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744777 tn?1235089263

Helping my son

My son who is 7 years has been diagnosed with ADHD by a Psychologist  and Social Anxiety Disorder by a Psychiatrist. We've had these diagnosis for about a year now.  He has also been diagnosed within the past 2 months with Autism (mild), Obsessive-Compulsive Personality Disorder and ADHD-Mixed type by a Pediatric Neurologist.  He is taking  Zoloft 50mg and Vyvanse 30mg.

When he was a baby he was slow to hit his milestones. He started talking around 8 months. Started walking around 18 months. He was a bed wetter until 5yrs. He's very immature for his age. He struggles in school to make passing grades. He has a hard time putting his thoughts into words, has a hard time making himself understood and gets very upset about not being able to.

He has always been very sensitive (crying), He worries about everything and never lets anything go. He has been in speech therapy since he was 4. He has been tested through his school for dyslexia and they said that he is "at risk" for it.
  
Okay.... now here is my question- With everyone my son has seen and with the medicine he is on we are still having some serious issues when it comes to his behavior.  He is not a "bad" or "mean" child.  He just shuts down at school, he won't talk to anyone, he hides in the bathroom and he has big "meltdowns" he's not able to be consoled when he is have the crying spells which recently has been almost everyday. He is now starting to have these "meltdowns" at home.  He is unable to make himself stop crying as well.  The littlest things set them off.  There has been no change in his home or school environment that would make him have more  "meltdowns" then usual.

What can we do to help improve these meltdowns and does all of this really sound like Autism?

I am at my wits end and don't know what to do anymore.  So any advice would be greatly appreciated.
7 Responses
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470168 tn?1237471245
You could also google Central Auditory Processing Disorder to see if that sounds a possibility.  This is also a sensory processing disorder.  I have it and my son has problems with screening out different sound sources.  In a classroom environment I would not be able to hear what the teacher was saying if there were other sound sources.  My ears seem to have a life of their own and tune into different noises, speech apparently at random.  It is very frustrating.  I cannot hold a conversation in a nightclub or bar because I cannot hear what the person is saying to me if there is background conversations and music as well.  When I answer the phone I have to cover the other ear to screen out other noise.  I also frequently tune out and appear deaf to the extent that my husband has to repeatedly shout my name or touch me on the shoulder!
Helpful - 0
470168 tn?1237471245
My son wears Irlen lenses (google Irlen Syndrome to see what that is).  He also has access to ear defenders in school and usually chooses to wear them for school assemblies.  If he doesn't wear them and it is noisy he either has a meltdown or gets totally overstimulated and retreats into his own world and effectively cannot engage for the remainder of the morning/afternoon.  The Occupational Therapist has also noted that he doesn't rely on them and will refuse them or take them off if he doesn't need them.  I think it would be helpful for an Occupational Therapist to assess him and his school environment to make sure that it is one of low arousal (if he is mainly hyper sensitive to things).  Some children fluctuate between being hyper and hypo sensitive to sensory stimulous so they may be touch sensitive at times and need tags removing from their clothes, yet at another time they may hurt themselves and not appear to feel any pain at all.  These are real problems of processing sensory information where the same stimulus can at times be pleasurable and at other times can be painful.  You can ask him "does noise bother your ears."  If he says yes, then that is the truth and how he experiences it.  My son cannot stand singing, or clapping, or sudden unpredictable noises.  Personally, I believe that if a child is showing avoidance behaviours and meltdowns then the environment and support structures need to be re-evaluated to make sure it is at a level that the child can cope in.  No-one with or without autism would stay in an environment that caused them pain or distress.
For more info on sensory issues you can google the name Olga Bogdashina and read an article by her printed in Autism Today.  She also has a book called Sensory and Perceptual Differences in Autism and Aspergers.  Our Autism Outreach department uses the questionnaire at the back of this book to get sensory profiles on the children.  I completed one for my son and found it very useful.  If your son is verbal the best thing you can do is to begin to explain to him that he maybe experiencing things differently to you and get him to talk about his experiences.  My son was amazed when I told him that I could not see/hear/feel the things that he could.  It is very frustrating for them to see their peers who are able to cope in situations when they cannot.  It affects self esteem.  It makes them think they are bad or stupid.  They are not.  We accept that a blind child cannot see.  Why can we not accept that, from what autistic adults tell us, in some way they too are deaf and blind.  Indeed autistic children have similar language impairments to deaf and blind children.  Some autistic children touch and tap their environments in the same way that blind children do.
But I would agree that this doesn't necessarily mean that removing him is the best solution.  He needs his environment adapted so that he can remain and he needs to be taught coping strategies so that he can request stress or sensory breaks.  There is alot that can be done.
Helpful - 0
340688 tn?1251230997
MEDICAL PROFESSIONAL
Unfortunately, many interventions and modifications to address "sensory problems" may exacerbate other forms of problem behavior. Data from a number of large scale studies show that the most common factor contributing to problem behavior is escape from unwanted tasks and activities. Therefore, I would be very cautious about "sensory" interventions that result in a child being removed from school work when he has problem behavior. Please discuss this with the behavior analyst with whom you are working.
Helpful - 0
744777 tn?1235089263
His Behavior Analyst is also the Educational Psychologist for our school district.  

