:: nice to meet you all, sorry to do so under our circumstances. i'm here trying to figure out what is up with my daughter. the story is long, and complex, so feel free to ask if you need more info. history: there has always been something. walked at 8 mo, bit of a late talker but nothing extreme-answer was she was so focused on motor skills, potty training was tough, maybe late 3? we've had different diagnosis's suggested throughout the years, but no one ever seems to agree, and no one ever has a plan. *I* put the plans in place for school. she's probably extremely hf Autism Spectrum Disorders (ASD). also has adhd like issues. definitely now has self esteem problems/depression/anxiety. impulsivity is an issue. she's hyperlexic (hence early rule in/out of Autism Spectrum Disorders (ASD)'s), social skills stink, but until this year there has always been THE bff. shes had some communication issues with pragmatics and not always the best at it, but much improved. comprehends everything she reads. can often repeat what she's read verbatim. sometimes incorporates things she's read into conversation. she also is very bright- (old fsiq:118, and she's a poor tester--noted as acadamic skills are very advanced). she's had an iep since 4 under comm. impaired, full array of services, and a para since k. most recent one is with her for the last two years, i'm not overly impressed but the good one got literally requested out from under us. iep is weak, and i havent insisted on compliance or real, appropriate goals--i cared more about insuring services. my bad--wont happen again. classification was changed around 8 to OHI at schools insistance, since comm issues were resolving, to retain services. placement has always been mainstream with the exception of spEd for reading/spelling/etc since she was on a much higher level academically and she needed small group/challenging work. just now moved her to spEd math. i couldnt, and still cant, even fathom her in a self contained class for the autistic or ed or anything less than typical. she also doesnt present with enough issues to label one way or the other. with the overlaps in symptoms she's not so clear cut. i've heard a lot of autistic flavor, possibly gifted, probably bored, hyperactive, etc over the years. once in a while defiant gets thrown in there...more by those who dont know her, or the whole picture--never by those who do. the last formal diagnosis was adhd, by a neurologist, who started her on focalin 5mg at oh, say, 80lbs or so....so umm, no, we saw no difference and Difficult Child'd it. he saw no need to try an appropriate dose and only wanted to take the edge off. (and as a huge aside, i know him, he knew what i needed for this school classification issue, and i've always assumed we were both not totally convinced of adhd...i had no idea it could present so differently in girls) so i can't conclusively say if it worked or not. that was 2 years ago. and now she's entering puberty. recent: impulsivity kicked into high gear at the start of this school year. hates school, difficulty focusing, poorer judgement than usual. huge frustration issues with school (quite frankly, very justified! two words: spiral curriculum). something was up, but we chalked it up to puberty, more rigorous, lecture heavy school, etc. no doctors were involved on any level--she does see the school psychiatric and has for three years. late nov, she started slamming her head on her desk and then was talking out loud to an "imaginary friend". she starts insisting this character is real (its a take on a real character in a game). first it was thought to be frustration and the imaginary friend was a coping mechanism. then the psychiatric thought she had a break with reality. i had no real reason to doubt her opinion, she's seen daughter for 3 years. she put me on high alert. i was desperately working on finding a kid psychiatrist and couldnt get an appointment to save my life. i saw a single instance of the talking to imaginary friend and it was pretty terrifying, at least after it having been suggested that she had a break with reality (otherwise, seriously, i might have told her to stop fooling around!). we were walking on eggshells with her. early dec, she slams head on desk and in the process somehow stabs her hand with a pencil. (she maintains to this day she meant to slam her head and the hand was an accident). it was suggested (actually, impressed on me--self injurious behavior) that she needed a psychiatric hospital immediately and ultimately was admitted to the psychiatric hospital that night. she stayed for 5 days, the first in which she slept til 11am (not admitted until 2am)--and by the time i came in a 1pm she had already seen psychiatrist and was diagnosis'd with Pervasive Developmental Disorder (PDD)-not otherwise specified rule out aspergers, depression and anxiety and was to be started on zoloft. he did NOT think she was hallucinating and felt it was part of Autism Spectrum Disorders (ASD). she was kept for medication monitoring (for zoloft??) which they forgot to write for so it was NOT started the next day, with no one realizing their error until daughter asks me if she's supposed to get a pill. she had a few "groups" but never saw psychiatrist again--after the inital hysteria at being there, she was