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Help me figure out the differences between autism and antisocial personality disorder
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<blockquote data-quote="buddy" data-source="post: 539748" data-attributes="member: 12886"><p>It is such an interesting question. My thoughts go all over the place on this and I imagine my response here will reflect that. I do think kids can have more than one diagnosis. If you take a kid who has Down's for example then disrupt their bond with neglect and abuse how can they not also have emotional challenges. People with neurological conditions have no immunity to chemical imbalances, genetic conditions, brain injuries from accidents and illnesses, so I do think some kids are just that lucky, they get to have more than one thing happen to them. </p><p></p><p>The thing about any kid is they can learn things, so kids with autism/asperger's clearly can learn or why bother with therapy at all?? I know for sure Quin has learned not always from direct copying but from doing something maybe random and impulsive or echoic or imitative at first, but over time it got him something....mostly attention that he craves so much but is so inept at getting using higher cognitive skills. When you look at manipulation in terms of the broadest definition, even a baby/toddler does that, it is how they get their needs and wants met. I think even kids who are not cognitively delayed academically can be at a very immature level emotionally and use toddler laws to get what they want. Are some people who fit the definition of antisocial really very delayed? </p><p>I DO believe kids with autism can have certain mental health diagnoses, I absolutely believe Q's early history of chronic pain and disrupted parenting caused attachment problems. He would panic and need to have the last of every food item when younger, would cry if I ate the last of my food without sharing some. If he saw a box was nearing empty he would cry. Kids with autism and healthy bonding are different with their parents, much closer than with other people even if it does not look developmentally normal. We have had to teach that here, and work hard at any degree of secure bonding. I know for sure Q feels things and he gets overwhelmed by his feelings. I dont think he is a sociopath, but he is definitely egocentric and he will smile and laugh inappropriately at sad things. Many kids with autism do that and many people with brain injuries do that. He still is upset over his cat dying two years ago. Yet, he did things that were unkind to him at times. He heard a little girl singing on the radio and said, awww that is so cute! He has said really sweet things, like your difficult child when he called to say sorry your dad died....asking to go check on my mom after her surgery and then when he arrived he actually went up to her and said, So, how are you feeling today? Then even waited for the answer! HE has no abiliy to hide or sneak for long. Doesn't get that other people can see through what he is doing so easily, and he does not have that classic Reactive Attachment Disorder (RAD) symptom of being superficially charming and then terrible to me or sneaky. But it gets so weird when he realizes he is really upsetting me then gets a smile on his face like, good! I got you! Sometimes I think it is defensive because he has never wanted people to know if he is hurt, upset, needs help, etc. But I know it can be just an automatic symptom that happens with his kind of brain injury too. And he has that I'm gonna not care about you before you get a chance to not care about me control thing going on sometimes. But after an issue happens, in his quiet thoughtful moments (car rides, on the way to falling asleep) I hear him ask questions like, do you think they will still be my friend if I show them that I wont do that again? He tries to think of things he can do to make them feel better, etc. He has on his own written me sorry letters. </p><p></p><p>But how can we not wonder, worry, no matter the diagnosis, how this is gong to play out for their lives in the long run? Some ARE vulnerable to predators...people who will suck them in and use them to do their dirty work. (and yes some become predators). That has already happened to Q. I suspect Terry, your difficult child has been manipulated many times too. He makes choices but is not really able to make choices that will benefit him in the long run. His choices are pretty short term goal oriented. And if a "friend" asks, he will do many things and would probably say your are stupid to think they are using him. I am guessing this based on his history not just current things, I mean....it is not like he has sudden behavior issues, right? So, if he has improved in his ability to handle some Aspie issues, can get himself into "friend" groups (maybe...again, are they using him??? hard to say)....then the same symptoms may now look more straight antisocial, rather than more egocentric. Of COURSE puberty adds to it, again, disabled kids are not immune to the effects of that, but it can be more dramatic since they already have those tendencies. Quin will say yes to anything if he thinks someone will pay attention to him and he can be "one of the guys". I have heard many kids with autism in social skills groups say things like, I just want him to play with me, or why wont the kids let me join the game? It is heart breaking. They also most certainly can try and like the feeling of drugs, and for them it becomes so super complex because they already had impulse control issues or judgement challenges, etc.