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sorrowmom
sorrowmom asks:
Q:

what should I do with our 9 yrs old son?ADHD?ODD?ASPERGER?BIPOLAR?

Our 9 yrs old son is causing the family to be torn apart. We have been seeing child pyschiatrist,pyschologist and therapist for almost 2 yrs.
The pyschiatrist that think he has ADHD puts him on Strattera and later changed to Adderall and now using Vyvanse but nothing help at all. And the pyschiatrist suggested a neurotest as he is probably seeing between Bipolar or Asperger.
We are seeing a pyschologist hoping to get a neurotest done on him to find out what exactly wrong with him. We read through so much about ADHD,Asperger,Bipolar and even ODD. We feel he matches completely into the syndroms of ODD but he is usually doing all these at home although we did have some complains from the school that he is very verbal abusive to his friends.
We even had to drag him to the children hospital one evening when he went out of control,verbal abusive to us and ransacking the whole house.
I dont know what to do anymore and I really need help.
Member Added on Jul 3, 2009
The hospital discharged him the same day without any finding.
Member Added on Jul 15, 2009
Thanks for the answers. We brought him for a neurotest on Wednesday.I am not sure what type of test they did but I must have filled in 200 questions. Prelimary evaluation result was that he has a genius level of IQ above 130 and the psychologist says its not uncommon that kids have high IQ to act aggressive BUT this doesnt solve our problem cos we are having daily war zone whenever he is home.
On 7/13/09 night, we even have to call 911 cos of his aggressiveness.
I would be bringing him to see his pysciatrist today and asked what is his advice of adding medication instead of just putting him on Vyvanse. Pyschologist spoke to pyschiatrist that something could be added to medciation to calm down his impulsiveness. I dont know what could that be..
Member Added on Jul 15, 2009
Today 7/15/09, we took him for his pyschiatrist appointment. The pyschologist that did his neurotest spoke to the pyschiatrist yesterday. They are saying about ODD and ADHD,ruled out Asperger or Bipolar. And he prescripted Depakote 125mg once in the morning and once in the evening.
I am hoping if anyone could let me know how well this Depakote works? Since I checked on the web and it says its for migraine,seizure and bipolar...
In Topics: Autism & Aspergers Syndrome
> 60 days ago

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Expert

lkauffman
Jul 6, 2009
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What the Expert Says:

It sounds like this has been a very difficult time for you and your family. I imagine one of the most frustrating aspects of this situation is that there is little explanation around your son's condition. What is the best way to characterize his symptoms? Why is he acting this way? What is the best treatment?

I would urge you to continue with the assessment from the psychologist to better understand his symptoms. It sounds like you have done a wonderful job of researching his behaviors, but the psychologist can help you put it all together and define a path for treatment. This is important because the treatments for Asperger Syndrome are different from ADHD, Bipolar, and ODD. The best empirically supported treatments for ADHD and ODD are similar, however.

I have included a couple of links below that may be of interest. The first link includes a list of commonly administered tests and questionnaires. The psychologist should administer an intelligence assessment (e.g., WISC-IV, Stanford Binet, Kaufman Assessment Battery for Children) and achievement tests (e.g., Wechsler Individual Achievement Test, Wide Range Achievement Test). The psychologist does not need to administer all of the tests I described, but they should administer, at least one intelligence assessment and one or more achievement tests. This will provide information on your son's cognitive strengths and weaknesses (how he tends to process information), as well as whether he has a learning disability.

The psychologist should also administer some questionnaires for you and his teacher that characterize his attention abilities (E.g., Conners Rating Scales, Child Behavior Checklist). There are also electronic assessments for attention (E.g., Conners' Continuous Performance Test).

To assess Asperger Syndrome, the psychologist should administer some tests of executive function (e.g., Rey Complex Figure Test, Cognitive Assessment System) and social understanding (e.g., Thematic Apperception Test).

These are just a few assessments that should be included as part of the battery. See the first link below for more information.

The second link includes information on setting up a behavior plan at home and at school. Ask the psychologist for help on this. Behavior plans are typically some of the most effective non-pharmacological (no medication) treatments for ADHD and ODD.

Please keep us updated and let us know if we can do anything else to help.

L. Compian, Ph.D.
Child Psychologist
Education.com
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Additional Answers (4)

Hand in Hand
Hand in Hand , Teacher, Caregiver, Parent writes:
Dear SorrowMom:

I'm so sorry that you've had such a hard time with your son, and his life has been so rocky so far. And I'm not surprised that the medications haven't worked to help at all. I am not a medical doctor, but if the medications are not working, it makes some sense to me to drop them.

Several parents who have been to psychiatrists, counselors, occupational therapists, and other experts have tried our less conventional approach and found that it worked well with children whose behavior was also extremely challenging.

I will try to explain in a very short post: there is much more information in our booklets and in the free articles on our website, which I will reference below.

The idea is that, early in a child's life, often prenatally or at birth or shortly thereafter, difficult things happen that frighten a child deeply. The child experiences a threat to his or her existence. A difficult birth, a prenatal difficulty in development or trauma to the mother, a stay in neonatal intensive care, an early illness, or any kind of medical treatment or other trauma can be the precipitating cause of behavior like your son's. For instance, they have shown that mothers who were close to the 9/11 disaster in NYC, and pregnant at the time, had children who were much more disposed to have symptoms of post-traumatic stress disorder, a sign that they experienced, and remembered, the fear that their mothers felt during this crisis.

