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Avatar universal

Has my son been properly diagnosed?

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.
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Avatar universal
From everything you describe and I have read here, I have dealt with a good majority of what you talk about here with my own son. I am also a RN and have researched my own son's diagnosis before I believed it and accepted it. My son exhibits and I can also say past tense also exhibited some of the same exact behaviors you mention. My son has been diagnosed with an autism spectrum disorder called Asperger's Syndrome and ADHD. Asperger's is a little like high functioning autism but is not too severe in that they are verbal, no cognitive impairment but most of all problems with socialization, poor safety awareness, always have to be 'directing' the situations or be the dominant one, have one sided conversations which is to their choice, like repetition thus like video games, the same movies, computers (they know what to expect), have difficulty with the regular day to day things like dressing, grooming because invokes fine motor skills/movements, have some sensory issues, have to hang upside down and/ or bounce around a lot, my son did not show affection until he went to therapy, do not understand proper tone and inflection when communicating, melt downs and tantrums, has to know exactly where ER ate going n he knows the exact way and direction to get from one place to another n if there is a change in plans he needs to be told, often he repeats the same word or phrase multiple times, has some unusual rituals and eccentric behaviors such as he use to always have ti be completely in the nude even No socks when using the bathroom, he has to have the exact number of stuffed animals sleep with him, about 60-70% of what he says is from a show or movie, he doesn't understand the give n take of conversation, has to be told multiple times the exact thing before he does it, does not understand social slang, unable to make friends the right way as example took blocks from a girl n was sent to time out for being mean but his rationale was if she was not occupied by blocks she would play with him and very narrow interests-- if you need anything or other questions pls reply
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Avatar universal
From everything you describe and I have read here, I have dealt with a good majority of what you talk about here with my own son. I am also a RN and have researched my own son's diagnosis before I believed it and accepted it. My son exhibits and I can also say past tense also exhibited some of the same exact behaviors you mention. My son has been diagnosed with an autism spectrum disorder called Asperger's Syndrome and ADHD. Asperger's is a little like high functioning autism but is not too severe in that they are verbal, no cognitive impairment but most of all problems with socialization, poor safety awareness, always have to be 'directing' the situations or be the dominant one, have one sided conversations which is to their choice, like repetition thus like video games, the same movies, computers (they know what to expect), have difficulty with the regular day to day things like dressing, grooming because invokes fine motor skills/movements, have some sensory issues, have to hang upside down and/ or bounce around a lot, my son did not show affection until he went to therapy, do not understand proper tone and inflection when communicating, melt downs and tantrums, has to know exactly where ER ate going n he knows the exact way and direction to get from one place to another n if there is a change in plans he needs to be told, often he repeats the same word or phrase multiple times, has some unusual rituals and eccentric behaviors such as he use to always have ti be completely in the nude even No socks when using the bathroom, he has to have the exact number of stuffed animals sleep with him, about 60-70% of what he says is from a show or movie, he doesn't understand the give n take of conversation, has to be told multiple times the exact thing before he does it, does not understand social slang, unable to make friends the right way as example took blocks from a girl n was sent to time out for being mean but his rationale was if she was not occupied by blocks she would play with him and very narrow interests-- if you need anything or other questions pls reply
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Avatar universal
Both my kids have an appointment with a nutritionist the beginning of september. I made a mistake when I typed my daughters condition, she has isolated pancreatic exocrine deficiency without cystic fibrosyis. She doesnt have the genes for CF and they have ruled out the other potential diseases that cause isolated pancreatic exocrine deficiency, so apparently she was just born with a pancreas that refuses to work properly. She is two now and she has been taking enzymes for 7 months now and what an improvement, shes gained weight, shes not so grumpy all the time, she doesnt have constant diarehhea, her belly shrunk, and best of all no more hospitalizations. We are just hoping it stays this way because if it does then she will just take enzymes any time she eats for the rest of her life, which is difficult now, but as she grows older and can swallow a pill it'll be a little easier and its much better then having CF and all the complications that comes with. Although they will watch her blood sugar to make sure she doesnt go diabetic, I am just thrilled it isnt CF. Its pretty amazing that a lifetime of medicine can replace the function of an organ. Well thank you for your suggestions I really do appreciate them. I will be checking out that book online as soon as I am done here : )
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Avatar universal
Hi!  I think you made an excellent decision.  My son's nutritionist did amino acid tests, a gastrointestinal function profile, IgG food antibody profile, and an organic acid profile. ( His homeopath also did hair mineral analysis, and a chiro did saliva testing.)
  The tests revealed my son's allergies, nutritional deficiencies, and other health problems. The  nutritionist was the most helpful "doctor" my son has been to.
  Is your daughter taking digestive enzymes for her condition? I certainly hope so!  They have been proven to be of enormous value with CF.
Pancreatic enzymes are so vital to good health.
Your son would probably benefit from digestive enzymes too. If you're interested in reading an excellent book about this,  get  Enzymes for Autism and other Neurological Conditions,  by Karen DeFelice.  I have dog-eared so many pages in my copy of this book.  It has been a most useful and enlightening reference.  I think everyone should read this book. Important info for everyone, not just those with health issues.

