At what point do you stop walking on eggshells? Is this ASD?

[Anonymous]

Anonymous wrote:Sounds like my ASD/PDA child

Same.

[Anonymous]

Anonymous wrote:Sounds like my ASD/PDA child

Agree - but fwiw there are some who say that PDA is a subset of ADHD while most say that it is a subset of ASD.

[Anonymous]

I have an explosive child. Diagnoses are bipolar, anxiety and ADHD. We have been through many medication trials to get it under control and after many years are in a stable period. Antipsychotics have worked best but the side effects make it tough to find the right one.

[Anonymous]

These seems really unfair to the sibling. I would do something extreme like change meds or change living situations before your NT child graduates HS and never looks back.

[Anonymous]

no one really knows what ASD is at this point.
he could get the dx as a 'catch all' for 'something is wrong', but being explosive is not fundamentally an indicator. My child is exactly like this and we got an ASD dx, however he has lots of friends and presents as neurotypical when not cranky so i have found the dx confusing and unhelpful. I mean - I guess it could be helpful in the sense that you might think he has ASD so is rigid and that makes it hard for him to be agreeable. And the ADHD makes emotion regulation tricky. But whether or not he has ASD, you know he is not flexible.
I guess the question is whether having an addtl dx would help HIM

[Anonymous]

Anonymous wrote:OP, your child's meds need to be re-adjusted. This does not sound like someone who is on a more or less correct mix of meds.

This is false.
ADHD Meds do NOT improve flexibility or emotion regulation, or if they do it is at minimum.
Potentially you could consider than an SSRI might. But it also may not.
These are very hard problems to medicate for.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Sounds like my ASD/PDA child

Agree - but fwiw there are some who say that PDA is a subset of ADHD while most say that it is a subset of ASD.

PDA is a behavior not a diagnosis. I would argue that my anxiety gives me PDA.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, your child's meds need to be re-adjusted. This does not sound like someone who is on a more or less correct mix of meds.

This is false.
ADHD Meds do NOT improve flexibility or emotion regulation, or if they do it is at minimum.
Potentially you could consider than an SSRI might. But it also may not.
These are very hard problems to medicate for.

ADHD meds are not the only psychotropic medications. Antipsychotics worked really well for my explosive child. Yes it's hard, yes you need a psychiatrist not a general pediatrician, but the pp's recommendation for adjusting meds was a good one.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, your child's meds need to be re-adjusted. This does not sound like someone who is on a more or less correct mix of meds.

This is false.
ADHD Meds do NOT improve flexibility or emotion regulation, or if they do it is at minimum.
Potentially you could consider than an SSRI might. But it also may not.
These are very hard problems to medicate for.

ADHD meds are not the only psychotropic medications. Antipsychotics worked really well for my explosive child. Yes it's hard, yes you need a psychiatrist not a general pediatrician, but the pp's recommendation for adjusting meds was a good one.

I am the PP who mentioned adjusting meds. Exactly. You need a reputable pediatric psychiatrist. And even then it's a process of trial and error with dosages, supplementary meds, side effects. But it can be done.

[Anonymous]

OCD anxiety is my first thought. There is no reason for a teen (especially a male) to be in the bathroom for 1.5 hours. He is lashing out because you are interfering with whatever he is doing in there in an attempt to control his anxiety.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sounds like my ASD/PDA child

Agree - but fwiw there are some who say that PDA is a subset of ADHD while most say that it is a subset of ASD.

PDA is a behavior not a diagnosis. I would argue that my anxiety gives me PDA.

Do you have labile mood changes from happy to sad/angry and back again in minutes? Do you have difficulty perceiving hierarchy or acknowledging it? Do you engage in leveling behavior? Do you/did you relate strongly to animals or toys in role playing? Etc.

[Anonymous]

Anonymous wrote:no one really knows what ASD is at this point.
he could get the dx as a 'catch all' for 'something is wrong', but being explosive is not fundamentally an indicator. My child is exactly like this and we got an ASD dx, however he has lots of friends and presents as neurotypical when not cranky so i have found the dx confusing and unhelpful. I mean - I guess it could be helpful in the sense that you might think he has ASD so is rigid and that makes it hard for him to be agreeable. And the ADHD makes emotion regulation tricky. But whether or not he has ASD, you know he is not flexible.
I guess the question is whether having an addtl dx would help HIM

Did you ask the person who diagnosed him how he demonstrated deficits in each the three areas of social communication and interaction?

To meet diagnostic criteria for ASD according to DSM-5, a child must have persistent deficits in each of three areas of social communication and interaction...:

1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

https://www.cdc.gov/ncbddd/autism/hcp-dsm.html

[Anonymous]

Sounds like my baby brother. The only diagnosis he ever got was OCD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:They seem used to being catered to and don't like when they don't get their way.

I would get into family therapy ASAP as you other child likely needs it more than the explosive one.

+1. It’s easier to build life around the challenging child, but it’s not fair to them because the world will not do that when they go to college, etc.

Family therapy has been life changing for our family, and my ASD kid has had violent outbursts, tantrums, and explosive behavior previously.

You don’t say when the neuropsych eval was, but you might want to consider updating it so they can get a more accurate dx now and also for college accommodations.

Where did you go for family therapy? Do you mind sharing the resource? I want to find someone skilled with these outbursts and behaviors.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, your child's meds need to be re-adjusted. This does not sound like someone who is on a more or less correct mix of meds.

This is false.
ADHD Meds do NOT improve flexibility or emotion regulation, or if they do it is at minimum.
Potentially you could consider than an SSRI might. But it also may not.
These are very hard problems to medicate for.

right but mood stabilizers do help for these things.