getting dressed has become a huge obstacle

[claudiac]

Hello, Dennis is a 7 1/2 year old that is a good student, a good eater but since he was an infant dressing him always seemed to cause stress, tears, screaming. Things haven't gotten better as he has grown. he complains that clothes bother him and tears come rolling out of his eyes. He was the same problems putting on his pygamas, everything is either to big or to small or to tight or it drives him crazy aroung the neck. When we finally get him dressed he quickly forgets about the problem and leads a normal life all day.
Dennis is in constant movement and walks on his toes. His toe issue has gotten better slightly but not completely.
He wants his shoes very loose.
Dennis spends the week end with us and the rest of the week with his mother where the situation is worse. He refuses to allow his grandfather to dress him. His mother has a very difficult time and now he is skipping school because he strips naked and gets into bed and won't get dressed.  
I am his step mother. I have mixed feelings between SID and mild mild mild SID with a lot of bad behavior add to it.
I have searched for help everywhere but in italy nobody knows about SID and there aren't occupational therapists.
I would really appreciate to know how I can diagnose what case I am in. How can I understand if he is using his tactile stress to his advantage and what I can do with my husband and his ex wife and her new partener to handle this situation.
Thank you for your help. Much needed.
Claudia

[Rachel Thompson, Ph.D., BCBA]

You did not mention whether your step son is diagnosed with autism or not. It is common for children diagnosed with autism spectrum disorders to respond strongly to certain forms of stimulation, but this is also observed in typically developing children. My suggestion is to honor his preferences when reasonable by letting him choose clothing before getting dress (and to select clothing for purchase). Give him a choice between outifits or articles of clothing that seem to meet his needs. Give him a short period of time to make a selection and then require him to get dressed quickly. Do not allow him to change outfits once he has made a selection and avoid discussing the outfit once dressing has started. Consider providing a reward for dressing within a reasonable time period (e.g., 5 or 10 min). Set a timer and then provide the word if he is completely dressed. If he is not dressed, help him to get dressed with minimal interaction. I agree with the post above that he is probably having some discomfort related to the sensation of clothes, but his difficulities with the dressing routine can be worsened if he is able to avoid school or otherwise control the family's activities.

[MaryannesMom]

Sensory problems are very real, and I would not dismiss this as bad behavior.  Sorry I don't know where you could get help in Italy.  I know it is frustrating, but try to put yourself in his shoes and think how it must feel to him.  

[tejodouro]

Maybe you can contact via e-mail an Occuptional Therapist in the USA that can advise you how to handle this.  Have you taken im shopping and let him try some clothes (such as loose ones and 100% cotton) that feel good at the store?  Also cut all tags from all clothes.  There are therapies such as using a very soft brush to brush his skin that helps to diminish the sensitivity of the skin. There is a book called the The-Out-of -Sinc Child by Kranowtz that could help you if you can not find local help. You can order this book on Amazon. This book describes the problems of SID and also gives some solutions. Good luck.

[claudiac]

Thank you. I have been attempting some of the things you suggested but others will be on my list now. Dennis has not been seen for Autism but we will discuss this in the family now.
Dennis has always had this problem, since he was an infant, but now it has suddenly gotten worse. Actually it is worse with his mother, his tantrums are terrible. Her boyfriend (that Dennis adores) has just moved in with them. Dennis has severe problems getting dressed with his father and I but never tantrums. He knows we put our foot down and won't give in but sometimes it is heartbreaking.
He is a happy child and very smart also.
I have one question: I don't quite understand what you mean when you refer to the possibility of him being a typically developing child. What would that mean?
On the other hand, what kind of specialist do we have to go to to get him diagnosed for Autism?
Thank you so much, part of this is me feeling better too and your help is so precious in this.

[Rachel Thompson, Ph.D., BCBA]

I just meant that the behavior that you described occurs in children with no diagnosis but is more common in children diagnosed with autism. As you may know, autism is characterized by social and language deficits as well as the presence of repetitive behavior. If you think that your step son meets this description I recommend that you have him assessed by a team of professionals that specializes in diagnosing autism spectrum disorders. Most large hospitals will have this service available.