Has my son been properly diagnosed?

[Alicia4]

My son, Aidan, is 5 and half years old and preparing to enter Kindergarten in apublic school on the fall. He started having behavioral issues when he was 2 1/2 everything from bouncing off the falls to repetitive behaviors like flipping light switches to figuring out how to break out of the house. When he was 3 and a 1/2 his dad left for a year long deployment to Iraq followed by 6 months of him living in Las Vegas to finish his enlistment and me and my two kids living in LA where we had relocated when he deployed. Just before his dad left his behavior started to worsen and once my husband was gone it went from bad to worse. A couple months after Aidan turned 4 his pediatrician and his preschool teacher suggested he be evaluated by a psychologist. So we took him for regularly for a few months and had him evaluated and we also to took him to a second doc for a second opnion and they both agreed he had ADHD and OCD. We hestitated on putting him on medication, but over the summer while he was being evaluated his behavior turned dangerous. He was only sleeping about 6-7 hours a night so he would wake up before the son got up and he'd go outside and wander around in front of our house, he was constantly repeating himself, you could hardly hold a conversation with him because any time you asked him a question he would be totally engulfed in his own world and it was very difficult to ever get an answer, he was hoarding food under his bed and eating boxes of cookies and fruit snacks in single sittings, he was hyper and couldnt focus on anything, even getting dressed, I would have to say something a dozen times before he actually did it and even then he wouldn't always complete the task and while it was hard at home, my biggest concern was school. He wasn't able to complete anything he started, he didnt have any friends and he almost always played by himself. He wouldnt participate during chapel time or circle time, he was always off in the clouds at home and at school. He had this awful fear of the cat and if he had to walk past the cat while he was close, Aidan would fall on the ground and start crying and panicing. This is just a sample of some of the things he was doing, and so they started him on 20 mg of Prozac and his fears, anxiety, and repetitive behaviors seemed to get better, but he was still out in the clouds  and when it came to the cat he went the opposite direction. Aidan became obsessed with the cat and actually took a screw driver and disassembled the two way dead bolt locks we put on the doors to keep him in the house all so he could pet the cat. So they put him 18mg of Concerta, and he seemed to be slightly less in the clouds and it was a little easier to hold a conversation with him. Then they put him on 27mg of Concerta and he got really grumpy and agressive, so they dropped him back to 18 and over the past 7 months have gradually brought him to 18mg of concerta and 60 of the Prozac. In February his father returned home for good and we hoped his behvaior would improve a great deal and it seemed to only get better as they gave him more prozac. In June, he was doing ok, except he was still in the clouds half of the time and still very impulsive, he would get upset easily but them would be quick to apologize. So in the beginning of July they kept him at 60mg of Prozac and moved him back up to 27mg of Concerta and he has gotten really aggressive and he's angry all the time, you can hardly be around him because he is so grumpy. If you ask him to do something more then once because he isnt responding to you the first time, he gets mad and repeats I hear you mom a dozen times. It's as though he is hearing me, but his brain isnt telling his mouth to reply and say ok mom and his brain isnt telling his body to move and do what mom said. He is frustrated with one thing or another all the time. At school he is fighting with everyone and his teacher said his ability to focus is worse then it's ever been before. Which brings me to my question, his teacher (who has a grown son with ADHD and OCD and 20 years experience working with pre-schoolers) disagrees with his diagnosis. She is concerned that he has a mild form of autism, which is why he is having a negative response to the Concerta and is so socially awkward. I have told his doctor what Aidan's teacher thinks and he disagrees. His doctor has just given me the ok to put him back on 18mg of Concerta since the 27mg has just made things worse for the last 10 days. My concern is that we have spent a year plus getting him diagnosed and trying different dosages of medications and I have a great deal of respect for his teacher and his doctor, at what point will the diagnosis become more clear? And also does my son sound like he has a mild form of Autism or is his teacher way off? Do you have any suggestions for his treatment and what our next move should be? I would greatly appreciate any feedback or suggestions.

[Sally44]

