Have you had him evaluated for Asperger's Syndrome (AS)? Some of the things you mention make me think very much of it.

The limited range of topics that he is willing to engage with is one strong sign that makes me think about Asperger's. This is one of the hallmarks of the diagnosis. (You can use these interests to help gain cooperation with schoolwork by incorporating them into assignments, especially if you homeschool, BTW.)

The fact that what he says will often not make sense to you is another one of these signs: we spent years with my son who is diagnosed AS asking him "What are you talking about? Please give us some context. What does that have to do with what we are discussing or doing?" He was initially very resistant to this, because he really didn't seem to understand that we had a different perspective and didn't automatically know everything that he knew, or what he had been thinking, or what he had seen, or what associations he was making. He would just start talking in the middle of a thought stream that had been going through his head, and expect us to know what he meant and what he was referring to - sometimes in words of his own devising. It was infuriating and frustrating for all of us - from his perspective, we were just being obnoxious and controlling by making him conform to some arbitrary speech pattern we wanted where he had to give background information first, instead of just listening to what he had to say. He has gotten much better about this, but it has taken a long, long time, and it will still happen sometimes, but he will usually self-correct now if we just say "What?"

Kids with AS often have real problems with transitions, and have to be warned ten minutes in advance, then five minutes, then two minutes, then one minute, in order to avoid a complete emotional breakdown when they have to "switch gears" and stop any activity, but particularly one that they are enjoying, especially if they are having to stop something they enjoy to do something difficult that they hate. Some of the out-of-control behavior that you are seeing when you try to get him to stop playing to do schoolwork may be a manifestation of something like this. (A good technique for handling this is to not only give frequent reminders about the coming transition, but to try to arrange activities so that the fun stuff comes after the not-so-fun-but-required stuff, so that there is a reward for getting through the unpleasant things, and the thing that comes after the transition is something to look forward to.)

The still eating with his hands could be related to fine motor challenges, or it could be a sensory behavior either related to not liking the feel or taste of utensils or to seeking the sensation of touching the food. Both of these (motor challenges and sensory avoidant and/or sensory seeking behaviors) are common in kids with AS.

I'm not trying to diagnose your son over the internet, but I wanted to make sure that this was considered

One more thing to consider: Ritalin can make some kids more impulsive and irritable, and it can cause confusion and uncontrolled speech, so you may want to discuss this possibility with the physician who prescribed it, since your child is on a high dose, is getting violent with you while on the medicine, and you noted that his speech can be incoherent.

I hope we can help you find the answers that your family needs.

Last edited by aculady; 02/10/12 06:22 PM. Reason: formatting