We have been the Autism route (mainly looking at Asperger) through both a therapist who specializes in ASD (and her consulting pyschologist) and through the school. The therapist said no to ASD but yes to ADHD and ODD (but we didn't believe it then).
What testing instruments did the therapist use? Did s/he do the ADOS or other autism-specific standardized tests? or was it a gut-level assessment?
The school said:
"Overall, while Son does exhibiit difficulty with social interaction with his peers, it does not appear to be at the level that would typically be indicative of an ASD. Also, Son does not display significant differences in the areas of communication (aside from his pragmatic difficulties), and restricted repetetive and sterotyped patterns of behavior, interests, and activities. Son does not meet the the criteria as a student with an ASD."
Forgive me, but the "aside from his pragmatic difficulties" IS a significant difference in communication. As Polar said, the school has a vested interest in not qualifying him for services. Whether he has ASD or not-- only your outside professionals are qualified to diagnose, I certainly will not from this distance. But schools are not allowed to diagnose medical or psychological conditions, either, and their educational assessments (which they are allowed to do) often seriously underrate what's there.
I do believe the ODD diagnosis - he was out of control. Screaming, kicking, throwing things, crying, refusing absolutely to do things, it was awful. Consequences have no effect on him. He has lost all sorts of priveleges and it makes no difference. He's missed baseball games, birthday parties, lost computer time, lost his DS, lost all of his reading time, been put in timeout. None of it matters. Rewards didn't work either. He once went 3 weeks without any kind of junk food (pizza, chiken nuggets, ice cream, cookies, sugar, sodas, anything) because he was fighting with us about brushing his teeth. The rule was that he lost all "goodies" until he had brushed his teeth twice a day for seven days in a row. If the prozac has done nothing else, at least he gets his teeth brushed now!
ASD can also look like that. I would really encourage getting in touch with a behavior therapist (google Board Certified Behavior Analyst, BCBA) to work on this stuff; they have good tools for this kind of behavior change.
One psychologist had us put him on an extreme time-out system. If he didn't do what was asked, we were to put him on time-out. If he didn't go to time-out, we were to physically take him to time-out and hold him down until he calmed down. He's too big for me to do that so if he acted up when my husband wasn't home, I had to ignore him until husband got home and he immediately had to take him to time-out and hold him down. Sometimes it would last for an hour. It made all three of us crazy and exhausted and didn't do a thing.
I would not expect such a system to work; and it sounds utterly exhausting.
We haven't seen a neuropsych or a dev. pediatrician. My husband is so opposed to any more assessments that we are fighting about it. He just wants son to be "normal". Well, he's NOT NORMAL so accept it and figure it out.
Indeed. I hope you can get DH to spend more time dealing with DS one on one so that he will agree to further assessment, because I think a really high-quality neuropsych workup-- preferably with someone who has seen lots of autistic kids as well as gifted and ADHD-- would help you sort this out.
You need better help, for your sake as well as your DS's.
This is so confusing. I'm ready to just accept the ADHD diagnosis and put him on the medication to see what happens. If it helps, it helps. If it doesn't, we do something else. The doc is recommending Strattera instead of a stimulant because needs it more at home than at school.
The very good thing about Strattera for a first try with this kid is that it is less likely than a stimulant to increase anxiety and make the oppositional behaviors worse. I would worry about the stimulant drugs in that regard. But there is something to be said for finding out what you are dealing with before starting the med experiments, too. I am not sure which way I would lean on this.
When he messes up, like playing a computer game instead of doing his homework, he starts saying things like "I'm so stupid" or "I hate myself" and that worries me.
That kind of thing, and the angry/oppositional behavior, in a boy can be depression or anxiety. I really think a neuropsych is the person you want to see. The full workup.
I guess I'll have to sit next to him while he's using the computer (it's in the kitchen).
If you can, for the short term, I would.
Hang in there,
DeeDee
