My nonspeaking autistic child has been s

You are not overreacting — and you are right that "it's just a behaviour problem" is the one answer that will not fix this. Months of daily screaming in a child who cannot tell you where it hurts is a pain question first. Keep the Tuesday appointment; the work between now and Tuesday is to make that visit answer the right question.

I cannot tell you what is causing it, and nothing here changes any medicine. What I can do is give you the list worth raising with the doctor, a tonight plan that fits in about 20 minutes, and words you can screenshot.

1. What you have tried vs. what to do differently

Tried: treating it as behaviour only.
Do instead: treat it as a pain hunt, in writing.
You already keep a pain and behaviour diary. The change is one column: body area + what happened in the 24 hours before. Pain in nonverbal children usually has a rhythm — same time of day, after meals, at bedtime, after activity, on certain days. A diary that shows the rhythm is the single most useful thing you can hand the doctor on Tuesday.

Tried: waiting to see if it passes.
Do instead: line up a head-to-toe look at one time. Pain that has been there for months is not a fresh symptom. One appointment where someone checks ears, mouth, throat, belly, back, skin, and urine is worth more than a month of guessing at home. Ask for it as a full examination, not as "the behaviour again".

Hidden causes worth naming out loud at the visit (name them so they cannot be skipped — a child who cannot point often gets a partial look):

• Constipation and a full bowel — hard, small or very loose stools, days without one, belly that looks swollen or tense
• Reflux or stomach pain — pain after eating, lying down, or in the morning
• Ear pain or infection — especially after a cold, and often without a fever
• Teeth, gums, mouth sores, grinding or jaw clenching
• Urine infection — sometimes the only signs in a nonverbal child are wetting, strong or odd-smelling urine, and unexplained distress
• Skin and nails — an ingrown toenail, a sore scalp, a rash in a fold, an itchy bottom, a tight fingernail or a hair wrapped round a finger or toe
• Head — headache, sinus pressure, eye strain or badly fitting glasses
• Musculoskeletal — a sore hip, knee, foot, tight new shoes, a heavy backpack, an awkward chair
• Sleep — pain that wakes them, or a sleep problem that shows up as daytime screaming
• Migraine or a pain pattern that comes in episodes
• Seizure activity that does not look like a convulsion — some episodes present as sudden unresponsive staring, drops, or brief behaviour change
• Less often but worth raising: thyroid, coeliac, iron deficiency, food intolerance, an allergy, a dental abscess

You do not need to work out which. You need to make sure the list gets covered.

2. Constraints and the avoid list

Never

• Do not start, stop, change or time-shift any medicine, supplement or dose, including anything bought online or handed over by someone else. If something has been suggested for sleep or for "calming", it goes to the doctor as a question, not as a trial.
• Do not give anything to make him sleep or to sedate the pain so you can observe him better. It hides the exact thing Tuesday needs.
• Do not run a self-designed elimination diet or stop foods he relies on. A short written food-and-stool log gives more information and costs less.
• Do not hold him down for a long time to "see where it hurts" — that raises pain and teaches nothing. One gentle touch of each area, in the same calm moment, is enough.
• Do not use pain medicine as a test ("if he's better after a tablet, it must be pain") and then stop telling the doctor. Tell them exactly what you gave, when, and what happened.
• Do not wait for Tuesday if anything in section 3 appears.
• No mystery powders, no herbal remedies, no prescription bought online.

Always

• Write down what you gave and when, even if it was nothing.
• Keep photos of the pain area, stool, vomit or rash — on your phone, with the date.
• Take the diary, the photos and the full medicine list, including anything from another doctor or hospital.

