My 5 year old son is extremely hard to deal with and I want to find out why he is sooooo difficult compared to other kids or his little 2 year old brother. One of my nephews has classic Aspbergers so I'm familiar with it. My son only demonstrates a few of the asperberger symptoms. My son has friends that he gets along with and likes to laugh a lot - he looks me in the eyes and can tell if I'm mad or happy. He is pretty athletic.
But... He obsesses over things like his little brother never touching or breaking his toys, he likes to organize his toys a certain way, he just blows up anything sometimes and cries for 30 minutes. If he wanted 30 grains of parmesan cheese on his spaghetti and I put 34 grains he will blow up and scream for 5 minutes.
We know that something is wrong and we want to get him help - but we don't want to just give him medication without knowing what's really going on. We've taken him to a children's Licensed Professional Counselor a couple times but he didn't know how to diagnos our son.
Can anyone please help me with these questions:
a) What kind of professional would have the best chance to accurately diagnos our son? A LMSW, LCSW or MD?
b) What if our son is some weird hybrid of diseases - what if he's 20% asbergers + 15% ADHD? What do we do then? Are there medications that can be safely taken in that situation?
A few other thoughts about my son's asberger like symptoms:
My son usually much worse in private at our home than in public. His teachers have never complained about his behavior in school or sunday school.
Time out has never ever worked for him. He just goes bonkers for an hour and repeats the same behavior once he gets out of time out. Any type of punishment has ZERO affect on his behavior. He is the most stubborn human I have seen in my life.
He often will get a thought stuck in his head and will NOT let it go for several hours / days. If he wants a strawberry cookie with white sprinkles the whole world will suffer for days until he gets it.
Sometimes he will repeat a sentence 10 times even though I'm looking right in his eyes and repeating what he said or just watching his eyes and nodding my head.
He can be a really sweet kid when he's not acting crazy. He will share cookies with his brother or say he loves his mom spontaneously.
My dad should come soon with some good advice. I’m no parent but I hope these things may help a little. I'm just trying to think of what may possibly help if I was in either your situation or your son's situation. (And because med help is down while I’m typing this, I’ve got plenty of time to make a blog reply for you to enjoy.)
First off, don't rely on meds as a "solution" or "cure". If you go that way, you may cause worse damage... My heart breaks when I read posts about mothers who thought they were doing the best thing letting their child's doctors prescribe poison (meds with questionable safety even for adults) only to find out their child is suffering severe damage as a result.
It's not necessary... Instead of trying to go for a cure, try to understand your son. If he likes to line up toys, let him do so. What’s wrong with lining up toys anyway? Same thing with him counting out grains of parmesan cheese.
Is the house going to blow up? What are you afraid of? Are you afraid of how other parents will view your child? If it is the later, maybe it’s time for some serious thinking. Maybe it is time to talk with your friends and help them understand autism better. It’s your son, not theirs.
Autism is not a death sentence btw. As far as his pickiness I can’t give much help, but I know I like to have things set a certain way. I find it most helpful if I can communicate with my parents or in this case my grandma. I let her know what I want and how I want it done.
A peaceful resolution is when we can work out a system that is agreeable for both of us. If not then a power struggle occurs and it isn’t pretty. My suggestion is to try to be as open as you can, try to communicate with your child in a way that’s not domineering and belittling. With me that only makes me mad.
For instance, the statement “Because I said so!” does nothing… My dad is guilty of this comment, “Because I am your dad and I say no!” It only makes me frustrated because I don’t know why he said so. (I mean he’s obviously mad, but what else?) (I have a feeling all children deal with this confusion). Please explain why you say so in a way your child can understand…
If he can’t have the cookie now, try to tell him when he can have the cookie. With me I like to know specific times. If I can’t have the cookie right now or go shopping at x store, then I like to know when I can. Tell him what time he can have the cookie and stick to that time.
And btw, what you may think is crazy behavior, has logic in his mind. I know people think it is crazy when I go off to pick up rocks in the little islands by parking lots or alongside the sidewalk. To me, I like to admire the beauty of things around me. Every rock is unique, just like people. I'm drawn to unusually colored ones. One of my hobbies is picking up little agates alongside the streets. Put in a clear jar and where the sun shines bright, it makes quite a show (like stained glass). No one else may enjoy it the same as me, but that's okay. It is my pleasure.
"Sometimes he will repeat a sentence 10 times even though I'm looking right in his eyes and repeating what he said or just watching his eyes and nodding my head."
