I am coming to the realization that my youngest's issues are very much captured by the Fetal Alcholol spectrum. He has various executive function issues, impulsive to the max, is very difficult to medicate etc. He was diagnosed at about 16 mos. For awhile I thought he might have some kind of mood disorder in addition or primarily, but really the more I read the more he seems to fit the fetal alchohol paradigm. HE was diagnosed by prominent child development center as Fetal Alcohol Effects (FAE), fits birthmother history, has had neuro pscyh testing up the wazoo, has seen at least two or three psychiatrists etc so we are pretty confident about what he doesn't have (e.g. autism spectrum, bipolar, garden variety ADHD etc). We have tried to some some medication that would help with some of the impulsivity issues cause it effects both his learning and his social interactions so significantly, but he has not been helped by just about anything (stims, mood stabilizers, AP). ONly thing that helped a bit is Abilify, but we can't increase the dose beyond about 5 mg, cause it leads to tics among other things. Recently we decided to do a medication wash to try to see what exactly it was doing--and when we removed it (titrated down very slowly) the tics have reemerged. We see psychiatrist in a couple of weeks, don't know what we will decide to do on the medication front, school is hard right now, both academically and behaviorally, though he is getting adequate support on IEP front. I feel like we need to provide more specific guidance on IEP front particularly on behavior/social side. He seems to have a hard time learning from consequences (a Fetal Alcohol Effects (FAE) problem from what I read). We have let go of many issues. am just really frustrated with how little traction we seem to have with this kid, and how unhappy he is much of the time with our simple rules/structure (like take a bath before you watch tv in the evening). Negotiating a la explosive child doesn't seem to get us anywhere because he can't follow through on anything he promises to do. Plus right now he has started puberty (just shy of 11 years old)!! and I am thinking that our problems are only going to grow. Anyone have any insight into mood/behavior issues with boy puberty, especially early puberty? Anyway, all this is background to my questions. Any of you have children with Fetal Alcohol Effects (FAE)? I am looking for a psychiatrist who is very knowledgeable in this area because of the medication challenges and also for some behavioral/therapist type guidance cause I feel that we are just getting nowhere. Any suggestions on where to go? HELP! and thanks. sorry I will update my info below on him when I get a chance.