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14/4/2016

Autism, Naughtiness & Sin

Below is a messaging chat between me and a Christian mother of twin boys. She became concern after researching on the internet that one of her twins, Son A, might have autism because he was different from his brother Son B. Her sons are dizygotic twins aged 2 year 4 months as of the conversation.
 
Ben: I understand you want to know more about autism
 
Mom: We note that our Son A current condition may be symptoms of autism, but we are not certain. Symptoms like not responding to name being called, echoing repeatedly what others have said, are typical. We didn't think much of it earlier, but as Son A grows up, the differences between Son A & Son B becomes more obvious.
 
Mom: Son A doesn't interact with his brother Son B in play. He is also not interested in other kids. Son B is very fast in telling us what he wants and pointing at the toys. Son A used to only scream and cry. Now we are teaching him to say what he wants. . He can echo sentences. I don't know if he's using them meaningfully or not. If we greet them both, Son A doesn't care. He doesn't look nor greet us. Son B does.
 
Mom: So I also wonder if it's just different personalities
 
Ben: How is Son A speech development? Monosyllable words, single words, 2 to 3 words or sentences?
 
Mom: Very good speech. Speaks in sentences Eg. alarm clock, Crescent moon, since below 18mths
 
Mom: On the other hand, Son B is very advanced in all areas of development
 
Mom: Though Son A picked up words fast and can sing tunes he hears; he doesn't seem to communicate much with us. He just cries and throws tantrums in frustration. Now he says "rabbit" for his favorite rabbit pillow. But he will still whine and cry first if his rabbit pillow falls onto the floor, instead of saying Rabbit. We kept teaching him to say what he wants.
 
Mom: He seems to be copying. Instead of saying something new
 
Ben: Can he communicate his needs to you in words? Eg I want to eat something?
 
Mom: Sometimes yes. He will say Eh eh. Then we say "Caleb wants to eat bread." Then he says the whole sentence
 
Ben: Immediate repetition or repeating old sentences?
 
Mom: Immediate as well as old sentences that he's heard before
 
Ben: Does he have any repetitive behavior that is odd or fixation on something for a long time - eg toy or object?
 
Mom: Fixation on wheels when young. Now fixated on rolling cars and trains on a ledge. Latest fixation is a large toy school bus. He can play with it for a very long time. But he will also snatch whatever Son B is playing with when he sees it
 
Ben: 1 car in particular or all cars/trains? How does he play with the car/train? Play with the wheels or push them up and down the ledge or some other part of the cars?
 
Mom: He does both. Play with wheels or rolls car back n forth on wheels. Then build a make believe mountain with a book n roll car over the mountain. As he does so, he says "over the mountain" He puts the book like an inverted V. He likes to stack 1 car on top of another object like a tissue box and move both along the ledge. Any ledge also can.
 
Mom: Son A doesn't seem able to read facial expressions. Son B can.
 
Ben: It is difficult to diagnose autism before 4 years old. though the symptoms appear after about 1.5 years old
 
Ben: But there is nothing in what you have written that suggest he has autism. Autism and personality are partially genetic. Twins especially dizygotic twins can be different
 
Mom: We tried an online assessment checklist and he got 10 out of 20. It says high risk for autism
 
Ben: I say so because 1. He has normal speech development. Already speaking in sentences.2. He has no fixated or repetitive activity
 
Ben: Playing with cars up and down a ledge is a normal play activity
 
Mom: He has terrible tantrums. We used to think he's just willful but looks like a complete and sudden meltdown. So we thought it was overload of sensory stimuli
 
Mom: But he can be pacified with pacifier n rabbit pillow. Quite quickly
 
Ben: What brings about the tantrums?
 
Ben: You scolding him? Sibling fighting? or toy is taken from him? or he is refused something?
 
Mom: Anything he can't get or there is a sudden switch of activity eg finishing shower and coming out of bathroom when he refuses to cause he wants to play with the water
 
Ben: That's normal for a child esp a boy
 
Mom: Or feed him 1 piece of bread. Once it's finished, he cries and screams
 
Ben: He wants a 2nd piece?
 
Mom: Yes
 
 Mom: Son B is more calm. Can be reasoned with. Son A is more prone to angry tantrums. And will not listen once he erupts
 
Ben: Son A is like my son. Quick to anger, knows what he wants, impulsive, got his own mind.
 
Mom: Haha Son A is v v v challenging. Wants what he wants no matter what
 
Ben: My girl is soft and tends to give in but she has learnt to disturb my son back
 
Mom: Son B gives in 90% of the time. So we thought earlier that Son A is just spoilt. Cause he used to vomit all his milk after crying so adults scrambled to give him what he wants. But when we beat his thighs to punish him after warning him to stop screaming, he looks bewildered
 
Ben: What you have observed is the personality difference between your 2 sons.
 
Ben: You had observed a spiritual condition give root - sin expressing as a willful behavior.
 
