Grrrr! Diagnosis Shmosis!

Discussion in 'General Parenting' started by jal, Nov 21, 2008.

  1. jal

    jal Member

    I really thought the new team was onto something with the thought that difficult child may be on the AS. Last night we go to psychiatrist and he's is adamant, betting his last dollar that difficult child is not, because difficult child can engage and joke. Can't people who are high functioning do that or is that impossible? psychiatrist says difficult child is definately ADHD and Bipolar. BUT THERE ARE TRAITS OF BIPOLAR difficult child DOESN"T EXHIBIT!!!!!!! He's never depressed, he's never truely manic and he has never once been up all night. Then there are a few traits he does have. He dismisses the fact that difficult child doesn't make good eye contact (it's the ADHD, he can't focus long enough to do it he says). difficult child used to flap arms and walk on toes when a toddler (dismissed). Now difficult child cannot tolerate a stimulant to save his life. We have trialed 15 different ones. Now psychiatrist wants to trial the Daytrana patch. This should be a lovely weekend! psychiatrist says the psychiatric hospital difficult child was in for three weeks in Aug would have picked up Pervasive Developmental Disorder (PDD) since they are the #1 hospital in the US for autism (difficult child was at Yale). Then I mentioned we are going to push for a new neuropsychologist evaluation and it seemed like psychiatrist was going to shut me down there too, but when I mentioned we could get it as part of our voluntary services he was like well that's a good idea. I was pretty pi**ed that he could not even entertain the idea that this is a possibility. He swears once we get the right medications the only limitation for difficult child would be whatever his level of intelligence is (which is high). Well, we have been with-him almost 2 years and we have not found the right medication combo at all. I know it can take a while, but no medications have ever helped difficult child improve at all. I know they are not the answer, but a little freakin improvement isn't too much to ask for, is it?
  2. Jena

    Jena New Member

    I know it can be so very frustrating i went through the same thing as many did here for so long until we found the right thing that finally worked.

    What makes the doctor say BiPolar (BP)? Does difficult child rage at all, not run of hte mill temper tantrums like really rage, throw stuff, verbally attack you? My daughter didn't fit the criteria for BiPolar (BP) either, so they diagnosis with bipolar not otherwise specified not otherwise specified. Which basically means she does not meet all the symptoms.

    Forgive me for asking i'm quite sure you must of posted before yet what are the main issues you are seeing in your difficult child, that he is struggling with?? I'm guessing attention problems is one of them.

    I too thought my difficult child may of been high functioning autism yet my dr shut it down as well. He said she doesn't present that way at all, she as yours is able to joke (with the right ppl), her responses verbally and facial gestures are not that of a child with high functioning autism.

    Is he still on the seroquel??
  3. trinityroyal

    trinityroyal Well-Known Member

    Jal, I'm sorry that you're continuing to get the diagnostic runaround.

    It seems that a lot of psychiatrists specialize in one thing, see symptoms of that specialty, and then ignore whatever doesn't fit the picture.

    People on the Autism Spectrum Disorders (ASD) spectrum certainly can engage, make jokes and behave in a very social manner. I, my difficult child and my Little easy child are all spectrum-ish to varying degrees, and we can all do this (Little easy child and I to the point of being able to "pass as normal" most days, difficult child not so much...)

    Also, even if the psychiatric hospital was the best in the US for autism, if they were given a psychiatric history that said bipolar, then they might not have been looking for Pervasive Developmental Disorder (PDD) symtoms at all.

    I am glad to hear that you're pursuing another neuropsychologist evaluation. I hope it gives you the information you need to get the right interventions for your difficult child.
  4. jal

    jal Member

    Jennifer - My difficult child rages, physically attacks, throws things, has a very low frustration level, been through 5 daycares, caused me to lose a job of 9.5 yrs., still on Seroquel uping it as of last nights meeting. He has been on Lithium, Depakote, Abilify, Tenex, Straterra, Clonodine, and the 15 stims I won't even list. He has destroyed his beautiful room in fits of rage, no longer has a door or light in his room, broken things of ours in retaliation, used to rip up books as an infant, is a flight risk at home (some times) and at school and daycare, has physically lashed out at peers and authority figures. Attention problem is HUGE! He is currently in out of district placement at a therapeutic school. The therapist at the new school was first to mention autism which has always been in the back of my mind. I reiterated that to his clinician and therapist (they are in home 2x a week) and they presented him at rounds last week and the psychiatrist on staff brought up Pervasive Developmental Disorder (PDD) too.

    Thank you Trinity, your response the other day to my thread gave me hope and this does too. It just seems that there would be some light relief in symptoms with-medications if difficult child was bipolar and ADHD.

    We were in the running to be presented at a conference with a childhood bipolar "guru" next month. It basically in a free consultation for a symposim being held on the subjuect. I was really hoping for the free consult. Unfortunately, we were not chosen. I think becasue difficult child is too young. They had someone too old (13) and they chose a 9 yr. old. I was just really hoping for anther fresh set of eyes.
  5. totoro

    totoro Mom? What's a GFG?

