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Daycare Center and Family Home Forum>New Little One, Interesting Behavior
Baby Beluga 02:18 PM 08-30-2017
DCB is 18 months and is showing some interesting behavior patterns.

*Will not eat - anything. Mom says he is a garbage disposal at home and eats everything. Here he will sit at the table but he puts his head down and closes his eyes. This is at every meal/snack time so I do not think he is putting his head down to sleep.

*He does not move. He is capable of walking now (started walking 2-3 weeks ago.) According to mom he walks and runs all the time at home. But here? He sits in one spot and refuses to move. Toys, other children his age, fun activities, nothing will entice him to move. If I take his hand and guide him to an activity he either picks his feet up off the floor or sits down and screams.

*He won't pick up anything that is his. For example, he sleeps with a bink. I put it on his cot at nap time but he won't pick it up to put it in his mouth. He will cry for it. He will stare at it. But he won't get it.

*When sitting his head is either down (chin to chest) or it is as far back as it can go and he stares at the ceiling lights.

*During pick up he won't move toward mom or dad. He will cry when they arrive, but won't move.

I am used to crying during an adjustment period but this little man is showing interesting behavior that is new to me.
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happymom 03:06 PM 08-30-2017
Could his parents be lying?

Have you seen him partake in the behaviors that they describe?
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Ariana 03:21 PM 08-30-2017
Inhad a child who I felt was ASD and acted similar. Extremely lethargic here. Would go from standing to sitting in a "sinking down" motion with his legs. He would stand in one spot when outside, not moving. Once I brought him out into the hot sun with no hat to see if he would move and he just stood there. He would sometimes lie on the ground not moving.

I took videos to show his mom, she was shocked. Apparently at home he was a complete genius. I started feeling like I was insane! I terminated care because of that feeling and because I felt mom was in major denial.

From what I coukd gather from online research some children with autism become hypotonic or hypostimulated. They react to stimuli by shutting down. Sinking into the carpet, putting their head down....basically going catatonic in a sense. It might be what is happening here. The first redflag for me was when I blew bubbles and he just sat there letting them fall and pop on his face with no reaction. I had never seen a child at 18 months do that! Mom might be telling the truth. From what I had read children on the spectrum act that way with us because they are stressed and out of their comfort zone. It is why many parents stay in denial I think.
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storybookending 03:32 PM 08-30-2017
Sounds too me like there is something developmental wrong there.
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Mom2Two 04:41 PM 08-30-2017
Maybe request a letter from pediatrician re development. He should have had a 12 mth mini-assessment by the pediatrician, you could request that.

Did you do an All About Me? You could ask parent to show you/tell you the favorite activities.

Or just trust your gut that this parent is lying to you. It's definitely a bit suspicious.
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Baby Beluga 04:42 PM 08-30-2017
When mom and sister brought him over for a meet and greet (I've worked with this family since 2012) he walked but preferred to crawl and mom carried him most of the time. I did not see him eat food but I did witness him throw a couple of toys (to which mom laughed ) He did not play though. Most kids who come in regardless of age make a beeline for the toys and play while parents and I chat.

During snack today I did hand over hand, picked up a raisin and put it in his mouth. As long as I did this he ate. When I stopped, he stopped eating.

An interesting thing happened this afternoon. He is my last one by about 1 hour and given his lack of movement I felt it was safe to bring my 5 month old into the classroom on his own rug/blanket with baby toys. The 18 month old walked over to the blanket and had the best time with the infant toys. Did not hesitate at all.

Do you think it's a case of being over babied and the independence of my regular crew is shocking?
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Baby Beluga 04:43 PM 08-30-2017
Originally Posted by Ariana:
Inhad a child who I felt was ASD and acted similar. Extremely lethargic here. Would go from standing to sitting in a "sinking down" motion with his legs. He would stand in one spot when outside, not moving. Once I brought him out into the hot sun with no hat to see if he would move and he just stood there. He would sometimes lie on the ground not moving.

I took videos to show his mom, she was shocked. Apparently at home he was a complete genius. I started feeling like I was insane! I terminated care because of that feeling and because I felt mom was in major denial.