</p><p></p><p>So, what can we do but look at each area of deficit or problem behavior and work to teach the skills needed in a way that matches their learning style? If their learning style involves direct teaching, role play, writing out the rules or behaviors expected and then discussing how that looks in real life and practicing it??? Well, then so be it. If they show that they are vulnerable or prone to chronic behavior issues, then they need increased monitoring and supervision and rules. </p><p></p><p>Easy said, BUT for so many, when it is not obvious to others (professionals) that this is what is going on, especially the severe end of the spectrum Reactive Attachment Disorder (RAD) kids, kids who really do not feel for others and despite the knowledge that the parents have that they were exposed to chemicals or alcohol, that they had disrupted bonding histories when very young infants thru preschool years, etc.....there is so little help. Their brains may be just as disordered as a child with CP but because they have behaviors that hurt others, or they can fake it in public or around decision makers, the help and support to increase supervision is not there unless you can independently pay for that all day every day. </p><p></p><p>It sometimes feels just too overwhelming.</p><p></p><p>I dont think your son is a sociopath. Just MHO, does that mean his behaviors or his developmental status isn't just as challenging right now? NOPE. I'd agree that he has lost the chance for now to make decisions about where he goes and what he does without supervision. And I would not trust the parents of his "friends" since clearly there are issues you have mentioned several times with supervision in those homes too. </p><p></p><p>I wonder for him about day treatment of some kind? Even public school is not going to provide the level of supervision he needs unless they agree to his having an aide nearby, but there is the bus too (or if he walks, rides bike etc...) and those are the danger times. </p><p></p><p>I think switching him to one of those really limited phones is a super smart idea, he is vulnerable and does need to contact you but if that doesn't stop some of the things he does, then he simply has to follow the schedule you provide and is agreed on ahead of time or he does not get to do anything. I am at that point with Q so I do not say that lightly. Even as limited as his choices were, they are nearly gone. Everything that has a chance of his being around people who know him is supervised directly. If I am at a mall or something, he can walk to different stores and then come check in with me, but when he doesn't know people he has tunnel vision and doesn't notice anyone so not worried about that yet. He is too afraid of strangers. I can't imagine doing this if he had been as independent as your son, but my sister is dong that with her son who recently got into some issues (he has adhd) and yeah, stinks to be him right now...no phone, no iPod, no computer, no going to friends houses, no going anywhere without the family group right now. He is adjusting now but not thrilled for sure. (this is the kid who gave or sold...jury is still out but I have MY opinion...I think it is a combo...his Concerta that the nurse gave him to bring home at the end of the year....school was wrong to do that, but he still has to deal with the consequences).</p><p></p><p>I wish it was an easy answer, it obviously is on my mind a lot too as you can tell by my post which again, I am sure makes little sense, but it is just where my mind goes when so overwhelmed and hoping there is not a bleak future for my son...or any of our gifts from God.</p><p></p><p>I do worry that people will see Q more as a thug as he gets older. Maybe he will act more like one too??? It is really scary.</p></blockquote><p></p>
[QUOTE="buddy, post: 539748, member: 12886"] It is such an interesting question. My thoughts go all over the place on this and I imagine my response here will reflect that. I do think kids can have more than one diagnosis. If you take a kid who has Down's for example then disrupt their bond with neglect and abuse how can they not also have emotional challenges. People with neurological conditions have no immunity to chemical imbalances, genetic conditions, brain injuries from accidents and illnesses, so I do think some kids are just that lucky, they get to have more than one thing happen to them. The thing about any kid is they can learn things, so kids with autism/asperger's clearly can learn or why bother with therapy at all?? I know for sure Quin has learned not always from direct copying but from doing something maybe random and impulsive or echoic or imitative at first, but over time it got him something....mostly attention that he craves so much but is so inept at getting using higher cognitive skills. When you look at manipulation in terms of the broadest definition, even a baby/toddler does that, it is how they get their needs and wants met. I think even kids who are not cognitively delayed academically can be at a very immature level emotionally and use toddler laws to get what they want. Are some people who fit the definition of antisocial really very delayed? I DO believe kids with autism can have certain mental health diagnoses, I absolutely believe Q's early history of chronic pain and disrupted parenting caused attachment problems. He would panic and need to have the last of every food item when younger, would cry if I ate the last of my food without sharing some. If he saw a box was nearing empty he would cry. Kids with autism and healthy bonding are different with their parents, much closer than with other people even if it does not look developmentally normal. We have had to teach that here, and work hard at any degree of secure bonding. I know for sure Q feels things and he gets overwhelmed by his feelings. I dont think he is a sociopath, but he is definitely egocentric and he will smile and laugh inappropriately at sad things. Many kids with autism do that and many people with brain injuries do that. He still is upset over his cat dying two years ago. Yet, he did things that were unkind to him at times. He heard a little girl singing on the radio and said, awww that is so cute! He has said really sweet things, like your difficult child when he called to say sorry your dad died....asking to go check on my mom after her surgery and then when he arrived he actually went up to her and said, So, how are you feeling today? Then even waited for the answer! HE has no abiliy to hide or sneak for long. Doesn't get that other people can see through what he is doing so easily, and he does not have that classic Reactive Attachment Disorder (RAD) symptom of being superficially