I agree with Sally. This could be aspberger's. My son has that and it was only diagnosed as PDD (which basically means "I don't know whats wrong with your child") it is annoying and nerve racking to not know whats going on. I took it upon myself to look into it and low and behold I found Aspbergers. It described my son to a perfect T. I just got frusterated again because no dr would agree with me. 4 Years of evaluations did nothing. On day on the verge of snapping I called our new pedi and plainly told him. I can't stand it anymore I don't even like this child anymore. (I love him dearly) dr asked what the behaviors were as I described them he stated "sounds like aspbergers" He told me to call this new psycopharmacologist we'd been seeing and tell him what I had just said. So I did, he agreed and imediately started Jake on abilify. What a hugh difference it made.
When this dr asked who told me it wasn't aspbergers and why. I told him the people in his now office and he wasn't because he didn't function academically at his age level. (he has a brain tumor that masked the aspbergers) I hope my story helps you. If you know in your gut what is wrong go with it.
Go onto the Autism forum and click on the Health Page icon on the top right hand corner of the page. Click on "Bhavioural Characteristics Behind a Diagnosis of Autism (ASDs). I am a parent of a 7 year old child on the spectrum. I have posted the DSM IV criteria for getting a diagnosis of autistic spectrum disorder, and parents have posted examples of their child's behaviour that meets the criteria. That might help you recognise your own son in those behaviours. You will see that any child only has to have a certain amount of the characteristics out of each section. So no child will have all of the characteristics and every child will be different.
Regarding repeating questions, words etc - google Echolalia and Autism and also Perseverant Speech and Autism and see if that sounds like what he is doing. If it is then he probably has a speech disorder that needs to be assessed by a Speech and Language Therapist. She should assess his expressive and receptive speech as well as assess for Semantic Pragmatic Speech Disorder. Difficulties with language and communication can cause many behavioural problems because they are struggling with something we do so naturally.
Also google Sensory Integration Disorder to see if that sounds relevant. Is your son over or under sensitive in any of his senses?
Sometimes not caring about consequences is really that they cannot see the consequences of their actions - there is a difference. Problems with predicting outcomes can be associated with poor Theory of Mind - google that to see if it is relevant. If it is then poor TOM is associated with autistic spectrum disorders, as are the above disorders mentioned.
Tantrums, getting violent, very emotional, sudden outbursts etc are also typical of autistic spectrum disorders. If there is a lack of control of emotions then triggers can cause them to be totally overwhelmed with emotions that they cannot stop or bring under control. Alot of work has to be done to get your son to recognise his emotional state and to teach him appropriate ways of calming down and coping strategies. Again a Speech and Language Therapist and Educational Psychologist should be working with you on this.
If you have a gut feeling that there is something else, then that may well be the case. My son has an ASD and I suspect he also has aspects of ADD. All of my other gut feelings relating to his speech problems, dyslexia, visual problems etc have all turned out to be true.
So look into the above mentioned disorders, as having any one of them will lead to enormous amounts of frustration and behavioural difficulties. And then go to your GP and say although my son has a diagnosis of ADHD I believe he also has XXXX and I want him referred to professionals who have experience of diagnosing this disorder.
What is your son like off meds? If taking them makes him worse, and there is no noticeable benefit to him being on meds, then I would speak with his GP about gradually weaning him off them for a time to see how he is.
As you probably know, disorders such as ADHD or ADS can also have anxiety and depression/bi-polar with them as well, so you will need to keep a very close eye on him when he is coming off meds.
Regarding meds, many people on the spectrum have posted saying that normal doses of medications can be too powerful for them. So when trying anything new it might be worth discussions starting on a very very low dose and gradually increase over time if it is beneficial.
As he is verbal what is his reason for wanting to hurt himself and others?
I once again understand and agree with Sally44. one thing (and I am sure sally knows what I mean) you need to watch out for the PDD diagnosis. This is actualy a non-diagnosis. and basically means" I don't know what the heck is wrong with your child." Because PDD covers such a wide spectrum of disorders and they are not all treated the same, different meds and treatments therapies work different for different disorders. For instance my son does well on abilify and in low key therapy and classroom situation. anything with too much stimulation is going to make him crack.
Autism is characterized by impaired social interaction and communication skills as well as repetitive patterns of behavior. A number of the behavior difficulties you describe are consistent with a diagnosis of autism. Therefore, I recommend that you seek the assistance of a qualified professional who specializes in the diagnosis of Pervasive Developmental Disorders so that you can receive an accurate diagnosis for you son. Although diagnosis alone will not point to an appropriate intervention, it will lead you to identify appropriate services for your son. I also recommend that you seek the support of a Board Certified Behavior Analyst, who would be able to conduct the appropriate assessments and to assist in developing an assessment and treatment plan for the behavioral episodes you describe. Please visit the website of the Behavior Analysis Certification Board (http://www.bacb.com/) where you will find a directory of service providers.
I think if you understand that the 'meaning' behind the things he is saying isn't there that that helps. My son has said many things, and I know he doesn't understand what he is saying. For example, he saw once on TV a situation where somebody got mad and decided to pack their bags and leave. Because he doesn't have the social insight, that is how he believes you resolve situations like that and he frequently threatens to 'leave home', and I have found him with his rucksack packed and ready to go. I have to keep all doors and windows locked because he cannot predict the outcome of his actions. Once I caught him in the back garden throwing bottles because he wanted to see if they were made of glass. He couldn't tell by looking at them, but he knew what broken glass looked like. He has frequently flooded the bathroom with his interest in water and pipework and more importantly blocking pipework!
I would go back to your doctor/paediatrician and say that you want assessments by professionals who have experience of diagnosising autistic spectrum disorders. In the meantime I would read up about the different diagnosis and make a note of his behaviour on a daily basis and make notes of what you think is autistic and what you think is ADHD.
Look at all other associated conditions as well. Google Semantic Pragmatic Speech Disorder, Central Auditory Processing Disorder, Executive Function Disorder, Sensory Integration Disorder, Irlen Syndrome, Delayed Echolalia and Perseverant Speech, Theory of Mind.
Many children with ADD/ADHD and/or Autistic Spectrum Disorders will have components of both conditions as well as any or all of the above mentioned disorders as well. Some professionals will say 'we know that children with xxx have these types of difficulties', but the truth is that every child is different with different combinations of disorders and different traits of those disorders therefore IT IS IMPORTANT to know how each child is affected otherwise they won't get the supports and strategies and approaches and therapies that they need for their individual strengths and weaknesses.
So sit down, make a plan of action, and start working through the list. It is a long slog - but worth it.
Hang in there. You will find him the help he needs. I understand so well how you are feeling right now. Take some comfort in knowing you are not alone. There are people who understand.
Thank you so much for your advice. It is so hard to handle a child that is having problems and you can even help him. My heart breaks when I start to get mad and him and then I look at him and I dont see anything behind his eyes.
Without his meds he is still a rollercoaster of emotions, but without some of the other side effects. He also does not sleep with out the meds.
When he talks about wanting to hurt others or himself it is always becuase he is mad or frusterated. I guess that is his way of releasing anger.
I have spent many sleepless nights crying becuase I just want to help him. I know what you mean by "not liking the child" even though you love him with all your heart. You just become so angry and frusterated with the behavior.
Thank you again.