Newly diagnosed teenager and violence

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Hi,
Have a recently diagnosed teenager that explains a lot of previous issues. However, in last year or two she has started having more serious issues, resulting in some violent episodes such that school is currently not available, and she cant be left alone with anyone without them being informed of the history. Special school is not an ideal option either as she is very suggestible and tends to take on symptoms from others.
Some time was spent in hospital with psych etc. but she is not ready to engage in this to any real extent, and insists she isnt getting any help...whereas there is just a disconnect between the help there is and what they are hoping for, a 'magic' fix.
Academically there are no problems at all, the only problems are behavioural, which are verging on psychosis (this was the reason for hospital; doc say definitely its an aspect of asd, however the teenager thinks they are incorrect)
Our options appear really limited, and Im reaching out to see if any parents might have dealt with this before and might see options that I dont see or have any advice/experience that might help.
Thanks

When the Florida shooting happened, many people have suggested that mental health care services must be increased in the state. However, have we paused to think that the current mental care services might not be part of the solution, but rather part of the problem?

Tantrums, or what other people would call behavioral problems, have always been the easiest autistic issue for me to deal with. I mean, my wife often would try to solve the tantrum issues from my children, only to see the same issues come back, again, and again. But as soon as I intervened, my children's tantrums disappeared, for good. I have never failed once to remove the negative feelings from my children for each specific issue, permanently. The funny thing is, I have tried for the longest time to teach my wife how my approach worked, but only until recently has she really started to grasp the essence behind it. My children are always happy, with big smiles every day, and are darlings to everyone around them. No exaggeration there. In the case of my son, it's even officially written into his IEP: that he smiles "from ear to ear."

Read this: http://www.eikonabridge.com/fun_and_facts.pdf

Many people, when they read what I have written, tend to dismiss it. A bit like my wife, ha ha. They always forget about the crucial step. The process has three steps, and people always forget about the second step. The second step is the most important step. Unfortunately, people always forget about this step, so they keep seeing tantrums come back again and again. The three steps are:

(1) When tantrum related to a specific issue happens for the first time, take note of it. If the child is already verbal, you can simply ask: "Is life tough now?" That's all. You don't need to do anything else in this first step.

(2) The second step is the most important step: you need to take your children out for fun. Something that is not routine would be great. Usually it works better outside home environment. See, sometimes I take my children out for frozen yogurt or ice cream, sometimes I take my son to Tesla car dealership, or elevator rides, sometimes we go fly kites, sometimes I take them to a gymnastic center for children. At home, I often play silly games with my children. I'll show one at the end of this message. The thing is, at the moment of maximum happiness of your children, you then ask the question: "Is life fun, now?" And then remind them about their negative moments. After you remind them about their recent behavioral issues, then you can summarize it all by telling them: "See? Sometimes life is tough, sometimes life is fun!"

(3) The third step is, next time the same tantrum strikes, you then remind your children about their happy moments, the fun time you had together (frozen yogurt, kites, Tesla cars, etc.), and then remind them "Sometimes life is tough, sometimes life is fun."

With these three steps, this approach has always worked for me, every single time. And for each specific issue, my children's tantrums just have never come back. Moreover, they have learned that the approach not only applies to them. Nowadays, when I get upset with them, they would remind me about "Sometimes life is tough, sometimes life is fun", too. Ha ha. See http://wrongplanet.net/forums/viewtopic.php?t=360648.

A very similar approach can be used to remove anxiety issues as well. See http://www.eikonabridge.com/anxiety.pdf

- - -

Here is a game that I play with my son when he goes to bed. I would pretend trying to jump on the bed, and he would come out from hiding and pretend to stick a strand of dental floss up my nose. I made him draw a picture, and recorded his voice, too. Then I animated the picture and edited the sound track, so that he gets to hear his own ideal speech. See, I always have fun with my children. My children started just like any other children on the spectrum. But after a few years, I see other children's lives ruined, while my children have thrived and kept plowing forward. Perfectly fine children are ruined by our society, every day. Autism is not a healthcare issue. It's an educational issue. Parents and teachers really ought to change their ways of approaching these children. I say that, because once upon a time, I saw smiles disappear from my daughter. I found out it was because a teacher was applying the "punishment and reward" approach to my daughter. After I intervened and told the teacher about the correct way of approaching these children, my daughter bounced back, before the damage to her became permanent. Seriously, the children are fine. The adults are the ones that have caused all the problems. There is really a different way of raising these children.