What you said about asking him "what" instead of "why" makes a lot of since.  Every time we would ask him why he was crying he wouldn't know.   Maybe by asking "what" he would be able to identify what is was that actually got him crying.  I will pass the along to the  to his "team" at school and I will also try this at home.  

He has been on the Abilify for 3 days now and we have already to started to see an improvement.  Since he started it he has not had any "meltdowns" what so ever.

His teacher mentioned something to me the other day and I was wondering if it sounds like a sensory problem.  She was quizzing her class on their Science work and she said they were "screaming" out the answers.  She said my son was staring to get very "worked" up so before he started to have a "meltdown" she let him go and sit by the computer and put the earphones on to help buffer the loudness of the class and she said this helped him, he had calmed down.  What do you think?
Helpful - 0
470168 tn?1237471245
If ABA isn't working then I think you need SALT, Ed Psych and Occupational Therapists to do assessments to find out what is causing the meltdowns.  There will be something.  It could be receptive language difficulties, or sensory integration.  There are so many things that you really do need to be a bit of a detective.  As your son is verbal, when he has calmed down after a meltdown, can you ask him what made him angry/sad.  Try not to ask 'why' because that is a hard question for them to answer.  But if you ask what made you bang your head, or you looked very angry - what made you mad?  Then just believe whatever his answer is.  Sometimes with sensory stimulation they can just get totally overwhelmed and not be able to identify what is upsetting them.  But in many cases competent professionals will be able to identify what is causing the difficulties.
Helpful - 0
744777 tn?1235089263
Thank you so much for responding to my post.  My son is already seeing one of the Behavior Analyst that is listed on bacb.com.  He is seeing her through the school system.  Unfortunately we haven't seen very much improvement in his behavior.  His Neurologist has just added a mood stabilizer to go along with him other meds. It's Abilify  5 mg.  Hopefully this will help with some of the problems we have been facing.

Thanks for you help, I very much appreciated it.
Helpful - 0
340688 tn?1251230997
MEDICAL PROFESSIONAL
I recommended identifying a Board Certified Behavior Analyst who will be able to conduct the proper assessments and make recommendations for improving your son's behavior. The website of the Behavior Analysis Certification Board (bacb.com) has a list of certificants by state, which allows you to email local professionals.

A diagnosis of autism is made based on delayed language and social development and the presence of restricted or repetitive behavior patterns. I assume that your son is experiencing difficulties in each of these areas if he received a diagnsosis of autism. Unfortunately, the diagnosis alone does not tell you how to deal with the many behavioral challenges that you may experience. That's why I recommend that you also consult a professional trained to address the behavioral difficulties associated with autism and other disorders.
Helpful - 0

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