Currently in outpatient day program at Children's Hospital

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I could really use some direction. I have a 10yo Aspie who was dx at 4yo. We started meds two years ago but the last year has been getting progressively worse with meltdowns that come out of nowhere and then end just as quickly. We started on risperadol last month but had to dc it due to my son gaining 4 lbs in two weeks. We are now on Abilify but have just started it.

Can anyone speak to me concerning Intermitant Explosive Disorder and any of your experiences as it relates to Aspergers? Our son's meltdowns come out of nowhere and are so out of proportion to the trigger. Then, once spent, he's perfectly calm. I seriously have no idea what to do but I'm feeling like I'm living with a ticking time bomb. We have typical escalations that we have had all along when he faces stressors or he gets "stuck" but these explosions are different.

Any help or guidance would be so appreciated. The hospital is recommending a therapeutic school, we are in our second stay in the outpatient day program in a month which means us staying at the Ronald McDonald House, and now we are having to deal with these atypical antipsychotics. I feel like we're drowning.

Thanks so much

Christy

Are there are situations in which he seems to be completely free of these new meltdowns, or are they happening regardless of stress, regardless of situation, and regardless of what has been going on in his life overall?

Has he learned self-mitigation techniques for his run of the mill meltdowns? Can he sense them coming and give any warning?

I'm asking these questions to see if there is anything at all that I, in my limited experience, have some ideas on. I do know I was very worried about what would happen with my son when he got to about your son's current age, because I knew that a lot of escalation was common with AS kids, due, usually, to hormones starting to kick in, and we did make enough progress in time to not have severe issues. But I don't know how close our stories are, if what worked for my son can help for yours.

I also recommend searching for some of Bjtaos posts, if I'm remembering the name right. She experimented with a natural supplement when her son was in a similar stage and got really good results. Always hard to be sure about cause and effect, but something happened that was good, and that will give you one more alternative to consider.

Meanwhile, please be very careful. I've read too often about too much medical intervention backfiring. Big time.

Are the explosions related to school? (Meaning, do you have fewer explosions during summer vacation when he's not in a camp?) Is he better during the outpatient program?

I don't know your son's situation, but with my son, the sheer number of triggers at school (any one of which he could handle easily on its own) leave him like a raw nerve at home, and he melts down constantly: it isn't about the particular trigger, it's sort of a last-straw thing. He's about the same age as your son, but has improved vastly since we got his diagnosis and found interventions at school that worked - though school hasn't started yet this year.

We're also in the Chicago area - I've found good help at the PDC at Illinois Masonic; they really understand Aspie kids - when we were concerned about suicide, the day program at Children's wasn't much help for us (my son can be really charming when he wants to be; he completely snowed the psych who screened him, and we weren't admitted.) They do have a psychiatrist on staff who specializes in these kids and deals with meds. Maybe a second opinion?

Dear Christymarie,

Have you had a chance to read the book, 'Congratulations, Your Child is Strange' yet? It is specifically written to help parents understand the meltdown process and what triggers it. And while I can't guarantee it will fix your problems, I think it might be a worth while read for you.

You can download a free copy at ASDStuff.com

Thank you so much for your responses. We are trying to analyze these ourselves as we go along so asking questions to fine tune is really helpful. Josh seems to have two different types of escalations. One is a sort of eb and flow where he gets stuck on a certain stressor and gets agitated. This may go on for up to an hour or more with me calming him down but not really having him able to move on.

The second type of escalation is much more violent and there is no calming him down. It is brought on by tiny things like leggos not fitting together or the weather being too hot. It can last 30 to 45 minutes straight and then he is perfectly calm. It's almost jarring in it's violence and then it's ending.

I think at this point we are thinking these are two distinct episodes that are brought on by two different things in his brain. I think they are working on the first by using the atypicals but I have no idea what we would use on the second type of escalation and so far my personal research is not giving me much to go on.

I also hate that we are mixing atypicals with stimulants. Arruugggghhhh. Sorry.

Christy

Hi Christie

My son is 11 1/2, and about 18 months ago, I felt the same way. I was just at a loss as to how to deal with out of the blue meltdowns. What helped us was calendaring every meltdown and writing down what was going on that day.

What we found was....our son never complained about noises or change or being hungry - a million different issues that seem to impact other kids. These were not concerns for us. What I found was that these stressors add up and if enough were going on, bingo we would have an out of the blue meltdown.

We have gone from violent meltdowns requiring restraints 5-6 times per month to maybe one 5 minute meltdown (no restraints) per month. This is a huge improvement.

We are making sure he has his sensory needs met and we have eliminated the main stressors. We are homeschooling for the time being. Because we can't afford for one of us to stay home, I am actually hiring someone to homeschool for/with us.

Our son was on a bunch of meds and had gained 50#s. He is almost tapered off of all of them now, just on the tiniest bit. I hope this will be gone within the month.

Trackers book explained meltdowns so well for me, and really helped me make those changes.

My son still can't regulate his emotions well. He has the most trouble when suddenly surprised or hurt. We can't say that he's all ok, but the improvement is amazing. In fact, when he was still in a really stressful school environment, the meltdowns were getting so bad, I was considering residential treatment, but just knew that anxiety is a trigger so how would being away from home help?

Good luck and take care.