I'll be thinking of you!

Enzymelover
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Avatar universal
I will make an appointment with a registered Nutritionist for my son, my daughter needs to a see a nutritionist anyways. She has  Isolated Pancreatic Insuffciency with Cystic Fibrosyis and its been a few months since she saw a nutritionist last. I will kill two birds with one stone. You are the 3rd person to mention that this week and I should have done it a long time ago especially since he has so many food allergies since birth and I use to have Celiac Disease. Thanks : )
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Avatar universal
Please, please please, if you haven't already done so, Make an appointment with a Registered Nutritionist and have food antibody and other advised testing done for your son. I could give you a really long post about my son, but I feel I should cut to the chase on this (and my son's waiting for his turn on the computer anyway). Undiscovered food allergies can cause severe behavioral problems. Food has a PROFOUND effect on the brain. A nutritionist may be able to help your son. Give the nutritionist your son's symptoms and see what he/she advises.
Pretty please? With sugar on it? Oh wait. No sugar.

Enzymelover
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470168 tn?1237471245
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.
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Avatar universal
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!
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365714 tn?1292199108
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.
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365714 tn?1292199108
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...
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365714 tn?1292199108
Tis true...lol.
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470168 tn?1237471245
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.
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365714 tn?1292199108
To even make it more frustrating, these feelings behind those meltdowns are genuine...

They aren't doing it out of spite.  I pitched an all out screeming fit when my parents made me take a bath all by myself... I honestly didn't think I could do it without help... I screemed and screemed. I felt like ly parents were being cruel...  But when I came to terms, exhausted myself, I turned on the water and started the bath. Nopt only did I do the bath, but I proved to myself I am capeable of doing so and that I didn't need my parents help. As an added advantage, I could fill the tub with about as much water as I wanted. (I made sure it never got to overflowing).
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365714 tn?1292199108
...and when I say I pitched a terrible fit...you can expect the stereotypical classic all out screaming, ear shrieking, bawling, kicking meltdown... Though I don't remember dropping to the floor at age 12 on that particular dispute, but I think I threw a pretty whiney one...certainly way immature for my chronological age...

It was a ploy to get my parent's attention...and hope for them to give in... I guess they saw it for what it was...
------------------
I don't know if any parents of autistic children saw that one coming...lol. Yeah it does further complicate the picture of autism...

You got the sensory meltdowns which are a reaction to an unpleasant stimulus
And then you have your all out classic bratty child meltdowns but with added vigor...

The louder and the more heart-breaking the better, as long as it works... I have to admit some of my self abusive meltdowns fell into that category, because hey if nothing else will get the other person to respond maybe _that_ will. And it usually does! And if it doesn't then it just escalated...

