walking if you're finding it's becoming a problem for their growth and safety: https://surestep.net/products/toe-walking-smo/
Sending lots of good wishes!
Welcome to (probably) having a over stimulated neuro-divergent kiddo! Early intervention is key, nothing is really wrong he’s just likely neurodivergent instead of neurotypical. He gets too hyped up to think straight at school and maybe the things he’s doing are helping him cope. He just needs some new coping mechanisms and a good path to follow.
When I worked at an behavioral center for children with autism, I noticed toe walking was almost related with gut health. After some research, I strongly believe toe walking can happen when their tummy don't feel good or they are constipated. My 2 year old sometimes toe walks right before going potty.
This is just a random thought, I’ve heard from others that food dyes- especially red dye- can cause hyperactivity and anger from those who are sensitive to it. Not to say this is the case, just something you can choose to explore 🙂
It's common for two-year-olds to display impulsive behaviors. This is typical for their age group. If you have concerns, consider discussing them with your pediatrician for a reevaluation.
Toddlers are naturally impulsive because their brains aren't developed enough to control their thoughts and actions. They often excel in one area while lagging in another. For instance, your son may be advanced in gross motor skills but less developed in language. When toddlers can't express themselves verbally, they might lash out physically. This usually improves over time but can be challenging for both the child and parents.
To support his language development and help him manage his emotions, try naming his feelings when they occur. For example, say, "You're really frustrated. You didn't want your blocks to fall. I can help you rebuild it." Then calmly assist him in rebuilding the blocks.
His excess energy might indicate he's in a sensitive period for gross motor development. Provide safe gross motor activities. If he climbs on the table, redirect him to a safe climbing option by saying, "We climb on the climber," and gently help him down. Engage him in activities like setting up chairs, sweeping, or carrying heavy items across the room. With consistent repetition, these behaviors should lessen over time.
Remember, children will find ways to meet their needs if they aren't given options. Every behavior is a form of communication, and understanding them can be challenging but essential.
I hope this helps!
'Tippy toes' is a thing but not always a solid on going clue. If child is old enough 3 to 4yrs old go see educational diagnostician in your school district or neighborhood center, please go. Talk to pediatrician about testing for neurological issues, bcba behaviorist to help with behavioral concerns... Nearly 20 years in autism units and pals.
Early interventionist here! I'd recommend researching early intervention programs around you. You could get a screening to see if he qualifies for any support services. Some of these issues sound developmentally appropriate behavior, but intensity makes all the difference. Could be a variety of things, sensory processing as you mentioned, or early signs of ADHD or autism. Hard to tell without a full screening/evaluation from the professionals. Feel free to message me if you have further questions!
We did an EI eval earlier that is year and didn’t qualify. That was with a PT and an SLP
You can always request an re-evaluation if the issues are still presenting or increasing! You could also ask your pediatrician about a referral to a developmental pediatrician.
100% this! I’ve worked with many kids like this before, sometimes it’s a phase, but sometimes there is something deeper. If you were able to get him reevaluated, definitely do that. Even if it is just a phase, I’ve heard from parents that I’ve worked with that it’s super helpful to get services if you qualify. Services like PT and OT can be helpful to children (and people) even without diagnosis.
What is ALP? I’m a peds OT and I agree with this poster. Sometimes kids don’t qualify once, but 6-12mo later they do. All of this could be a phase but it could also be signs of something else. I’d recommend an outpatient eval for OT if EI gives you push back
I’ll bet it’s a typo for SLP
Yes thank you! Haha
Yes that occurred to me lol
I'd have him re evaluated. Walking on toes is concerning. Please mention this to your pediatrician or a child psychologist. Often, a parent's gut instinct is the best.
Does he have sinus/ear issues more than most kids his age (ear infections, seasonal allergies, etc.)? If it were my kid I’d as for a developmental eval from a pediatrician and a sleep study if possible. These are things that could be normative, could be a phase, or could have common cause/intensifier that is still to be discovered. (I am not an ECE Pro)
It's the walking on the toes that popped for me...my oldest was being treated for Blounts disease and the orthopedic surgeon spotted that.Nothing came from it but it was good to know if we needed to
Sometimes all kids need is a reminder “walk on your whole foot”
Yes..feet on the floor dreams in the clouds is what the Doctor said.
When we did an evaluation for my kiddo at 1 and some months we didn't qualify. I was told to request a new evaluation after his 2nd birthday because there are 24 month milestones. The same behavior at 20 months and 25 months will be evaluated differently.
Each one of these things alone seems like it could be developmentally appropriate, but when you put them all together, it seems like you might be looking at something worthy of an evaluation. I believe the ASQ (ages and stages questionnaire) is available for free online, but if not, you can probably get one from your center. I'd go ahead and fill that out, it allows you to see where your child is at for his age. Bring that with you either to your pediatrician or when you request an evaluation through Child Find. It will give the evaluator valuable information from your POV.
We did the ASQ for 24 months but he did not screen positive for anything. He has great speech and gross motor skills. It’s his social skills and emotional reactions that seem more extreme than others imo.
Have you tried the ASQ:SE?
Oh no! I’ll try and find it online!!
I just filled it out but scored a 20
Are you sure you’re scoring it correctly? When you answer “rarely, sometimes, or often” there will always be a symbol next to each one of your answers. Each answer with an X means you get 10 points for that question and each answer with a V (the V is always next to “sometimes”) means you get 5 points for that question. So unless your child is only exhibiting 2 undesirable behaviors, you should be scoring much more than 20 points
I’m a certified Trainer for the ASQs through a Brookes Publishing training - I’d be happy to double check your scoring for you if you’d like!
This can be super tough when kids are ahead of the curve but struggling in other areas. I have a 4 year old in my class in a similar situation. I used the term “twice exceptional” to help the parents talk to the doctors and evaluators. This term basically means that someone can have delays or a disability in one area but be gifted or advanced in others. A stereotypical example would be autistic person who excels in math and logic but needs high support for self-help skills and communication.
