Need advice for parenting a 12 yr old with Aspergers

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KellieT
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25 Feb 2011, 11:55 pm

My Step-son was diagnosed about a year ago and he was immediately put on Prozac for his anxiety... seemed to help for a while but has been having melt-down over irrational fears stemming from his ocd... Atavan was prescribed for his anxiety attacks... but I just dont want to keep medicating him... anyone have any advice for me .... he curls up on the floor when he doesnt want to do something... ex: eat dinner because its "tainted" in his eyes somehow... help!



ja
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26 Feb 2011, 12:14 am

We tried celexa for anxiety.

Different kids react differently to different meds. For instance, our 9yo (ASD/ADHD), does well on Concert, but does terrible on Ritalin, and Focalin. Your son may not do well on Prozac - maybe it's not the med for him. Give something else a try.

Good Luck



DW_a_mom
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26 Feb 2011, 1:52 am

Has the family addressed all the possible environmental factors? These made soooo much difference for us, and most families on this board.

- Make sure you honor all his sensory issues. What you think is a small thing may not be small at all to him; AS kids often experience noise, sight, smell, touch and taste differently than the rest of us do, and something as common as a flushing toilet can be like nails on a chalkboard to them. Think hard about what he has tried to tell you, and how things can be best mitigated. It isn't always easy because babies will cry and heat registers will hum and so on, but he needs to feel that people are at least trying to understand him and his needs, and to meet them.

- Make sure that he is allowed to employ self-calming techniques, commonly known as stimming. Most AS kids need to MOVE or chatter to stay centered. Seems odd to us, but it's true. It's a need, not a want, and asking a child to constantly suppress it 24/7 because we find it odd or annoying actually backfires. AS kids can and will learn time and place for these actions, but home needs to be the free space.

- Reduce the load in his life. What kinds of homework accommodations does he have? What are his activities like? Most AS kids need more down time than average, and not having it increases stress and anxiety.

Some of the drugs you are describing can trigger fears and hallucinations in teenagers so medication should be a last resort, only after you've dealt with everything else. For some families on this board medication has made a positive difference, but it is no substitute for mitigating the issues a child confronts in his daily life. What an AS child needs more than anything is for the world to spend some time bending towards him, instead of insisting he bend towards it. A child can't learn up and grow when there is the equivalent of a metaphorical siren going off in his ear constantly. So ... get rid of the siren.


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Mom to an amazing young adult AS son, plus an also amazing non-AS daughter. Most likely part of the "Broader Autism Phenotype" (some traits).


Chronos
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26 Feb 2011, 3:25 am

AS and OCD, though maybe somewhat co-morbid, are still entirely different things. As are AS, OCD, and general anxiety. Medication should not be used to control AS. However it's not inappropriate to use medication to control OCD if it is found to actually work.

Unfortunately, the medication available to treat OCD was not designed to treat OCD, and that it can, is only a side effect. I have never heard of medication completely suppressing OCD. At best, it may suppress certain symptoms and make the others more manageable temporarily. In children, it's almost impossible to find a dosage or combination that yeilds much in the way of stable, desirable results because their brains are so dynamic. SSRI's also tend to cause very severe mood swings and suicidal thoughts in teenagers. Because of this, it's important that cognitive behavioral therapy also be used in the treatment of OCD. In fact CBT can be a very powerful tool not only in the reduction of symptoms, by preventing new symptoms that arise from taking hold and becoming unmanageable.

In studies where medication or CBT was used, it was found that CBT was just as, if not more effective than the medication, without the side effects. Sometimes though, medication is needed to get the person to a point where they can do the CBT.

As for the anxiety, I don't believe ativan is appropriate to prescribe for OCD induced anxiety because the anxiety produced by OCD is not normal anxiety and does not come in the form of attacks. With OCD, the anxiety dissipates instantly when the situation causing it ceases to exist, and this might happen hundreds, or even thousands of time per day.

I think you should look into an adolescent OCD treatment program for your son, which uses not only medication, when applicable, but extensive CBT as well. You also need to figure out what aspects of his anxiety are related to the OCD, and what aspects aren't.

Stress and lack of sleep will also make OCD worse, so any activities that reduce stress and distracts his brain are good.



aurea
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26 Feb 2011, 3:08 pm

Hi, I have a 12 year old son also. My son has Aspergers, adhd, ocd, gad and tourettes. He is on Lovan for anxiety and strattera for the adhd/ocd. Neither drug have taken everything away, they have simply taken the edge off and helped to make life more bearable for my boy.

How long has the dinner anxiety been going on? Is this a new thing or has it always been there? Does your step son live permanently with you? I ask these questions in order to try and better understand and offer advice. I do know what your going threw.

My 12 year old has had to have dinner at my sister's house twice now (he's had plenty of bbq's and never had issue, just when food is cooked inside it's an issue) Both times he has eaten at my sisters house he has felt extremely sick and screamed and cried that his Aunty is poisoning him. :oops: My sister has even made sure to cook food that I myself cook for him at home.
It could be the smell from the oven, certain smells leave an after taste, just because we can't smell it or taste it doesn't mean it isn't there. It could be the pots/pans she used. It could be the way she arranged his food on his plate, it could be the air freshener in the dining room. What ever it is, it is very very real to him. To compensate now, if my son ever has to eat anything any where other than home, I pack his food for him, although he is always first offered what the other people are eating. His home cooked stuff is simply a back up.
If he is living with you permanently, I would have him help prepare his meal, so that he can see for himself what went into his food. If he is mainly residing with the other parent, I would ask the other parent to send over some prepacked home cooked meals and have them on stand-by. Let him know that the other parent prepared his food, he may feel more comfortable with this.

Another thing to note, that I have noted with my own son. The more stressed he is the worse his co-morbids become. I'm a bad bad parent, sometimes when I know my son has had a particularly tiring/stressful day, I allow him to eat his dinner at the computer or in his room by himself. If he has had to interact with several people that day or try something new or go shopping etc etc My son needs hours of down time= pc time,pacing time, game time, quiet reading, a short sleep, time to himself. If he doesn't get this "down time" you can guarantee, even though my boy is medicated his co-morbids will kick it up a notch and we will have at the very least a meltdown. His sensory issues will be off the charts also.


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Mum of 2 fantastic boys. oldest 21 yrs= newly dx'ed ASD
youngest 12yrs =dx'ed ASD, ADHD,OCD,GAD and tourettes.


draelynn
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26 Feb 2011, 6:36 pm

Everyone that already commented here have given some wonderful advice. The only thing I have to add is - blood sugar. With food issues it may be tricky, but many have found that maintaining a stable level of blood sugar can be an effective tool in helping to curb meltdowns. Providing little snacks every 2-3 hours just to make sure he stays even keel - something substanial - not junk foodie. Protein bars were my daughter's saving grace.

My daughter is an extremely picky eater too - she's nearly vegetarian and has, maybe 12 foods she'll eat. We have just been working with her to help her identify exactly why she doesn't want to try a food, and why she doesn't like a food. Not forcing her to eat - just getting her thinking and talking about what's holding her back. I don't know if that will work in your situation. For us we were able to identify some of her 'red flags' - anything 'new' is automatically a no, certain colors and textures, wrong shapes (spaghetti and macaroni are fine, but not bow ties,etc... french fries, ok, mashed potatoes, not) We are at the point where she'll humor us with a tiny bite of something new. Even if she spits it out we feel it's another step forward. She's trying.