From what I coukd gather from online research some children with autism become hypotonic or hypostimulated. They react to stimuli by shutting down. Sinking into the carpet, putting their head down....basically going catatonic in a sense. It might be what is happening here. The first redflag for me was when I blew bubbles and he just sat there letting them fall and pop on his face with no reaction. I had never seen a child at 18 months do that! Mom might be telling the truth. From what I had read children on the spectrum act that way with us because they are stressed and out of their comfort zone. It is why many parents stay in denial I think.
I tried bubbles today. He did sat in the grass and did nothing. My crew LOVES bubbles and goes wild for them.
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sahm1225 05:28 PM 08-30-2017
Can you ask mom to show you a video of him at home?
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hwichlaz 05:47 PM 08-30-2017
My first thought is...
He's shutting down, over stimulated. I'd suspect ASD.
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Baby Beluga 02:20 PM 08-31-2017
Well jeesh, two thoughts on possible ASD. I am going to have to do more observing and research on ASD and him.

Shutting down to stimuli is a perfect way of putting his behavior. It is interesting though because he was at a local center from 6 months old until coming to me at 18 months. In his most recent class at the center he was one of 13 children. He is now one of 4. And although we are an active group the overall feel and vibe of our room is pretty calm. I wonder if the stimuli of his last classroom allowed him to "disappear" and he is unable to do that now? Mom did say his last teacher said he just sits in the middle of the room with a toy and watches the other kids play.

On the bink - I mentioned it to mom and she said he has been doing the same at home. Cried for his bink the night before even though it was in his crib with him. She said "but last night I didn't go in and put it in his mouth" so I am thinking she usually inserts if for him.
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Baby Beluga 02:21 PM 08-31-2017
Originally Posted by sahm1225:
Can you ask mom to show you a video of him at home?
This is a good idea, thank you.
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Ariana 02:56 PM 08-31-2017
Mom reported to me that his last caregiver got rid of him because she could not handle his needs. At the time I thought she meant he was just needy. Slowly though I realized she meant his ASD needs.

Conduct an MCHAT questionnaire for him. When I did this I got 8 redflags. Parents got "a few".

Although it is quite possible he is just over babied at home, to me this just doesn't make sense. A baby, unless there is abuse happening (another thought I had), seeks stimulation and exploration.
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SunflowerMeadow 09:28 PM 08-31-2017
I find this behavior odd. Definitely get a consult.
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daycarediva 02:33 PM 09-03-2017
He definitely needs an evaluation.

Any way you could have an open house? Party? Invite parents? See how he behaves with mom present for any length of time.
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Baby Beluga 08:47 PM 09-04-2017
Just a small update:

Spoke to mom at pick up on Friday. He was previously at a center 2-3 days a week for 1 year before enrolling with me. Mom mentioned that the teachers at the center "babied" DCB.

DCB has also gone to two different peds for normal check ups. So if there was a developmental delay it may have been missed.

I want little dude to work out but boy I am so confused by this one!
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Baby Beluga 08:52 PM 09-04-2017
Originally Posted by daycarediva:
He definitely needs an evaluation.

Any way you could have an open house? Party? Invite parents? See how he behaves with mom present for any length of time.
I saw him with mom and sister present for about 1 hour. He seemed a little physically and socially delayed but otherwise I didn't see any huge red flags. Made eye contact, put EVERYTHING in his mouth, was loud, etc. Mom says he says a few words at home (momma, dadda, apple, cup) and a few others that I cannot remember at this moment but I have not heard one word from him. Just occasional pointing and babbling. Usually when mom has picked up and is holding him.
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Unregistered 03:21 PM 09-05-2017
I had one many years ago that had strange behavior with me at first - only walked on his knees, not playing or doing things for himself, not engaging with me very much. He was removed from the previous daycare because his parents didn't think he was learning anything, and he was much more animated at the interview than his first few days with me. I figured out that the previous daycare just wasn't very nice and must have been very crabby at him. It took just a few weeks for him to get comfortable and be the little boy he should be.

I had another one that used to do the staring down or up and go stalk still whenever I would redirect or just no-nonsense direct (time to put the toys away for lunch, now). Turned out, his dad screamed and threatened at home all the time, and when dad left the home he completely stopped that shutting down.