In this case what I wish when it is an argument that triggered it is for the person to back down and shut up... But if they don't then I have to put my pride aside and leave the scene to cool off...  Sometimes I still get tempted to throw a fit…it’s a bit of an impulse as a reaction to frustration… Once again it takes maturity to spot that coming and do what I can to stop it before it erupts. For instance I was panicked about not finding something before leaving work. I may feel frustrated that my grandma is not helping… No I didn’t feel tempted to lash out, but other times in the past I would feel tempted or lash out against my sister or anyone else in the area, as if I thought they should all stop what they were doing to help me find x…

I was a bit frantic, but I did find what I was looking for. I felt like I was going to be late, but I realized I’ll make it on time… I just about always make it there about 5 minutes early…  That helped calm me a little…and I made it to work and checked in 5 minutes early like usual.  A lot of the anxiety that triggers meltdowns is blown way out of proportion...  I have to cognitively realize that even if I may not be able to line my emotions with what I realize. (That seems to be a weakness with autism, is being able to control how I feel at a given time…) At least I can control my actions... At times it’s hard and may be very hard to control them, but it is possible. If all else seems to be failing sometimes praying helps.

A worker in 1st grade always asked me whenever he saw me in the hallway at time out, "Who's responsible for your behavior?? He wouldn't let me go or leave unless I replied "I am. I am responsible for my own behavior."  As a kid I felt it was unfair and thought that I had no control over my own impulses...I resented that worker....  But he is right.  I may not have liked that back then, but as an adult I know I am responsible for my own behavior, even if I may not want to believe it every time...
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365714 tn?1292199108
I don't know if this will help your children, but with me there came a point my parents just flat out refused to dress me... I vaguly recall throwing a terrible tantrum that I couldn't do something... (I don't remember what age exactly...)They stood firm and wouldn't do it for me...  If they just caved in once, I had a "saftey net" that I could just rely on if I needed it... which knowing me and my obsessions, that would be just about every time...

As harsh as it sounds and as much as I hated it back then, it was good of my parents to stand firm by their decision. The same thing up to age 12 I let my mom pick out my outfits... At some point I got sick of the styles she picked out and we had a verbal arguement. The result: she gave up picking clothes out for me. I had a fuss, but I'm glad now I know I can rely on my own judgement to wear... I've had to learn somewhat the hard way, but I'm glad.

