Well it's not Asperger's - I guess it's ODD afterall!

[TerryJ2]

I agree. I see autism spectrum here.

 

[TiredSoul]

Also his IQ was 135 at age 5 and dropped to 105 at his 3 year re-evaluation. He said that is an unusually large drop. Could this be cognitive dulling from medication?

 

[TerryJ2]

Maybe, or it's the way your difficult child takes tests. If there is a huge gap between sections of the test, such as verbal and math, or if reading is fast but comprehension is slow, that could be on the autism spectrum. They should have explained that to you.
Get a new dr!!!

 

[buddy]

I agree with the others here. First of all, Autism Spectrum Disorders (ASD) in any form can't be diagnosed by a test only. Just can't. Needs to be evaluated and they need to meet diagnostic criteria in the DSM (currently being modified) and a test is only one piece of information to use. I've administered that protocol before. There are a few that are very similar to that one. They are helpful to give you a place to investigate. If there is a strong positive sign or a totally no way score that may tend to sway you more but a borderline score, no way. Just need to look at how real life is. The bottom line is how do you approach teaching the skills that are lagging? How do you start to teach him to notice feelings even if he can't fully relate to them. There are things that can be done to teach our kids how to respond more appropriately so they can get along in the world. My son will say out loud...(because he has gotten so big and is worried now)....MOM, I don't want to be big like him right???? So, we have a talk about how those are thoughts that stay in our thinking bubble until we are in private. He talked to me about that and really did well the next time we were in a mall and I saw him look at a guy in a cell phone booth and after we walked out he said a similar thing. I thanked him for waiting to say that. He sometimes seems to say things just for the reaction, but honestly, just because something GETS a reaction and it is reinforcing to him...doesn't mean that was his intention. We can never know unless we have a chance to see the same behavior and NOT let it bug us and see if he continues. My son often will continue and dig in ONCE a person gives something attention. But the same behavior will happen for a short time anyway even if I dont react, heck, even if no one is around like if he is in the bathroom and swearing or saying awful things. If I yell to him to stop and that increases it does that mean he MEANT to get my attention and to irritate me? It can feel that way. But really when I let it go, it just disappears. So the same behavior, depending on my reaction, can look very much like an attempt to irritate me or just something he does because he doesn't get it/is a tic/is a habit/whatever. I dont know if that makes any sense, it is hard to explain.

I would not get so hung up on the ODD diagnosis. It is scary and at this point you really dont know. this person does not seem to be an expert in the area you need to have evaluated. If there is any question in your mind about Autism Spectrum Disorders (ASD) then you need a true Autism Spectrum Disorders (ASD) clinic or therapist etc. If you can find one of course....I know that can be the big hurdle. Sorry for how that all went down, but following the advice of others, looking for contributing issues and working on the skills he needs may be your next best bet.

 

[bigbear11]

I thought that is how Strattera is supposed to work - 24 hour coverage???

Jules, Strattera is generally recognized as a non stimulant 24/7 medication. However, like everything else it is certainly possible that kids react differently. One thing to make sure is that the target dose is high enough... between .8 and 1 mg per kg of body weight. Unlike the stims, Strattera is weight dependant so it is often under dosed and then folks get frustrated that it doesn't work. Just a thought.

You also asked about it being a SNRI if it would help with depression and/or anxiety. Actually, increased anxiety can be a side effect in some kids. It hasn't had that effect with TRex which is important since she has anxiety issues anyway. Here agin everyone is different.

 

[TerryJ2]

I have an example that may or may not help you, in regard to Aspie thinking ...

Last night, difficult child asked me to rub his shoulders. We had stayed up late, and husband had gone to bed hours earlier. I had my arms full of stuff I had just brought upstairs, and did not want to answer difficult child by shouting across the hallway. So I put the stuff down and by the time I got to difficult child's room, he had shouted, "MOM!!!" really loudly 2 more times.
"Shhh!" I said. "Dad's trying to sleep. What are you doing?"
"You didn't answer me the first time so I shouted so you could hear me." (He's shouting this, too.)
"But now you're shouting and you know that you're not supposed to. Besides, your voice sounds angry and it does not make me want to rub your shoulders."
"Well, I just wanted to make sure you heard me."