Those were my experiences, anyway. I hope your little guy comes around or gets the early intervention if he needs it.
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Ariana 03:44 PM 09-05-2017
Originally Posted by Baby Beluga:
I saw him with mom and sister present for about 1 hour. He seemed a little physically and socially delayed but otherwise I didn't see any huge red flags. Made eye contact, put EVERYTHING in his mouth, was loud, etc. Mom says he says a few words at home (momma, dadda, apple, cup) and a few others that I cannot remember at this moment but I have not heard one word from him. Just occasional pointing and babbling. Usually when mom has picked up and is holding him.
It was the same with the kid I had. Much more animated when she was here. This literally went on for over a year because it was so confusing. Towards the end I invited her in for a chat and at that point I knew so much about ASD I could see the subtler signs. He would push toys into her rather than giving or showing them. She would speak to him like he was 6 months old and the only response he could give was to repeatedly ask her questions "blue car?" She was a teacher and an ECE somit made it all the more confusing for me. Why didn't she see what I was seeing!

My only advice is to keep an eye on it. It will soon become blatantly obvious that something is going on (if it is in fact developmental) My little guys started at 16 months and I knew for sure at around 2.5 yrs.
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Mom2Two 05:55 PM 09-05-2017
Our resource office just sent out an email about separation anxiety, and the article said that some children show separation anxiety by withdrawing. I'll try to post some of it:

Separation anxiety can appear in many forms. And, it does not happen ONLY during the first two weeks of school. Most of your preschoolers will transition fine into the classroom. However, you will have a few that do not.

They may sit quietly on a chair and not interact. They may cry. They may have an all-out breakdown. What's a preschool teacher to do?

Symptoms
We have all seen, at least once, all out separation anxiety attacks! As in the scenario at the beginning of this article, you may have helped to "peel" a child off their parent or had a child (or two or three) who cried and/or screamed.
Sometimes we miss the silent cases in our classrooms. The children who sit by themselves and look at a book or a toy or nothing at all. They don't interact with the other children. They may hesitantly nod answers (if they respond at all) to the teachers.
Try your best not to let these children fall through the cracks. The more vocal children need more immediate attention at drop off time. However, be sure to spend some intentional time building trust with your silently anxious children as well once your group is calm.
Separation anxiety does not only happen at the beginning of the day. Children may respond to this anxiety when their parent or caregiver picks them up.
They may run to the parent and cry. They might act out by running around the room. They might become defiant and not acknowledge or respond to their parent at pick up time.
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Mom2Two 05:57 PM 09-05-2017
PLEASE--DON'T LEAVE ME!


Picture the scenario with me for a moment:

It's the third week of preschool. Everyone seems to be getting used to a routine together. One day, when nobody expects it, one of your "I'm here! I Love School! I'm ready to face the day!" preschoolers grabs Mom's ankles and won't let go.

Crying. Pleading. "Please! PLEASE! MOM--DON'T LEAVE ME!!!". Mom looks at you with that deer in the headlight look because even she is not sure where this came from!

Separation anxiety can appear in many forms. And, it does not happen ONLY during the first two weeks of school. Most of your preschoolers will transition fine into the classroom. However, you will have a few that do not.

They may sit quietly on a chair and not interact. They may cry. They may have an all-out breakdown. What's a preschool teacher to do?

"A child's apprehension or fear associated with his or her separation from a parent or other significant person." This is the definition of separation anxiety from The American HeritageŽ Stedman's Medical Dictionary, according to www.dictionary.com

It is the fear of the unknown. And let's face it. In preschool, there are many unknowns for children because so many things are new. And new=unknown!

They are in a new building, facility, environment.
They are around other children they have not met before or have not seen for several weeks or months (such as during winter breaks, holidays or summer break).
They are around adult strangers: adults other than their parents or primary caregivers.
They are in a large group for the very first time in their lives.
Let's talk Maslow's Hierarchy of Needs. Many of us have taken classes where we studied his theories along with Piaget and others.

Maslow stated that there is a hierarchy of stages of human development that we all go in and out of throughout our lives. Once one has been met, and we are secure in that need being met, we move on to the next level of growth.

The stages are based on basic human needs we all have:

1. Physiological--These are our basic needs: water, food, sleep, breathing, etc.
2. Safety--Once our basic needs are met, we look for our safety needs to be met. For children, this would be their families, pets, and their own bodies.
3. Love/Belonging--Once our basic and safety needs are met, we grow into the stage of love and belonging. This is as crucial as our basic and safety needs. This stage is developed by building trust--with other children and with new adults in our lives.
4. Esteem--Once our basic & safety needs are met and we feel we are loved and belong, we then develop confidence in ourselves and build respect for ourselves and for those around us.
5. Self-Actualization--With all the previous needs and developmental areas intact, we can then grow and develop even more such as by developing problem-solving skills, spontaneity (being flexible!), etc.

