My son is 14. He was diagnosed with ADHD tourettes Aspergers Obsessive Compulsive Disorder (OCD) and a mood disorder. He has been very difficult since birth. He has dangerous anger to people and destruction of property. It has happened at school and home. But he is constantly cussing and arguing and talking and gesturing sexual. It is like an obsession. He gets great satisfaction from it. What can we do? He does it in front of my girls. No behavior plan has helped. No Dr. Or counselor has helped. I am desperate.


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Has your son been in residential treatment before? It sounds very appropriate for him at this time. Is he compliant if on medications?

"A residential treatment center (Residential Treatment Center (RTC)), sometimes called a rehab, is a live-in health care facility providing therapy for substance abuse, mental illness, or other behavioral problems. Residential treatment may be considered the "last-ditch" approach to treating abnormal psychology or psychopathology."
No he has never. The Er sent him home. I have no clue how you find one of these centers? He takes Risperdal guanfacine Prozac and strattera. All are at maximum amounts.


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My son is 14
To be fair: puberty is a massive challenge for ALL kids - whether they have other challenges or not. And schools and social media make it worse.

He was diagnosed with ADHD tourettes Aspergers Obsessive Compulsive Disorder (Obsessive Compulsive Disorder (Obsessive Compulsive Disorder (OCD))) and a mood disorder
ADHD is a common diagnosis, and does not explain his behavior - but it is frequently co-morbid with a wide range of other diagnoses.
Obsessive Compulsive Disorder (OCD) doesn't explain his behavior either.
Tourette's is more obvious. Is the cussing and sexual gesturing part of that? Or is his Tourette's more subtle?
Does he have an actual mood disorder diagnosis? As in... bi-polar, or depression, or anxiety... ?
Who provided these diagnoses, and when?

He has been very difficult since birth.
So, this isn't just something that started at birth. I'm guessing puberty made it all worse. Can you tell us more about his early years?

He has dangerous anger to people and destruction of property. It has happened at school and home. But he is constantly cussing and arguing and talking and gesturing sexual

He does it in front of my girls.
Is this a step-son? How old are the girls?
You may need to put their safety ahead of his well-being.


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He takes Risperdal guanfacine Prozac and strattera
Straterra is known for all sorts of side effects and drug interactions. Especially with Fluoxetine (Prozac) and risperidone (risperidal), among others.

If the risperidone isn't impacting his behavior, then he's on the wrong medications or has the wrong diagnosis.

Also note that risperidone isn't a long-term medication. It tends to cause liver damage. It's just usually a first-try drug, because it doesn't have such a long ramp-up.
No he is my birth son. He is their brother. They are 9 and 16 and 20. The 16 year old called the police a few weeks ago because she was scared he was attacking us and the house and coming after her. He cried a lot as a baby. He had fevers and chorea after shots at a year. After that he was very irritable and regressed and hard to handle. Around 3 he became obsessive. He had tics. He would throw fits over things. He couldn't sit still for school. They diagnosed him with tourettes and ADHD. Started medications. He showed learning problems. Began to be oppositional and fixated on things. Diagnosed him with Obsessive Compulsive Disorder (OCD) and Aspergers. doctors counselors and he never got better. Lots of meltdowns and destruction of property. Attacking us. Then they added mood disorder. They claim don't diagnose in a child bipolar.


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OK, reviewing the updated list of diagnoses?
Asperger's is an umbrella diagnosis. Pervasive. There are a LOT of potential co-morbid diagnosis here - including ADHD, Obsessive Compulsive Disorder (OCD), anxiety, learning disabilities.

There is no medication for Asperger's. It is a differently-wired brain. His needs were different from the day he was born. And... while knowledge about Asperger's and Autism Spectrum Disorders (ASD) have been out there for many decades, getting that info down to the practice level and getting early and accurate diagnosis has been lagging far behind.

They claim don't diagnose in a child bipolar.
If they won't diagnose bi-polar when it exists (don't get me going on that one)... then at least they have to give you DMDD. And this group of mental illnesses are major - not situational depression, for example. Hyper-sexuality often goes with bi-polar.

He's in a family of six. Of which the siblings are all girls. (sorry, it's bad enough with brothers and sisters when all of them are neuro-typical. Neurotypical girls are going to make a non-neurotypical fellow feel really inadequate really fast. Even when they do not intend to)

What kinds of interventions has he had from a young age? Does he have an IEP at school? Is he receiving specific autism services?

Do you have a safety plan for your girls - and for yourself?


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Tourettes is co morbid very often with mental health issues. Has his doctors taught you about it and treated it? Seems as if he has had many diagnoses,which is not uncommon. But its then hard to figure out the root cause. Has he ever seen a neurpsychologist? May be worth it. Testing is intensive and for every possible issue. I recommend it since he has been so hard to pin down.

Good luck.
It has gotten really bad Several times. Police involvement and children services maybe four times. Wrap around twice and county appointed counseling in the home. I am embarrassed to say I got arrested when he was attacking me by the car and I was trying to pull him off of me. Someone saw it and called the police. It was reduced to a misdemeanor. Lots of counselors and social groups. Two school incidents that led to restraining and police.


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how long has he had the "mood disorder" and Asperger's diagnoses?

it sounds like the interventions and services seem to be treating him as though this is a "behavior" problem. Yes, his behavior is a problem, but I really don't believe he is in control of that behavior. He hasn't been taught the skills he needs. And this is NOT your fault.

But if you try to handle an Aspie as though it was a normal rebellious teenager... it's a guaranteed recipe for disaster.
He has had an Iep since grade 1. He has done social skills and Occupational Therapist (OT) and pt. lots of counseling. Problems with schools. Issues with teachers, tutors, bus drivers and friends.
For example 3 days this week we have people to see. Wrap around home counselor and counselor at a place! Why does nothing ever improve? He will cuss the entire ride there and back! Grab my boobs and talk about sex! Plus my other kids are needing my time and attention. We do so much for him. He is in youth group and challenger teams and he goes places we give him money to go. It seems like we reward him constantly but he never is good behaved!


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You ever take him for a neuropsychological evaluation? Plain therapists really dont know how to do evaluations. I agree this is not behavioral.
I think I have. But it was awhile ago. He had testing done by a psychologist in fourth grade. What all does that entail? He had a fba done then and and is getting one again.


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He had a fba done then and and is getting one again.
That is NOT an evaluation. It's totally behaviorally focused.

He needs a comprehensive evaluation - the kind that take 6-10 hours, and include all sorts of other inputs (you, school, other professionals he sees). Typically done by someone with extensive training who specializes in testing (in the US, often a neuropsychologist; elsewhere, it may be a PhD-level psychologist with specialty in evaluations), OR it could be a team approach out of a children's or teaching hospital.

The evaluation should NOT just provide labels. It should be a whole big report - with details about where to go from here
Yes the hospital did it once. Then they had him see a counselor there. That was many years ago. She was a student psychologist. We got nowhere. Did a triple p parenting Thing with a nurse.


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Hi and welcome, Michelle.

You situation sounds very serious.

I am very concerned about your two minor daughters (especially the 9yo). They shouldn't have to live with someone who displays these types of sexual behaviors.

You say he grabs your boobs and talks about sex. Does he do this to your girls? Or even while they are present?

You and your girls need help now.