charming and then terrible to me or sneaky. But it gets so weird when he realizes he is really upsetting me then gets a smile on his face like, good! I got you! Sometimes I think it is defensive because he has never wanted people to know if he is hurt, upset, needs help, etc. But I know it can be just an automatic symptom that happens with his kind of brain injury too. And he has that I'm gonna not care about you before you get a chance to not care about me control thing going on sometimes. But after an issue happens, in his quiet thoughtful moments (car rides, on the way to falling asleep) I hear him ask questions like, do you think they will still be my friend if I show them that I wont do that again? He tries to think of things he can do to make them feel better, etc. He has on his own written me sorry letters. But how can we not wonder, worry, no matter the diagnosis, how this is gong to play out for their lives in the long run? Some ARE vulnerable to predators...people who will suck them in and use them to do their dirty work. (and yes some become predators). That has already happened to Q. I suspect Terry, your difficult child has been manipulated many times too. He makes choices but is not really able to make choices that will benefit him in the long run. His choices are pretty short term goal oriented. And if a "friend" asks, he will do many things and would probably say your are stupid to think they are using him. I am guessing this based on his history not just current things, I mean....it is not like he has sudden behavior issues, right? So, if he has improved in his ability to handle some Aspie issues, can get himself into "friend" groups (maybe...again, are they using him??? hard to say)....then the same symptoms may now look more straight antisocial, rather than more egocentric. Of COURSE puberty adds to it, again, disabled kids are not immune to the effects of that, but it can be more dramatic since they already have those tendencies. Quin will say yes to anything if he thinks someone will pay attention to him and he can be "one of the guys". I have heard many kids with autism in social skills groups say things like, I just want him to play with me, or why wont the kids let me join the game? It is heart breaking. They also most certainly can try and like the feeling of drugs, and for them it becomes so super complex because they already had impulse control issues or judgement challenges, etc. So, what can we do but look at each area of deficit or problem behavior and work to teach the skills needed in a way that matches their learning style? If their learning style involves direct teaching, role play, writing out the rules or behaviors expected and then discussing how that looks in real life and practicing it??? Well, then so be it. If they show that they are vulnerable or prone to chronic behavior issues, then they need increased monitoring and supervision and rules. Easy said, BUT for so many, when it is not obvious to others (professionals) that this is what is going on, especially the severe end of the spectrum Reactive Attachment Disorder (RAD) kids, kids who really do not feel for others and despite the knowledge that the parents have that they were exposed to chemicals or alcohol, that they had disrupted bonding histories when very young infants thru preschool years, etc.....there is so little help. Their brains may be just as disordered as a child with CP but because they have behaviors that hurt others, or they can fake it in public or around decision makers, the help and support to increase supervision is not there unless you can independently pay for that all day every day. It sometimes feels just too overwhelming. I dont think your son is a sociopath. Just MHO, does that mean his behaviors or his developmental status isn't just as challenging right now? NOPE. I'd agree that he has lost the chance for now to make decisions about where he goes and what he does without supervision. And I would not trust the parents of his "friends" since clearly there are issues you have mentioned several times with supervision in those homes too. I wonder for him about day treatment of some kind? Even public school is not going to provide the level of supervision he needs unless they agree to his having an aide nearby, but there is the bus too (or if he walks, rides bike etc...) and those are the danger times. I think switching him to one of those really limited phones is a super smart idea, he is vulnerable and does need to contact you but if that doesn't stop some of the things he does, then he simply has to follow the schedule you provide and is agreed on ahead of time or he does not get to do anything. I am at that point with Q so I do not say that lightly. Even as limited as his choices were, they are nearly gone. Everything that has a chance of his being around people who know him is supervised directly. If I am at a mall or something, he can walk to different stores and then come check in with me, but when he doesn't know people he has tunnel vision and doesn't notice anyone so not worried about that yet. He is too afraid of strangers. I can't imagine doing this if he had been as independent as your son, but my sister is dong that with her son who recently got into some issues (he has adhd) and yeah, stinks to be him right now...no phone, no iPod, no computer, no going to friends houses, no going anywhere without the family group right now. He is adjusting now but not thrilled for sure. (this is the kid who gave or sold...jury is still out but I have MY opinion...I think it is a combo...his Concerta that the nurse gave him to bring home at the end of the year....school was wrong to do that, but he still has to deal with the consequences). I wish it was an easy answer, it obviously is on my mind a lot too as you can tell by my post which again, I am sure makes little sense, but it is just where my mind goes when so overwhelmed and hoping there is not a bleak future for my son...or any of our gifts from God. I do worry that people will see Q more as a thug as he gets older. Maybe he will act more like one too??? It is really scary. [/QUOTE]
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