    You know this is so lame! THis is why they are called Spectrums...
    Just like when they were pushing Autism on K. I just truly feel she is not. She has sensory processing disorder (SPD) and I feel that she really has BiPolar (BP).

    N on the other hand seems to really honestly show signs of being on the Spectrum a bit. She to flapped more as baby and toddler and still does it a bit. She toes walked, she spins a lot. BUT SHE MAKES EYE CONTACT!
    Her speech digresses when she is anxious. She does so many other things that can put her on the Spectrum... but the experts or not so *expert* experts don't want to even consider it.
    I at least say well consider the therapies for her, wouldn't they help?

    Sorry this is lame.
  6. trinityroyal

    trinityroyal Well-Known Member

    Let me tell you a little secret about eye contact...

    Everybody, and I mean EVERYBODY who knows me (husband included) would tell you that I make great eye contact and have no issues with it.

    But I don't really. I rarely make eye contact at all. When I was 5 and doing my first dance recital, my teacher told me that if I was too scared to look at the audience, I could look at the clock on the wall right behind them. They would all think I was looking at them, but I was looking just a bit above them.

    From there, I learned that if I look at the spot just above people's eyes, right between their eyebrows, then it is a very convincing show of making eye contact without actually having to do it. Toto, I wonder if N has learned that trick as well.

    Eye contact isn't as good a predictor as everyone thinks it is, because there are some awfully good ways of faking it, such as:
    - Look at the spot between the eyebrows, mentioned above.
    - Look at the tips of someone's eyelashes, either upper or lower. You can shift the gaze if you don't want to seem like you're staring
    - Look at the upper cheekbones.
  7. 'Chelle

    'Chelle Active Member

    I'm kinda shaking my head at your psychiatrist's reasoning. My difficult child can engage - in certain situations - especially with adults in a one on one, even more after he gets to know them a bit better. Start getting more people involved and he starts to shut down. Your difficult child may sit and talk to psychiatrist, but how is he in other situations. My difficult child can get a joke - does your psychiatrist think spectrum people don't find things funny? I do know that sometimes he finds them funny in a different way. Once I was reading a Readers Digest in an office waiting for one of his appointments and laughed at one of the jokes they had in the mag. difficult child wanted to know what was funny and I read him the joke. He thought is was funny, but when I had him explain what was funny about it, his conclusion was a bit round-about and different from the way most people would see it, but when I looked at it the way he saw it, it WAS still funny. My difficult child used to have rages, which stemmed from his anxieties and not being able to truly articulate what he was thinking/feeling/needed.

    However, with these things my difficult child IS Pervasive Developmental Disorder (PDD), I'm sure of it. His eye contact is better, but remains poor in most situations, he doesn't get many social situations (at 15 thinks parties and gatherings like that are stupid and pointless LOL), still can have sensory issues (especially sound and light bother him), and can get a bit "stuck" Obsessive Compulsive Disorder (OCD) about things.

    If you're not sure your diagnosis is right, do get a re-evaluation with a neuropsychologist. Any good doctor, psychiatrist should not be bothered by you getting a second opinion as they should only want what's best for your difficult child.
  8. Nancy423

    Nancy423 do I have to be the mom?

    my difficult child sounds similar and I took the questionaire for Pervasive Developmental Disorder (PDD) and it says she's a possible "mild" but when they screened her in K-1st grade, they said no. She does not give eye contact to new people, but is fine with people she knows. she used to hit her had with- her palms when upset and her room is full of holes, no door, and broken toys (well , used to be until we tossed everything in a room stripping) we've been given Rx's for all the ADHD medications from neurology and psychiatry and nothing worked. One psychiatrist said she's bipolar (I don't think so). i'm finding that some docs are not comfortable giving diagnosis's around here - they'll tell you what they're finding but won't put a label on her.

    I wanted to let you know I think we're in the same boat.
  9. jal

    jal Member

    I think you are right about the same boat! My difficult child will hit himself at times when upset, room is trashed, he thinks some things are funny that aren't, but then also finds things appropriately funny. He has definate sensory issues and cannot take a joke. He also gets stuck on things almost Obsessive Compulsive Disorder (OCD) like. We are definately going to push for the 2nd neuropsychologist evaluation.
  10. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    This is up to you, jal, but I think the person who diagnosed him as definitely not having any form of Autism, including Aspergers is not informed. My son has it and he has a GREAT sense of humor. It's a quirky sense of humor, but it's great and he laughs at jokes. And he is DEFINITELY on the spectrum.
    They tried to push "bipolar" at us too, but we knew better. He didn't act bipolar. He acted like a spectrum kids. The medications were very heavy duty and caused severe side affects (bipolar medications) for three years and he never even needed them.
    Go with your gut. If this man doesn't know that an Aspie can have a sense of humor, he's uninformed. If you want to read a site where Aspies post, and they all have really great senses of humor, try:
    Also on the eye contact, it is also VERY common for Autism Spectrum Disorders (ASD) kids to make eye contact with family, but be unable to do it with strangers. Most little kids, even babies, will meet your eyes even if they don't know you. Go to a grocery store and smile at a baby in a shopping cart and they will meet your gaze and smile back. It's a red flag for autism (although by no means a given). Some Autism Spectrum Disorders (ASD) kids socialize, but they aren't very good at it and often have no friends, which is very sad...Obsessive Compulsive Disorder (OCD)/obsessions are part and parcel of Autism Spectrum Disorders (ASD). These kids can obsess like no others!