Sometimes a lot of learning is just that... if the child is capeable of dressing themselves, then it's time to make them responsible for that.
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470168 tn?1237471245
It is a good idea you using the chart with stars to get rewards he likes.  It may take a while for him to understand what the process is of getting stars and the consequences etc.
I just wanted to post that alot of the stuff you mention I am still working on with my son who is 7.5 years old.  On schooldays I still have to dress him in the morning because he just can't get his act together to dress himself.  But I leave him to do it himself on weekends and in the evening.  I would say try to see if he can do these things, but if he is repeatedly showing that he is not able to do it try not to stress out too much about it.  There have been a number of times when I have had to 'lower the bar' regarding my expectations of what my son can do.  And the frustrating thing is that he is capable of way above some of his peers in other abilities.  But everyone keeps telling me that is how it is.  There are adults who can give seminars and speechs about autism, but they cannot make their own beds because of the planning it involves.  Sounds bizarre, but it's true.
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Avatar universal
I am going to google all the info you gave me and then I will make another post. I am so greatful for all your feedback....for everyones feedback, I am on a mission to gain as much knowledge before my sons next appointment on Monday and I half the battle has just been knowing where to start and everyones suggestions and feedback have been extremely helpful.  
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Avatar universal
When my son gets hyper, he is totally in the clouds and some of the time he does appear as if he is slap happy. The hyper part isn't what frustrates me, (although I can get tired just watcing him) it's that I can't get his attention for any length of time. If he is bouncing of the walls and I am trying to get him to focus and get in PJ's for bed, at times I literally have to hold on to him, get on my knees and repeat several times to him that he needs to look me in the eyes. Then once I repeat that a few times, I can give him direction and some of the time he will follow the directions, but most of the time he will get his shirt and pants off and then like a mosqito to light something will grab his attention and then I quickly get him back on course he might get into his pull-up and then he gets distracted by something else and I might have to re-direct him once or twice more. We started a chart with 6 things he is responsible for everyday: getting dressed, throwing away his pull-up, putting his dirty clothes in the laundry, putting his dishes in the sink, cleaning up his toys, and doing his homework. It doesn't sound like much responsibility for a child almost 6, put if he could do most of those things without being told more then twice or even without being told at all, I would be thrilled. Anyhow, he gets a star for everytime he completes a task, today for intstance he got 2 stars for getting dressed because I didn't have to dress him this morning or tonight, although I had to stand by and keep him on task and it took him 15 minutes, I didn't have to physically get him dressed, he was able to finish on his own. Then at the end of the week if he has a few stars on everyday he gets a present (a new batman puzzle). Then we will build up from there, adding on new tasks and hopefully he will get better at them the longer he does them.
Aidan does get put on time outs although up until he was put on medication they were completely inaffective. He would sit on the steps and I would speak to him in a calm firm voice after his 4 or 5 minutes and explain to him what he did wrong, and a good chunk of the time it was very difficult to get him to pay attention to what I was saying and even when he did pay attention and was remorseful and apologized, he would go straight back to what he was doing and then he'd end up back on the stairs and we'd go back and forth until I came up with an alternative solution. Since he has been on medication, the time outs have become a little more effective, although I don't use them as often as I use to. He is obcessed with his movies, his Leapster and his cousins gameboy now too and it seems the threat that he might loose any of those things is at least some of the time enough to get him to straighten up. I will say when he is agressive, he is flat out angry and when he gets angry it becomes very difficult to reason with him. I put him on a timeout when he gets that mad because 5 minutes by himself is about the only thing that difuses the situation enough so that I can talk to him and he here's me.
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365714 tn?1292199108
When your son is hyper, is he giggly, laughing, as my dad puts it "Slap Happy?) when he is doing some of his misbehaviors?

It could be the cause/effect reaction he's looking for.  I think some cases it's the predictable reaction that autistic people (and others) are looking for. One of our family friends has a nonverbal autistic child.  When he was younger, he used to love slapping my dad on his belly. Every time he slapped my dad's belly, he said "Ow!" It was the "Ow!" he enjoyed. (not the act of hitting, I'm sure.)

Same with me when I was around age 6. Dad and I read a Bernstein Bears book Hop On Pop. I got the idea "hopping on pop, must be fun. I hopped on his belly. He retaliated by saying "Ow!"  Once again predictable cause/effect...

I think a good way to break the cause effect, is to bring an "effect" that is less desirable... One that he won't like. (but not something like physical contact...that may bring a different reaction).  Like the light switch, if I did it too much, I was kept away from the switch. If I got too hyper, I was forced to sit in time out... Usually I'd calm down even though I hated being there. I know that "Supernanny" says one minute per year for the child, but for an autistic one like me, it seemed to be I was in forever. Maybe I was put in longer and it likely helped.

Now if your son is not "Slap happy" or appearing happy at all when he is aggressive or misbehaving, there's another reason. He's not doing it for fun.  He's likely frustrated or angry at something. Likely built up emotions or as a reaction to something he didn't like. For instance if it's a sensory thing, he may get angry if being grabbed or touched. If a light is flickering and he turns it off without laughing, chances are he does not like that light. If it is flickering, I don't blame him. That light needs to be changed.

I hope this helps in some way.  Likely it's one of those ABA things. I don't know...