compliant, well behaved and motivated to follow the rules to come home. model patient. (she's NOT a manipulator at all) couldnt say enough nice about her. psychiatric hospital sent us home with appts for second psychiatrist, therapist for intake which included third psychiatrist and a one month rx for zoloft. NOW: she's seen a second psychiatrist who went down the conduct disorder road--Obsessive Compulsive Disorder (OCD), odd, adhd, anxiety, impulsivity disorder, and watch for signs of kleptomania?? after less then an hour appointment. also kept saying "its allll about her", wth that meant, i'll never really know. i ditched her, and pray i dont live to regret it. now with a third psychiatrist who confirmed aspergers and impulsivity control issues. also seeing a neuropsychologist. he too agreed with above. he suggested trying stimulant therapy for the adhd like stuff. (treat the symptoms regardless of labels idea) we agreed that would give us a lot of info very quickly, sent me to regular pediatrician for rx, got one for concerta, and promised i'd check with psychiatrist before starting it. neuropsychologist was trying to discourage formal testing to save me money???? even though i assured him i didnt care and was insisting we need it to figure out whats going on. i seem to be the only one who thinks it will be useful to help her, even if its in life skills, or edu, or whatever, since there is NO conclusive test for ANY of these suggested labels. maybe i'm wrong, who knows, but its my kid, my $$, and what possible motivation can he have to NOT want to test this kid, especially with a cash in hand paying parent whos insisting on it??? i have to follow up with him so she can draw for him, and then he's implied we can decide on which testing to do (i've already got test slot scheduled for early feb) mentioned the nepsy. school is on board to do the edu testing, because, quite frankly, i cant really cant afford all of this. no one really expects edu testing to show much of anything by that shes bright. she did great on 50 mg. zoloft. or so i thought. amazing holidays with her--happy, social, good mood, etc. we thought it was a wonder pill. i get tag teamed by school when i go in last week to plan the triennal and told she is manic-y and symptoms are ramping up again (their words, not mine) after a fabulous 2 week honeymoon. did not specifically say she was talking to imag. friend, but talked about making her hands into puppets (two hands talking back and forth kind of thing) and i really didnt think to clarify any further, mainly because it sounded like she was bored and entertaining herself rather than hallucinating, and i took it as she did it once, not constantly . but the manic word along with ramping up scares the daylights out of me. according to them this was happening for the last week. WHY they didnt feel the need to call me immediately i'll never know. it was a huge problem--i still had the carpy psychiatrist appointment and had cancelled it the day before--i'd have kept it had i known this information. i saw nothing unusual at home. called psychiatrist in a panic who is confused over why i'm calling and drops zoloft to 25mg. just in case. go to psychiatrist today for an emergency appointment where she proceeds to rip me a new one...as i sit there dumbfounded. she rants there are two many doctors involved (i dont disagree but i believe we need her AND a neuropsychologist right now), she doesnt seem interested in getting to the bottom of if there is a mental illness here, a dev. delay, or comorbidity of multiple issues. she seems to be missing my point that *I* am doing what everyone is telling me to do, and that *I* have to rely on the school psychiatric to some degree, and that *I* am not an expert, and that if *I* knew what was really going on with daughter i've have told her, and that *I* am terrified FOR daughter. also not getting my panic that if there IS an underlying mental illness and we are missing it, with the Autism Spectrum Disorders (ASD) label, she is excluded automatically from psychiatric hospital. she also said neuropsychologist testing wasnt useful in guiding her diagnosis, implying shes not thrilled about him being involved. (i understand its NOT the dsm-iv, but ftlog!) she then decides we SHOULD start the concerta and Difficult Child's the zoloft entirely?? she tells me not to be concerned since concerta is metabolized fast. she also says if, when we see her at the end of march, we need to we will consider abilify. (again, *i* thought that mood stabilizers come first, then symptom medications, which is really the reason i felt the need to check on the concerta to begin with). i have no idea how exactly abilify made it into the conversation when she is pretty insistent that Autism Spectrum Disorders (ASD) explains it all. and THIS is the one i thought was good. i'm ready to slam *MY* head on a desk. if you read this far, thanks. any words of wisdom or even random thoughts are welcome i'm overwhelmed, i'm ready for my own axis diagnosis, and this is exhausting me. i literally cant do this. i dont know who to believe, what to do, where to turn. i do.not.care what the label is for label purposes, call her whatever you want. but the treatment for these things is very different. i just want to help my kid. properly.