Hi,
Sorry you lost the shrink. Because frankly, I do think that's his best hope. The psychologist sounds like she's out of her depth. The school & after care aren't coping, and can't really if they have no diagnosis or suggestions on how to deal with him.
He's too much of a handful, you've been trying to get answers for years now, I can't understand how our health system has got this bad.
There have been times when a desperate parent, fed up at getting no help, has gone to the media. I'm hesitant to suggest it, but it's sounding that desperate. I would be suggesting 7 rather than 9, they're more likely to give you a fair go. But hey. whatever you can rustle up.
Did you take him to the hospital when he cut his head? The only other thing I can suggest is to keep taking him there every time there's an 'accident' so they can document everything.
Can you take him back to Westmead? The lack of services in your area surely has to help, someone somewhere has to be able to see that this kid has not had appropriate assessment or intervention in all this time and you've run out of resources or answers.
That throat clearing - it sounds like what difficult child 3 does. It could be a stimulant, or it could be a tic. My vote - a stimulant, maybe a way of trying to deal with anxiety.
He's had a diagnosis of autism, and a stimulant would fit that, but there is definitely something else here that needs looking into. Things are happening here that go way outside what you see in Pervasive Developmental Disorder (PDD).
I'd be giving serious consideration to taking him by the hand and sitting with him somewhere, such as outside the child psychiatry unit at Westmead, or POW kids. Take a thermos and your knitting (metaphorically) as well as a history. This isn't the way it's supposed to be done, but everything else seems to be letting you down.
I know it's drastic, but the only other thing I can think of, is to move. Change addresses. Go to a different area where you have to begin the whole process over again. Somewhere where you CAN fit into Westmead's area. Somewhere that you CAN find a pediatrician who isn't a wimp. You shouldn't have to do this, with a health system as good as ours is supposed to be (yeah, right).
OK, some of my suggestions are a bit off the wall, but maybe someone has some ideas that may be more feasible.
Thinking cap's on for you. This just isn't right.
Marg