Reply to Lamictal as mood stabilizer for child?

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[quote=Anonymous][quote=mamakr]OP here.  The psychiatrist sees both adults and children and came highly recommended.  However, I'd have no problem trying someone else and would love suggestions if anyone has any!  I live in Montgomery County, MD.  
He had neuropsychological testing done a couple years ago and the doc who did it said he displays some symptoms of ASD but not enough, in her opinion, for a diagnosis.  Regardless, even WITH an ASD diagnosis, I don't know what could or would be done differently as far as meds go.
Also, he does see a therapist.  I think she's great however, the problem is that my son also has processing issues.  Once he leaves the therapist's office, I don't know how much info he has retained, which causes me to wonder if therapy can even work for him.  I really don't know that he is taking her suggestions and using them in the real world.[/quote]

I have a DS who has been diagnosed with MERLD, ADHD and dysgraphia.  The paragraph in your opening post really reminded me of a certain period of my DS's development -- the part about difficulty on playdates and not being able to socialize or play games with others (as well as your frustration of not being able to enjoy the adult benefits of the playdate).

You have described your DC's social problems and rigidity as a function of "obsessiveness".  I saw the same things in my DS, but they were really a function of language/communication difficulties, perhaps related to the slow processing and executive dysfunction.  I would really encourage you to get a full speech and language assessment done.  We got it done at the Lab School, and I learned so much about his expressive, receptive and pragmatic communication skills!  IMO, it was the most useful assessment we got done.  While the neuropsych diagnoses the slow processing, attention and executive dysfunction aspects of my DS's profile, the speech and language assessment revealed in more detail pragmatic communication deficits as well as expressive and receptive comprehension problems.

For example, my DS had great difficulty understanding the rules of a game, negotiating different rules with peers and reading body language or tone when someone disagreed but didn't state so explicitly and openly.  DS missed entirely when someone disagreed with a rule change but didn't say, "no".  Because of expressive difficulties, DS couldn't explain his rationale for the rule change, often repeating an explanation, which looked obsessive but was really his only choice because his weak expressive language skills made it difficult for him to explain himself.  Layer the slow processing on top, and board games became a situation where everyone was moving fast and talking fast and he simply couldn't keep up and would get frustrated.

I really stopped inviting kids over to the house unless we rehearsed the playdate before  -- what do you say, what will you choose to do, what if he/she wants to do something different, etc.  I also kept short timeframes (never longer than 2 hours), broke it up with snacks or other activities, and set it up somewhere in the house where I could discreetly keep track and offer support (usually not in DS's room, but in the living room or somewhere else where I was doing something within ear range).  Often I invited kids out for movies, pool, or playground dates instead of playing at home.

I found a good speech therapist at Lab who helped tremendously with the pragmatic/social communication practice.  Sometimes the therapist would work with other therapist's and their child clients to set up a game and help all the kids learn the rules of how to play.  The speech therapist could point out things like, "Billy says that it's your turn, but his face looks pretty unhappy, maybe we should ask him what's wrong... or whatever."

IME, the frustration, anxiety and "obsessiveness" you describe could be a function of language problems which would really be better improved with language therapy rather than some kind of brain chemistry imbalance improved by drugs.

As for Lamictal, my DS has never taken it, but my bipolar MIL did for awhile.  It is a proven mood-stabilizer with "lifting" properties, and often doctors will use it instead of an anti-depressant (which shouldn't really be used in bipolars).  I think it helped her, but I was not close enough to really know for sure.

When I see a combination of so many medications, it really makes me feel like the diagnosis may not be right.  In this case, I mean the "diagnosis" of what's causing the social problems.  Not necessarily the overall diagnosis of ADHD.   It's very common for kids with ADHD to have problems with social communication. [/quote]

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