Expert: Catherine Ridenour - 12/2/2007

Question
GOOD MORNING CATHERINE,

I AM WRITING ON BEHALF OF MY 10 1/2 YEAR OLD SON. HE WAS DIAGNOSED 3 YEARS AGO AT NYU CHILD STUDY AS HAVING MULTIPLE DISABLITIES, SIGNS OF ASPERGERS. HE IS BRIGHT LIKES TO READ, LEGOS. HE IS WARM, HAS A GREAT SENSE OF HUMOR. HE MISSREADS SOCIAL SITUATIONS , HAS NO REAL FRIENDS. HE PLAYS LATERALLY FEELS MORE COMFORTABLE WITH EITHER OLDER OR YOUNGER CHILDREN. HE'S IN COLLABORATIVE CLASS, 5TH GRADE , AND GETS PULLED OUT FOR PT/OT/SPEECH. IT'S BEEN A BATTLE WITH SCHOOL; SINCE DAY 1.
HE'S BEEN SEEING A PEDIATRIC NEUROLOGIST AND WAS PRESCRIBED PAXIL IN LATE AUGUST, TO BETTER HELP HIS MOOD AND CONCENTRATION. STARTED AT 10MG THEN TO 20MG. HE SEEMED OK AT 10 BUT STARED HEARING A VOICE. BY BRING HIM TO CSW, SHE NOTICED OCD AND STATED HE WAS HAVING SUICIDAL THOUGHTS AND ACTUALLY HAD PLAN. THIS VOICE WAS TELLING HIM TO JUMP OUT WINDOW OR STAB HIMSELF. HE NEVER HAD THESE THOUGHTS BEFORE PAXIL. WE TOOK HIM TO PEDIATRIC EMER ROOM IN NYC WHERE HE WAS TRANSFERRED TO MENTAL HEALTH HOSPITAL FOR KIDS. BEEN THERE FOR 2 DAYS . HE IS EXTREMELY HOME SICK AND DEPRESSED. THEY TOOK HIM OFF PAXIL THIS WEEK, CUTTING DOWN TO 5MG OVER 6 DAYS. YESTERDAY THEY STARTED HIM ON RISPERDAL, VERY LIGHT. HE FEELS HE IS PSYCH WARD. HE ALWAYS LIKES CALM PEACEFUL SURROUNDINGS SENSITIVE TO NOISE AND TOUCH. MY SON IS VERY HIGH-FUNCTION BUT HE MISREADS SOCIAL,ROUGHHOUSING WITH OTHER BOYS, ETC. IF HE GETS HURT, HE DOESN'T LET GO OF IT. WE ARE SOOOO HEARTBROKEN FOR OUR BOY. HE'S THE WARMEST KID YOU EVER WANT TO MEET. WE ARE A TIGHT KNIT FAMILY AND LIVE IN NORTHERN NJ. ANY LIGHT YOU CAN SHED WOULD BE GREATLY APPRECIATED.

WARM REGARDS, JIM

Answer
Hi Jim,

Hopefully, he will become stable enough to come home, soon. I know he is uncomfortable at the hospital with the unfamiliar noises and people.

I have no direct experience with risperdal. However, for some people on spectrum, it is very helpful. If you don't notice significant improvement in a month or two, I would get him off of it due to the side-effect profile.

The saving grace for bright kids with Asperger's is that, as they get older, they collect a catalog of social responses that they can use to cope in the world. Each new situation requires new learning, but once they learn it, they never forget. In my experience, these kids are about 3 or 4 years behind their peers, emotionally. But, they do continue to grow and by the time they are in their 20's, many function at a nearly adult level.

Depression can be a lifelong issue for people on spectrum. They know they are different and that difference is invisible until they mess up. People who do not understand autism can be very cruel and impatient toward them. Our daughter has taken an antidepressant of one kind or another since age 12. For her, it balances brain chemistry helping her be more calm and to sleep better.

I wish I had more concrete advice for you. The most important thing for him is parents who believe in him and go to bat when needed. Keep after the school to provide appropriate education. You know him better than anyone.

Help him find his passion in life. For many that is art or music, though many also excel in math/science or computer programming. Guide him in turning it into his career. There are many high-functioning autistic people who have been very successful. Check out Dr. Temple Grandin's books, she has written about helping spectrum kids transition into the work world in "Developing Talents". (I know it seems early to worry about that, but the foundations can be laid now.)

Write back and let me know how your son is doing in a month or two. I care.

Catherine