This hierarchy is not one that we "climb", reach the top and stay. Life happens and impacts a certain area and brings us back to that level of need.

For example, we may be in between or at Esteem and Self-Actualization when the death of a family member occurs. This will impact us to the point of our own safety needs (remember, that includes family) and our sense of where we belong is impacted. During the grief process, it can take a while for us to develop a new routine and find a "new normal" that allows us to develop that sense of esteem and actualization again.

For preschoolers, starting school after a summer home or after being home for 3 years with no large group experience brings children back to Stages 1 and 2!

Will my needs be met?
Can I trust these new adults?
Will I have friends?
Will I eat here?
Will Mom/Dad/Grandma etc. come and get me?

Symptoms
We have all seen, at least once, all out separation anxiety attacks! As in the scenario at the beginning of this article, you may have helped to "peel" a child off their parent or had a child (or two or three) who cried and/or screamed.
Sometimes we miss the silent cases in our classrooms. The children who sit by themselves and look at a book or a toy or nothing at all. They don't interact with the other children. They may hesitantly nod answers (if they respond at all) to the teachers.
Try your best not to let these children fall through the cracks. The more vocal children need more immediate attention at drop off time. However, be sure to spend some intentional time building trust with your silently anxious children as well once your group is calm.
Separation anxiety does not only happen at the beginning of the day. Children may respond to this anxiety when their parent or caregiver picks them up.
They may run to the parent and cry. They might act out by running around the room. They might become defiant and not acknowledge or respond to their parent at pick up time.
Longevity
There is no clear cut answer for this. At the beginning of the school year, separation anxiety can last from one day to three weeks.
It can go away and then return one or two months into the school year.
Many times it returns after a school break or a vacation.
In some children, it will return after a weekend.
My thoughts:
I have, for the past several years, worked in a half-day program where the children are in preschool either Tuesdays and Thursdays (for 3 year olds) or Mondays, Wednesdays and Fridays (for 4 year olds).
Because they are only in the environment every other day, it is common to see this anxiety for up to 3 weeks--and yes, I DO let parents know that this can happen!
In full time programs my experience has been that children work through this within 2 weeks.
There will be a child now and again who does take a very long time. Consistency and working with the family will be key.
Separation Anxiety Tips for Teachers
So, what's a preschool teacher to do? Here are 8 Tips!
1. Plan Ahead
Acknowledge YOUR feelings! When I child has extreme separation, how do YOU feel? Do you feel unsure of what to do? Sad or down that the child is reacting this way? After all, your classroom is AWESOME and SOOOOOO much fun! And, you LOVE children--it's why you are in the field! How does this child not SEE this?!!
If a child this anxious makes you anxious, you will most likely be ineffective in helping him or her transition. Talk with your co-teacher, assistant and aids.
Who is better able to help the child(ren) transition? That person should be the primary receiver of children when they are dropped off.
This does NOT mean that the rest of the staff brushes their hands of it. It means that the rest of the staff needs to be attentive to all others in the group while the primary person receives the children who need the extra help.
The staff will find it helpful for the director to be present during drop off and pick up time for the first couple of weeks. Ask your director to be there to help. Typically, your director will help with the children who have transitioned rather than with those having a tough time.
They are NOT avoiding the conflict! As a director, I get involved if needed. The teacher needs to build the trust with the child and parent. If I am the child's transition person, I will need to be in the classroom in the morning for months. The child's teacher or other everyday staff person should be the person to work on this with the child and or parent.
2. Greet and Meet
Acknowledge PARENTS' feelings. There is nothing worse than dropping your child off for school and having them react with anxiety. The emotions of the parent can be apprehension, guilt, frustration, anger and helplessness. Realize how difficult this is for them as well.
Greet each child and parent at drop off time. Assure them that you will help their child to settle in. Assure them that their child is NOT the first to react this way. Assure the parent that this is very common in preschool.
I have, for 20 years, told parents that I have a "7 minute window". If their child is still this upset in 7 minutes, my heart breaks and I will call them! I do not want their child traumatized by school! I want them to love school! But love is born out of trust, and trust takes time!
Give parents suggestions on how to help their child. Suggest they do a puzzle together or read a short story, or participate in the arrival activity you have set up (and you should have one set up! The children should have something to focus on.)
Let the parent know how you can and will help. If their child is crying, suggest that the parent hand their child over to you (showing child that the parent trusts you with them).
What I typically tell parents is:
1. Perhaps you could ______________ (read story, do a puzzle) together.
2. Let your child know that once you are done doing that, you will be leaving and will see them after __________(whatever your last activity of the day is).
3. Let me know when you are ready to leave. Remind your child, "That was a fun puzzle. Mom's going to leave now. Have fun with Miss Cheryl and your new friends. I'll see you after storytime!".
4. When you say you are leaving...LEAVE!!! Don't stay for 1 more puzzle, or 1 more story.
5. Do NOT leave without saying goodbye. This will make the next day even more difficult.
http://www.preschool-plan-it.com/images/separation-anxiety-resource-cover.jpg$1.50 USD
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I have created an editable letter that you can personalize for your program.
Click here to go to my Preschool Cubby Store to read more!
3. Accept Child's Feelings
This is a big one. In an attempt to help children transition, many well intentioned comments or statements are made to the child which actually dismiss how they are truly feeling. Our comments and statements won't change a child's feelings.
Please avoid saying things like:
"Don't cry! This is a happy preschool!"
"Are those tears? You are a preschooler now! Preschoolers don't cry at school."
