This forum is an un-mediated, patient-to-patient forum for questions and support regarding
Asperger Syndrome issues such as: Balance, Behavioral Issues, Causes, Characteristics, Classification, Clumsiness, Communication, Diagnosis,
Gait – Walking, Genetics, Medications. Parenting, Prognosis,
Restricted and repetitive interests and behavior, School Issues, Screening Sleep Disorders, Social interaction, Speech and language, Treatment
You don't say if he had any speech delay or communication problems. One of the differences between autistic spectrum disorder and aspergers is that those with aspergers tend not to have speech delay and they tend to do okay (or very well) at school. But they can have speech processing difficulties and may appear not to understand what is being said to them when they are young.
Aspergers children also tend to get obsessions on things that they know loads about, or pet topics they like to talk about regardless of whether anyone else is showing an interest in what they are saying.
There can also be sensory problems which can affect all of the senses and how the senses interact with eachother. So seeking continual movement, tasting non-food items, seeking/enjoying certain sounds etc may come under sensory issues, which would need to be looked at by an OT. A good book I would recommend is Sensory and Perceptual Differences in Autism and Aspergers by Olga Bogdashina. She also talks about learning styles which can be different in autism and aspergers.
They also tend to take word meanings literally and would have difficulty understanding sarcasm or understanding when someone was being nasty to them by the tone of their voice.
There can also be a need for rituals/routine, which can sometimes give the impression that the child always wants to be in control. But by keeping control the child is getting the predictable outcome that they want/need. If they allow someone else to take charge or contribute then 'they don't know what will happen'. I think the needing to be in control to reduce their anxiety etc can also present as ODD. He isn't going to want to do what you say/suggest because he may not be able to mentally see what the outcome will be. But if he does what he wants then he knows what will happen. That can also show itself in social communication as they usually have problems with age related peers and tend, as you say, to go for younger children or adults.
This lack of understanding of social communication rules is present in autism and aspergers. Not knowing the 'unwritten' social rules that everyone else just seems to pick up is common. Not being able to hold a conversation or doing it in an odd way, or having difficulties with the timing of two way conversations is also common.
Reacting overemotionally to things and having tantrums and meltdowns is common and continues through to adulthood. They seem to get flooded with emotions that they cannot contain or get under control quickly and it seems (to us) to be out of proportion to the event that triggered it.
Along with a number of disorders there can also be problems with Executive Functions. These are higher brain functions and tend to get noticed as the child gets older and is supposed to become more independant. It involves things like planning,sequencing, managing time/understanding time, predicting outcomes etc, organisation skills etc. So, for example, if you have to tidy your room where would you start, what tools might you need, how much time will it take, what structure shall I use to keep my toys tidy etc. These things may be very difficult for some people. It also becomes noticeable at school with planning topics, revising for exams etc.
May have trouble expressing or understanding certain emotions. We can be given very little information and draw conclusions from it. Someone with autism/aspergers may not be able to 'see' beyond what is made aware to them and therefore have no insight into anothers emotions.
I think it would be helpful for your son to have a full multi-disciplinary team evaluation to tease out what is the root cause of some of his difficulties. He may have Aspergers, along with ADHD/ODD etc, or he may have traits of some of these but not enough to get a full diagnosis. Some symptoms are common to a number of diagnosis.
I don't believe that's what he has because all the ADHD meds didn't work on him.
In my opinion, if you have x disorder and take a med made to remedy that particular disorder, and the disorder is not remedied, than maybe you don't have x disorder after all.
For example: Once upon a time, I started coughing so I took some cold & cough meds, The coughing continued and got worse, so I tried other cold and flu remedies. The cough became non stop with sharp stabbing pains in my ribs. I went to a doctor and had severe bronchitis only remedied with an inhailer.
If almost all ADHD meds don't work/ease the hyperactivity/silliness, etc. than I think he must not have ADHD, but something else causing ADHD-LIKE symptoms.
Anyway, he has no speech issues and articulates nicely, like a little proffesser.
Anytime he talks though, he's spewing facts, summerizing how to play a computer game, or commenting on key points in a books plot/story. "look Jake and Mary found a gold coin on the beach! That must be a clue! .....chatter, chatter...etc.
He rarely plays by himself, and if he does, makes excessive noise and motion trying to get that constant attention.
Alot of what you describe applies to him as well.
I try to make things as simple for him as I can.
He has a hanging clothes cubby with complete sets of folded clothes for each day, including top, bottoms and underwear. His shoes are under the cubby.
I made places fr all his stuff, animals in the basket, legos on the lego table, Mr. Potato Head & parts in a plastic shoe box, books in bookcase etc, but everything is still strewn everwhere, and I have to oversee cleanup to restore things to their rightful places.
Also, I use an audible scheduler, that goes off and tells him what to do.
Beep, beep, beep, he goes to the scheduler, and sees the time 7:30am reads the text which says "time to get up", etc. The whole days events are layed out for him this way, so he knows what to expct.
It's just tiring treating an almost 8 year old like 3 year old. :(
j
I do think that alot of what you mention about tidyness and having to keep prompting him is still normal for alot of mums with kids, but obviously you know that there is something behind it. Just don't stress too much about it because he isn't doing it deliberately. I think that an OT would be appropriate to help in this area.
Do you think he has problems with information retrieval? I know you've said that he is a walking encylopedia and knows lots of things. But if he has to retrieve specific information relevant to something that is expected of him is he able to do it?
If he had no speech delay then any evaluation would probably be looking at whether Aspergers is relevant. I have attached below a list of the different criteria for Aspergers. I think you use DSM IV in the USA, but have a look at what the symptoms are and write down examples of where your son fits the descriptions. I think asking for a multi-disciplinary assessment through Health is better than going through Education. If you can afford it (if you can't automatically get access to an OT) you could consider getting a private OT's report relating to organising/prioritising etc skills and Sensory Integration or Sensory Issues.
I would get some advice from an OT who has knowledge of sensory integration problems or sensory issues. Ask her about the continual seeking of movement. In a 'normal' person our senses regulate our body and our responses to sensory stimuli. If that system is out of order or balance then you will see some sensory seeking activities or apparent lack of a response eg. continual movement, staying still, appearing deaf, or covering ears at certain noises, sensitive to touch or no reaction to pain. My son doesn't always seek movement. But he does need to use movement to 'get him going'. So if he has to do some homework he has to use a trampette we have in the lounge and he will jump on/off this whilst he is doing his work.
I did read somewhere else that if meds for ADHD are not working then it might not be ADHD. But I don't know much about this condition. I think the differences you will be looking for between Aspergers and ADHD is going to be in Social Communication (where you have said he has a problem). Is he able to relate to his peers and have a social/verbal dialogue with them, or does he appear odd in his approach or responses? And can he demonstrate 'imagination'. Does he try to re-enact/play in a way that is replicating things he has already seen on TV? This one can be quite hard to tease out. For example all children may want to play 'Transformers', but the child with Aspergers may want to say the same dialogue and may want the other children to say the same dialogue as the storyline he has already seen. If he appears to be trying to keep to a 'script' and is trying to keep control of the game so that everyone follows the script then that could be used to demonstrate lack of imagination.
Along with obessions and interest in some subjects there is also a lack of general interest in other things. So they tend to have a restricted area of interest and are unable to be interest in or pay attention to things outside of their topics of interest.
So from your first posting, and looking at the criteria below you have mentioned that your son has problems under Section A and has difficulties with the areas mentioned in (2) and (4). So continue through the criteria to see where he meets it.
I tried to attach the diagnostic criteria but it is too long. You can find google 'DSM IV for Aspergers' to bring it up.
Hope that helps.