Expert: Celtica - 7/9/2008

Question
Dear Celtica
I am writing to you about my son Jonah. He is now 17 and has had receptive language, communication and obsessive difficulties since he was 2yrs old. As Jonah's mother I have not been able to gain a diagnosis for him.
Jonah did not speak until he was 4 years old. He was not speaking fluently until he was about 12years. He has no empathy. He does not care how people feel. He cannot understand other people may have different opinions from his own. He is unafraid of danger. He does not understand when people speak in long conversations. He likes to change the subject to skateboarding, because this is his special interest.
He smells things all the time. He finds it difficult to swallow some foods. All his teachers thought that Jonah had hearing difficulties, but his hearing has been tested several times. His hearing is within the normal range. He is very inattentive and cannot pay attention.

The specialist we saw recently thinks it is ADHD, but I am sure it is Autism. Jonah was not hyperactive as a child. All the specialists we saw when my son was little said he was not hyperactive. I am very confused and don't know what to do to help my son. I don't know if it is autism and ADHD. I know that you are not able to answer this, but could you please suggest what I should do to establish the cause of my son's problems?

Jonah said he will not take Ritalin to help his concentration. I cannot force him to take Ritalin because he is almost an adult and he has to make his own choice. But this will not help him when he has to go to work. He does not want to get a job, because he only wants to skate.
He does not even want a part-time job.

He was bullied for many years at high school and I had to take him out of school and teach at home for this reason.
I do not know how to help my son. He seems very young for his age. I think the bullying may have affected him very badly.
Also, he only has only a few facial expressions. He finds putting things in order very difficult and finds it hard to put things in alphabetical order.
How can I get the right help for my son before he becomes an adult?
Thank you for listening to my worries.

I look forward to hearing from you.

Best wishes,
Miranda

Answer
Hi Miranda,

This is not ment as a diagnosis, but your son does indeed sound like a person with Asperger's or HFA and ADD. Please go and see another specialist, and make sure it's someone who has seen a teenager/young adult with AS before.
You could probably contact your local autism society (or the Autism Society of America http://www.autism-society.org) and ask them for a specialist they can recommend in your area. Even consider seeing a specialist in another state, if they say he's really good (if you can afford to do so). His hearing problems could be CAPD (central audio processing disorder. I suspect I have it too, and all standard hearing tests I have done so far came out fine, yet I often have trouble understanding other people and am often totally unable to understand more than a few words now and then when there is background noise (even if it's just the TV on low volume)). He may also have sensory issues which should be assessed too.
You could try to tackle his concentration issues through diet (low sugar, gluten and casein free), if he doesn't want to take his meds, but this doesn't work for everyone and he may not like those foods (it may help, but in other people it may not make any difference at all. It's helped me alot, but for someone I know with AS/ADD it didn't do anything at all).
Can he tell you why he doesn't want to take the meds ? Maybe the dose he's taking is too high or too low. Optimally, he shouldn't really feel any different when he's on medication, only that he suddenly can read or concentrate on whatever he never could before. If he feels "drugged" or odd of different, his dosis is very likely too high, if he feels the meds don't have any effect (and therefore it seems not to make any sense to take them), the dosis is either too low, or he cannot monitor the changes in his ability to contrate himself very well. It this is the case then you should try to help him to find out what's the case, and if it gets clear to him that he really can concentrate better, he might take them more regularily. If you feel the dosis is to high or too low, talk to his doctor about it as soon as possible.
Maybe he would be interested in getting a job in a place selling (or repairing, or manufacturing) skateboards, or in giving courses in skateboarding to kids or something like that. I don't know what it's like where you live, but in my town there is at least one store, probably more than one, selling exclusively skateboards and rollerblades. I don't know if there are magazines about skateboardng - probably he could try writing an article about a skateboarding event (if there is such a thing) he's been to, or start getting interested in taking pictures of people skateboarding (and thereby getting interested in photography in general, so he might become interested in becoming a photographer or even sports journalist or something). What I'm suggesting is trying to use his special interest to get him interested in other things (that might be useful for a later career).

Hope that helps,
C.