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<blockquote data-quote="Marguerite" data-source="post: 426213" data-attributes="member: 1991"><p>Welcome.</p><p></p><p>From what you describe, the problem is no longer just at home. it's just that it was at home that you FIRST noticed things were not right.</p><p></p><p>We are dealing with similar stuff and have also lived through the process. I think you are probably on the money with ADHD plus probably Asperger's. Depending on how autism and Asperger's are defined in your area, if there was no history of language delay the label would be Asperger's rather than autism. However, increasingly Asperger's is being labelled as high-functoning autism. The labels are once again shifting, I was told that the new DSM criteria will not even mention Asperger's. </p><p></p><p>WHat you describe with school performance fits Asperger's and High-Functioning Autism (HFA). Being able to do well in concrete subjects is typical. In difficult child 3's case he also was/is hyperlexic, his fascination/obsession with the written word and with numbers also meant he learned spelling and grammar very early. He could skim a piece of writing and do a comprehension exercise at a basic level. "What did John say to his mother?" was easy. But as he got older, he "hit the wall" as I call it, and suddenly began to fail rather surprisingly and spectacularly, in some small areas only. A glitch, the school thought. An off day. But I could see it was because the work had become more abstract and challenging. "Why do you think John told his mother about the dog?"</p><p>Then as he moved into middle school and higher, the questions became even more challenging. "When Jack punched Fred, what did he think Fred had done?"</p><p>That last question is a classic "theory of mind" problem. difficult child 3, at 17, does understand theory of mind intellectually, but at an instinctive level he falls back on egocentricity. The mental effort to keep up is extreme.</p><p></p><p>We are now having problems with difficult child 3 and executive function. Increasing his ADHD medications has improved his functioning, but not a vast amount. This is our current urgent problem.</p><p></p><p>Now to behaviour. Your son is trying to cope academically at school, and being able to do well at least in some areas provides some comfort and some standing for him. But he is beginning to struggle, and this will be knocking his confidence. He can't lash out at school; he has to guard himself there as best he can. But he can't control himself too tightly for too long. So at home, where he feels safest and most secure, is where you see the real person and his struggle.</p><p></p><p>I suspect you may also need to change your own parenting style when it comes to how you relate to him. I'm not saying you're a bad parent or a slack disciplinarian; chances are, you're too good. Because what usually works well for most kids, the 'normal' kids, can be disastrous and lead to much greater discipline problems with a kid on the spectrum. The reason is, we tend to assume a certain capability of social understanding in our discipline methods, and these kids, especially if they're bright, are good at copying other people's behaviour. They slide under the radar because they imitate, almost instinctively. And part of what they copy, is your behaviour as a disciplinarian. So you need to change tack - become a model for the behaviour you want from him. In every interaction with him, you need to help him understand that HE has to make the choices. You can help him by laying out the range of choices for him. If you try to stand your ground, you will teach him how to be stubborn. But if you work to compromise, you will teach him how to compromise also, and to give way appropriately.</p><p></p><p>You do not have to become a doormat - far from it. But you probably do need to get into his head, think the way he thinks, and work from there. Reduce the number of things you want to "fix" about him, and let the rest go for now.</p><p></p><p>A book that will help - "The Explosive Child" by Ross Greene. Read up on it, we have a sticky in Early Childhood forum that can give you some pointers. If your diagnosis is right, this book will help a lot. It could help a lot anyway, but I found that it produced a major improvement in difficult child 3. He's still a long way from perfect, I still run a lot of interference for him, but he is now able himself to see where he needs to go socially.</p><p></p><p>I would strongly recommend requesting a neuropsychologist referral. If the GP says there's no point, there's nothing wrong, use the following arguments:</p><p></p><p>1) He's doing so well in some subjects, but beginning to struggle in others. I would like to determine if we have a gifted child here, even if he is only talented in some areas. It would be a shame to not give him every opportunity to excel. Similarly, if there is a problem we have not been able to identify, and we do not offer him a little support in the areas he is beginning to have trouble with, it will prevent him being able to fully exploit his talent areas. We need to do this sooner rather than later, in order to be able to give him as much run-up time as possible.