Aspergers Behaviors and Parents Health

[Ken_In_NH]

Our son is 14 years old, diagnosed with Tourettes (VERY severe tics, whole body) and Asperger's Syndrome.  He has severe social disabilities.  His behaviors at school (especially when bullied) have isolated him completely, and he has no friends.  He is involved in Boy Scouts, which appears to be the only thing in his life that is positive.  His behaviors at home run the gamut, from helpful and caring to destructive and bordering on (if not in) self-injurious.

He is on several meds, which have moderated some behaviors, but lately his bedtime behaviors have gone off the charts.  It does not matter whether he has just completed the most fun activity there is, it is like a light switch goes off.  If he has to take a shower, then there are 5 or 6 things that happen every shower that become huge deals (the shower water got on his towel, so the towel is useless, he used too much shampoo, so he is stupid, etc).  These same things occur nearly every time, and he makes a big show of these major things.  When he brushes his teeth, he stands there and scrubs his teeth until toothpaste and foam come out of his mouth, then (again), he says he is stupid.  The stress this causes is phenomenal, and this has gone on for years.  

When he is heading up to bed after these episodes, he often says 'I wish I could go to sleep and not wake up', because of his tourettes.

Are there any therapies that can affect this behavior?  He is seeing an MD for med management, and couselor, which appears to have no affect.  

Also, when these therapies like conseling have no affect, is there a 'next level'.  After five years of intervention, he is literally where he began.

Thanks,

Ken

[Jason C Bourret, Ph.D., BCBA]

Your son's age is one that can be particularly difficult even without having to handle the challenges that your son seems to be facing.  It sounds like your son is on medication that has been successful to some degree but not completely successful and that he is in counseling that you are not finding effective.  Behavior therapy alone or in combination with medication can be effective in treating tics associated with Tourette’s syndrome and the types of behavior problems that you are describing.  If you are finding the medication to be insufficiently effective, discuss plans for alternatives that might be more successful with your doctor.  If you are finding the counseling ineffective, I recommend finding a certified behavior analyst with experience working with children similar to your son.  It sounds like your son is quite bright and could benefit greatly from a well designed treatment program.  Children with the challenges your son is facing can be effectively treated.  As a parent, I believe that the key is to find a therapist/behavior analyst with a track record of success in treating similar behavior problems (feel free to ask for data from previously successful treatments that he or she has overseen).  

[MaryannesMom]

Is he on an anti-depressant?  He really, really needs to be, and cognative therapy to get that "I'm stupid" tape to quit running in his head.  I feel for him, and wish you all the best of luck.

[FSG]

I think although he has problem of this and that, but he still smart enough to notice the difference between him and other (it tears my heart when think of this). I believe he has potentials to do something he will be great at. Help him to discover. If he should frustrated in the future, he always has something that he is pround of to catch his back.

[Sally44]

Are there any dinnertime clubs at your son's school?  If not, is this something that the school could start.  Your son might be able to be involved with it.  Maybe a club around an interest of his?  He could then 'help' other children learn how to do whatever this club is about.  This was very successful for a friend of mine whose son is Aspergers and who was finding social interaction very difficult and was getting teased/bullied.  Because these children need structure and routines it is frequently forgotten that there is no structure of support during 'free time' at school.  
He does sound very low as well.  Do you use Social Stories with him at all?  I agree with the other comment that we need to stop this 'stupid' self assessment thing all the time.  My son can also do that at times and call himself stupid, a loser, useless etc.  Remember that autistic/aspergers people are very 'honest' in their choice of words.  So if he says he is stupid that is how he feels and how he is interpreting his performance.  They also tend to use words literally.  So counteract that by saying 'stupid means ....., getting water on your towel is not stupid it is an accident.  
If he has any areas of interest try to get him into those types of clubs.  If there are any parent support groups where the children meet and socialise then go along to that.  I have found a brilliant one in the next town to me.  It is for children with Aspergers, Autism/ADHD and their siblings and friends.  It is held once a fortnight at the local community college and they hold it in the gym.  They get out all the equipment plus a trampoline and bouncy castle and they have 2 hours to let off steam.  They are supervised.  Parents meet in a separate room for tea/biscuits/chat/info finding/should to cry on etc.
Try to chill out on the finer details that drive us all up the wall.  They are very picky about stuff and they cannot be hurried along.  I too get my stess levels through the roof and afterwards I haven't achieved anything by getting so wound up.  
So try and get as much positive/self esteem building stuff going on as possible.  Praise every single little thing he does and make sure you frequently tell him how wonderful he is and how much you love him.
Adolescence is a tough time (I can just about remember that far back), but he has got alot more on top of that on his plate.  As he has such difficulties with social communication is there any professional from an educational perspective who can spend time with your son maybe helping him to navigate through the social structure more easily?  We call them Social Communication specialists and they are different from Speech and Language Therapists.