THis also could still be due to anxiety. It can be that bad. difficult child 3 would seem fine, happy and no problems, but as soon as we were heading to school (or often after he got there) he would complain of nausea. At school he was vomiting often several times a day. I would get called to come collect him. Often I had to cancel doctor's appointments I was already o nthe way to, because I had to turn back and collect my child. it got so that when I had a doctor's appointment I would give difficult child 3 a day off school so I wouldn't get disrupted. You can only cancel so many times...
His aide and the teacher were insistent difficult child 3 was making himself sick, was actually trying to vomit but often only had the dry heaves (because he often wouldn't eat his lunch or anything else during school hours; he would bring it home and eat it after school - remember, our kids get packed lunches in Australia, sent from home).
Then I began to pay much closer attention. I suspected he might be trying to make himself vomit, so I watched him closely. Over the summer holidays - no nausea. No problems. But a week before school was to go back, we were heading off on a drive in the car for his birthday treat (he'd asked to go to the technology museum). He voluntarily spoke up and mentioned school. "This year at school if kids are mean to me, I will just ignore them and walk away."
I replied, "Good for you. That is the best way. All they've ever wanted from you is a reaction. By choosing to not react, you will be the winner."
Within fifteen minutes he was complaining of nausea. Stopping the car to give him fresh air did not fix it. However, after another hour of us talking about howe much fun the museum was going to be, he began to come good.
A few days later I was checking his clothing to see if he needed me to buy new school clothes for him. We were about to go to the mall, a place he loves. A few minutes later he felt nauseous and ran to the bathroom. He didn't have tom==ime to shut the door after him, I saw no fingers gonig in his mouth. I'm not sure he could even do it - I think he's too squeamish.
Since then I've noticed how he can really feel very sick, purely from anxiety. He also has a hard time recognising that his feelnigs of dread plus nausea, are simply anxiety. It feels too serious. He says, "I'm dying," or "Something really awful is going to happen, I have to get out of here."
He picks up on vibes - unusual, in someone with autism. We travelled to Tasmania, he was enjoying the trip but one day we went to Port Arthur, a historic ruin of an old penal settlment. We were waiting in the (very beautiful) gardens for a tour guide and he began with, "I feel terrible. Something very dreadful is going to happen. I have to get out of here, I have to get out..." over and over. He knew nothing of Port Arthur's recent history of being the site of a very nasty massacre, Australia's most notorious and most prolific mass murderer went on a shooting rampage there. We kept difficult child 3 with us, he wasn't able to hear the tour guide so we interpreted what we felt he could handle. The massacre wasn't mentioned, only the convict history. In Tasmania even the name of the murderer is not mentioned. We saw the memorial at the rtuins of the old Broad Arrow cafe, but kept difficult child 3 away from it. It was a very long and difficult day for him and for us, but we felt he had to see it through. It really freaked us out, though. Even now, I'm not sure if he knows the massacre story of Port Arthur.
Next day we had to go back there to drop easy child 2/difficult child 2 off, she was going on another tour. difficult child 3 was in a panic in case we made him go back in there too. Even in the cr park he was panicking. He was OK once we went a few km up the road to a small zoo where the rest of us spent the day.
So never underestimate the severity of symptoms that can be put down to pure terror. Medically it's called anxiety, but for a child it can be devastating.
A kid who is choosing to stick fingers down his throat is also similarly desperate to make it stop, whatever it is.
Either way - find a counsellor, do some digging. Be preapred for the child to not recognise a connection between feeling deathly ill, and being afraid.
What has worked for us:
1) removal from the worst causative situations, to begin with.
2) Slow reintroduction to these at a rate he can handle, and when equippped with various coping strategies.
3) Any unpleasant goings-on need to be stopped and need to be seen to be stopped. If this cannot happen, then he needs to be permanently removed from this until he can begin to handle it in small doses.
Success in handling this, is the best cure, long-term. HE needs to know he can overcome this and move beyond it. But it's like learning to surf - first you begin with standing on the board on sand. You lie on the board and practice the paddling movements. Then you try in fairly calm shallow water. Then slowly take small steps until you're at last riding a (small) wave. As you gain experience you get to understand your board, the water and your own skills, and soon can be whatever you want, including pro surfer.
But you can't make a kid a pro surfer, if he can't swim and doesn't know how to use a board. He has to go through the steps slowly, you don't hand the kid a board and tell him to ride the tsunami. You'll only make him terrified of the ocean.
If the boy is deliberately making himself vomit, there is an element of deception has crept in and this will get in the way of therapy. It makes it all the more urgent to get help fast and to work on any deception component.
But if there is doubt - go gently. Let someone else accuse, if tere are to be accusations. Because whatever it is, I strongly suspect this kid is upset by something at school and feeling desperate.
Marg