"We are big kids now, not babies! Let's dry our tears and play!"
Again, these types of statements dismiss how they are feeling. Their anxiety has to do with being separated from their family and the fear of this new, unknown place. Acknowledge how they might feel.
Some statements that I have seen to be helpful are questions, even if they just nod when you ask them!
"You look sad this morning. Are you nervous about Mom leaving?" You can then explain what will happen when Mom leaves and what you will be doing.
"Are you nervous about school because you are new?" You can then respond with telling them how you felt on YOUR first day teaching preschool! Or, if it is your first year with this group, tell them! "I'm a little nervous, too. Today is my first day with this group! We can be new together!"
4. Reassure
Once the parent has left, sit with the child, reassure them that their parent will be back later in the morning or later in the day. And then try and get them involved in an activity that you have available.
If the child does not want to interact or get involved, accept that. Offer a quiet choice.
We all want to see our students "switch" from crying to playing happily. In time they will. For now, let them be!
Offer your arrival activities "There is playdough on the table you can use or there are books and puzzles over here!" Then step aside and let the child think about their options.
If they are very adamant and vocal that they do not want to play, really--accept that! Don't force play and interaction. They need to calm down from this anxiety.
You can reassure them by saying something like, "I understand you are still upset. When you are less upset. If you feel up to it, you go right ahead and choose one of those activities. We will be cleaning up in a few minutes to all get together for a fun Circle Time!"
Another thing that we have, over the years, found extremely helpful is to have a visual schedule that the preschoolers can "read" on the wall at their level.
You can show them this and reassure the child that their parent will be coming back after _________(name the last activity of the day).
A visual schedule is simply a set of pictures of your activities each day in the order you do them such as:
http://www.preschool-plan-it.com/images/image1.jpg
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You can show the child while pointing: "Right now we are doing this (point to arrival activities). Then we will have Circle. We will then play and have fun in our centers like dress up, science, blocks, etc.
We will wash our hands and have snack and then play in the playground.
After the playground, we'll come in, sing some songs (or play a music game) and then read a story.
After our story, Mom will be here to pick you up!"
I have created a Preschool Schedule Pack. It has printable cards for all the areas of your day that you can print, laminate and use. It also includes some blank cards for you to add your own, unique activities to.
You can read more about this resource by clicking here!
5. Provide Parental Support
I recommend having a Parents' Tips page to hand out to families.
It would be ideal if you had a Parent Orientation before school starts. This is a time for parents and teachers only--no children! Holding this for 1 hour a week before school starts can help parents tremendously.
During the orientation, address separation anxiety and hand out the tips list.
You might also have a Parents' Tips List to hand out the first morning of school.
Include the information I listed above in #2: Meet and Greet.
You can also CLICK HERE to go to my article for more information on developing your own Parent Tips List for Separation Anxiety.
6. Call or Text Them!
If a child has a tough time being dropped of, that is the vision the parent has in their head all day: My child is crying. My child is sad. My child is angry.
Let them know that their child is doing fine a little later in the morning!
You can do this by texting them a picture of their child involved in play (do not include other children in the pictures for confidentiality reasons).
You might also call the parent(s) of the child(ren) who had a tough drop off. Either ask your director if she can call on your behalf, or have someone cover your room for 5 or 10 minutes so you can do this.
Do not call in front of the child. Seriously, this will start it all over again!
Make the call quick! "Hi _______. I just wanted to give you a quick call to let you know that _________ is doing great! He (she) is building a castle in the block area with some of her new friends. She calmed down within ____ minutes."
Parents will not only love and appreciate this type of quick call, but will develop trust in you that you are concerned about their child.
I mean, YOU know you care about them all, but this shows the parent that each individual child is important to them and they are not just one big group of kids to you!
7. Talk About It
When I say talk about it, I mean both to the children and to the parents!
WITH THE CHILDREN:
At Circle Time, talk about how they are feeling about school!
Perhaps do your first ever group graph called HOW DO YOU FEEL TODAY?
Show the children emotion faces (perhaps have stickers or little ones to place on your chart).
Talk to them about the new year and how it can be scary! Does any feel sad? Who feels happy? Who feels scared or afraid? etc.
Let them put a sticker next to their name or you can put it there for them.
WITH THE PARENTS
Be available at pick up time. Talk briefly about their transition. I suggest including a few brief items to EACH parent as they pick up:
A. Use the child's name.
B. State the amount of time it took for them to settle in.
C. State a favorite activity and a friend's name.
D. Give the parent an idea of what will happen the next day to help their child prepare on the next school day:
Something like:
"Julie had a fun morning. She settled in within 5 minutes. She played with playdough and enjoyed building a castle with blocks with her friends Joany and Robby. On Thursday, we're going to paint and she said she's pretty excited about that."
You might even have a pretyped letter that has these items on them and then fill in the blanks with each item for each child (with the help of your co-workers throughout the morning) and hand them out (do NOT put them in backpacks! Have parents see them right away) to the parents as they pick up their child.
If a parent wants to talk longer about their child's separation, I suggest calling them at home after school is over. I do not recommend having a long talk about it in front of the children. This can (and most likely will) add into their existing fears/anxieties.
8. Resources
There are several resources to help you and to help families with separation Anxiety in Preschoolers
Books
I suggest the following books to read at school and/or at home!
Don't Go!http://ir-na.amazon-adsystem.com/e/i...1&a=0618072500 by Jane Balkin Zalban

