Has my son been properly diagnosed?

[Alicia4]

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.

[MJIthewriter]

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).

[MJIthewriter]

...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...

[MJIthewriter]

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.

[Sally44]

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.

[Alicia4]

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.  

[Alicia4]

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.