Expert: James Michael Roan - 12/4/2006

Question
My nearly seven year old just got diagnosed with this last week. We have
suspected since he was two that he had aspergers and aspergers runs in our
family.  Things were somewhat complicated because my son is also hearing
impaired and didn't get aids till he was four so he had a speech and language
delay also and couldn't really be understood by anyone but my husband and
I, until he was nearly 5. He is quite bright, somewhere between above average
and gifted, he has many aspergers traits but the problem is his behaviour is
almost always perfect at school and terrible at home.  We have reached crisis
point because it's been hell for the whole seven years  but now he is
becoming more violent and we are struggling to handle it. He is having
between 10-20 tantrums per day and increasing violent hitting,  kicking,
pushing, spitting and so on.  He controls everything we do, from the moment
we get up to the moment he goes to sleep.  Im becoming afraid of  him. He
has major sensory issues including smell, taste, texture, sight - terrified of
wet paint (the way it looks), balloons (can't go to parties at all because of
this), doesn't like the way clothing feels and frequently complains of sore
stomachs related to these anxieties.  We can't go anywhere, do anything that
normal families do but then he goes off to school and appears nearly normal.
He is having some social problems however and is extremely obsessive about
some things.

He could not get diagnosed with aspergers because his language was delayed
and he could not get diagnosed with autism because his language was too
good. Though he still talks in a flat unusual sounding voice, he is very close
to normal in his speech especially for someone who is hearing impaired.

The question is what now? We have virtually no support and his school I think
probably think we are mad because he is so good. My husband and I are on
the verge of a marital breakdown purely because of his behaviour ruining our
lives, we just can't cope anymore.  We have no social life, all our friends have
gone and I am out of love with my child.  Everything is a drama, even cleaning
his teeth.  He is petrified of toothpaste and the dentist recently said he was
starting to have problems because he was not using toothpaste and that we
absolutely must start using it now. So he gave us a special low tasting one
(we have tried many types in the past) and we have had to  physically hold
him down to brush his teeth and he goes berserk.  He has to have ear drops
regulary due to his ear problems, same thing. Have to sit on him to get them
in.  If he so much as knocks himself he is in hysterics for ages.  I can't go on
like this, I just can't. Im desperate for some ways of managing it. We are
consistant with rewards and punishments but neither work.  He is currently
not allowed any toys and he still keeps being naughty.

What do I do? I feel like Im on the verge of a  nervous breakdown.

Answer
Hi Ted;

I can see you are in serious need of respite care. I am unable to handle that, but if you live in the U.S. you should contact the Department of Developmental Disabilities (DDD) in your state to see what is available for your family in this area.

As for an immediate solution I strongly urge you to lighten up on your son's exposure to social interaction at school by first finding a quiet place for him to spend lunch and recess to get away from peers. Make sure he's not being bullied. He's able to handle it at school through shear guts and intelligence but the sensory difficulties and tantrums are a sure sign of extreme anxiety and more than likely depression. Make an immediate request for a school-based emergency reevaluation to formally observe his unstructured free play experiences, and to assess, formally, his anxiety and depression.

Don't force him to do anything at the moment. Brushing without toothpaste, if he'll do it will still work okay.

Tell me more about his behavior when you can.

Kind Regards,
James