Help with medicine

[swoo]

I have a son who is 13 and has Asperger's.  He currently takes Paxil ER (25mg) and Risperdal (1mg) and has for the past 4 years.  Both seem to work well for him.  We 1st reported to the Dr. that he seemed withdrawn/depressed/anxious with occassional anger outbursts.  These medicines were chosen.  Several months ago we reported he was having concentration/focusing issues that were being reported to us by his teachers.  We went back to the dr. and he was prescribed Adderall XR 5mg, then 10mg. then 15mg.  He was easily frustrated/aggitatedy , so we decided to take him off the med.  It has been week 3 and his behaviour at school has not been good.  He's receiving notes in his agenda almost daily of talking and having to be corrected more than once.  He's talking back to teachers, refusing to do work and I'm getting phone calls from his teachers. Could this be related to the Adderall?  If so, do you suggest putting him back on it or is there something better than Adderall?  Please advise.  Thank you.

[Rachel Thompson, Ph.D., BCBA]

Although medication can be helpful, medication alone will not solve behavior problems. I would be very cautious about adding or adjusting medications to solve each new problem that arises. It is important to work with your son's school to be sure that he has an effective behavior plan in place. I suggest that you identify a local Board Certified Behavior Analyst to oversee appropriate assessment and development of intervention. A list of certified professionals is available at the website of the Behavior Analysis Certification Board (bacb.com).

[Sally44]

I agree with above posting.
What kind of school is your son at?
Is it a mainstream only school that has no experience of children on the autistic spectrum.
All the things you mention are common to his diagnosis.  In school they should be presenting his work in such a way that he can cope with it.
If he has problems following whole class instructions he may need to be taught in smaller groups.
If he has auditory processing or auditory memory problems he may need to be presented on typed worksheets.
If he is attention and focus issues his environment needs to be assessed to see if it is too over stimulating.  He may benefit from a workstation.
He may need a TA to check that he understands what he should be doing.
He may need extra frequent breaks during classes.
He may need an identified place that he can go to when he is feeling overwhelmed.
He may need a 'choose time' built into his daily timetable to motivate him.
He will probably need some kind of adult support and structures during breaktimes and dinnertimes because these children have difficulties with social interaction as part of their diagnosis.
Due to his age he is probably going through puberty.  So he will have all those extra hormones floating around.
Talk to him, when he is calm.  Ask him what upsets him at school.
If your son is taking medication so that he is easier to handle in a mainstream school, then maybe that isn't the right school for him.  If he is becoming depressed because he is self aware and can see he has difficulties with other people but he is not receiving any help or interventions to help improve those skills, then again that may not be the right school for him.
You need a school that has experience and expertise in teaching children with aspergers.  Depending on his abilities that maybe an school that only has children with high functioning autism or aspergers, or it maybe a school that is a mixture of mainstream children and those on the spectrum which also has the extra teacher to pupil ratio and experience and expertise in aspergers.  
Has your son been assessed by a Speech and Language Therapist and an Educational Psychologist who have experience of children with aspergers?  Have they clearly identified and itemised his areas of difficulty, and have they made recommendations to his school about how he should be supported in those areas, including therapies, programmes of support and provision etc?

[Rigil]

Is there anything this Dr hasn't given your son.  Seems to be the easy way out here for the Dr without looking at long term solutions for your son "Withdrawn/depressed/anxious with occassional anger outbursts for a child with Aspergers is not unusual.  Have you an IEP at school in place for you son and a place where he can have time out when feeling overwhelmed.  Has he been assessed for learning difficulties, mine is "Visual-Spatial-Orientation integration problems, with inability to form visual images".  The problem became more pronounced at age 14 years.  I'm attempting to give you options/suggestion as to your sons issues.  

Teenage years for me and many other Aspergers people are very difficult.  Acceptance by our peers, understanding of gender issues, relationships and rejection are overwhelming.  I was always fighting bullies, saying the wrong thing, getting over stimulated around other children and going down in my grades.

Have you considered social skill development, coping strategies, awareness/understanding of his Aspergers with a psychologist that specialises in Aspergers.  Sex education is understated as an issue for aspergers teenagers and there some books on the market to assist parents.  Try googling for these books.

In some instances medication is essential for well-being, I personally found medical Doctors preescribe what they do not understand.  Actually that is their amin function, to medicate.  Try counselling for your son first.

BTW stimulant meds like Adderall  can cause increased anxiety, irrritability/aggression and sleep problems.  Seek out a Clinical psychologist who specialises in Aspergers, my experience with meds is negative and many other aspergers people state the same.  Our disorder is neurological, not mental health.  We can develop mental health disorder from continuous social rejection and trying to understand this world.