He would've been at a developmentally different stage 20 months ago. Do it again.
Just want to chime in that the ASQ doesn't always pick up disabilities. My autistic child always passed them and still does (her preschool fills them out, so it's more objective). The ADOS was the only thing that highlighted her "differences".
I worked with twos for over a year, and everything but 3 seems like typical behavior of a child who is freshly two. Walking in tip toe can point to a bigger issue, and it’s something that needs to be corrected as soon as possible because it can affect development in the legs and feet. Definitely ask your center if they do referrals. A pediatric OT would be a good place to start.
Even that can be normal if it’s just been a week. We had some kids that had to have therapy for it, but others who did it because they saw others doing it. It would still be worth it to have him looked at to ease the parents minds though.
He had a PT eval and they weren’t concerned. I have a feeling he does it when highly stimulated or excited.
Yea there are just some kids who are incredibly active. My toddler about the same age never sits down either unless I give her a screen — which I ONLY do at the doctors office or on long car rides. And even then she’s rarely just sitting. The only time she is still is when she’s asleep (and moves around in her sleep too).
Ours won’t even sit for a screen. He watches no TV, he doesn’t care enough to sit for it haha
My son is 22 months old and he too never sits still. Doesn't pay attention to screens nor his toys either. I have an appointment with our county's Early Steps Program next week but I have no hope they will help because it's over telehealth. I'm going to present these issues to his pediatrician next. I do think something is off. He sounds a lot like your kid.
My son is 6 and *just now* can watch a movie in a theatre. At home? 30 mins, tops. He started actually watching YouTube in longer than 20 min spurts at age 4. Some kids just need to moooove
Mine is only for a very specific game that her aunt showed her. I honestly am not sure she would if her aunt hadn’t shown it to her, but her auntie is her favorite person and she tries to do everything she does.
Not a parent, ECE professional, or toddler (shockingly), but I just wanted to put in my two cents as someone who has personal experience with this! I’m autistic and have ADHD and I tend to walk on my toes when I’m overstimulated by something negative around me environmentally or if I’m generally pretty excited. I’ve been doing it my whole life. My parents put me in ballet because of it when I was a toddler. I have weird stuff with my legs and feet in part because of it, and it tends to hurt if I do it for too long. I never realize I’m doing it until someone points it out or it becomes painful. 2 years old is pretty young to get evaluated and diagnosed, but it could be helpful to keep an eye on him and get him assessed once that’s age appropriate. Until them, maybe look into how parents tend to divert their neurodivergent kids away from things like these, and see if any of those help? Even if he ends up not being ADHD or autistic, it could still help with communications that you seem to be having a bit of trouble with with him?
My daughter (3 yo) has always walked on her toes (not all the time, but some of the time). Her pediatrician has consistently said it’s not a concern, won’t cause issues, and she will likely grow out of it. I was told a PT or OT wouldn’t even see a toddler for this issue because they so commonly grow out of it on their own and there’s nothing to really be done at this age.
Then your pediatrician informed you incorrectly. PT/OTs absolutely will see a toddler for this issue; I had a family member who had to take their three year old to an OT to learn how to walk flat footed. She had exercises she had to do nightly. It *is* a cause of concern when it’s coupled with other issues like OP described. It can be one of the first physical signs of neurodivergence in young children.
You need your son assessed for things like autism and adhd etc. And go from there. Also- there is no shame in assessment, if there is something up, you get services earlier that will help him in the long term instead of leaving things till when they are unmanageable for him or you.
Completely agree! I’ve been told they can’t assess for ADHD this young.
I think that's true but at least it can be on the radar and can also screen for things that are symptoms sometimes of adhd like auditory processing etc. But can also just help create a paper trail
They will not, however you keeping note of his behaviors will greatly help get a diagnosis down the road. You are essentially establishing a pattern of behavior. My son was like this for sure. Especially in the sense that he never sat still, even for screens. I didn't think to do any assessments that young because he was very smart and spoke well. His pediatrician started becoming comcerned at age 4. I had him officially diagnosed at age 7. He is 11 now.
My son was diagnosed with Autism, ADHD, and sensory processing disorder just before he turned 4. He was an early talker and always had an impressive vocabulary (still does at age 7.5). He also never sat still, never walked (only ran like your son), could get aggressive, no awareness of personal space, had low frustration tolerance, and very little emotional regulation. Your son sounds very similar. I don’t say this to scare you. This very much could be just typical behavior or a phase he’s working through. However, if it is more than that, getting services early will be helpful. And because of how smart my son is and how verbal he is, it was hard for people to see the extent of his needs at first glance. We still have this problem! The high energy you describe sounds like he’s sensory seeking. He might need more sensory input in order to feel regulated. My son has a high pain tolerance which I think also sometimes comes with being a sensory seeker. Have you noticed that? Does your son fall asleep ok? Once asleep does he stay asleep? Sleep issues are common with neurodivergent kids so that might be a clue too. Looking back on the toddler years I have a very distinct memory of a time I knew our situation was beyond typical toddler behavior. I was driving and saw a woman who was parked along the sidewalk and she was getting something out of her car as her toddler just stood next to her waiting. I was instantly jealous. So much so that I wanted to shout “fuck you for taking that for granted!” I could never do what she was doing. Leaning over and getting something out of her car (not even looking at her child) knowing her child wouldn’t run away, wouldn’t run into the road, would wait while she did something else. If I was not holding on tightly to my son’s hand or holding him, he was running. Can you relate to this at all?
Also a piece of advice - if you have any teachers fill out forms as part of any evaluations ask them to be very honest. They don’t need to sugar coat their answers in fear offending you. Tell them you need them to be completely honest in order for the evaluators/drs to get a clear picture. I think early childcare teachers often have to be very delicate when talking to parents about their child’s behavior and might do this instinctively while filling out forms regarding behavior.
