We ended up switching schools for DS9 last year to an environment with smaller class sizes, lots of hands-on learning and time outside. It made quite a big difference for the remainder of the school year (ending June 2018). The current school year started well, then got a bit bumpy. He has been able to see the school counselor a bit, who seems to have some experience with kids like him. I don't consider it to be a substitute for more intense therapy, but it seems to be helping a bit.
About 2 months ago, we decided to start a course of medication for ADHD, with the help of our Pediatrician. We moved to a new Pediatrician for logistics purposes. I feel like we got really lucky in finding a doctor who would listen to us and DS9, connected with DS9 and seemed to understand our situation. We have always struggled, trying to determine if his anxiety was causing the ADHD-like symptoms or the other way around. We didn't really have a reason for starting by trying to address the ADHD, but we needed to start somewhere. We did not necessarily see a huge amount of change in his behavior on this medicine, aside from what seemed to be a horrible "crash" when it wore off (intensity / meltdowns). We worked with our Pediatrician and started medication for anxiety. We are not too far into it, but it has really seemed to help. It's great for him to be able to calmly talk through situations that would have caused meltdowns in the past. I understand there is no silver bullet, but it really seems to be helping now.
Thanks to all here who have helped with your comments and sharing your research.
