We met with the social worker at the psychiatric hospital

[TerryJ2]

Thanks Susie.
We were allowed to bring in rice milk and Rice Chex cereal. I am going to call in a bit and suggest they serve him breakfast cereal for a nighttime snack.

Yes, oatmeal has gluten. Who'dathunkit?

I really do need to learn brushing. I wonder if I need a referral from the pediatrician to have it covered by ins? I know the pediatrician got the hospital info and request for records because he ran into husband at the gym and mentioned it briefly.

My husband was much better at understanding the soc wkr's accent and told me a few things in the car that I had missed. Also, during the mtng, I said, "What?" several times and he repeated himself. Hey, they have classes for accent reduction so people like that should be required to take them.

Well, I'm off to clean up difficult child's rm a bit ...

 

[Shari]

Terry, I don't have anything more to offer/add except my hugs. I so wish we all had answers...

 

[klmno]

Terry, I'm glad you are hanging in there- it sounds like things are more forward, although not as fast as everyone would like. I don't know what techniques work best with Aspies, but The Explosive Child techniques have really worked well with my son- along with backing way off of an attitude toward him like he's just a bad kid and has nothing wrong that more punishment will solve. The book New Hope for Child & Adolescent Bipolar was very useful for me when my difficult child first got his diagnosis. (I might have name a little wrong but it's something like that). Anyway, my son's issues with boundaries and respect got a whole lot better using different techniques and changing attitude toward him and what was going on with him. I've started reading the book Star recommends, too, but set it down and need to get back into it. It is How to talk so your kid will listen and how to listen so your kid will talk, I think.

 

[Sara PA]

Terry,

Did anyone ever check the side effect profile of the eyedrops your son uses?

 

[trinityroyal]

One Q for you all: if you had to choose, which would show a lack of boundary comprehension more, bipolar or Asperger's? That's one of difficult child's biggies. That, and anger issues.

That's a difficult question.
My vote would be with bipolar on that one.

My difficult child (who is both) had a lot of trouble understanding boundaries, because of his Autism Spectrum Disorders (ASD) social skills deficits. Once he got a handle on what the boundaries were, he started trying to find creative ways to cross the line with other people and break the rules. In effect, he knows perfectly well what the rules are, but he just doesn't choose to follow them, which definitely smells like BiPolar (BP) to me.

I think there are elements of both conditions in there.

 

[WSM]

We have to make sure difficult child gets a lot of sleep, because lack of sleep sets him off. No easy feat when he gets up in the middle of the night to play on the computer or watch TV or read. husband has been setting his watch for 20-min increments and doing bed-checks to make sure difficult child stays in bed.

We have a night wanderer too; once the police found him on the street; we took him home and a couple hours later escaped again and ran off and it took about 8 hours, with dogs and helicopters and lots of police to find him.

We went to radio shack and got a motion detector alarm. Abt $20. We can put it outside his door after he goes to bed or accross a field a few feet away from his bed. He can't walk through it to get to his door without it going off. It does mean he can't go to the bathroom in the middle of the night, but...an 11 year old wandering the streets at 3 am is going to end up dead in a canal.

He did 'disappear' it a couple times. And we had it across the far end of the room between his bed and the door on a table. He started putting books on the table and unthinkingly placed the alarm on top of the books--until we realized he was crawling under it.

But it keeps him in bed and makes it easier for us to rest. Getting up every 20 minutes is horrible.

 

[klmno]

I got side-tracked in my last reply and didn't really say my point- sorry- I'm old now and becoming a little scatter-brained LOL! Anyway, my point was that when you asked about boundaries, I tend to look at it like asking if our treatment and strategies thaat we are trying are working. I figure if they are working, then we're on the right track and if the diagnosis gets adjusted along the way, then so be it.

What I originally interpreted as defiance, disrespect of boundaries, etc., in my difficult child does not appear that way to me now, at least not usually. That is because now I see an underlying issue and can pick up on it a little quicker and I act differently toward him, so he reacts differently (usually- we haven't perfected this yet). To me, that confirms that his issue is rooted in a mood disorder and possibly added anxiety. I'm not certain that my son is BiPolar (BP) just yet. It could be that he was rebelling because he felt like his problems weren't getting addressed or acknowledged- it could have been a number of things. I guess what I'm trying to say is that you have to start with some treatment plan and see if it works or not.

Are they doing neuropsychological testing while he's there?

PS- BiPolar (BP) can be mis-diagnosis'd at schizophrenia (sp), so don't panic over that just yet- it flipped me out, too and I was panicking about whether or not my son was hallucinating, assuming that it would mean schizophrenia. This can happen as a result of medications and as a result of BiPolar (BP). My son does have grandiose thoughts/behavior that I used to see as defiance but now I recognize more readily (thank god). When that happens, I ask him if someone told him those things or if he heard or saw something, trying to check and see if he is hallucinating. Funny how I don't think I'd even be shocked at this point.