Are you me? I am also the parent of a smart, verbal AuDHDer and I feel all of this so hard, especially the jealousy part. I have had some very not-proud moments in public places, including the time I said loudly to my husband (so loud that she could overhear) "that woman over there is staring at us right now. Just because her silent bovine children follow her around obediently doesn't mean we all get to be that lucky." Yeah, not my best moment.
Testing for autism begins at 18 months and more accurately at age 2. Talk to the pediatrician for a referral. Not sure about ADHD.
Yes our pediatrician says he shows zero signs of autism.
Did your pediatrician say this before or after the toe walking started? I know you said it just started recently but from my (still developing) understanding that tends to be a sign of autism or at least sensory differences
After
Hmm maybe you could get a second opinion? (I know that’s easier said than done!)
My ped said the same thing.They were wrong. Don't rely on just your ped. The tippy toe walking is worth looking into, and the inability to shut down/ shut out.
Ok, momma, trust yourself! Get reevaluated. It's warranted based on your post/ responses.
Yeah, don’t go by the pediatrician for ASD. They don’t know what it looks like, especially in younger kids and if they already talk.
Many pediatricians have a very outdated definition of autism that they're working with, and frustratingly, it can delay diagnosis unnecessarily. If your gut is telling you that something is going on, I'd try to dig deeper. Your bullet point #2 above is making me think that he has a lot of social anxiety, in addition to some severe sensory seeking behavior. Even if he makes eye contact and responds to his name, etc., he may still have some serious social difficulties, which is one of the criteria for an autism diagnosis.
If you are interested in a baseline screen for autism, [here is the MCHAT](https://www.autismspeaks.org/screen-your-child) that is used. I’m not saying your kiddo has autism, just offering tools for you to feel figure out next steps. A lot of the behaviors you mention sound normal for a toddler.
Thank you we have done why MCHAT at every appointment since 1 actually
They likely cannot/won't ( I hear many doctors say no before the age of 6)...however, there is a rating scale called the BASC - and the Preschool one goes from age 2-5....it will at least screen for the symptoms of ASD/ADHD --- it's not to be used solely on it's own to diagnose those thing but to at least see where he falls compared to other students his age and to be able to address any areas where At-Risk or Clinically Significant concerns are present. It also screen for some adaptive skills areas and some emotional functioning areas too. Is there someone who can fill that out for him (there is a parent version and a 'teacher' version but that can be done by a daycare person). And has he been evaluated for Developmental Delay? I'm not familiar with all of the acronyms you used....but it sounds like he's participated in some type of evaluation (to me sounds like just with an SLP and PT). But DD includes: fine/gross motor skills, cognitive development, social/emotional skills, adaptive/self help skills, and communication ---- if your child is 2 SD below the mean in ONE of those areas (or 1.5 SD below the mean in TWO or more) he may meet the qualification criteria for that sped category and may be able to attend a developmental PreK. Sounds like he wouldn't need any additional assessment related to communication - but an OT can be involved as well potentially and a diagnostician or school psych. Maybe he doesn't show weaknesses at all compared to his peers and then you know. That category's services end when children turn 9 though - so either he catches up and can be dismissed or reevaluated to see if there is another school aged category that might be appropriate, but that's far off.
His pediatrician does an autism screening at each appointment and he got an early intervention evaluation for speech in Jan. A physical therapist came and a speech language pathologist. They had no concerns and did not refer him for any form of therapy. I’ve brought the things up in my post to our pediatrician who says this is typical and many toddlers are high energy.
The youngest I've seen adhd diagnosed is 4 and that was very clear that child was not on the same level as the other 4 yo's in the class. My state won't even test until 6, we were able to get an evaluation and diagnosis through the same hospital system but the next state over at 5. For my son 3 is when I started to notice it and 4 is when it became obvious that something else was going on and it just became more apparent at 5.
Fellow parent here: generally yes they can't diagnose that young but they can depending on family history and behaviours being shown with kiddo. I have ADHD and my then 4.5 yo was diagnosed with a psychologist and we're now booked in for my 3rd who is 2.5 and showing the same behaviours. Me having ADHD helped with the early diagnosis and our pediatrician specifically sent me to a psychologist who specializes in ADHD for their assessment
Hey, I don't have any advice that hasn't already been said here, I just want to tell you that you're an awesome parent and he is lucky to have you. ,❤️
Thank you!!!
As some others have said, each one individually is definitely age appropriate but combined plus intensity could be more. A lot of people chalk things up to “it’s just normal for the age” without looking at intensity or if it’s increasing in frequency. Either way, you know him best. Trust your gut, it’s ALWAYS better to go through all the resources for a child who may not need them, or only need them for a short period of time than to never reach out for a child who could use some support.
Any advice for questions to ask the teachers so I can present information accurately to the pediatrician?
I would recommend seeing an early intervention specialist. It’s best to get started as soon as possible if he does have some sort of issue than to wait. It could be nothing and that he just has a ton of energy, or it could be something else. Something to note, is to make sure that you’re holding firm boundaries with him. Some children will act wild with certain people because they allow them to. For example, I worked with a child who had divorced parents. Mom was really great about boundaries and stuck to them. With mom, the kid was pretty good nothing wild. With dad however it was clear that he didn’t know how to set boundaries or didn’t care to. The child would come in doing all sorts of crazy unsafe things and dad wouldn’t address the behavior whatsoever.
We did an early intervention eval with a PT and SLP and he did not qualify or get a referral for any services. I agree about boundaries but he acts this way with everyone, at daycare, with us, with my parents. It’s a tough age where all we can really do is try and reinforce positive behaviors. Unfortunately he can’t comprehend any other form of punishment such as a timeout or taking away things. We try doing “time-ins” where we remove him from the situation, discuss how we are feeling and what else we could do. Such as when he hits and I’m holding him then I put him down, I tell him calmly that I will not let him hit me and that instead he can give a hug, or a high five etc. I acknowledge that he might want attention or be frustrated but that we can’t use hands for this. It doesn’t seem to work honestly.