</p><p></p><p>2) I am concerned that there may be some underlying problem we have not been able to identify, perhaps partially masked because as an apparently bright child (and we won't know without an assessment) can mask it for a while to a certain extent. I think he has been doing that and now the mask is beginning to slip. I do not want him to fall too far behind, I would like to get some answers fast. You do not think there is anything wrong - I accept that, but I still feel concerned. I would feel greatly reassured to know you are proved right by an independent neuropsychologist assessment Can you please refer him to someone who can administer a neurospych assessment on him, hopefully to reassure me that there is no problem? Because if you are right and there IS no underlying problem, that also will be valuable information we can use to put some management strategies in place, to help him lift his game in the subjects he now is suddenly having trouble with.</p><p></p><p></p><p>In summary - your first argument is, he's been doing well in school across the board and now has problems that seem inconsistent with past great progress. We need to eliminate a previously masked learning difficulty. And the second argument - you could be right that there is nothing wrong, doctor. Let's prove it.</p><p></p><p></p><p>I used both these arguments on a particularly recalcitrant GP that used to be in our area. The doctor wrote me the referral fully expecting to be supported by his colleague and proved right. At that point, we had already had speech pathology assessments and a psychologist's report that indicated autism. All we needed was the last piece of the puzzle - the third required specialist to confirm. When the report came back that confirmed difficult child 3's autism, the GP never even read it. When I turned up next with a difficult child 3 with croup (and the doctor wouldn't even listen there - difficult child 3 ended up in hospital a few hours later) and the doctor said there was no point checking his tonsils etc because "if he has a sore throat, he will tell you," (not if he's non-verbal as he was at the time and also doesn't notice pain), I said that difficult child 3 had a diagnosis ofautism and also of language delay; he could not tell me. The GP then shouted at me, in front of a waiting room full of patients, to "stop trying to find things wrong with your child."</p><p>It was VERY satisfying to be able to tell him that I didn't diagnose my child, the specialist HE referred us to had given the diagnosis. Argue with the specialist.</p><p></p><p>You CAN beat these guys at their game. You just have to play by the same rules and speak their language.</p><p></p><p>Joining this site will give you information, encouragement and support. Without this site I never would have kicked as many rear ends as I have, and with such success. We now are in a good place, despite the current executive function problems. </p><p></p><p>Welcome, and let us know how you get on.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 426213, member: 1991"] Welcome. From what you describe, the problem is no longer just at home. it's just that it was at home that you FIRST noticed things were not right. We are dealing with similar stuff and have also lived through the process. I think you are probably on the money with ADHD plus probably Asperger's. Depending on how autism and Asperger's are defined in your area, if there was no history of language delay the label would be Asperger's rather than autism. However, increasingly Asperger's is being labelled as high-functoning autism. The labels are once again shifting, I was told that the new DSM criteria will not even mention Asperger's. WHat you describe with school performance fits Asperger's and High-Functioning Autism (HFA). Being able to do well in concrete subjects is typical. In difficult child 3's case he also was/is hyperlexic, his fascination/obsession with the written word and with numbers also meant he learned spelling and grammar very early. He could skim a piece of writing and do a comprehension exercise at a basic level. "What did John say to his mother?" was easy. But as he got older, he "hit the wall" as I call it, and suddenly began to fail rather surprisingly and spectacularly, in some small areas only. A glitch, the school thought. An off day. But I could see it was because the work had become more abstract and challenging. "Why do you think John told his mother about the dog?" Then as he moved into middle school and higher, the questions became even more challenging. "When Jack punched Fred, what did he think Fred had done?" That last question is a classic "theory of mind" problem. difficult child 3, at 17, does understand theory of mind intellectually, but at an instinctive level he falls back on egocentricity. The mental effort to keep up is extreme. We are now having problems with difficult child 3 and executive function. Increasing his ADHD medications has improved his functioning, but not a vast amount. This is our current urgent problem. Now to behaviour. Your son is trying to cope academically at school, and being able to do well at least in some areas provides some comfort and some standing for him. But he is beginning to struggle, and this will be knocking his confidence. He can't lash out at school; he has to guard himself there as best he can. But he can't control himself too tightly for too long. So at home, where he feels safest and most secure, is where you see the real person and his struggle. I suspect you may also need to change your own parenting