8 year old Downs Syndrome with possible other issues

Collin is 8 and has diagnosis of Downs.  His behavor is getting worse at school.  Transitions are the worst but he might have other issues. He can speak but not clearly and does not seem to be able to keep a conversation going. Most answers to questions are I dont know.  He can read up to 50 words and is doing some addition. He doesn't walk down the halls at school he runs.  Noises bother him. Testing with an FM System at school showed significant problems understanding when there were background noises (drop from 92% to 62%).  He has to adjust his pillow and glasses just right before bedtime.  He has problems playing with children often acting like a tiger to initiate play. He got angry at one teacher for not giving him the computer chair when it was his turn on the computer (She was a visitor to the class and ignored his requests for the chair) he was so angry he pulled some feces out and tried to put them on her and the aides to came to help.  He hides under the tables at school to avoid work and/or people. He is refusing to go to the regular class room for integration in art, music and PE. He insists on bringing all of his school supplies to school and back home every day.  His behavior at home is fine we do not see this aggression but he is stubborn and must be dealt with on many issues by saying, if you want this you must do that, and this works.  At school they say his becoming very aggressive.  I think some of it is boredom and sometimes he just wants to play. His teachers think the bad behavior starts as control issues and boredom issues then esculate into attention seeking issues. They say they solved the refusing to leave the bathroom issue by sending him to a bathroom they could unlock the door.  After this we had significant issues at home with him soiling his pants which ended over Christmas vaction. School admins. just want to ship him off to a phase 3 class room where they have a quiet room to lock him in and a fenced playground because they are worried that he might run away. In fact, they say we should spank him for his bad behavior.  They have suspended him 5 times this school year. If he has other issues as PDD spectrum or OCD, how do we go about getting him tested and diagnosed?  Does diagnosis really matter if what he needs is very specific behavioral modifications?  How do we go about getting the best programs for him and what programs would those be?  What medications might help him?  Some of the symptoms of PDD Spectrum seem to apply and some symptoms of OCD seem to apply, is it possible to have both?  Or does only some symptions of each mean neigher is possible?  I know these are a lot of questions but the school is pressuring us to move him very quickly like in the next two weeks so I need to understand what is really best for Collin. They say this not common behavior for children like Collin. Isn't it in some cases? Please forgive the length of this letter.  Thank you.

[Kevin Kennedy, Ph.D.]

Your son definitely is displaying behaviors not typical of most children with DS. The question about possible Pervasive Developmental Disorder is appropriate and deserves additional investigation. Such assessment is conducted by pediatric mental health professionals, and it would be prudent to arrange an evaluation asap by a child psychologist or child psychiatrist. It is very likely he will require a very specialized environment along with pharmacological treatment. If he displays symptoms of OCD, these are not particularly problematic in comparison with his regressive, disorganized and aggressive symptoms. Due to his special needs, the school system is mandated to provide for him in a suitable setting - the question is, what will the suitable setting be? It would make sense to preserve a positive relationship with the school system and to collaborate with them. Ask to see the options for a more structured setting and see what you think. They may have a program that is suitable. Your description indicates that the curren tprogram cannot provide the degree of structure, supervision and behavioral intervention your son requires.