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365714 tn?1292199108
Sounds quite similar to me and my story. I'd have fun once I could understand the rules and what was expected. If I wanted to play that game again, after being shown how to do it, then I can activly participate.  But still I tend to be rather solitary. It may be part my nature more than autism. That's great you got your son to enjoy that game!  I think I've played it a few times with family and friends. Or sometimes I just liked to hide just for the sake of hiding...  When I was younger, one of my favorite spots was in the laundry area, hidden in the pile of clothes. Another area I would love to hide was an unfinished sort of a crawl space (without being closed off) in the laundry area of the house. My mom tried to explain that area was "too dirty" and make it off limits... I didn't really hide there too much.  Age 11-12 in our other house, I liked to hide right next to the downstairs freezer. For some reason, if I was quiet enough, my parents had trouble finding me there.

As a child (up to age 6-7?)I used to flick light switches on off and see how fast I could do it. To me it was a game...one that almost always ended immediatly after a few flicks... It annoyed my parents and they'd pull me away from the switch or scold me.  II still don't know why I thought it was so funny...  I'd laugh as I did it and if my parents got angry, I'd laugh even more... For some reason their frustration made it all the more funny, even though I wasn't planning on being defiant... I just liked the reaction. ON OFF ONOFFONOFFONOFF "Stop it!" "You're gonna break that light switch!"  It seemed rather predictable... I don't recall doing it much when by myself. I think I did a few times, but usually it was done in relativly close proximity to where my parents were... I guess it could have been a subconsious attempt to get attention? That I don't know... I'd be more inclined to do it when hyper than when calm.

I guess that's what I was like when I got into OMG hyper mode... I guess the light switch was a form of "stimming", one that I wasn't allowed to do, and eventually lost interest bothering.  I also liked at the time th eidea of going different places (2 outlits at opposite ends of the room) and see how that would turn on/off the same light... Once again I think that was a relativly short lived aqctivity that lost its appeal after awhile.
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470168 tn?1237471245
I've just managed to teach my son how to play Lurkey-one-two-three.  This is like Hide and Seek, but all the Hiders have to try to get back to a winning post before the seeker spots them and gets to the winning post before them.  It has taken some time to teach him, but he likes to hide.  But he wouldn't hide on his own he needed to hide with someone else.  Then he had to be taught that when hiding he also had to try to be aware of where the Seeker was so that he knew when it was a good time to run for the winning post.  But tonight he hid on his own and he beat me three times back to the winning post, so I am happy that he has learnt how to play.  The thing is though, that if I hadn't asked him if he wanted to play and learn the game then he wouldn't have asked to join in with us and most likely would have appeared unaware of what we were doing.  So I'm happy that i've taught him something that he obviously likes to play and one that he can play with other kids.
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470168 tn?1237471245
Obviously, if he is a danger to himself or others off medication, then that is not really an option, unless he is in an environment that can cater for that.
(I just read through your first post again about flicking light switches, my son also did/does that.  It is sensory based and indicates a visual perception problem).
What type of school is your son at?
It might be useful to you to get in touch with an advocacy service that can tell you what are your son's and your legal rights regarding education provision.  If your son is at least average intelligence with the types of problems you describe, which could be down to a number of diagnosises (some on the spectrum with possible ADHD), then you may be able to get him into a private school funded by the state because the state education system will not be able to cater for his intelligence and his needs.  Therefore he will either be in a mainstream school and not be able to learn at all.  Or put in a school for children with low IQ or behavioural problems which cannot meet his intellectual level.  That is the position that I am in, and many other parents find themselves in the same situation.
But you are right to question what is causing your son's behaviours, but you also need to get an idea of his intellectual ability and that needs to be assessed taking into account the fact that he may have verbal/communication problems and therefore should not be assessed in a way that relies of these abilities to demonstrate intelligence.
You might also find it useful to get some advice from a nuticianist about his diet.  Try to find one that has experience of children with ASDs and ADHD.  For example fish oils can help concentration.  Also removing sugar (incase of yeast problems) and using probiotics.  Keep a food diary for a few weeks to see what he is asking to eat and how his overall dietry intake looks.  Then just try to give a very health balanced diet.  If you wanted to try gluten free or casein free diet you could do that sometime in the future to see if you notice any improvements.  
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365714 tn?1292199108
That lacking imagination and imaginative play is sort of a joke in the autism communities. Try lurking forums like wrongplanet.net and you'll see several remarks and topics where the people break apart the DSM definition of autism. As it turns out, it's true for some people, but not all. Some people lack imagination and some don't. (Both autistic and not). I think with autism, a lot more of the imagining goes on in the head and less externally.

