My son has ADHD/Asperger's. My husband, who has multiple graduate degrees, took several long years to admit there was anything the matter, and had to be dragged through the diagnosis process. Why? Because he has ADHD and Asperger's himself, and feels happy and fulfilled, and doesn't want anybody fixing in his son what to him is normal. He is grudgingly coming to terms with the fact that he is not typical, and actually has some atypical challenges and strengths, which is a first step towards recognizing that his son needs help as well. In 20 years, I am fully expecting him to say that I was right all along and thank goodness I intervened early
So perhaps this child's parents have a similar outlook.

There is no magic cure or pill, apart from prescription stimulants for executive function (Ritalin and such), which this child will not receive before he is 18 since his parents won't have him evaluated.
What you can do:

1. Discuss this with his parents with the Nobel Prize - level diplomacy of an Israel-Palestinian peace talk, without mentioning meds, or ADHD or Asperger's! Frame it in terms of attention issues at school (or to cross the road), organizing himself (not forgetting to hand in homework), limiting self-stimulation, understanding social context and non-verbal cues better - all to get better grades, not get bullied or teased, have friends and be more successful. Point out that social skills groups are quite helpful for that, as well as organizational coaches. His own parents can teach him how to study efficiently at home. They can request extra time from the school is he is too slow, which would come in handy for the SATs and high school exams. The school can also give him preferential seating next to the teacher to avoid distractions, repeat directions to him, etc. Many schools will require a diagnosis first, hint hint.

2. I told you there was no pill. There is one - caffeine, the best-known legal stimulant in the world. Its activating effect on dopamine is proven. Dopamine is the neurotransmitter that is lacking in ADHD brains. A little caffeine goes a long way, because there is such a thing as adrenal fatigue when you've had too much. Find the minimal dose that works for him, and tell the teacher that his best work will be in the morning.

3. Help this child directly by giving him books is a great idea, if his parents don't see it as high treason. When he turns 18, you can also advise him to get himself evaluated for ADHD and/or Asperger's, and get medication and receive accommodations from his university's disability services.

Good luck. My nephew has ADHD and slight Asperger's tendencies. His parents (DH's brother and SIL) never had him evaluated, even though he receives extra time at school. He barely passed his end of high school exams, and is going to a trade school. Too bad for such a sensitive and artistic soul, but that's what happens when you stifle a child's potential.

Anonymous wrote:

Anonymous wrote:OP is there any way you could express your concerns to the child's pediatrician? The pediatrician would not be able to reveal anything to you, but he would be in a better position to make a recommendation to the family.

Op here. Good idea. I think i can do that.

Completely inappropriate to call a doctor without getting consent of the parents first.

I have found it effective to ask the parent, "Where do you see Johnny in ten years?" to draw out the idea that if he doesn't get help now, he won't be able to support himself or go to college.

You can say, "What is your plan for how Johnny is going to take care of himself once you are gone?" (phrase that a little more nicely!). They need to realize that the status quo is not working. You can ask what progress they see he is making and how the teacher says he compares to peers, just to get the conversation going. Then let it sit for a while and revisit it.

Take Johnny out alone if you can and point out social rules. "That man is waiting for us to finish at the cashier so we don't feel rushed. He is standing quietly so others are not distracted." They don't know the rules or the reasons, so point them out. Good luck.

Anonymous wrote:OP is there any way you could express your concerns to the child's pediatrician? The pediatrician would not be able to reveal anything to you, but he would be in a better position to make a recommendation to the family.

Op here. Good idea. I think i can do that.

OP is there any way you could express your concerns to the child's pediatrician? The pediatrician would not be able to reveal anything to you, but he would be in a better position to make a recommendation to the family.

OP here. Thank you so much for all of your thoughtful responses. This child and his future are more important to me than my relationship with his parents - the relationship will survive regardless. And i know there won't be a diagnosis, they WON'T test him. So focusing on the behavioral issues is all i can do.
Thank you pp for the booklist. Very helpful. I know there are so many parents who have to deal with these issues and much worse. You all are so strong and a very valuable resource for someone lime me, just trying to help.

Anonymous wrote:A family member's child, now in middle school, has some disturbing behavior issues both in school and at home but for whatever reason the parents will not have him tested. Another family member recently suggested an "intervention" of sorts because the parents seem to be in complete denial as the child's issues are getting worse. I don't think an intervention is appropriate - i think it would create a new set of problems.
But i do think that the child's needs should be put first - and this child clearly needs help. I have researched asperger's and ADHD and found that either of these conditions might be present. At least some characteristics of these conditions are fairly evident. But obviously I cannot diagnose this kid! So i was thinking of talking with the parents about addressing some of the symptoms/issues. We are close and i don't want to destroy our relationship but i truly want to help this kid!
I am feeling so torn about what to do. I am hoping that someone here can help me. Unfortunately the parents are closed to the idea of testing. The school (MCPS) cannot force it. But it is possible they would be open to addressing some seriousBooks issues such as major social problems, excessive pacing and hand flapping, physical awkwardness and basic executive function. Any advice, suggestions, guidance is appreciated. I know it is not my child but minding my own business in this case is feeling more and more wrong. My heart is breaking for this kid - he has no friends and no clue how to navigate the world outside of his home environment. So sad and disturbing. Sorry if this rambling.