Ben: He needs more discipline for the next 10 years compared to Son B
 
Mom: Yes. We are trying to strengthen that now
 
Ben: My son has now improved after 8 years. Medicine/psychology will tell parents to show more love and care but stick to the bible for discipline principles
 
Mom: It's because my parents give in to Son A every time in fear that he would vomit, so my dad even takes away Son B toys to give Son A.  Son A gets disciplined more often. We beat his hand if he beats people. So Son A knows how to toe the line. When he pushes the envelope, we go after him
 
Ben: Anyway Son A doesn’t fit in the DSM classification of autism. Autism children except savants have low IQ and the 1st symptom is speech delay / communication issues. Followed by unusual tantrums over nothing major and then unusual repetitive activity
 
Mom: Maybe he has Asperger's? Cos we also noticed his speech development is very fast. Atypical
 
Ben: Asperger is v difficult to diagnose. Not at this age. But the treatment for that is usually counselling and behavior modeling later in life if they cannot cope in school.
 
Mom: Smelling his rabbit pillow for long n sucking pacifier I would deem as usual, right?
 
Ben: Yeah that's normal even some adults still have their stuff toys. Your kids should stop using pacifier, bad for teeth
 
Mom: Yup. He refuses to. Wakes up at night crying for it when it drops out. Son B stopped 1 year already
 
Ben: Since your both kids have different genes, expect them to be different
 
Ben: our both kids need to be called many times before they respond too. They seemed to be lost in their own world
 
Ben: If a pediatrician were to see son A, the paeds will refer him to a paeds OT for further evaluation. The diagnosis is also based on your input to the pediatrician and the OT observation. But again difficult to diagnose before 4 years old. The end diagnosis will be nonspecific behavior needing OT + parent counselling
 
Ben: and that means more trips to the doctor and OT
 
Ben: Sin is not a medical diagnosis.
 
Mom: My husband has a question: what does this mean? "Followed by unusual tantrums over nothing major and then repetitive activity over unusual stuff"
 
Ben: Normal tantrums are in situations like kids are denied something or they are being punished. Kids tend to cry loudly with exaggerated contortions in their faces - which is actually normal and look really pitiful. That attracts attention especially grandparents. Some kids do cry softly or just sob like adults.
 
Ben: Abnormal situations are like kids cry over a bird chirping ( not dog growling ) or when the choo choo train move in reverse direction they are used to seeing
 
Ben: abnormal repetitive activity are meaningless activity like hands flapping, head banging on the wall or obsessions with objects that are not toys (age related). Autistic kids can get excited by the stimulus from head banging.
 
Ben: And you can print out the questionnaire and show me what you indicated as signs of autism.
 
Mom: We were alarmed that his tantrums mean he arches his back and doesn't care if he hits his head or not, loud n sudden outbursts made worse by the fact we don't know what he wants cos he won't say
 
Ben: A lot of these behaviors can be solved by discipline.  My son used to be like that and he used to have a couple of repetitive bad habits - which included head banging. Which all got better over time after sufficient scolding has been administered
 
My thoughts
 
Early childhood psychiatric disorder like autism and ADHD attention deficit hyperactivity disorder have been getting a lot of attention among young parents. Doctors and health information websites will emphasize the importance of picking up these conditions early so that intervention can take place. However, the symptoms are also often confused with the willful behavior and poor attention span in normal young children. These behaviors usually start around one and half years old (age of the terrible two). I belief all these are the manifestations of the sinful nature of children. The naughtiness, rebellious and psychiatric conditions are part of a spectrum. Those that result in dysfunction are categorized under the DSM V neurodevelopment disorders.
 
The bible answer is for parents to love and discipline their children. Although it seems cruel to discipline a child, yet the bible recommends discipline as necessary ingredient to train up a child. It may seem illogical to associate discipline as vital for growth but I have witnessed it happen to my children. Their willful & impulsive nature had been tempered over the years through teaching of proper manners, scolding and sometimes caning. There is also a role of discipline too in managing children with autism and ADHD especially the willfulness and impulsivity side.  
 
Through proper discipline by parents, children are taught to 
  • recognize bad behavior (outward sin)
  • curb their own willful desires (sinful thinking)
  • learn that bad behavior deserves punishment
  • the need for repentance
  • it is done out of parents’ love
 
 
Supporting bible verses
 
Proverbs 13:24
Whoever spares the rod hates their children,
but the one who loves their children is careful to discipline them
 

Proverbs 22:6
Start children off on the way they should go,
and even when they are old they will not turn from it
 

Proverbs 22:15
Folly is bound up in the heart of a child,
but the rod of discipline will drive it far away
 

Proverbs 23:13-15
Do not withhold discipline from a child;
if you punish them with the rod, they will not die.
Punish them with the rod
and save them from death

 
Proverbs 29:15
A rod and a reprimand impart wisdom,
but a child left undisciplined disgraces its mother
 

Hebrews 12:11
 No discipline seems pleasant at the time, but painful. Later on, however, it produces a harvest of righteousness and peace for those who have been trained by it
 

    Q&A

    Here I post some of the more interesting questions I had been asked and the replies I gave. My replies are based on my knowledge and experience. I do not have the perfect answers. But it is my hope they bring some understanding to you. 

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