    You will see for yourself by reading the Aspie posts that Aspies have clever senses of humor :)
  11. jal

    jal Member

    Thank you MWM. difficult child has poor socialization, no close friends. As a baby this kid was great but at the time he hit around 2 all this started. He has trouble making and sustaining eye contact with everyone including myself and husband. I am really thinking that psychiatrist is wrong. Although difficult child exhibits a lot of bipolar traits there are a few key ones he does not and the sensory stuff that goes on is unreal. difficult child used to complain about the sun burning him while riding in the car, I would start the vacuum and the kid would freak by running all over the house, jumping on furniture and the vacuum (those things have stopped), but he is constantly on the go like a motor, can't sit still, never. Falls out of his seat at class because he squirms so.

    Example: After dinner this week the clinician was coming for a session. difficult child wanted ice cream for dessert. We asked him to wait a bit. He rushes through dinner just to get dessert. He wigged out. Got on the couch, couldn't sit still, writhing his body all over if while complaining about not getting ice cream right this minute (this lasted about 15 min). husband comes over and difficult child hits him with a pillow twice. We send him to take space in his room. He goes into total meltdown, throws his body onto the floor (without using his hands, he often just collapses face first). Both husband and I have to carry him down to his room. He is screaming, trying to hit and bite. We place him on the floor in his room and he goes on and on. The clinician comes in - something gets thrown down the hall by him. It takes a bit of time, maybe 10 min in his room before it becomes quiet. He had fallen asleep.

    The school nurse where he used to go to school had mentioned to me that his episodes are almost seizure like in the he has this huge meltdown, wigs out and then falls asleep. It has been a pattern. I asked about and EEG and was tol well he'd have to have the seizure activity while he was hooked up to it. I have asked about an MRI and was told that there is no physical reason for it. UGH!
  12. jal

    jal Member

    MWM - I tried the link but it said the site was under construction.
  13. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Jal, I knew my son was misdiagnosed. Autism Spectrum Disorders (ASD) kids do have a few bipolar traits, but my son was just too different from most bipolar kids to have it. Bipolar kids tend to be friendly, even if they are obnoxious or overbearing. They also can have sensory issues, but extreme sensory issues is more an Autism Spectrum Disorders (ASD) trait. The isolation is really big with Autism Spectrum Disorders (ASD). I would move on and get another evaluation. Our doctor was wrong and insisted it was bipolar, and I"m so sorry we stuck with him for three years. That was three years of heavy duty medications, fifty pounds that my son gained on the medications, and being cognitively dulled. Worst of all, he didn't get his Autism Spectrum Disorders (ASD) interventions grrrrrrrrrr. Obsessive Compulsive Disorder (OCD) is just part of the life of a spectrum kid. They have "special interests" and can't let go. I have bipolar Obsessive Compulsive Disorder (OCD) and it's a different type of Obsessive Compulsive Disorder (OCD). It's up to you, but I'd find somebody else with lots of experience with high functioning autism. Sadly, many psychiatrists don't know much about it. That's when they push the bipolar diagnosis. They understand bipolar--it's a psychiataric disorder. Autism Spectrum Disorders (ASD) is a neurological disorder and many just don't "get" it or don't keep up enough to know about it--it's only been acknowledged for a little over ten years. Before that our Autism Spectrum Disorders (ASD) kids were considered SEVERE ADHD or mentally ill or mentally retarded (even when they really weren't). There is so much hope now, I wish all our health professionals kept up, but not all of them do. (((Hugs))) PS--Did you want the Pervasive Developmental Disorder (PDD) Assessment Test online link? I'll get it. Also, I would NOT trust any school assessmsents AT ALL: Developmental Disorder (PDD)+asse
  14. jal

    jal Member

    Thank you - I did the Pervasive Developmental Disorder (PDD) online test and it came back moderate. The school he is in now though is therapeutic. It is split up for kids who have emotional/behavioral issues, autism, down syndrome, wheel chair bound etc. His new school therapist was the first one to call me to mention this and he had only been there 3 days. Next the clinician and therapist from DCF voluntary services presented him at rounds and felt he was Pervasive Developmental Disorder (PDD) and so did that psychiatrist on staff. I have often wondered. Thank you so much for all of your inut. I really felt put off by the psychiatrist last night. I am going to start looking for another opinion.
  15. trinityroyal

    trinityroyal Well-Known Member

    Jal, if the school therapist, DCF voluntary team and psychiatrist are all agreeing with your mommy gut feeling, then I think you're right to seek another opinion. Even without that, if you're feeling put off by the psychiatrist, it's time to find another one who can work WITH you not agin you.

    Hope you get the answers you need.