If you think it is ADHD and/or Asperger's, you can give the kid some written resources that might help. Just give them to him with the caveat, "I know that you don't have X, but this book is aimed at helping people with (whatever problem he is currently having), so I thought it might help, even if you don't have X."

At 13, kids are old enough to choose most of their own reading material, so he can find some info without bugging his parents too much.

Books that might help (they helped me kid with ASD/ADHD):

The Teen's Guide to World Domination:
http://www.amazon.com/Teens-Guide-World-Domination-Awesomeness/dp/0312641540/ref=sr_1_2?ie=UTF8&qid=1436289574&sr=8-2&keywords=dominate+your+world

Executive Function Workbook:
http://www.amazon.com/Executive-Functioning-Workbook-Teens-Unprepared/dp/1608826562/ref=sr_1_6?ie=UTF8&qid=1436289689&sr=8-6&keywords=teen+adhd

Social Skills Picture Book
http://www.amazon.com/Social-Skills-Picture-School-Beyond/dp/1932565353/ref=sr_1_3?ie=UTF8&qid=1436289871&sr=8-3&keywords=social+skills+teen

Asperkid's Secret Book of Social Rules
http://www.amazon.com/Asperkids-Secret-Book-Social-Rules/dp/1849059152/ref=pd_sim_14_12?ie=UTF8&refRID=1KGDQ327K5MXR115KQHH

OP - In most cases I would tell you to mind your own business, because this is a family member, I would say something even if you risk losing that friendship or relationship.

What's more important - this kid's future or your relationship with this family member?

Before you saying anything though, make sure you are very specific about what behaviors you see, but do not use any diagnostic words like ADHD or autism. Make sure that you write it down so that you can "rehearse" what you're going to say. And make sure that you don't sound like you're accusing anyone of being a "bad" parent or neglectful parent.

Good luck OP -this is a tough one.

If you care about the child, remain in his life. Diagnosis is not the important thing, especially for someone not in his immediate family. Constant support is. I would also avoid symptom/diagnosis checklists because they are so general and vague that almost anyone with "behavior problems" fits into them. In fact, I can make myself fit into most ASD/ADHD symptom checklists and I'm sure that as a teenager with bad behavior I fit quite a few more.

What's important here, if you truly want to help this kid, is communication, inclusion, friendship, and time -- lots of time -- spent with this child talking. Are you willing to do that, OP?

The school isn't going to go out of it's way to test him; the parents need to ask for this. I don't think there's much you can do if the parents are asking for advice.

If this relative is close with you, you can always include him on family get-togethers, outings. But that's pretty much it.

How do you know he hasn't been tested? How do you know if he has received therapy? Therapy isn't a magic wand -- his problems could persist despite whatever his parents have done (and not told you about).

My general advice would be to ask questions rather than give suggestions. For example, "How does kid feel about his social life now that he's a teenager?" or (if appropriate) "I had X issue with my teen; do you have the same problem?"

A family member's child, now in middle school, has some disturbing behavior issues both in school and at home but for whatever reason the parents will not have him tested. Another family member recently suggested an "intervention" of sorts because the parents seem to be in complete denial as the child's issues are getting worse. I don't think an intervention is appropriate - i think it would create a new set of problems.
But i do think that the child's needs should be put first - and this child clearly needs help. I have researched asperger's and ADHD and found that either of these conditions might be present. At least some characteristics of these conditions are fairly evident. But obviously I cannot diagnose this kid! So i was thinking of talking with the parents about addressing some of the symptoms/issues. We are close and i don't want to destroy our relationship but i truly want to help this kid!
I am feeling so torn about what to do. I am hoping that someone here can help me. Unfortunately the parents are closed to the idea of testing. The school (MCPS) cannot force it. But it is possible they would be open to addressing some serious issues such as major social problems, excessive pacing and hand flapping, physical awkwardness and basic executive function. Any advice, suggestions, guidance is appreciated. I know it is not my child but minding my own business in this case is feeling more and more wrong. My heart is breaking for this kid - he has no friends and no clue how to navigate the world outside of his home environment. So sad and disturbing. Sorry if this rambling.