3. Red flags — stop DIY and get clinical or urgent help

Go now, to your local emergency department or call your local emergency number if any of these happen:

• Hard to wake, floppy, unusually drowsy, or not responding the way they normally do
• Trouble breathing, noisy breathing at rest, drooling, blue lips, or cannot swallow saliva
• A seizure, or an episode that does not stop, or a first-ever episode
• One side weak, face dropping, sudden loss of vision, sudden severe headache
• A swollen, rigid or very tender belly, blood in the stool, black stool, green vomit
• Unable to pass urine at all, or very little urine with a very unwell child
• Sudden severe pain with vomiting and drowsiness; pain with a fever and the child looks toxic
• A rash that does not fade when you press a glass against it, especially with fever
• Signs of anaphylaxis after food or medicine — face or throat swelling, voice change, collapse. Use his prescribed auto-injector if he has one, as you were trained, and call
• Any fall or bump on the head, followed by vomiting, drowsiness, or a change in usual behaviour
• Any day the screaming comes with fever and he looks flat or pale, or comes back within 48 hours each time

Do not wait for the appointment — call the doctor or a same-day clinic instead: new or worsening pain, pain waking him from sleep, blood in the stool, weight loss or not growing, vomiting, a limp or not using a limb, pain lasting longer each time, or any new thing you have never seen before.

Two things to ask the doctor that most parents forget:

• "What would make you want to see him sooner than Tuesday?" — get the answer written down before you leave.
• "If it is pain, what is the plan, and what should we not do at home while we wait?"

Tonight and today — about 20 minutes

1. Two-minute log, three times a day (after waking, after dinner, at bedtime). Not a full diary. Four lines: what happened · where on the body · what happened in the day before · what calmed it.
2. One gentle body check, calm, at bedtime. Look at gums, tongue, back of the mouth, inside the cheeks. Check ears for redness or discharge from outside only. Check toes and fingers, the skin between the toes, the bottom, the back of the head and the neck for a sore spot, redness or a wrapped hair. Check the back of the heels, the bottom and the shoulders for a red patch from shoes or a chair. Do not use cotton buds in the ear and do not open the mouth with a spoon.
3. Warm, not hot, comfort — a warm (not hot) cloth or warm bath, a steady hand, reduced noise and light, and the same familiar position. Never ice or very hot water.
4. Keep food, drink and toileting normal and regular — do not withhold food to make him sleep, and do not change his diet as an experiment.
5. Sleep and mood protection for you — one fixed 30-minute window when another adult is home and you are off duty. Sleep loss in the caregiver makes the noise louder and the next day harder; it is a health decision, not a luxury.
6. Tell the school and the family member nearby the same sentence (see below), so he does not hear "he's just being difficult" while you are trying to hold the pain open.

Words you can screenshot

To the teacher or school staff:
> "He's been screaming most days for months and we are checking whether it's pain, not behaviour. When it starts, please note the time, where he seems to be pointing or holding, whether he's eaten, drunk and used the toilet that day, and what was happening just before. If he seems to be holding a body part, tell us which one."

To the elderly relative or sibling at home:
> "He can't tell us where it hurts, so we've stopped assuming it's a tantrum. If he's screaming, don't say he's naughty or try to discipline him out of it — check where he's holding, tell me the time, and help me get him to the bathroom and a drink. Warm bath, quiet room, nothing spicy, and call me if it doesn't settle."

At the appointment — say it first:
> "He's been screaming most days for months, he can't tell us where it hurts, and we've written down a pattern. Please do a full check for a physical cause — tummy and bowels, ears, mouth and teeth, urine, skin, back and hips, sleep — before we look at this as behaviour."

At the appointment — the questions:

• "What is on your list, and what would you rule out first?"
• "Is there anything about his growth, his stool, or his sleep that worries you?"
• "What would make you move this appointment earlier?"
• "What should make us come back the same day?"

If you want to show him rather than ask him: whatever he already uses — a picture card, a symbol board, a phone photo, sign language. Point to the body part together, let him choose, and praise any answer. Two minutes, once a day, no pressure, never during a screaming episode.

What "success" looks like in the next 24 hours

Not silence. Silence is not the goal and I will not promise it. Success is:

1. The diary has real patterns in it — the same time of day, the same triggers, the same body part.
2. On Tuesday the appointment is a full physical check, not a behaviour review.
3. You have three named answers: what they looked at, what they found, what they want to watch for.
4. You have one written "come back sooner if" list in your hand.
5. You got one real break today.

If Tuesday turns up nothing, that is not proof there is no cause — it is a reason to ask for a second look or a specialist view. Keep going until someone has actually looked.

One thing that would change the plan: his age, and whether he can point to or show a body part at all. If you tell me those, I can tighten the checks.