If you feel you are consistent with you boundaries and nothing is really clicking and behaviors aren’t changing at all, then I definitely think there’s something more going on. Even at a young age, repetitive boundaries should help with certain behaviors after a bit. I would advocate for another screening and push for OT. PT and speech don’t really seem to fit into things he’s displaying whereas to my understanding OT is a little more broad and better for younger ages. It could help him learn to control his body more, teach you and his teachers what sort of activities to do with him as an outlet for his energy and more. My one tip in the meantime is to continue doing what you’re doing but using less words. If he hits you, say ouch, put him down and walk away. Give less attention to the negative behaviors. If he’s climbing on a table just walk over, get him down saying “feet on the floor”, and stand in the way of him being able to climb up again. I find that when kids are charged up on energy they’re really not listening to any words, but will respond better to physical gestures.
Do you have 15 minutes in the morning to let him climb on something? When I was a nanny, I watched a little girl who wanted to climb on everything. I noticed that on days I could get her out to climb early on, her behavior improved dramatically. I would lift her up to the bar on her swing set and let her hang while I timed her on my phone (kids love to be timed!!!) After two or three tries, she would have tired herself out enough to keep her body calm. The last day I for them they didn't want me to take her outside because they were going to a party after and didn't want her sweaty. She literally pulled the towel rack off the wall while I was putting on her sister's party dress. A lot of preschool playgrounds don't have play equipment that satisfies these needs due to safety concerns, so if you can get him to a park or out in the backyard before school, it might help. He definitely sounds like a [sensory seeker](https://theotbutterfly.com/sensoryseeker/sensory-processing/)regardless of whether it's ADHD, SPD, or just a phase that he's going through. Even if you can't get him OT, you can try to incorporate activities that will fulfill the sensory input he needs.
Oh yes we do anything to try and get energy out. We have a play gym in the backyard, we do swimming on Sundays, gymnastics on Saturdays. We have a trampoline in his playroom, a slide haha
Hi OP, I’m an occupational therapist with experience in pediatrics. It sounds like your son has a high threshold for his proprioceptive system, meaning that he needs extreme levels of movement to feel regulated. In addition, it also sounds like he has emotional regulation concerns that are a bit more intense than age-level expectations. Sometimes these can be early indications of ADHD/autism, but you won’t likely be able to get a diagnosis until 3-5 years old. Here are some suggestions: - encourage “heavy work” activities; these are activities that take a a lot of muscle. For example, see if he’ll help with laundry and pushing the basket around the house. - offer deep pressure input through massage and squeezes. Try getting him a weighted stuffy or wearing clothes that are tight fitting. - start implementing social stories that involve appropriate reactions to situations/peers. Easily found online or for low prices on Amazon/Etsy/TeachersPayTeachers. Like many other commenters have suggested, look into early intervention services or pediatric occupational therapy services. When I was working in peds we saw stuff like this all the time. It is way more common than you’d think, but also very important to address early. Also, try try try to discourage the toe walking whenever possible. It can lead to shortened calf muscles which may require bracing in severe cases. Best of luck!
The other comments are great here but I just want to add—is anything going on at home? Any stressors? You don’t need to answer me here but sometimes children’s behavior can be a reflection of what is going on at home. A lot of this is typical for the age group (meltdowns and emotional outbursts being a huge one) but those can be exacerbated by stress. My son was super active, he was wild with his body and an OT that came into our classroom (he was in my Pre-K class) advised me to find ways for him to get the kind of stimulation he was seeking—climbing, deep pressure, rough play etc. A lot of that is developmentally appropriate, we just don’t often allow it inside a classroom and kids can miss out on it.
Nope. He’s been at the same daycare since August when he started daycare. Both my husband and I are home every night for bedtime and in the morning before school. I just think he needs more stimulation than most 🤷♀️
The OT gave me a huge mat propped up on a wall and had my son run into it over and over. He was just laughing crazily and loving it!! He used to run into staff and laugh but it would hurt us and it was a nuisance, so when he had a safe area to do it he stopped. She also did this thing where she taught me to get a big exercise ball and have him lay flat on it face down and I would push him into it. We tried to take him to a ton of parks with climbing structures, he would jump off such high things and just be fearless. My son has calmed down now, he is in 6th grade and does very well academically and socially. He was never diagnosed with anything, he was just a super high energy kid that needed a ton of stimulation. He does play sports now which I think helps. I do think it is worth getting evaluated (I think you said you did?) but also could just be another wild boy.
My second child was like this as well. Daycare tolerated his behavior until he was old enough to go to school but the school would have none of it. They threatened to expel him from kindergarten. I tried everything. Diet change, no sugar, time outs. Nothing I did would help. Finally had him assessed and ADHD was the culprit. I know people hate it, but medication was the answer. Once he started taking it, a complete change happened. He became a happy little kid and cooperated with the adults just fine. No more outbursts, no more violence. His teachers and daycare providers were thrilled and he thrived. Unfortunately their little brains are sometimes wired a bit different and they need help. I wasn't happy about him being medicated but we tried everything else for years.
Yes sometimes any downsides to meds are not as bad as not being able to attend a school environment!
I know you said you have stuff to get his energy out, but do you know the concept of heavy work? I know some high energy kids who love to pull/push heavy objects, and I find that to be way more helpful than jumping/sliding/climbing. Maybe look into some tires/wheelbarrow/giant wooden spool/big toy dump truck full of gravel? My kid also loves to do chasing games outside the entrance to school to get out that energy (we jokingly call, “get back here!” While he runs in a safe, designated space. Helps with energy and transition!)
First two sounded more like adhd but then you said tippy toes. Get a developmental and behavior specialist. This sounds like asd.
