The below is a (moderately paraphrased to remove potentially problematic language, and to keep it concise) question from a parent.
My 4 year old has sensory processing disorder, an expressive language delay (but is not nonspeaking), and has been diagnosed with global developmental delay.
Socially, he’s normal for his age, but he’s highly skilled in specific areas.
He can pick out a sad face from a happy face or an angry face, something my autistic 6 year old had to be taught.
He can count to twenty in twos, to one hundred in fives and in tens. He can name 2D and 3D shapes.
But he can’t draw a stick person or anything that looks like what it’s supposed to look like. He can’t trace lines or letters.
Sensory processing disorder is a common co-morbidity of autism. Because of the SPD and having an older autistic child, autism is a strong possibility.
The global developmental delay is absolutely to be expected in such a premature child, and simply means that he’s likely to lag behind his peers in some skills. If he also had an extended stay in hospital as a baby, he has missed out on a lot of growth, development and learning time. A lot changes in the first 5 years of life, so even a few months of delay can make a big difference.
The diagnostic criteria for autism require a certain number of indicators for social disability, but there are many adults who have only recently been diagnosed because their environment or their coping strategies made social diffuculty hard to spot. At 4 years old, the social demands being made are very minor. He is not expected to follow many social conventions because of his age. He may still show delays in social skill development later in life as the complexity of the social rules increases.
In terms of recognition of emotional expressions, this also does not rule out the possibility of autism. Some of us can read expressions, others can’t. Some of us don’t have an intuitive grasp but memorise the expressions quickly.
He sounds a lot like my stepson, Squeak, who will be 5 this year. Squeak has been able to recite the alphabet and count to one hundred since he was about 3, but his drawing skills have lagged behind. His drawings lack detail, and many look like indistinguishable boxes, circles or squiggles.
When looking at your child’s drawings, consider his developmental delay. He may not have developed the skill of making his reprrsentative symbols look like the object in question. Other things to consider are that perhaps he needs glasses (it would account for the blurry scribbles) or that he has a motor function disability that is making it difficult for him to control the pen (accounting for the issue with tracing).
There’s also an aspect that I hadn’t considered when I first started working with Squeak, and that is that our art represents our experience. Squeak draws in a style I would describe as “exploded”. Many of the parts of what he draws are disconnected and their placement seemingly random. They look almost like blueprints or schematics. I’ve put this fown to it just being the way the objects and concepts are stored in his brain. Less an image and more a “mind map” of objects or parts of objects.
Your son may be drawing how he experiences objects too.
I also want to talk about the purpose of drawing for small children. Many of the children I have spent time with have shown little concern over whether the finished picture looks good, or at all like the original object. They seem more interested in the process, and in communicating with us through their art. I have also noticed this seems to be quite gendered, with girls showing more attention to detail, and boys more interest in getting the idea down on the paper (in general).
We started using drawing as a kind of therapy for Squeak very early on. It’s an excellent opportunity to sneak a peek at what’s going on in your child’s head by using the picture as a conversation starter. Let them narrate their picture to you and you will learn lots.
For example, Squeak used to draw lots of boxes. When asked what he was drawing, he said it was Tetris, or Minecraft. He’s always been very into tablet games, and those are his favourites. He was telling us, without telling us, that he would rather have been home with mummy and playing on her smartphone than sitting in a library with us. After a while, he seemed to get used to the idea that visits with us were a no-screens zone, the drawings of games decreased in frequency.
Another time, I spotted him drawing squiggly blobs in lots of colours, and drawing lines between them. When asked, he said he was drawing paints and mixing thembby drawing lines between them. I asked if he had any paints at home, he didn’t, so I bought some for his visits.
He drew “houses with lots of rooms”, he wanted a doll house…
Alt: Child’s drawing in brown pen. There is a large, loopy squiggle containing lots of zigzags. Outside the squiggle are four rough circles with triangular slices out of them.
This is Squeak’s representation of the game PacMan. The large squiggle is the game area, which the PacMan sprites are about to enter. The zigzags may represent either the jagged bottoms of the ghosts, or the shapes of the corridors and walls.
It didn’t matter much what the pictures looked like, it was the conversation they started that allowed us to better provide for his needs. I can’t offer you a diagnosis for him, but I can recommend that you engage with him about his drawings, you might get some interesting insights. Even if there are no revelations, you’ll still be spending quality time together and having fun!
For now, his diagnosis of GDD sounds adequate, you can always reevaluate at a later date if he does start showing social difficulties.
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