Yes, and the scooter is just one thing!  As you say, it takes alot of effort and patience with every single thing.
But one tantrum we had about a month ago, was in a supermarket cafe where we had gone to get some dinner.  My son wanted chicken nuggets, but the woman on the counter said 'we don't call them chicken nuggets anymore, we call them chicken chunks', and straightaway my son is making noises and pulling faces and getting upset.  He won't listen to me saying 'it is the same thing', because to him the name is different so the food is different.  So instead he says, 'okay i'll have fish fingers'.  I'm thinking, okay this is a really positive thing he's done, he's changed his mind and chosen something else.  Then the woman on the counter says 'we don't call them fish fingers anymore, we call them fish nuggets'.  Well all hell broke lose, my son is shouting at me and at the woman on the counter and lying on the floor kicking and screaming, whilst i'm just standing there at the front of the queue, not really knowing what to do!  Anyway, I eventually just ordered for him and we went to sit at a table.  Eventually my son calmed down.  The food came, and I managed to persuade him to try it, and of course it tasted exactly the same.  Plus my son also apologised to me for getting angry and upset.  But when he does get upset he behaves like it is the end of the world for him.  But his degree of distress is actually reflective of how he feels about the situation, regardless of how I see it.  But we had a chat about things being different but similar, so I think he did learn something from the experience (as did I).  But be warned about 'changes'.  Supermarkets are renounded for them, they change the location of products, they change names, packages, colours, perfume, ingredients etc etc.; it is a nightmare for someone on the spectrum who likes predictable routine and 'sameness'.
And I also think, regarding things they don't want to attempt, it is because they are very focused and interested in a more restricted range of things, it does mean they are not at all interested, curious about 'trying' other things.  So they become brilliant in their areas of interest, and due to lack of trying/practice they fall behind their peers in other areas.  But because they have enough self awareness, they know what their peers are capable of and know that they will underachieve.  But trying to get them to understand that practice is all it takes is hard for them to take on board.  Maybe that is part of being unable to predict outcomes, I don't know.  So in many ways they can come across as 'perfectionist' in their expectations, refusing to try things out of their areas of interest.

[Alicia4]

Very interesting what you wrote about your son and the scooter. My son absolutely hates trying anything new and he hates trying anything that requires any effort. He has all the attention span and patience for his puzzles and Leapster, but homework, a new sport, or a new food....FORGET IT! It makes me nuts, because I know how bright he is in certain aspects, like you said about your son, I know there are things that Aidan can do that most children his age aren't even capable of....but it's getting him to realize he has so much potential. He is so quick to give up and get frustrated. When I want to introduce a new food that I think he will really like I have to put on my boxing gloves. There is a spaghetti restaurant that he loves and I decided I wanted him to try their meatballs because they are really tender and easy to chew. I hadnt pushed red meat on him up until this point because I know alot of younger children arent fond of the texture and how hard it can be to chew. So I took him to this restaurant just about once a week for about 9 months and we started with meltodowns over a single bite and finally 9 months later he asks for them and loves them. Sounds like a silly accomplishment but it was great. It took me nearly a year, but that seems to be the norm with him....if I want him to try something new, I put on the boxing gloves and re-introduce it regulary so that its clear it isnt going anywhere and after 3 months to a year, he welcomes the change. It pays to be persistant, but it sure is tiring!

[MJIthewriter]

Sally44, maybe that's one thing you can say if you get odd looks from crosserbys when it comes time for your son graduate from a scooter to riding a bike. You can say he needs to prove to himself that he can do it.

[MJIthewriter]

In these cases a lot of it is having to help the child to prove to themselves that they can do it... There are a lot of things I'm sure I can do, but emotionally fear and anxiety keep me from achieving those things. That's why I need someone to push me... walking with me through the steps for the first few times, then making (read forcing) me to do it on my own. If I don't get the chance to prove myself that I can do it, then I will likely forever rely on someone to do it for me until that can't happen.

As a child and parent this is rather painful emotionally... The child genuinely believes they can't do it even if they can.  That is one reason for putting up such a huge tantrum.

As a parent it must suck to hear and put up with the tantrum and the embarrassment associated in public...  To make the transition easier, you can gradually pull away as you help the child with the task. If it seems the child is able to do it on their own and all you really need to do is watch them, it may be time to move on to let them do it themself. (and turn a deaf ear to all the tantruming and crying... after all the child must prove to themselves they can do it.)

I believe that's what's holding me back from independent living... Thankfully now I have someone who will be working with me on a weekly basis to help get me closer towards that goal. At least that's what she claims.

One of my goals:  go to my psychologist on the cab by myself and back...  I just need to get over the anxiety of being alone and just do it...rather than wimping out each time...

[MJIthewriter]

Tis true...lol.

[Sally44]

I agree with what you are saying, but I think as parents you have to be very sure of what your child is capable of before you withdraw support completely and let them get on with it.  But once you know your child can do it, but maybe isn't because it is a routine they have that they don't want to change, then just put your foot down and let them take responsibility for it.  An example of this is that I managed to move my son from a 3 wheeled scooter to a 2 wheeled one.  Doesn't sound like a great accomplishment, but the fact is I knew that his balance was good enough for a two wheeled scooter.  But my son wanted his 3 wheeled one and was terrified of falling of a two wheeled scooter and the fact that he couldn't do it and had to persevere and learn just irritated and frustrated him to hell.  As we always to go to school with me walking and him on the scooter, you can imagine that we had a number of complete tantrums and meltdowns in the middle of the street and he was late to school etc.  But I didn't give in and now he can ride on a two wheeled scooter.  Which means he can ride on a two wheeled bike.  This is something I shall attempt in a year or two.  But at least I know he is capable of it.  But my point is, you have to be very sure that they can achieve something before you push because they find it very hard to try new things and when they fail it makes it even harder to get them to try the next time.  I suppose we are all the same to some extent, none of us like to get out of our comfort zone.