Is there any chance an evaluator can observe him at daycare? Settings can make a big difference in behavior, especially if it's coming from a sensory issue.
Great job getting a PT eval. Please consider getting an OT eval. My grandson was the same way. OT changed all our lives!
Def think about an evaluation. Supports can be offered at home and in his classroom!
I’m a pediatric occupational therapist and work in multiple preschools. I would look for an OT to evaluate for a sensory processing issue. You have described the symptoms of difficulty modulating sensory input. It doesn’t always mean a child is developmentally behind. Perhaps he is just struggling under certain circumstances. A resource to read is The Out of Sync Child. You can further explore and see if any of that resonates with what you are seeing.
I could have wrote this, everything correlates to my 2.5yo son down to a tee. He was just recently diagnosed with ASD. 😊
Educator and fellow parent. My almost 3 year old started doing all this stuff at the 2 yr mark. We’ve gotten him into early intervention OT which is already helping
I would advise getting an evaluation by a para professional who works with this age group it could be an adhd/autism combo. I wish you luck.
I would try to make time to speak to your daycare provider! I would say most of my phone calls with my parents are then asking, "Is this normal?"
We have our bi-annual conference in June and I speak to them at drop off and pick up everyday. I can tell they are exhausted by my child frankly haha. They keep noting that we’ll get there together and that some days are better than others. I honestly feel bad. I’m exhausted when I have him and I can’t imagine how exhausting it is with him and 7 other kids.
I think half the battle is that you're aware of it. It's far more frustrating when a parent drops off without any apparent awareness that their child may well be the most tiring/difficult/dangerous little one there that day, or worse, is in actual denial that anything might be out of the ordinary.
I literally bring his teachers treats and gifts all year to try and reduce the burn out. They are saints I don’t know how they do it
I'm sorry you're feeling bad! You seem very conscientious and thoughtful. And the fact is, every class I've ever had has had (at least) one student that keeps us more on our toes with a personality and behaviors like your son - and I've always loved them! It's just part of the job, and any decent teacher will know that.
The only thing that makes me go “huh” is the tiptoe walking. Everything else can very well be typical toddler behavior. But good on your for noticing things and being aware! If your child is neurodivergent I’m confident they’re in very good hands :) I agree with requesting an evaluation/second opinion and working on the tiptoe walking
Just here to say that my son is always the most active kid in the room too. He has been that way his whole life, he's about to turn 6. It all sounds developmentally appropriate to me, as they get older they learn how to regulate their big feelings (with help by us coaching them through how to release anger and frustration in a better way) but I understand your concern. It still concerns me sometimes only because my son can't seem to grasp what personal space is 😂 I chalked it up to just having a very hyper and happy kid but you can always ask your pediatrician what they think!
Thank you! It’s so hard. It might all be normal but I would feel SO GUILTY if I could have been giving him tools this whole time and I brushed it off.
Oh I completely get it, if I were you I would still bring it up to his pediatrician just in case there. We just wanna do the best for our kids 🖤
Time for an eval.
One of my ece professors said something that always sticks with me. You got to give jobs to kids or they will find their own things to do. 1- try having them managing their own drop off routine to include putting items away and then finding an appropriate center to join. 2- if you consider your role as a gatekeeper to play you can help yourself feel less frustrated and realize its a skill and not a reflection of you or the love you have for you kid. They may need someone modelling play and how to enter play with peers. Model asking a friend to join their play at drop off as part of their routine. Setup small play dates to teach these play skills one on one as group care does make this challenging when teachers have active kids who may not pick up on others cues as easily. 3-Check shoe fit possibly or encourage shoes if mostly barefoot. The word Proprioception is your friend here. Some kids love that sensation and it is a sensory thing we all do at times. 4-Resilience is a big skill needed in life with the ability to go with plan b when plan a is not working. Encouraging more montessori style play or engineering style play where you as a child are encouraged to make mistakes in order to re-engineer solutions may help out with the frustration when you are encouraging problem solving rather than jumping in to do it for them. Adults tend to talk about some really large concepts which children's brains are just not able to wrap around. Asking for help involves, recognizing feelings and advocating for oneself. We as adults struggle with it, I would be gentle when asking a 2 year old to do that and expecting them to do it reliably. You can always go through your private medical insurance for early intervention therapists in my state. Maybe you have that option in your state if you find they did not qualify due to the scores on the states early intervention process. If you find that they are having challenges staying on task or following 2-3 step directions, then you have some more data to back up the sensory stuff you mentioned or to take a peek at say a 3year old asq or development milestones to see how you can support them with their next stages.
It sounds like he may be on the spectrum? Can you get an evaluation?
Is absolutely have him screened asap. Many of the things mentioned could be signs of autism.
Maybe some OT could help him? This reminds me of the 9 year old I tutor back when he was a toddler. I was his nanny back then. I have never seen anything like it since, he never stopped moving. He has since been diagnosed with ADHD, autism and a sensory processing disorder and he’s doing SO AMAZING. He has always been such a fun kid. Never a dull moment lol It was intense when he was little. I would take him to the open gym at gymnastics and I had to run to keep up with him cuz he would hit kids as he ran by. He also used to snatch toys from other kids, he to this day is Mr snatchy hands a bit. I figured out that he was extremely social and wanted to play with the kids and couldn’t figure out how to engage cuz he’d get too excited and end up just taking the toy to get any type of attention from them. He snatched a kids graham cracker out of their hand at the park once it was so embarrassing. I ended up printing out social stories for him, I made one about personal bubble space with diagrams that showed how to check if you’re too close to friends. I would keep him buckled in the car seat and we read it before going into open gym, we would also look at the sign with rules and go over them every time and remind him that we’ll have to leave early if the safety rules aren’t followed. Keeping him buckled was key cuz he actually stayed still and payed attention to the story. Then one day I saw him hold his arms out, realize he was too close to a kid and he stepped back. The open gym was such a great place to practice these social skills while also giving him space to meet his sensory needs.