style when it comes to how you relate to him. I'm not saying you're a bad parent or a slack disciplinarian; chances are, you're too good. Because what usually works well for most kids, the 'normal' kids, can be disastrous and lead to much greater discipline problems with a kid on the spectrum. The reason is, we tend to assume a certain capability of social understanding in our discipline methods, and these kids, especially if they're bright, are good at copying other people's behaviour. They slide under the radar because they imitate, almost instinctively. And part of what they copy, is your behaviour as a disciplinarian. So you need to change tack - become a model for the behaviour you want from him. In every interaction with him, you need to help him understand that HE has to make the choices. You can help him by laying out the range of choices for him. If you try to stand your ground, you will teach him how to be stubborn. But if you work to compromise, you will teach him how to compromise also, and to give way appropriately. You do not have to become a doormat - far from it. But you probably do need to get into his head, think the way he thinks, and work from there. Reduce the number of things you want to "fix" about him, and let the rest go for now. A book that will help - "The Explosive Child" by Ross Greene. Read up on it, we have a sticky in Early Childhood forum that can give you some pointers. If your diagnosis is right, this book will help a lot. It could help a lot anyway, but I found that it produced a major improvement in difficult child 3. He's still a long way from perfect, I still run a lot of interference for him, but he is now able himself to see where he needs to go socially. I would strongly recommend requesting a neuropsychologist referral. If the GP says there's no point, there's nothing wrong, use the following arguments: 1) He's doing so well in some subjects, but beginning to struggle in others. I would like to determine if we have a gifted child here, even if he is only talented in some areas. It would be a shame to not give him every opportunity to excel. Similarly, if there is a problem we have not been able to identify, and we do not offer him a little support in the areas he is beginning to have trouble with, it will prevent him being able to fully exploit his talent areas. We need to do this sooner rather than later, in order to be able to give him as much run-up time as possible. 2) I am concerned that there may be some underlying problem we have not been able to identify, perhaps partially masked because as an apparently bright child (and we won't know without an assessment) can mask it for a while to a certain extent. I think he has been doing that and now the mask is beginning to slip. I do not want him to fall too far behind, I would like to get some answers fast. You do not think there is anything wrong - I accept that, but I still feel concerned. I would feel greatly reassured to know you are proved right by an independent neuropsychologist assessment Can you please refer him to someone who can administer a neurospych assessment on him, hopefully to reassure me that there is no problem? Because if you are right and there IS no underlying problem, that also will be valuable information we can use to put some management strategies in place, to help him lift his game in the subjects he now is suddenly having trouble with. In summary - your first argument is, he's been doing well in school across the board and now has problems that seem inconsistent with past great progress. We need to eliminate a previously masked learning difficulty. And the second argument - you could be right that there is nothing wrong, doctor. Let's prove it. I used both these arguments on a particularly recalcitrant GP that used to be in our area. The doctor wrote me the referral fully expecting to be supported by his colleague and proved right. At that point, we had already had speech pathology assessments and a psychologist's report that indicated autism. All we needed was the last piece of the puzzle - the third required specialist to confirm. When the report came back that confirmed difficult child 3's autism, the GP never even read it. When I turned up next with a difficult child 3 with croup (and the doctor wouldn't even listen there - difficult child 3 ended up in hospital a few hours later) and the doctor said there was no point checking his tonsils etc because "if he has a sore throat, he will tell you," (not if he's non-verbal as he was at the time and also doesn't notice pain), I said that difficult child 3 had a diagnosis ofautism and also of language delay; he could not tell me. The GP then shouted at me, in front of a waiting room full of patients, to "stop trying to find things wrong with your child." It was VERY satisfying to be able to tell him that I didn't diagnose my child, the specialist HE referred us to had given the diagnosis. Argue with the specialist. You CAN beat these guys at their game. You just have to play by the same rules and speak their language. Joining this site will give you information, encouragement and support. Without this site I never would have kicked as many rear ends as I have, and with such success. We now are in a good place, despite the current executive function problems. Welcome, and let us know how you get on. Marg [/QUOTE]
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