Expert: Catherine Ridenour - 3/21/2007

Question
My son does not have a clear diagnosis at this time. For now he's labeled as PDD-NOS & seizure disorder.  The past 4 or 5 months have been extremely difficult to manage his behavior at home & school. He has extreme fits of anger and aggression against brother, parents & teacher. He just started resperdal not much of a change. Desperate for something other than behavior modification technique.
Thank you - Sandi  

Answer
Hi Sandi,

Giving Risperdal a try is fine. However, if it does not help a great deal in a couple of weeks to a month, don't continue. I'm sure the doctor acquainted you with the side effects. Ask your doctor to consider attention deficit disorder. Kids on spectrum can have it just as easily as any other child. Medicating ADHD can help with the outbursts because he will not be so overwhelmed by his environment. Some autistic people do better when taking an anti-depressant. It seems to balance the brain chemistry.

It is likely your son has Asperger's syndrome, which is an autistic spectrum disorder that primarily affects social function. If this is the case, he is not aware that other people have feelings or even thoughts of their own. This realization does not usually dawn in normal children until about age 4, so you certainly can't expect it from him any sooner.

What complicates the matter is that he really does not have any clue about his own emotions, either. The emotions of kids on the autistic spectrum are pretty black and white. They are happy, mad or sad with very little in between. They can go from one to the other instantly and without warning. This volatility is hard to manage but don't give up. Establish logical consequences for misbehavior, follow through and don't ever back down. Physical punishment is a big mistake, autistic kids do not respond well to it at all.

He must be supervised around other children who are his age or younger/weaker. This vigilance is tiring but necessary. He does not understand that he can injure them and has no control over his impulses to defend his territory.

Watch for the triggers to his outbursts. Is he under florescent lights, is there a background of noise that is irritating him? Sometimes a hat or earplugs solves some of the problem.

Remember to reward good behavior. Never make a promise you can't keep. Autistic individuals don't hear "maybe" very well. If you said, "we might go the park", he heard, "we WILL go to the park." They take words very literally and must relearn the meaning every time the situation changes.

Try to avoid letting him get hooked on television. It's tempting to let him zone out on it so you can have a little peace, but I have talked to many parents who can't change the channel or turn it off without major reaction from the child. Limit his TV time carefully.

Here are some links where you can find more information.

http://www.neurodiversity.com/main.html (many links to books, articles and resources)

http://www.patientcenters.com/autism/news/resources.html (books and resources)

http://www.ninds.nih.gov/disorders/asperger/asperger.htm (the definitions and government links)

http://www.autism.org/temple/meds.html (about medication)

http://www.autism.org/ (many links to information)

http://www.angelfire.com/pa5/as/asteachersites.html (teaching resources)

Best wishes,
Catherine