 

[Nomad]

Not from what I have read in books, but mostly from experience...I can tell you this based our situation with a child with a bipolar diagnosis and that of a good friend whose child is clearly an Aspie...
1. My child has much greater issues with sleep. For my child...not sleep is almost a daily thing unless medication is introduced.
2. My child has much greater issues with impulsivity
3. My child has much greater issues with mood swings.
4. My child has more issues with racing thoughts and it is unclear if her child even has this issue. In addition, my child is more likely to have periods (although brief) of rapid speech.
5. My child is frightening slow to learn from mistakes and although this is a big concern for this other family, it is clearly more of a concern for my child and our family.
6. ANXIETY: Both children seem to have issues with change and anxiety. However, the anxiety part of it all seems to be more prominent with my child.

I don't know if this was helpful at all. I think the top two (impuslivity and sleep problems) really stand out in my mind with bipolar disorder.

 

[luvmyottb]

My child definitely has mood disorder, but was recently diagnosis by psychologist as possible Aspie. I think she is definitely more mood disorder. Mom gut.

Characteristics of my difficult child BiPolar (BP), anger, tantrums, impulse control, craves carbs, low tolerance for frustration, crosses boundaries, doesnt seem to learn from her mistakes, mouthy, odd, drama queen, loves to be the center of attention and universe, bedwets, lies, steals, cheats, can bully, wears inappropriate clothing, very touchy and feely with strangers. Now, she doesn't fit the BiPolar (BP) sleep characteristic. She sleeps 9-11 hours a night and wakes fairly quickly.

Her Aspie characteristic is social. Emotional immaturity, gets along much better with kids 2 or 3 years younger. She doesn't read where kids get tired of you hanging all over them.

I hope they can figure out your difficult child. It can be so difficult. Hang tough.

 

[Christy]

My thoughts on the boundry question...

My son is bi-polar and possibly Pervasive Developmental Disorder (PDD)-not otherwise specified. (neuropsychologist evaluation says not Pervasive Developmental Disorder (PDD) or on the AS spectrum/psychiatric hospital says yes-definitely. We are having a follow-up with the neuropsychologist done).

Part of my son's boundary issues just stem from a lack of social awareness. This usually presents as social faux paus like standing too close, sharing too much info, asking inappropriate questions, not picking up on social cues.

Other boundary issues he has stem from a sense of entitlement and that is the bi-polar part. He knows something is wrong but does it anyway. He feels like if he wants something, he should have it.

I hope you will get a clearer picture from whatever testing is being done at psychiatric hospital. Hang in there and thanks for the update. I have been thinking about you.
Christy

 

[TerryJ2]

Sara,
no one thought about checking about Xalatan side effects.
I just checked it online. It's a Pfizer product, and it says:

"Pediatric Use: Safety and effectiveness in pediatric patients have not been established."

It says that it contains a prostaglandin analogue, and I cannot find anything relevant online about it ... mostly articles on excreting aspirin or other medications in urine.

I'm definitely going to address the issue with-his eye dr., regardless whether it has anything to do with-his current situation. Thank you.

 

[TerryJ2]

WSM, wow, we haven't gotten to that point! I have considered the alarm, but if the Klonipin works, we may not need it.

 

[TerryJ2]

Christy, Klmno, Nomad, luvmyottb, trinity and everyone, my eyeballs are rolling around in their sockets. difficult child has so much of both, but I'm learning more about bipolar, just to make sure (orderng a cpl books, too). My son definitely hangs on me, shoulder butts me in the arm when he wants something, and also has issues with loudness, but only around us at home. He'll shout and when we tell him to lower his voice, he'll yell, "I'm NOT SHOUTING." Even that, to me, could be both.
Arrrgh.
It may be yrs b4 we figure it out.

****One thing I forgot to mention that was insightful, which the soc wkr mentioned, was that difficult child's physical and angry overreaction to husband the day of his psychiatric hospital admittance was probably a stress response to the police coming by, and to the intense counseling session he'd had with-Dr. R and husband, and then anxiety built up and he didn't sleep, and then couldn't cope any more, and blew his top.

 

[tiredmommy]

Terry,
On the boundaries issue... I'd have to say that those I've known with-autism just don't recognize the boundary. It just doesn't exist for them. so to speak. They miss clues with body language and don't understand social norms. My mother has bipolar and I'd have to say she's rather like Janet's Cory and continually tests the boundaries she encounters. She has quite a bit grandiose behavior and I personally believe it relates to that.

 

[BusynMember]

I disagree on the boundaries. I had bipolar as a kid, and it was pretty bad. I didn't have as bad boundary issues as those with Autism Spectrum Disorders (ASD) who literally can get in your face and scream because they don't understand it is wrong. THey also tend to hug a lot when it's not appropriate. This doesn't mean all Autism Spectrum Disorders (ASD) kids.
As a bipolar kid, I didn't know when to stop talking and was seen as bossy and didn't have many friends. I had poor boundaries, but not as bad as my son. Autism Spectrum Disorders (ASD) kids are more clueless, don't "get it." Bipolar kids are not as clueless, although I remember being a spacy kid. I wouldn't go up to anyone and just slap him or grab his ruler or scream in his face. I knew better than that even when I was almost dying because it was so hard to sit still in my desk when I was hypomanic. And I could hold a give-and-take conversation. Autism Spectrum Disorders (ASD) kids usually can't. They answer "yes." "no." "I don't know." They talk inappropriately about their own interests and ignore what others are saying (I'm talking about with peers).
My son has improved with social skills classes and his Autism Spectrum Disorders (ASD) interventions. He used to touch people, especially hair. He would scream in faces and laugh. He would hit and run away and think it was funny. He did not know how to hold a conversation. Many, if not most, have "iffy" or "off to the side" or "looking down or all around" eye contact.
Very hard question. Boundary problems are rampant in kids with disorders. They need serious intervention.