No, psychosis is not part of ASD. Why do you think your child is psychotic? People with ASD can be become more upset by things that others find to be minor problems, and this is compounded if there are communication difficulties and they don't feel understood. It doesn't mean they're psychotic, and they don't belong in a psych ward. If you're new to autism, you'll need to do a lot of reading and researching to understand the complexities of the condition. Unfortunately, many health professionals don't know as much about autism as they should, and will tell you all sorts of incorrect things. Be careful out there, and inform yourself as much as possible.

Also, Google "autistic meltdown". This can happen when an autistic person gets completely overwhelmed. Different people exhibit different symptoms during a meltdown, but they are not psychotic. Giving them some time alone in a quiet place, doing something they enjoy or just resting, can help them recover. Depending on the person, recovery can take a few minutes or a few days or more.

Thanks for the responses, Ill read those links

She spent 4 months in a psych ward because of a potential danger to herself and others. In the end the diagnosis was that her hallucinations and psychotic-like symptoms are a result of a combination of ASD symptoms/OCD/obtrusive thoughts, and she needed psychological help to tease it all out but that she was not actually psychotic. In terms of ASD she is high functioning but profoundly autistic in terms of understanding and identifying emotions. She believes there is something more wrong with her than traits of ASD, so does not really engage well with the psychologist. She is also so suggestible/sensitive to stress, that every time she engages with the hospital she takes a step back - when we have been unable to make a meeting she has had a better week
However, we do see her symptoms closely correlate with times of stress and possible disappointment/anger, and as her parents we strongly feel she just cannot cope with her emotions and lashes out, much like in that description of autistic meltdown. The psychologist in the hospital feels that she kept this in for so long that she has defences in place as if she was involved in a trauma, such as a "second personality" to put something between her and this stressful world

I guess we are looking for help in terms of continuing to engage with the psychological services to help her tease this out (but stressful for her) or to create a safe space for her and hope that these symptoms reduce in time as she comes out of puberty and feels safer and feels more able to maybe understand her diagnosis as she grows up

I think you should try to find a psychologist with a specialization in autism. I'd like to say I'm shocked that no one at the hospital could recognize a meltdown, but I'm really not.
You should also consider getting some books on autism for your daughter. She needs to be able to advocate for herself, too, and it may help her put into words some of the difficulties she is having. Autistic people often struggle to describe, or even recognize, their feelings. She may be able to use the books to show you which symptoms of ASD she experiences (there are many, and most people don't experience all of them).

Hmmm. 'Second personality', or just bog standard autistic masking?

https://spectrumnews.org/opinion/viewpo ... ind-masks/

There are a lot of good articles on this site. As for masking, you could say that if I have a 'second personality', I also have a third and a fourth and a fifth and then some. I see it as a coping technique, not a trauma based splitting of the personality. It's damaging over time, but sometimes it's useful. Who knows, maybe the psychologist is right, maybe your kid has something unusual, but it's entirely possible to have pretty rough meltdowns that are caused by sensory sensitivities rather than anything social. Or a combination of the two. It's usually not just one thing that sets these off.

Did they do a sensory profile of her? Here is a good explanation of oversensitivities and undersensitivities:

http://www.autism.org.uk/sensory

One of the most painful things for autistic people is constantly being misinterpreted. Are you sure this psychologist understands her? I second Yippi Skippy's point about needing someone who understands about autism, particularly autism in females, not the least because her problems are serious. My anxiety got a lot worse from dealing with a therapist who misinterpreted everything I said. I've seen a lot of members on this site say the same thing.

Autistic people have good reasons not to be trusting. Most people can't be trusted with our deepest feelings and thoughts - not because they're mean, but because they just don't get it. Being nice is not enough. One has to learn.

That said, you daughter might simply have trouble with the hospital because they have fluorescent lighting, or some such thing.

Your daughter might be right that there's something else as well. There are a lot of possible co-morbids. Historically, things such as depression and anxiety were treated as part of the autism, but seriously, there is no rule that says that if you're autistic you have to be mentally ill as well. Such things are treatable.

Sorry, I'm not entirely sure what you mean by 'does not engage well', but I sort of assumed you meant your daughter does not trust the psychologist's judgement, which sounds perfectly reasonable.