My First Day at Nursery Schoolhttp://ir-na.amazon-adsystem.com/e/ir?t=presplanit-20&l=as2&o=1&a=1582349096 by Becky Edwards

First Day Jitters (Mrs. Hartwell's Class Adventures)http://ir-na.amazon-adsystem.com/e/i...1&a=158089061X by Julie Danneberg

I Love You All Day Longhttp://ir-na.amazon-adsystem.com/e/ir?t=presplanit-20&l=as2&o=1&a=0060502789 by Francesca Rusackas

The Kissing Handhttp://ir-na.amazon-adsystem.com/e/ir?t=presplanit-20&l=as2&o=1&a=1933718005 by Audrey Penn

Will I Have a Friend?http://ir-na.amazon-adsystem.com/e/i...1&a=0689713339 by Mariam Cohen

Visual Schedule
As I recommended above, make a visual schedule for the children and parents to see to help them tell time throughout the day!
Parent Tip Letter
Put together a Parent Tip Letter with your advice for parents and how to handle separation anxiety with their children. Click here for an article on what to consider when you develop a Separation Anxiety Parent Tip Letter.


Until next time,

​​​​​​​Miss Cheryl

https://misscheryl.leadpages.co/preschool-cubby-pl/
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Baby Beluga 10:32 AM 09-06-2017
Thank you for sharing those thoughts on separation anxiety. It was/is something I keep in mind when dealing with this little one.
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Mom2Two 01:08 PM 09-06-2017
Can you add a tag of separation anxiety to this? It might be helpful to someone else someday. I had never thought of silent non-interaction as symptomatic of separation anxiety, but now it totally makes sense.
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Tags:asd, developmental delay, developmentally delayed, separation anxiety
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