 

[klmno]

Take a breath and relax! I'm posting the link below due to many posters discussing bipolar symptoms. I'm starting to get a little concerned about every negative behavior seen being interpreted as a sign of bipolar.

http://www.thebalancedmind.org/learn/library/about-pediatric-bipolar-disorder

 

[gcvmom]

I can't really say for sure about the boundary issue, because I see it in BOTH my difficult child's when they are unmedicated and NEITHER one has an Aspie diagnosis. But then I still believe ADHD to be at one end of the spectrum and autism at the other.

I would be REALLY frustrated if I could not understand the clinician who is responsible for my difficult child. It's not like you're ordering a pizza, for gosh sakes! These are critical issues you are discussing! If you can't get someone else in there to talk to, then I think the tape recorder is your next best solution.

That's funny what you say about stripping the room -- difficult child 1 would absolutely FLIP if moved any of his clutter. He finds comfort in the mess, I think. It's more like a den or lair!

Hope your hip improves so you're not in too much pain while you're cleaning. Ibuprofen anyone?

Thursday will be here before you know it! I hope his transition to home goes easily.

 

[Nomad]

Our daughter was diagnosis'd Aspie by a psychologist. However, her own psychologist and psychiatrist (a very famous woman) both said it was incorrect. I could see some traits after reading a book on the topic. But the bipolar symptoms were more prevalent. The book Bipolar Child REALLY hit home with me.

Luv posted this and wow...it sounds familiar.
"Characteristics of my difficult child BiPolar (BP), anger, tantrums, impulse control, craves carbs, low tolerance for frustration..." and it sounds familiar in our household.

Raging has improved greatly with age and proper medications for my difficult child.

VERY Often observed behavior (most of these are serious and ongoing, but have been helped by medication):
Crossing boundaries
Impulsivity
Craves carbs
Low tolerance for frustration

Current and accurate:
Odd
Drama Queen
Loves to be the Center of Attention

Often
Wears inappropriate clothing
Very touchy/feely with strangers

Relatively Often
Lies
Mouthy

Continued:
"Her Aspie characteristic is social. Emotional immaturity, gets along much better with kids 2 or 3 years younger."

In a social gatherings, my difficult child will gravitate towards either children or those a few years younger. sometimes she will speak with folks my age, especially if she knows them from "my circle" of friends.

She is socially immature and often struggles.


"She doesn't read where kids get tired of you hanging all over them."

Just a few years ago, my difficult child had terrible problems with this, but in recent years, she is doing better. I do believe therapy is helping her with this issue.

Overall...medication and therapy has helped GREATLY with the raging aspect to all of this and has made inroads into other things. Without medication and therapy, life would often be DANGEROUS and completely miserable for her and our family.

Here is something interesting:
http://ajp.psychiatryonline.org/article.aspx?articleid=175265
http://www.autism-help.org/comorbid-bipolar-disorder-autism.htm

 

[TerryJ2]

Thanks, klmno. I'm still confused. (Not to worry. I'll be confused for yrs to come. )
That website described difficult child as a baby:
"Symptoms of bipolar disorder can emerge as early as infancy. Mothers often report that children later diagnosed with the disorder were extremely difficult to settle and slept erratically. They seemed extraordinarily clingy, and from a very young age often had uncontrollable, seizure-like tantrums or rages out of proportion to any event. The word "no" often triggered these rages."

But here is a description of aspies, that is also my difficult child (Myles and Southwick):

"Students with-AS ... state in a monotone voice a seemingly benign phrase, such as "I don't know what to do." Since no emotion is conveyed, these behaviors often go unnoticed by adults. Then at a later point in time, the child engages, seemingly without provocation, in a verbally or physically aggressive event, often called a tantrum, rage, or meltdown. The child may begin to scream, kick over a desk, or totally shut down."

Sigh.
No wonder it's so diff to figure out. He could very well be both.

I want him home to cuddle and play board games, but I dread having him home. I'm going to bed.

 

[klmno]

That paragraph about aspies would fit my son, too. I think that's why the entire lists need to be looked at. When I read the other aspie characteristics, it doesn't fit my son. When I read the other BiPolar (BP) ones, it pretty much does- although again, I can't be 100% sure that my son is BiPolar (BP) at this point, I am sure he has a mood disorder, has mood cycling, and all BiPolar (BP) techniques that I have tried so far have helped him. But, things like trying to jump out of a car could be unipolar depression. Therapuetic parenting could help a lot of difficult child's, not just the ones with BiPolar (BP).

Really, I don't think the docs are near the end of diagnosis criteria on a lot of these issues. There might be more on the spectrum then we think, given all the similarites.