My sister asked me to ask around and see if I could find some alternatives for her son.
Some background: He's 14-years-old and severely autistic. He is non-verbal (though he can communicate through typing or pointing out letters on a board) and has sensitivities to egg, dairy, and gluten. He eats pretty poorly (mostly meat) and will sneak foods he can't tolerate whenever he gets the chance.
Recently he has been struggling. He's a big kid (tall and very strong) and has a terribly explosive temper. He throws and breaks things constantly, screams, scratches and hits himself, tears up rooms, etc. He has also been known to pee on things when he's angry. He could very easily hurt someone when he gets angry. As a result of the violent outbursts his doctor ha been trying some different medications to try to stop the behavior or at least make the outbursts more manageable. His behavior is markedly worse when his 5-year-old sister is present. He does NOT like to share the attention of their mother and gets angry when his sister even talks quietly. So far the meds they have tried either didn't work or made him worse. The doctors have now mentioned Resperdol and Ablilify, but my sister is very concerned about side effects and would like some alternative suggestions.
I'm honestly not too sure where to even start looking...so if anyone has any ideas, suggestions, or experiences to share that would be great! Thanks in advance.
What about trying the meds and then while things calm down a bit do some more idea-generating? Sometimes it's easier to plan and brainstorm when the danger is not as present, and this would not likely be the "perfect" blend of meds anyway if there have been so many trials so far. I'd be very concerned about the potential side-effect of hurting sis more than the potential side effects of trying the antipsychotics. I'm usually pretty anti-pharm, but in this case there are so many dangers I'd be inclined to go with the doc. If the kiddo does a felony type of thing at home, he'd end up in the hospital anyway, and they would med him pretty harshly.
ETA: I know you were looking for alternatives, (of which I have no great ideas other than seeking residential care--which would end up in med-land anyway) so I'll be interested to see if some folks have other ideas too. Sorry for being a negative nancy on this one!
My going in 13 yr old is similar, though bit more verbal. My advice: try the meds, at least until the teen yrs are over (per a neurologist I trust). Abillify works much better for our son. Actually, he went from non-verbal to verbal ( still severe apraxia) with it, he started sight reading - his skills really spiked, and his teachers were amazed. IMO: your niece needs her mom just as much, and if they can be together more in a safe and no threatening environment it is so worth the meds.
I agree with the others who say try the meds. In addition to the huge safety issues for sis and family and community, it can't be any fun to be that boy right now. No one wakes up in the morning thinking, "oh, I think I'll terrorize my family today - what fun!" While he is raging, he can't be learning any other coping skills. For the kids I work with, similar diagnoses and behavior to what you described, the goal is to teach alternatives to violence. But often, meds are a first step, to help the child be calm enough to be receptive to therapy and teaching. It will probably take a few tries to find what works, but it really can be worth it.
Rhu - mother,grandmother,daughter,sister,friend-foster,adoptive,and biological;not necessarily in that order. Some of it's magic, some of it's tragic, but I had a good life all the way (Jimmy Buffet)
My son is very similar. Severe autism/nonverbal with ongoing aggression issues. To be honest, I couldn't imagine trying to deal with him day to day without medication... it's not a miracle cure-all, but it does take the edge off and makes him more safe to himself and others. For me, my son being on psychotropic medications is a safety precaution - yes, there maybe alternatives to medications, but in our case they are not effective enough on a day to day basis.