If it isn't AS, then what is it???

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Difficult situation. I have a question: Is his violence induced by something such as sensory overload? Or is he violent without provocation? I think this is an important distinction that can help make the diagnosis. ASD doesn't usually present as an unprovocated violent person-however, vioence can occur as a result of overload. If he is having violent outbursts and no one can determine why, well that's probably BPD and in that situation meds might be truly indicated to calm him.

Well, mama - I think you nailed why there is inconsistancy in the dx.

At first it seemed that the meltdowns were unprovoked. However as time progresses, I can see they are from.... sensory overload (an unexpected hurt or scare), anxiety or frustration. I can't think of a single episode that wasn't caused by one of those things. In addition aside from the unexpected startle or hurt, there is usually pretty subtle rumbling, but it's there if you're watching.

BUT - at the time, because if asked if he was anxious, he would say no. If asked if he was frustrated he would say no. NOW, I'm thinking of the situations and realizing he just doesn't know what those feelings are in himself. He can probably define them for someone else, but not himself

The neuropsych listened to his answers so is dxing bipolar, the neurologist is listening to the events and his affect and is dxing AS with a mood disorder.

Thank you, Thank you, Thank you! This is exactly where we are at. Our daughter was given an EI (Emotional Impairment) designation at school, in spite of the PDD-NOS Dx due to her meltdowns. At the end of the year IEP, the school recommended that they were moving our daughter from her mainstream classroom to an EI room in another school as they "were not equipped to deal with her behavoir" where she is at and are "unable to provide a para-professional" to help out in the mainstream setting. This is EXACTLY what I have been trying to express to our local school district - they all stare at me with blank faces. Up until the last two weeks of school when the district EI specialist got involved, they hadn't done anything to address any of the sensory issues that our daughter has. I recv'd a call the next day from the OT at the school, asking questions so that they could set up a "sensory diet" that the district specialist had recommended (which I am thankful for - it does sound like the specialist is at least recognizing that there may be some background issues that are causing the behaviors that aren't being addressed).
I'm not sure that I agree with the the intervention methods being the same for BPD/EI vs. Austim/Asperger's, as one of the earlier members mentioned. Fundamentally, BPD is caused by a chemical imbalance, I think. It can be controlled with meds in most cases. However, with Autism, some of the behaviors may be controlled with meds, but unless you get at the underlying stresses and address those, it's a lot harder to make any progress. I'm thinking mainly of addressing sensory issues and social integration issues. I'm not saying that autism/Asperger's can be fixed but that you need to understand the underlying issues and determine how to best manage them in order to fix the behaviors. With some of the other disorders like bi-polar, I think that the underlying cause is more chemical in nature? Or, maybe it's just that no one has actually pinpointed what the underlying cause of autism is? Not sure if I'm making sense on this or not.....

"As he's getting older, if something happens that makes him feel not great, he goes right into I want to kill someone mode and have a violent meltdown.

He can be rude and pushy BUT he is never intellectually mean on purpose. I say intellectually, because he will try to punch someone for hurting his feelings, but he wouldn't plan a witty comeback or intentionally hurt someone's feelings. "

With bipolar it moods can happen at any time.. bipolar doesnt just happen when triggered but happens at other times as well. I have. I have borderline personality disorder (as well as being an Aspie), borderline personality people get major mood swings and can react majorly to things due to having heightened emotions. The experts distinguished my issues as being not bipolar and ruled bipolar out, by the fact i only get the swings IF TRIGGERED

(I dont think your son has borderling personality disorder from what you've said, as rocking and no friends is more Aspie but wanted to share with you how the psychs ruled out BPD as i think in the same way it could be ruled out in your son).
.........

I know you said you dont care what label your son gets, but what label he gets can really affect things... eg what if he wants to join the army when he grows up. I know a guy who that was his dream but he had an ADHD label on him from when he was a child, so he never is allowed to join, he felt devistated over it. (maybe if it was an Aspie label he would of been able to as its not a psych. illness as such.. past bipolar may disclude him from things when adult). This is just an example, there is probably many others which could affect him when older if wrong label is given. (its very hard to get wrong labels off medical files).

He'd be best taking him to someone who specialises in Asperger's to get an opinion and diagnoses there.

I COMPLETELY agree. I don't think he has BPD or bipolar disorder.

And yes, labels tend to follow you for life, so it would be far better if he didn't get stuck with the wrong one(s).

For what it's worth, he sounds quite like my son who is 8 years old and was dxed with Asperger's last year. My son doesn't have the violent outbursts, but I am conscious that he has the potential to go that way without the help he is currently getting.

My son is only 5, so I can't offer too much advice. I did want to say though that my son was diagnosed as PDD_NOS/ possible Asperger's when he was 2.5

My son is the same as your son in these areas:

Makes good eye contact (always has)
Very affectionate with me, and some with my husband and other adults.
He doesn't seem too rigid about routines, and is pretty flexible. He loves going new places.
Does not interact with his peers.

I just wanted to point these things out, and maybe your son does have PDD-NOS as well.

Good luck and Welcome to Wrong Planet!

Thanks Angelbear!

Can you tell me what drove the PDD dx for your son?

I have to say that I do think a mood disorder is in play as well, but I think the mood disorder kids can name thier feelings when stable. DS cannot, so I think there's more to the story.

Last night, I could see his mood changing. Just not happy with anything, wanted a friend over (well, he only has one friend now, so if they can't come over...) Was not happy to talk about his special interests. I finally got him to engage in some internet research for me about a video game I was thinking of buying for myself, and that seemed to drive a positive shift.

Ds has a really tough time with toileting issues. He had soiled himself to a small degree and did not want to clean himself up. Showers are often a trigger. Do you think that the fact he had an accident and didn't want to clean it would cause the rumbling type behavior I was seeing last night (from an AS perspective)?

Once I got him in the bath, he willingly got in the shower and got into a much better mood. Could this have been sensory driven and I have just been missig the clues?