So you can safely assume that your son is terrified, deep down inside, and that these feelings of terror, from something that must have happened to him long ago, are driving him into these behaviors. And you, frightened and beside yourself with all kinds of responding feelings, have communicated more upset to him, so there's been a fear-inducing feedback system set up between you and him--he gets scared, acts out, and you feel scared/mad/resentful/helpless, and communicate that something is indeed very wrong, which scares him further, and digs him deeper into his emotional state.

The way out is what we call Staylistening. This intervention works best with children who are not on any drugs. The next time your son does something even slightly off track, you move in, put your arms around him, offer warmth and eye contact, say, "No, I can't let you do that," and stay close to him. He will fight, scream, try to get away, hate you, and be a wild child. Your job is to communicate that you care, that you will stay with him until he feels better, and his job is to offload all those feelings. He has tried to do this in the past, but it doesn't work for him to cry and rage and destroy things, without a partner in the interaction who is transmitting caring, and confidence that he's OK, he will come out of this, he is a good boy, and worthy of your support while he feels awful.

The things to say to a child in the midst of offloading feelings of fear are something like, "I'm right here, watching over you. I won't let you be hurt." "I don't want to leave you while you are feeling so badly." "I know this feels awful. I'm sorry it's hard." "You are going to have a good day. This won't last forever." "I want your life to be good. But I need to stay with you while you're trying to hit or hurt." You need to use a confident and caring tone. Don't coo or speak softly--he needs someone to communicate that all is well in no uncertain terms while he feels as terrified as a human being can get.

Signs that it's going well are perspiration, trembling, deep fright and panic, and what looks like crying, but with few or no tears. Thrashing and writhing and arching and kicking all go with this process of shedding deep and nameless fear. So does blaming everything on your parent.

This Staylistening is very challenging to do, but if you can do it and stay with him, preferably holding him (and protecting yourself from his attacks by gently holding his wrists so he can't hit or hurt you) for the duration of an emotional episode, which I would guess would last for an hour or perhaps more, he will emerge feeling better, much better. He will feel at peace. He is likely to be affectionate, and free of challenging behaviors for a while. The deeper the fear he has stored up inside, the shorter this period of rest and cleared behavior. He will need to go many times to this panicked, "I feel like I am going to die so I'm going to kill someone first!" place in order to clear out all the upset that has built up over time.

There are other important things to do as well: Special Time and Playlistening are two, but there's not room to describe these here. Big picture, you want to build his sense of safety, which has somehow taken a big hit, and to try to connect with him during his emotional outbursts, and to persist until he can accept the connection and feel your support. Feeling support soothes the mind, and lets children act reasonably and creatively. Our booklet set, Listening to Children, describes "Listening Tools," and gives you an understanding of what's going on with him emotionally.

This approach has changed the lives and personalities of many children. You will need courage and emotional support to do this. Please visit our website for more about the approach, how it works, and how to access support if you decide to give this a try. I'm citing an article below that gives you an anecdote about helping a child with aggressive behavior that illustrates Staylistening, and the goodness of children trapped in aggressive behavior.

Yours, with respect and an offering of hope that things can get better,

Patty Wipfler

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armyfrogs
armyfrogs writes:
My daughter is PDD-NOS basically on the autism spectrum and ADHD.  We had trouble with her when she was very young being aggressive tword others and her self and at the same time very very loving all in the same day.  I had her to a specialist who put her on ritalin the generic stuff and very low dose and that did a small bit of help but then she suggested adding a anti-psychotic to her pills also VERY small dose less then 1mg and she is almost 100% normal makes friends very social and loving.  Didn't know if just maybe the Anti-psychotic was something you haven't tried?  It maybe worth a shot it helps with bi-polar and autism spectrum disorders. Risperdone is one that my daughter is on.  Hope that helps.
> 60 days ago

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jdbillings
jdbillings writes:
I also have a son that is 9 and he has been diagnosed with ODD, ADHD, OCD, and Bipolar. He is also tearing our family apart. I would suggest maybe getting him a PSR worker they help teach him anger managment skills and coping skill. Check with your local family support services to ask questions about PSR workers.My son also takes Geodon 40mg morning and night and also Stattera 40mg once a day and since they have added the Strattera there has been a big difference. It took me a couple of years to get the doctors to believe me and I truly understand your frustrations. I have been there and still are. It is really hard to have a child like this and I have two of them. My daughter is about to turn 16 and she has all of those but the OCD.I hope that this may help you.
> 60 days ago

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Mom1966
Mom1966 writes:
I am sad to hear about your situation but I must admit I was relieved to read your story. My son was diagnosed with ADHD 4yrs ago, but there has yet to be any relief in our home. We have been through 7 diff meds, 4 psychologists, 3 pediatricians, 2 psychiatrists and participated in 2 medical studies and we are still no closer to a solution.  We have began to zero in on bipolar and we are on seriqual xr along with concerta. We have now maxed out the recommended dose of seriqul and no help.  His rage is out of control and we are at a loss.
> 60 days ago

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