I can understand the concern about medication. We have three OCDs in the house, only one on antidepressants - difficult child 1. For him, it works well. He has tried to cut his medications back but finds himself pacing the house, constantly checking and re-checking doors and windows.
You can TRY behaviour modification, but frankly, we've had t learn to live with it.
Antidepressants are the medication to recommended, because a lot of Obsessive Compulsive Disorder (OCD) is anxiety-based. So anything you can do to reduce the child's anxiety, is a good start.
Looking at your son's "list" - he has ADHD, speech delays, Obsessive Compulsive Disorder (OCD) - what's Auditory Processing Disorders (APD), by the way? I'm wondering if you've had him checked out for Pervasive Developmental Disorder (PDD). It would explain things under one blanket, instead of different labels.
Have a look at
www.childbrain.com and look for their Pervasive Developmental Disorder (PDD) test. It's not officially diagnostic, because such things are not permitted to be, but you can print out the results (whatever he scores) and take the printout to a doctor or therapist for their opinion.
One important thing to bear in mind - you need a good reason to rule out Pervasive Developmental Disorder (PDD). It really requires an assessment, not simply someone talking to him for a while and saying, "no, it's not Pervasive Developmental Disorder (PDD)."
difficult child 1 was diagnosed as ADHD when he was 6. I remember asking at the time, "Is it possible he has some form of high-functioning autism? There are things about him that ADHD just does not explain."
I was told no, there was no way he had autism in any form. But I was never given a diagnosis for anything other than the ADHD (which, as I said, never explained the range of problems he had) until he was 15. At that stage he was formally assessed by a psychologist trained in autism plus his pediatrician (it's what we have to do in Australia - in the US, you do best seeing a neuropsychologist).
easy child 2/difficult child 2 was diagnosed at age 10, as having ADD (inattentive-type) with some Asperger's traits. Since then we've been told she doesn't have Asperger's itself, only traits. The doctor's reason for saying this - she makes good eye contact with him. But she says herself, she has to really make an effort to make eye contact, especially with people she doesn't know well. She knows this doctor very well so the eye contact isn't an issue - with him. When we do the Pervasive Developmental Disorder (PDD) test on her, she scores as mild Pervasive Developmental Disorder (PDD).
Although we see Obsessive Compulsive Disorder (OCD) traits in easy child 2/difficult child 2 and difficult child 3 (plus difficult child 1, of course) they are not medicated for anxiety. We handle it in other ways, in general trying to find techniques to help them calm themselves (deep breathing is good) and to try to give them an environment where they feel safer. For difficult child 3, this has meant home schooling.
We're also having problems with difficult child 3 NOW, which are connected to his history of language delay. I've posted about this just this week, if you want to have a look to see what can happen further down the track. Although difficult child 3 would probably score as normal NOW when tested for current gross language dysfunction, he is having subtle problems related to his ability to mentally connect words and ideas at the same rate as people who had no history of language delay. Different parts of the brain get pressed into service, for language use, and this means that although he functions well, it is in a sufficiently different way that he needs to learn differently, to be taught differently, in order to be able to cope.
difficult child 3 is 14 now, I'm just giving you a heads up for when your son is getting older and beginning to have trouble in more subtle ways with some school subjects.
difficult child 3's language caught up fairly well by the time he was 7 or 8. I remember his school counsellor saying, "Isn't it wonderful to see how well difficult child 3 is doing! He's talking - no more language delay there - and he's mixing with the other kids. It's great to see he's no longer autistic."
Unfortunately, it doesn't work like that. difficult child 3 said it best himself when he was 8 - "I'm getting better at pretending to be normal."
A label doesn't change your child in any way. All it changes is maybe your perception of your child, and it can make it easier for the child to get the right sort of help and support.
My three youngest kids still have their ADHD diagnosis and take medications for it (stims). The stims make a HUGE difference in their ability to cope. In fact with difficult child 3, the stims help him function, with language. When he's been on too low a dose, his communication is affected. When the medications haven't been working at all, he has even begun to lose his speech. His understanding is still there, but his ability to mentally access the words he wants to say, seems to be what is affected. As a result we go to great lengths to make sure he has his medications. A day missed here or there - no effect on language. It was after four or five days we began to notice problems.
difficult child 3 started on stims when he was 3 years old. You can imagine the reactions we got. But because the response was so marvellous, we stayed with it and ignored the critics. Not easy.
How does the Obsessive Compulsive Disorder (OCD) manifest itself with your son? Is there any reason it cannot be tolerated or accomodated?
Marg