A non autistic child likely engages you in their fantasies a lot more than an autistic one.  If an autistic child lets you in their games, chances are you'll have a set of rules to play by to keep it fun for them.  It was sort of like that playing with me.  Yeah if asked to, I'd play things like tag and I'd follow along. But if not asked, then I played by myself. Sometimes I had a friend or two to follow me. I preferred being one on one with people (and still do) than being in a large group/crowd.

Socially as a kid, I could take or leave people. There were times I got lonely and wanted people with me, but most of the time I was pretty self sufficient. I enjoyed activities if people actually asked me and let me in as well as let me know clearly what I am doing.  If I'm left confused, then I go off and abandon the group to find something I know how to do.  If they wanted to play along with me, then I let them. One high point in my childhood was when I started making some kind of building out of boxes, carpet scraps, and misc things. It started out with just me and a little 4 year old and just one box. She moved away so I was left by myself to start expanding the box. A neighborhood boy was interested, so I told him what I was doing and gave him some orders. "See that dumpster there. You go in and pull out a big piece of carpet for the fort I'm making. I'll go and find some boxes."

Then another boy came along. I let him know what I was doing. Next thing I knew there were about 3/4 boys playing along with me creating this monster of a building out of boxes.  We cut ends open, so that we can crawl through the structure, nap, or talk.  It was fun until the structure got too big and had to be thrown out...
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As an adult, I'm pretty content just staying home on my computer as long as life would let me. I have to _force_ myself to do things. Often I feel an aversion to going out, but eventually I have to pick a day and stick by it for shopping, getting things. Talking to people, etc.  Usually it helps if I have someone else with me to print off and remind me of such and such event occurring outside. Chances are if pressured enough, and shown the way, have someone with me, I find myself enjoying the times out.  But having that person with me makes a big difference. Left up to my own devices, I'm pretty unmotivated. It isn't that I don't have goals or things I like to do, just connecting the dots to get the ball rolling is where it breaks down.

Given the choice to face the unknown or do something familiar, I rather do the familiar. Getting around that feeling takes a degree of force. Sometimes external force.  It also takes willingness on my behalf.  A lot of times I just don't feel like it...

That's something I need to work on. I believe my mom struggles with the same feeling and that may be why she and my dad have disagreements.  My dad likes to go out and do things like watch movies, come over and visit me, etc. Mom, if she's like me, doesn't feel like going, in fact may groan at the thought of having to stop whatever she is doing at the time, but if pushed far enough and made to go, likely finds the experience enjoyable. That is if she will let herself be forced out of whatever she is engaged with.

If I can overcome it with myself, then I can likely do a lot more and give a lot better advice. I believe this is my biggest problem. I don't know if it is autism, depression, OCD or ADHD or just a HUMAN thing... Maybe none of the above (except the human part) or all of the above? Or it could be any combo... Who knows? If I can understand what causes people to feel lack of motivation and block them from doing x- and find a solution, I'd probably win the Nobel Prize, lol. I can imagine the countless wives being thankful to get their husband off their bum and do the list of house chores that need done.

