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Originally Posted by mrsfru  I would really, really encourage this! As a dog trainer, I have seen this type of thing work great!!! GL!
Also, your story was actually similar to one the developmental ped was trying to paint for us this morning as she encouraged us to think through and work hard on the boundaries and such now (b/c we are really struggling!). She said that is is very common for kids w/Aspergers to get more difficult in these ways as they get older. Thanks for sharing your story this week--I know it hasn't been easy (going through it OR sharing it).
mrsfru
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You are welcome! Its helpful for me to share....I don't have many IRL people who get what I am going through!
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Originally Posted by Thystle {{{{{{{{{{{{hugs}}}}}}}}}}}}}}
Have you considered getting a 2nd or 3rd opinion by a different pdoc? The meds he is on can be counteractive to each other. For many mood disorder/bipolars the antidepressants can make them suicidal, and Abilify made my son violent. And to have those meds together might be making things worse. Antidepressants also made my Aspie hubby violent.
There are many autistic people that will never truly connect and there is no amount of therapy that will make them. Just be prepared for that possibility. 
And MANY are chronically disorganized and easily given an ADHD dx and meds when it wont help. Any chance of finding someone who truly specializes in autism?
Have you been over to wrongplant.net and their forums?
Sorry if this has all been said before, as I don't know your history.... or what you have done or tried or know. I feel it in my core as a mom and I it's all I have to offer other than hugs. |
His psychiatrist specializes in ASD. He also saw a psychiatrist about a year prior to this one, and another one in day treatment in November. They all seem to think the SSRIs are the way to go, and that Abilify is the best mood stabilizer alternative for him to Risperdall which makes him gain weight. We have tried reducing his SSRI's and I assure you that he does phenomenally better with them than without. He becomes extremely violent without them, and suicidal. That is why he is staying on the Celexa along with the Zoloft, he couldn't tolerate removing it, but it wasn't really helping the depression enough itself. The combo of the two seem to work. Though clearly its no cure-all.
Clearly there are serious limits to both medications and therapy. I strive each day to come to grips with whether my expectations of him are reasonable. We are going to start therapy with a psychologist who specializes in autism, which our current therapist does not. I am hopeful that she may provide not only more effective therapeutic interventions but also insight on what we can realistically expect of our DS.
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Originally Posted by soso-lynn While I do not know all the details of you situation, I can assert, as an Aspie, that using any system with arbitrary rewards and consequences will lead to your child perfecting his manipulative skills and loosing any respect for you. If you expect him to listen to you and trust your judgement (such as understanding that the video games are not good for him, if that's the case), you need to earn his trust and respect. Aspies will never give that freely just because someone is their parent or a specialist.
Also, inpatient facilities and other such arrangements have the potential to really do a lot of damage. As a teenager, I spent some time in one (under very different circumstances) ans I can assure you that it definitely made all of my "undesirable" Aspie traits much worse for a time.
Finally, perhaps you should look into what his meds are doing to him. He is at a crucial state of his development where he is learning a lot and shaping who he will be as an adult. I, personnally, would prefer to do that with my neurotransmitters intact. As you stated, his behaviour can be self-regulated to a certain extent under the right circumstances so perhaps you could ask him what he thinks about the meds he is taking.
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I appreciate your feedback. Absolutely I agree that reward systems have made my son more manipulative, and more self-centered (ie: what am *I* going to get for doing A, B, or C, rather than being intrinsically motivated by a sense of right and wrong, love and respect for parents, etc.) However, I have no idea what to do to "earn" his trust and respect as you say. Nothing I have ever done has made a lasting difference in his behavior or his respect for my authority. A huge factor in this is my ex, who has actively encouraged disrespect for my authority for the last five years since our divorce. He criticizes everything I do, even encourages them to make fun of me. Thankfully, they are not seeing their father unsupervised anymore per court order, but DS1 has been very susceptible to this given his temperament. However, my other two (same father) have not had issues with disrespect, even being on the spectrum as well. My 11 year old Aspie son is the poster child of compliant, kind, and respectful, so I personally do not see this as a trait of Aspergers, but more a result of his temperament and his mood disorder and ODD.
Inpatient therapies or group residential placement is of course not anything I ever envisioned for my child, but what are the alternatives when a child is a danger to himself or others and all the outpatient therapy and interventions are not working and allowing him to function in daily life, at home or school?
I am also not fan of my son being on three meds and looking at adding a fourth for ADD possibly, but when I am providing a stable home, love, good nourishing food, adequate sleep, intensive therapy, and he is still unstable, raging, obsessive, aggressive....what choices are left but adjusting/increasing meds or looking at inpatient? Dietary and vitamin therapies have not been effective at all. Probiotics, fish oils, elimination diets...all fail to provide any stabilization of his moods and behavior. Yes, his behaviors persist to some degree despite medication, and yes, he can regulate himself well in certain conditions, but when the medications have been decreased, he cannot function
at all.
I do strive to respect his input, and he recently chose to go down on the Abilify because it was making him too sedated. I am not sure what you mean by neurotransmitters "intact" - these medications to my knowledge do not alter his transmitters, but increase the amount available in the brain. The doctor described like trying to run a bathtub with the drain stopper out. The faucet runs and runs, but the tub never fills. Its emptying as fast as its pouring in. An SSRI is like a plug, keeping the seratonin in the brain. However, I can see how its possible that we are on the other side of the equation now, and the tub may be overflowing....but then why does reducing his SSRI's (which we tried to do at three different points in the last seven years) have induced violent rages? When talking to DH (not my ex, my current hubby and DS1's stepdad) about the meds, he agrees that maybe they really aren't helping much. We put him on the Abilify because he was violent, aggressive, irritable, doing poorly in school, lying, manipulative...and guess what? He still is! So maybe it really isn't helping him. Maybe the benefits we have seen are placebo? Maybe his rapidly changing brain is objecting loudly to the meds and we need to back off instead of increase? Who knows. DH did say, "We probably need to put him inpatient to get him off the meds though." Talk about ironic.
I truly appreciate your perspective, and your post got under my skin a bit, in a good way. It gives me lots of stuff to think about.
She agreed that his behavior toward the electronics is obsessive and addictive and completely supports their removal at this point. She is increasing his Abilify, wants to wait on the ADHD med so that we can do some testing but we will look to that in the very near future. She told me to call the police and have him taken to a holding center or the ER/psych hospital if he becomes violent again. I asked her what will happen if the meds don't stabilize him and she said back to day treatment, and the step back from that is residential treatment. So I feel much better knowing what the steps are from here.