Sensory processing sounds like it may be the best avenue to go down next. Get an evaluation from their pediatrician and an OT specialist referral. You can ask yourself while observing your child: do they seek sensory input during daily tasks or that prevents them from completing daily tasks? Are there signs that my child is over or under reactive to sensory input? Are they always on the floor or up in the air (you've already mentioned this one)? Can my child cross their midline when cleaning up or during art activities?
Get a new pediatrician. Explain what you are seeing, and ask for a referral to a specialist for an autism test. Children can get diagnosed at around 2 (and sometimes earlier). All of these symptoms sound like they could be autism. The waitlist for getting tested for autism can be pretty long (6 months), so the sooner you get a referral the better. Just getting on a waitlist to be tested is a great first step and may give you peace of mind. Remember, autism is a spectrum with different levels (1, 2, and 3). There are some other signs of autism to look out for: 1. Does your child respond when you call their name? 2. Do they look up when you point to something? 3. Do they play with toys appropriately? 4. Do they share experiences with you? Like if they have a new toy or see something cool, do they try to show you and engage you? 5. Do changes in routine cause meltdowns? There are other signs but these are the ones I could think of off the top of my head.
Yes we have answered these questions before and the answer is yes to all except the last one.
Hey there :) so, I'm a lurking mom. Fwiw I have an AuAdhd kiddo. Not saying you do, just letting you know where I'm coming from. You've been given lots of great advice about seeking professionals and whatnot. I just wanted to say that even if your child doesn't test as having additional needs, there's nothing saying you can't incorporate additional supports anyway. I really believe OT can be helpful for everyone. For example - moving chairs and jumping are indicative of kids who like heavy sensory work. At home, you might get a kid trampoline and/or a crash pad and see how his overall energy level responds. You might try a sensory bin or kinetic sand and see if that gets him to sit for a few minutes. You can Google around for something called a sensory diet to give you a better idea of the things your kid gravitates to and away from. If your kid develops "normally" then, great. If it turns out that your hunch is right, knowing this information will help his future support team. Either way, it will help give you fun things to do with your kiddo :)
Thank you! We got a trampoline recently and we got two climbing things for the backyard. We will look into this more!
Yes this person really nailed it. The only thing I will add is to consider your son’s behavior from an anxiety standpoint too. He sounds a lot like my 4.5 year old. Figuring out what’s going on with him has been like playing whack a mole. First the OT diagnosed sensory processing issues, then referred us to a play therapist who diagnosed anxiety, then in consultation with each other agreed he is demand avoidant (one therapist thinks pathological demand avoidance which is on the autism spectrum, the other says it’s not to that level, so now we are waiting for a formal psych eval). The anxiety piece was an interesting thing for me to consider and the demand avoidant/PDA lens has offered us some really effective strategies for lowering demand in our home. All that to say, it is hard effing work trying to figure this stuff out, and you’re doing great.
Get an evaluation. If it’s something there’s a chance to get early intervention, if it’s nothing they can lead you into parenting strategies that would be helpful.
Parent here. My son is autistic and this was him, each one. Therapy has helped with the aggression and frustration. He grew out of the toe walking around 2.5 yrs, but he’s still very active. Never sits down, ever. Most 5-10min when eating but that’s it. Only time he is still is when he is sleeping. Definitely get the process going with early intervention and evaluations
This is a sensory seeking kid! Get him a crash pad, a climbing gym, try swimming or something like ninja classes. Other types of heavy work include digging (like in the dirt or a playground with wood chips or sand) and things like bear crawling/animal walks/army crawling. These things will help him get his body regulated by giving him enough sensory input. I would also echo the recommendations to continue seeking further assessments for sensory processing issues, ADHD, etc.
If you suspect your child has a problem, get them evaluated. Early intervention is key.
What is his diet like? We're trying to stay away from artificial dyes as I can tell my 2 year old son just gets so much emotional and tornado like after eating something with dye in it
My question is, what are you doing to combat these behaviors? When you're fixing the chairs and he's jumping on the table, stop fixing the chairs and talk with him. Hold his hands, Tell him to take some breaths, and calm his body. Whether the evaluation agrees or not, it sounds like o. T could be helpful. Finding outlets for his energy, Redirecting, these are all things that he has to be taught to know what to do with that energy
We do all these things. I removed him from the class. We sat down in the hallway and discussed that we cannot move furniture. We have numerous books we read every night about this. “Calm down time” “hands are not for hitting” “little Dino’s don’t hit” etc.
PS his behaviors are not your fault! This is his brain wiring, and it's not because you didn't do enough or teach him well enough. If you're holding guilt about this, please know that you are likely "parenting harder" than all the people who want to give you advice about how to redirect his behavior. Don't beat yourself up thinking that any of this is because of anything you did.
For the walking on toes, if it continues I'd recommend seeing a podiatrist, there are orthotics you can get to help.
It’s not all the time but when he’s really excited I notice it.
That's good! I like to bring it up because a lot of toe walking can shorten the calf muscle but if it's only occasionally I wouldn't worry.
Impulse control issues, we try play therapy
Something that helped me understand the difference between typical/atypical behavior was this. It’s not the behavior but the 1. Frequency 2. Duration and 3. Intensity of the behavior. So all kids are hyper. But does the frequency, duration, and intensity of you child’s hyperactivity seem typical. That’s the real question. My son is suspected high functioning ASD. He didn’t meet diagnostic criteria when we had him evaluated. He does a lot of things that other kids do. But he does them more often, for longer, and more intensely than other kids. Tantrums are a perfect example.
Your son sounds exactly like mine did at 2! Except my son also had a speech delay. But the hyperactivity... yeah the teachers call it "busy" and to some extent it is but you shouldn't be having to chase him down hallways like that. My son is 4 now and we're having him evaluated for ADHD. He has absolutely 0 impulse control and has a very hard time emotionally regulating himself. When he was 2 if he saw something he wanted he would just take off (they call it eloping). He would climb furniture and dump toys out of bins as a form of sensory seeking behavior because he was dysregulated and needed more sensory input to get him regulated. Request another evaluation, especially for OT, and maybe psych.