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470168 tn?1237471245
My post was so long, I had to do it in two parts!
You also mention your son repeating things he has heard.  This sounds like echolalia, which my son also has and this too is part of an ASD and also indicates language processing problems.  Google 'echolalia and autism' and it should give you some good examples.  My son can talk his own speech, but he also uses alot of phrases he has heard from TV or DVDs, and if he hears something he likes he will repeat it a number of times to himself.  He will also 'replay DVDs in his head' and will repeat the dialogue quietly to himself whilst he is doing that.  If I ask him 'what are you watching' he will give me the name of the movie.  He also has a brilliant memory for things he has seen or heard on TV.
My son is also brilliant at constructions toys such as lego and puzzles.  Again children with an ASD tend to be good at visual/spatial abilities and poor on language and social communication.  My son scored on a percentile of 93 for visual/spatial skills and pattern recognition and only 2 for understanding verbal instructiions.  (which may explain the fact that you have to keep repeating instructions to him).
He may also have Executive Function Disorder.  These are skills such as planning, sequencing, organising, prioritising, initiating, inhibiting.  It is also typical of children with these types of problems to not have any understanding of time.  So anything involving words about time as in 'do this today, tomorrow, in 5 minutes, when you have finished etc' mean nothing to them because they have no concept of time.  If you have problems with executive functions you will find it hard to follow verbal instructions that involve planning, sequencing ie. do this and then do that.  You can google Executive Function Disorder to see what that is, but it usually accommpanies an ASD.
This could explain his difficulty when you ask him to do a number of tasks.  He cannot sequence them or plan them or organise them.  But he might also have problems with visual/verbal or auditory memory or processing.  
For visual perceptual problems you can google Irlen Syndrome and have your son assessed to see if that would help relieve any visual sensory overload.  That might also help him with concentration and help him to stay engaged for longer.
If he has problems with noises and appears to not like them, but later on appears as if deaf.  That means he has effectively 'turned off his ears' to stop sensory overload.  You could try getting a pair of ear defenders, the type you get from a DIY store that are to protect your ears if you work in loud environments.  My son has a pair of these for just over a year now.  He uses them when he needs it and takes them off when he's okay.  He seems to be getting better at tolerating noises, but I found that the ear defenders helped him cope in 'out of home' environments eg. socialising in family groups, going to the cinema etc.
My son also would prefer to always be at home and is always anxious about going out and wants to know where we are going and when we are coming back.  
When you have to go out you could try giving him a clipboard with pictures on of the places you have to go to and he can tick each one as you do it.  It will help him see that he is moving down the list and it is also a visual way of him understanding the passage of time.  Because if you don't understand time, then leaving the house is scary because you have no understanding of 'when' you will return.  You will also need to make sure you keep to the sequence of the pictures you have given him because if you change the sequence eg. go to the petrol station before the supermarket and the picture list has them the other way round, then you can expect a tantrum because you have changed the 'expected routine'.
I think your son meets more of the criteria than you think.  Sometimes it is difficult to match the behaviour with the criteria, but you have mentioned alot of it.
Although you say he has imaginative play, is that always in all circumstances, or only in some areas?  If he does indeed have alot of imaginative play then he might be more Aspergers, which is still on the autistic spectrum.
Although you say he doesn't rub or lick things, you have mentioned plenty of other sensory behaviour and no-one child will show all of the symptoms, just enough of them to get the diagnosis.
My son rarely flaps, and he sometimes spins.  But you have mentioned rigid routines he needed around bedtime.  Sometimes these rigid routines and behaviours can be interpreted as OCD when they are not, they are part of the ASD.
You say he has normal speech development yet he has problems communicating with peers and might shout at them in an attempt to play with them.  He also repeats TV dialogue and phrases from his leapster.  These are speech problems.
Out of the list of the critieria it usually says things like 'the child must exhibit 2 out of the following 6 items'.  If it does appear that he doesn't have enough of the criteria for a diagnosis, he might get a diagnosis like PDD NOS, which basically means still on the spectrum, but not enough of it to get one of the other diagnosises.
Sorry this is such a long post!  Post back if you want more clarification.
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