Monday 27 January 2020

'I fear I will resort to slapping my four-year-old daughter, who is running us all ragged'

David Coleman addresses your parenting woes.

Children with an ASD usually don't play
Children with an ASD usually don't play "make-believe", or engage in group games, imitate others, or use their toys in creative ways.
David Coleman Columnist Health & Living PIx Ronan Lang/Feature File
David Coleman

David Coleman

David Coleman addresses your parenting woes.

Question: I am at breaking point with my four-year-old daughter and I am considering physical punishment. She bites, kicks, hits and lies on top of her two younger brothers.

When I ask her why, she replies "I want to. I want to make him sad". She is extremely sensitive to noise and covers her ears when out and about. She talks lots at home but won't say anything when she is in others' company.

She looks at me and her dad but won't make eye contact with anyone else. She is extremely rigid when it comes to routine and needs days to get used to the idea of a change, like going on holidays etc.

She has very strict rules for herself about dressing, including the order clothes have to go on her. She is totally ruining our family life with her aggression and controlling behaviour. Please help.

David Coleman Columnist

David Coleman answers: Your daughter does sound like she is very difficult to live with, never mind to try to manage. However, nothing warrants hitting children. So please don't resort to physical punishment.

Slapping or smacking her will only make the situation worse, as it will legitimise her own aggression and may lead her to be more violent with her brothers.

That said, you definitely need to do something to help her.

I suggest that you bring her to your GP, or your Public Health Nurse and ask for a full developmental assessment of her. Specifically, I think you should have her assessed for an Autistic Spectrum Disorder (ASD).

I am not an ASD specialist, by any means, but the combination of all of the different difficulties that you describe are unusual to find together. Lots of children may have one or two of those difficulties, but few have them all at the same time.

Many of the things that you mention in your brief description of her may be associated with something like an ASD, and this seems more likely when they are found in the combination.

For example, her intolerance of loud noises (assuming her hearing has been checked and is normal) and her desire to block this out.

Her, apparently, self-imposed social restrictions of not talking to, or making eye contact with others outside her immediate family.

Her apparent lack of empathy towards, or indeed intentional hurting of, her brothers.

Her significant rigidity and desire for sameness, routine and order.

You haven't mentioned about her play, with other children, or alone. But children with an ASD usually don't play "make-believe", or engage in group games, imitate others, or use their toys in creative ways.

There is a lot going on for your daughter and the key to understanding her better is to get a full and comprehensive assessment. Some solo practitioners may offer to carry out ASD assessments, but best practice in this field always encourages multi-disciplinary assessments.

The approaches of the different disciplines, like psychology, psychiatry, speech and language therapy or occupational therapy give useful perspectives that make diagnosing an ASD more effective.

Also, the main purpose of getting an assessment is not simply to have a diagnosis but to find out what your child's particular needs are and how you, as parents, can meet those needs.

So assessment alone, without a subsequent intervention plan, is pointless.

When you go looking for a multidisciplinary assessment, with the HSE, your primary goal should be to find out what can you, or the professionals do to help your daughter to make her life easier.

The easier things are for your daughter, the easier they will be for the whole family.

If nothing else, it may give you and your husband greater insight into your daughter and may help you to be more tolerant and patient, with a new understanding that her difficult behaviour is not her "fault". Rather it is a consequence of how her brain is wired and how she experiences the world.

I don't have any quick fixes for you, but I do, again, urge you to get a full and comprehensive assessment carried out. In my experience, the HSE often offers the best service in this regard.

Thankfully, she is young still and the earlier you can intervene in a targeted way, the more likely she is to do better in the longer term.

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