Expert: Valerie Herskowitz - 5/13/2010

Question
QUESTION: Hi,
I'm from the Philippines. My son is a 10year old boy who was dianosed as PDD NOS by his developmental pediatrician. He has had theraphy since he was 2yo. Occupational therapy and speech theraphy. At the age of 8, his speech pathologist suggested to stop the sessions since he's progressing in his speech already.  

    The problem started when I gave birth to our second child.  His speech started to be a problem to us.  He keeps on repeating the questions he asks 3 to 5 times if he doesnt hear the yes answer. Even if our answer is no, he will repeat the question over and over again until we say yes.  Or if we answer yes, the same thing happens. He will reverse the question.  Like "can I let my playmates play inside the house?" If i answer yes, he will say "who? my playmates?"  and other times if we answer no, he will ask over and over again "why?"  and if we answer why, the same question... "my playmates can't play inside?" every question must be answered by yes.

    And he seems to not understand everytime we discipline and talk to him regarding good manners.  He seems to forget easily what we teach him.  He has low average reading comprehension skills.  But he can have a high average on reading if he is focused or he likes what he is reading.  But that happens only once in a blue moon.

    I need your advice on this matter as I am really frustrated and my patience has already reached its limit.  I feel pity for my son everytime I yell at him for having bad behavior.  I tried to talk to him in a very calm way, but to know avail.  It seems that he really wants me to yell before he follows my instructions or listens to what i'm telling him.

ANSWER: It sounds like your son is having some obsessive issues fueled by anxiety. Unfortunately the only way to deal with it is with consistent behavioral interventions and/or some medication to help his anxiety. Have you worked with a someone to help you with these behaviors or is he on any medications for anxiety?

---------- FOLLOW-UP ----------

QUESTION: thank you so much for your reply... i really appreciate it... it gave me idea what's happening inside him...

regarding obsessive issues... i agree with that... materially he's had this obsession with airplanes... everytime he starts a conversation with anybody, he always talk about the same thing over and over again...(airplanes and him wanting to be a pilot of one of the airlines here in the philippines) if you change the name of the airline he will get mad and won't stop bothering you about that.  With anxiety however, my question is... what could be triggering his anxiety?

And when you say behavioral interventions... where could we have that? can we have that with occupational therapists?  Because in our place here in the Philippines we only have occupational and speech therapists... I haven't really heard of anybody specializing in behavioral therapy.

And lastly... you're asking if my son is on any medications for anxiety... no he's not... is it safe though?

Thanks again...

Answer
Hi Janice

Pretty much everyone with autism has anxiety issues in some format or another. And most have the obsessive issues as well. Just the need for things to be the same triggers their anxiety, so they try to exert control of the universe. This results in the OCD behavior.

Do you have a doctor in the Philippines that you can go to and discuss medications? He's 10 now, so there are some safe drugs that can help. I'm not a doctor so I really can't give you specifics, but most people find that the normal drugs for OCD behavior don't work. However, drugs for anxiety do. They surely help my son!!

No behaviorists? Try a clinical psychologist. Are they there in your town? They can also help you to develop a program to help you with his behaviors. If you can't find anyone, then email me at:
info@valerieherskowitz.com and we will set up a consultation and I will help you via the phone.

Keep in touch