I'm not a parent of an ASD kid, but I HAVE ASD.

She may be being violent because she is bitter (IF she is) because she feels that no one understands her. Also, she may be feeling terribly frustrated because she doesn't know how to express / explain what is going-on within her. Also, she may be feeling like she'll always be a second-class citizen.

I would suggest asking her about the things people have listed here, and asking her whether or not she feels they pertain to her, so as to get a better feeling of what she's feeling / experiencing.

Also, what medications (if any) is she on? Meds have caused many people, here, alot of trouble, and can take some time to find the right one, for any given individual----for instance, I have taken Ritalin for ADHD, and it makes me EXTREMELY angry (like, I-wanna-hurt-somebody angry).

Ritalin had sort of that effect on me, too---it occurred the one time I took it---at age 13. Apparently, I let out such a scream that my mother discontinued giving it to me, right away.

Ritalin is a stimulant which, apparently, has a paradoxical effect on younger children, but a "stimulating" effect on older children. Perhaps, I was just too old for ritalin?

Thanks so much for the thoughtful replies and the time you put into them. Some of these links are eye opening to us, even though we had googled this quite a lot, and certainly some ring true. I think she has violent tendencies from frustration, lack of understanding and feeling she isnt getting any help.

By 'does not engage well'.....i mean that she thinks it is doing no good and is quite negative going into it to the point that it would take an amazing shift for her to get anything from it. She thinks the help she gets should be something that 'fixes' her, as opposed to this being something she needs to work at herself

One of our biggest problems also is how suggestible she is - in the hospital she acquired symptoms from others that she never had before, some of which are still there to some extent.....so its not ideal to go through a list of possible symptoms with her and to see which ones resonate with her...as she will probably end up acquiring some of these symptoms!

She has had all these symptoms pre-medication but thanks for the idea

The way she is now - we have been told that due to her risk level (although she has never actually hurt anyone yet) that we must tell anyone she is with about the risk. This now means she is home all day, not in school, with us trying to find things for her to do, and thats not ideal from a baseline mental health point of view either. It feels a bit catch 22 in that she isnt allowed to be with people until she is a bit better. At this point I feel like its almost our job to keep her safe until she matures enough/comes to terms enough with her diagnosis that she could work with someone on it, but it feels like our opinion in this is divergent to the 'psychiatrist' opinion which is all about managing risk. Id just love to find parents who have been in a similar situation and see if anyone else has faced this kind of a decision and what they did and how it panned out

A common coping/defence strategy among autistic girls is to mimic the behaviour and opinions of those around them. Some girls with autism become "social chameleons" to disguise their symptoms and blend in with their peers, which is part of the reason diagnosis rates are lower for girls. They often don't even realize they're doing it, because it's a survival skill they begin to employ at a very young age.

A quick reply:

1) I talked to someone in an autism organization recently who mentioned that it's hard to find therapists for people on the spectrum. She commented that regular therapists tend to 'focus on the wrong things and not know how to talk to someone with autism'. This is my experience too. Make sure her therapist is someone who understands autism.

2) Do you think your daughter could spend some time with animals? Getting her a dog, for example. Dogs don't hurt you in the way people do. It might be better for her than school, actually. I doubt she'd hit a dog.

I just wanted to add that some therapists just might be able to learn, even though they have no formal training in autism. Listen to your daughter, though. Perhaps ask her if she's able to write down what she thinks about her experiences in the mental health system? We are often better at writing than talking.

We got her a cat a couple of years ago, and adopted another one we found a few months back. She likes them, they curl up with her, but she has at times said she gets an urge to hurt them.
We think a dog would be a good idea too, and have looked at getting one. We are hoping to be away a bit over the next month or two and then to get one.

I think a psychologist with that specialisation is exactly what she needs. Or even preferably a psychologist who is autistic him/herself. We finally have an appointment with a psychologist on Thurs so will talk to them about this then. We were planning to go away for a bit as a family to give her a bit of a break and try for her to be in a better mental place when we get back, but she is not too well just now so we will have to see. But even that is something we think they are missing.....a layer of interpretation....because of her autism. Its a difficult situation to know what to do.
Thanks for the reply

A lot of autistic folks find a change in routine and surroundings stressful, not relaxing. Something to consider if you're thinking that a vacation will improve her mental state.