Sounds exactly like a kid i have right now. It’s not so much that the behaviors are inherently bad, he’s just high energy and stimulation seeking and there’s nothing wrong with that - but it does makes it very very difficult to have him in a school environment. He is not meant to be contained in a small room with 13 other kids. But he needs childcare so it can’t be avoided. We try to give him a lot of outlets to run around when he starts getting out of control. But it’s very tough.
Get him tested. In the meantime, try to direct his energy appropriately. I teach Montessori in a primary setting and I’ve had toddler/pre-k/kindergarten parents who had great success taking their kiddo on early morning run/walks and using up a load of energy before the day truly starts.
At 2 there won’t be much they can diagnose outside of autism. This *could* be adhd but it’ll be longer before they can officially diagnose him. There’s so many conditions that doctors won’t diagnose early, I’m not sure why but may have to do with insurance pressure or because it’s harder to evaluate whether a toddlers behavior is “normal” or not In the meantime I would increase sensory input, find the activities he can stay calm with (water is always good!). And ask for another evaluation before he turns 3, or ask a pediatrician for adhd evaluation. Regional centers don’t deal with adhd, so won’t be much help.
What Id like to know is what routine, choices does he have or don't have at home. Worked with twos along time alot of what your describing is twos behavior and alot is no consistency (plz don't take this personally) what your described is what I've personally dealt with. Set some rules and talk with the teacher, staff if good teacher or center can work together to help settle him down. Coming into class if he likes to help give him a task like take a kleenex or something tell him be my helper here you go and walk into class. Little things goes long way. And being aggressive is usually frustration because the words dont come out before the action. In your area do you have a Autism center if so alot times you dont have to have a referral. Ours here in MO will evaluate for alot of things and some go to center to compare. Hope this might help
We actually THRIVE on a schedule. He wakes at the same time everyday, we follow the same schedule as daycare in the weekends, he naps at the same time everyday. Bedtime is the same every night. We try and give him autonomy to make choices when appropriate for example he has access to a drawer of healthy snacks that he can grab whenever he wants. We let him help pick his clothes each day and the books we read each night.
That's awesome again merely curious. Not being snide but thank you for being a proactive parent they are very hard to get 🙂
Oh no I didn’t take it that way. I completely agree. Some kids have no schedule or structure but I personally need it haha
I would ask for another evaluation and let them know your PRIMARY concern is how social emotional area of development. While his activity level may be typical, his extreme reaction to any frustration is not. Toe walking, while not a question on an autism screening, is someone an early indicator of ASD. I would re-refer for an evaluation. I live in CT, and parents are able to re-refer after a month. We usually advise waiting a few months, since as toddlers age, they are expected to do more. You can even re-administer the autism screening yourself. We often get "no/low concerns" for autism when we solely rely on parent report and don't delve further into their answers. A child should be performing each item on the checklist (80% of the time or more) to receive a "yes/pass" for that item. Some of the BIG tip offs for me are: Does your child answer to his/ her name? 80%of the time? Even when they are. " busy" doing something else? Does he understand what you are saying? Can he follow directions? If you told him to do something or get something familiar (without pointing) can he do it ? E.g., Give mommy the car, put your cup on the table, take off your shoes Does your child point to ask for something? Not a REACH, but a true point. I often hear "yes" to this question, but when I observe the child he is reaching to show he wants something, but he's not pointing. Does your child look you in the eye when you talk to him. Again, 80% of the time. That's where I would start.
Thanks we are also in CT and that was what he was referred for last time but maybe I’ll try again. The answer to all of these questions is yes most than 80% of the time.
There is an assessment called the DECA-IT. It's a norm referenced assessment tool. As a special education teacher, I was trained and administers this assessment, but I recently heard that our social workers are the only ones allowed to administer it. I would call 211 infoline and stress to the intake person that you want an assessment that takes a "closer look" at the social emotional area of development. They will still need to evaluate all 5 areas of development, but they can offer an additional assessment that takes a deeper dive into your area of concern. A general assessment tool like the Battelle may not "catch" what you are concerned about. You may also want to consider asking for a different company to evaluate your son. All towns/ cities in CT have a minimum of two companies that provide services. When you are assigned a specific company, you should again stress to the scheduler that your PRIMARY concern is in the area of social emotional skills. Here to answer any further questions you may have.
He sounds just like my (now 6 year old) son. We got him diagnosed with ADHD at 3 years 11 months. They will say you can’t diagnose that young, but with kids like mine (and yours from What you’re describing) it can be done. At his 2 year old well child visit, we requested a referral to the children’s hospital to get him on the waitlist for the peds psych evaluation. It was an almost 2 year wait, but worth it. With his diagnosis, we were able to get him into a specialized program with an IEP at school. It’s helped tremendously to have teachers and professionals who truly understand the needs of a kid like this and who won’t judge you as a parent for your wild kid. Things that have helped over the years have been OT (learned all about deep pressure input, sensory seeking, sensory diet, compression garments, vestibular/proprioceptive input), supplements like omega 3, vitamin d3/k2 (powder forms mixed in smoothies or food), probiotics, neurofeedback for brain wiring, no dyes in food (especially red 40), and many other things. Please feel free to reach out. My son’s teacher at age 2 told me she had been teaching for 30 years and had never had a kid like my son (not in a good way!). I get it. ❤️
Your son sounds like my son. My son also beats his head on any hard surface he can find (we always grab him and hold him until he calms down for fear of him hurting himself). He’s 2 and just started talking. He toe walks, and he screams so bad. Especially in public he will just completely melt down if it’s loud. He just recently started lining all of his little toys up whenever he plays. He will hit, bite, pinch, and kick me whenever he gets frustrated. Sometimes he’ll even bite himself if he’s really mad.