There are a couple possibilities that pop in my mind. If he is frustrated while he says it, it could be he doesn't understand you heard him. A head nod means nothing. Especially if he is not looking at your face. To make eye contact feels as painful as having a lazar beam shined into my eye. I use it sparingly. Perhaps even as a means of aggression...
People often accused me of the very same thing, repeating myself over and over. I did not know they heard me. I thought they either didn't hear or were ignoring me. This made me frustrated. What would help is if you can come up with a signal both of you understand that means "I heard you." even if that means saying that.
For a long time I would end just about every one of my sentences with "Okay?"
I expected everyone to reply with "Okay" so I knew they heard me. If they didn't reply with "okay" I assumed they didn't hear. I would repeat the sentence until I got an "Okay".
Autism is a "spectrum" disorder, which often times includes ADHD. Obviously your son has traits of Asperger's. Just because he doesn't have every single one doesn't mean he doesn't have the ones he has, so you will have to deal with it as if he does has Asperger's, especially when dealing with those traits. In other words, what works for a neuro-typical child in those situations, is NOT going to work for your child.
Does he do things in multiples of numbers like 10 or 30 or some other number.
"Same thing with him counting out grains of parmesan cheese. " It maybe okay if HE counts out the grains of cheese, but the way I read it, mom has to count out the grains and the son verifies the count and pitches a 5 minute fit at any discrepency. I agreee that medications are not a cure. Inasmuch as the drug company TV ads portray.
I am a retired school psychologist, so please regard my comments as one who has only part of the expertise and skills necessary to make an accurage diagnosis.
It is difficult to make a definitive diagnosis on a child five years of age. Children are so variable at that age. With the concerns you have expressed, I would suggest the first place to start would be with a pediatrician. He/she can guide you from there. Some times these issues can be resolved with improved behavior management and parenting techniques.
The doctor may refer you to a large hospital clinic where he can be evaluated by a multidisciplinary team--child psychiatrists, social workers, occupational therapists, psychologists, etc. I have found that you will more likely get a diagnosis and treatment plan from a team of experts than you will from an individual who professes to have the appropriate skills. Again, the best place to start would be with a pediatrician.
Aspergers Disorder is one of 5 diagnoses on the Autism Spectrum. Diagnosing Aspergers is not as simple as looking at another child who has the diagnosis and saying something like "my child is similar but not identical so he doesn't have AS".
Diagnosis of AS is possible at 5 years old but the average age of diagnosis in the US is around 11 and in the UK around 7 years of age because of the increasing social independence that comes with age. That social independence makes the diagnosis of AS easier in many ways as there are more differences possible and clearer levels of achievement that are common in children as they age.
You specifically asked what professional is the most likely to be able to accurately diagnose AS. Beyond diagnosing is making accurate and helpful recommendations - that's the reason for an evaluation, the label is more for the bureaucrats who need to tic things off on forms and such. So, a Licensed Clinical Psychologist who has expertise in Child and Adolescent psychology is the most likely to be able to do the differential diagnostic part that is not easy (i.e., ADHD, OCD, AS, something else, more than one?, etc.). Sadly, most pediatricians today may have heard of AS but most can't tell me the diagnostic criteria or the major alternative diagnoses to be considered and/or ruled-out. Most Social Workers do not have the training in the testing that goes along with really intensely looking at the issues that may surround AS or mimic the diagnosis. Psychologists have both the training and the authority in every state to diagnose AS and the majority of alternative or comorbid issues.
My daughter has Tourette's OCD and ADHD - her brother got all of that and a little Aspieness too. She needs to line up thing exactly - and freaks when her homework isn't stapled, etc. Don't assume Asperger's yet. It took my son until 9 to have a borderline diagnosis and that was after several top doctors took a whack at him. You definitely need to go higher up the psych chain to start to get any ideas.
There are no definite tests for some of these things - my son does not fit into any criteria perfectly. He's ADHD - but will happily sit and do homework for hours. He has obsessions - but he lacks a robotic tone and he is not pendantic about them. He can switch topics easily. He is better at judging when people are not interested. I have a whole group of doctors wondering if this is a quirkly gifted child with some hypersensitivities and poor social skills (maybe do to ADHD) or is it really Asperger's - because he seems to be "strange" one minute and absolutely charming the next. It isn't easy.
But again, diagnosis is not as essential as trying to figure out what is causing the behavior and how to alleviate the pressures that start the triggers.
Positivelyt hing about the OCD'ers in our family - they love to keep their rooms clean and organized. And they all fold laundry beautifully - so look on the bright side.
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