This could easily turn into a major argument, and major disrespect from difficult child. Years ago, it would have. Now I know that I have to express myself in a normal tone of voice, and make sure that he knows what the situation is. It totally de-escalates everything. (Not to mention that he was waiting for a shoulder massage and knew enough not to escalate, so he IS learning.)
I had to really think about this, and whether he was just being a brat or whether it was because he still has problems with-theory of mind. (In a sense, not having good theory of mind could be a facet of major league immaturity, too. "It's all about ME!")

But he answered my question matter-of-factly--"I didn't think you could hear me." When I looked at it from his point of view, it made sense.
I once again told him, "Shh, wait," and that time, he did wait, quietly.

He is still ODD but since he's been on lithium and seroquel, it has helped a lot. He is more willing to talk things out, and that helps me to get inside his head. That's always the hard part--getting inside these kids' heads and figuring out just what they're thinking, because it's sure not what everyone else is thinking!

I hope I explained this clearly and didn't muddle it all up.

 

[whatamess]

Buddy took the words out of my mouth... any practitioner worth their salt will use the ADOS and other diagnostic tools ALONG with their expertise on how Autism Spectrum Disorders (ASD) presents. And that may be it right there- so many 'experts' know very stereotypical symptoms to indicate Autism Spectrum Disorders (ASD)'s and are not aware of how large this spectrum is and how different kids present. For an Autism Spectrum Disorders (ASD) disorder you have three main diagnostic criteria related to: 1. communication (expressive/receptive) 2. social deficits 3. restricted/repetitive interests. Listen, I just attended a camp for families with a child on the spectrum. 17 families. Each child unique. Austism presented itself in all myriad of ways. Verbal, non-verbal, partially verbal, using communication devices, talking with peers but about repetitive and obssesive topics, ambulatory, partially ambulatory, stimming with words, stimming with their bodies, stimming with books, some said and did things that were provocative, some swore, some smiled all day, some could read, some could not, some paced, some twirled, some ate everything, some ate only toast, some danced, some hid, BUT they were all unequivocably on the Autism Spectrum.

 

[BusynMember]

Oh My Word! Any professional versed in autism should be running to diagnose this child with an Autism Spectrum Disorder based on what you are saying in this thread.

We are really on the same page here. Agree 100%.

Buddy, also an excellent post.

 

[Allan-Matlem]

Kids could be helped more if we identified their missing and lagging skills , unsolved problems and then using the collaborative problem solving process to teach these skills indirectly, solve problems and improve the child-parent relationship. Diagnoses maybe helpful but don't buy very much

Allan - AllanKatz-parentingislearning

 

[whatamess]

I love it when Allan pops up! His message is unwavering and delivered in a way that I feel calmness vibes coming from my computer.

 

[TiredSoul]

Kids could be helped more if we identified their missing and lagging skills , unsolved problems and then using the collaborative problem solving process to teach these skills indirectly, solve problems and improve the child-parent relationship. Diagnoses maybe helpful but don't buy very much

http://www.livesinthebalance.org/still-barking-wrong-tree - see what Ross Greene has to say on Aspergers diagnosis

Allan - AllanKatz-parentingislearning

Thanks Allan. I am very familiar with Ross Greene and CPS. I have identified difficult child's lagging skills but don't know how to teach them. I've even sent his school the Lost At School care package.

 

[InsaneCdn]

Not that I'm an expert in cps... but, we found that none of it worked until we got a couple more dxes. These ended up being the root of the problems. Now? We have tons of catch up, major skills gaps, etc. But we know what we are dealing with, and it makes it easier for difficult child, for us, and for school.

 

[Allan-Matlem]

CPS - skills are mainly taught indirectly by taking the kid through the CPS process. Also using ' guided participation ' we involve kids in household and other activites where we can encourage ' thinking and reflecting, perspective taking, identifying the concerns of others , underlying values ,seeing the consequences of certain actions, planning, using hindsight , foresight , practicing to articulate concerns , brainstorming solutions that are mutually satisfactory. We can talk about other peoples problems , concerns etc

 

[AUrquiza]

Regarding PCIT - It is an evidenced-based intervention for parents and young children (2-8 years) - specifically for parents with children who are defiant, non-compliant, aggressive, etc. There is also some research demonstrating improvements with PCIT and children on the Autism Disorders Spectrum. There are a number of PCIT providers in the state of Washington. I would suggest finding some of the recognized PCIT providers. Although you can also contact Naomi Perry at Harborview for contact information on several other PCIT providers. Good luck.