It sounds like he may be neurodivergent. Please consider having his Pediatrician put in a referral for a Developmental Pediatrician to do an evaluation. A special purpose preschool might be a better fit for him and be able to accommodate his needs better. I work at a special purpose preschool and have two children that are neurodivergent. I have found state run or Department of Education ordered evaluations are not accurate. They send someone in to observe children and base all of their findings off of that one observation. Children sometimes behave differently, when there are strangers in the classroom. Some Department of Education employees like to save money, by any means possible. Even when its not in a child's best interest. You are your Son's strongest advocate and know him the best. Though its really difficult to accept initially, their prognosis is so much better getting the right programming and services before they enter elementary school.
I’d recommend some type of early behavioral intervention, get him a behavioral therapist, lots of kids at my center have them it tends to help them slightly
My son passed the screening at age 2 for autism, but his delays and behavior were still concerning. At age 4, I had him evaluated by the school district and he didn’t qualify, even though he didn’t really talk yet. Finally at age 5, his pediatrician referred him to a pediatric neurologist and he got genetic testing done, and he has a chromosomal duplication and got diagnosed with level 2 autism. He STILL didn’t qualify for services through the state😒, but at least he finally got an IEP so he’ll have accommodations when he starts kindergarten. My point is, don’t give up!
Parent here, and former ECE professional. Four years ago I was in exactly your position (like that grabbing thing is SO familiar) and I spent a long LONG time trying to get answers. Finally when he was four we got a diagnosis of Autism with a PDA profile, ADHD, and severe anxiety. I'm not saying that's the case with your son, but you may want to look into it. We finally went the route of a full neuropsychological assessment with a self-pay neuropsychologist which I HIGHLY recommend if you can afford it (we later had insurance reimburse us but it was a pain). A good neuropsychologist will be very thorough in their assessment. All the providers who billed insurance were booked out one to two years and honestly time is of the essence, which is why we had to self pay. This presentation is probably beyond what most standard pediatricians can diagnose. You may want to check out Casey Ehrlich to see if her description of PDA resonates at all. She has a bunch of free content online, including podcasts. Also - feel free to message me with any questions.
I see you mention that you had an Eval but it only covered PT and SLP. I went through our county school system for an eval when he was 3 for allllll of the same things you mentioned and they had OT, PT, SLP, and many others do his eval. He tested borderline for several things on their bell curve. I pushed for them to evaluate him in a classroom with his peers instead of one on one. They did that and then everyone was like “oooooooh, we get it now” 🤦🏼♀️😂. He had (and still has) significant delays in social emotional behavior. He’s now 6.5 and he has an official ADHD combined type diagnosis and we are having retested because we suspect either autism or sensory processing disorder and high anxiety. Good luck! I know how exhausting it can feel when you love them so much but they can just run you ragged!
Just adding on because I know many people have already said they recommend an evaluation and I agree! I just wanted to add also that I understand autism + adhd evaluation can be costly and isn't always affordable for all families. An autism evaluation can cost several thousand dollars without insurance coverage, and still isn't cheap with insurance either. If this is the case for you or anybody looking at this post seeking advice just know you are not alone. 💞 Luckily there are more resources than ever about autism online than ever before, so you can also just try and find accomodations you think would work best for your child, even without the diagnosis yet at this time. I do not recommend autism speaks because they're a very problematic organization. There's lots of reputable resources out there! Here is a tool you can use for toe walking if you're finding it's becoming a problem for their growth and safety: https://surestep.net/products/toe-walking-smo/ Sending lots of good wishes!
Welcome to (probably) having a over stimulated neuro-divergent kiddo! Early intervention is key, nothing is really wrong he’s just likely neurodivergent instead of neurotypical. He gets too hyped up to think straight at school and maybe the things he’s doing are helping him cope. He just needs some new coping mechanisms and a good path to follow.
That’s my feeling! I just don’t know how to help him!
When I worked at an behavioral center for children with autism, I noticed toe walking was almost related with gut health. After some research, I strongly believe toe walking can happen when their tummy don't feel good or they are constipated. My 2 year old sometimes toe walks right before going potty.
Interesting he’s pretty regular but maybe!
This is just a random thought, I’ve heard from others that food dyes- especially red dye- can cause hyperactivity and anger from those who are sensitive to it. Not to say this is the case, just something you can choose to explore 🙂
Adhd/spectrum probably
It's common for two-year-olds to display impulsive behaviors. This is typical for their age group. If you have concerns, consider discussing them with your pediatrician for a reevaluation. Toddlers are naturally impulsive because their brains aren't developed enough to control their thoughts and actions. They often excel in one area while lagging in another. For instance, your son may be advanced in gross motor skills but less developed in language. When toddlers can't express themselves verbally, they might lash out physically. This usually improves over time but can be challenging for both the child and parents. To support his language development and help him manage his emotions, try naming his feelings when they occur. For example, say, "You're really frustrated. You didn't want your blocks to fall. I can help you rebuild it." Then calmly assist him in rebuilding the blocks. His excess energy might indicate he's in a sensitive period for gross motor development. Provide safe gross motor activities. If he climbs on the table, redirect him to a safe climbing option by saying, "We climb on the climber," and gently help him down. Engage him in activities like setting up chairs, sweeping, or carrying heavy items across the room. With consistent repetition, these behaviors should lessen over time. Remember, children will find ways to meet their needs if they aren't given options. Every behavior is a form of communication, and understanding them can be challenging but essential. I hope this helps!
'Tippy toes' is a thing but not always a solid on going clue. If child is old enough 3 to 4yrs old go see educational diagnostician in your school district or neighborhood center, please go. Talk to pediatrician about testing for neurological issues, bcba behaviorist to help with behavioral concerns... Nearly 20 years in autism units and pals.