sensory integration dysfunction v. bipolar v. adhd

[susiestar]

Has anyone ever tried to treat him for anxiety? It sounds like he is maybe afraid of something?

It must be terribly hard to live with your son, esp since any outing out of the house has him refusing to interact. (but it is better than having him pee on someone's feet the way mustang67chic's dog started doing - JUST a joke! Don't hit me!)

The other kids must be upset at how their lives have changed since he was born. The older two are esp able to remember how it was before he came. And miss it.

How you must worry and be frustrated!!! I am glad you found us - it sure sounds like you can use a soft place. I thought it was hard with Wiz, but he was at least verbal. I am sorry if it sounded like I was criticizing.

Maybe you can try something like the stress eraser (biofeedback gadget used to help learn how to calm yourself - check ebay because I saw used ones there being auctioned much cheaper than the internet price of $149 I saw at a biofeedback place online) could be used to show him that he can calm down - and maybe motivate him to?

Have you tried a prn medication for anxiety or even an antipsychotic like risperdal to help stop the hitting, yelling, shouting in-your-face behaviors you describe? They sound like he just doesn't know how to calm himself or his fears. Could that be part of it? I would think that maybe that would be worth a try, esp given his total lack of functioning outside the home and minimal level of functioning inside the home.

On another topic, I hope you and the rest of the family are able to get some breaks from him. Maybe have husband stay with him and take the other kids for a weekend trip to a hotel? Or a day trip to a kid's museum or other attraction? (And then a day trip somewhere to get a massage and then go and just chill with a cup of coffee or whatever and relax to make up for taking 3 kids to an attraction!).

Also PLEASE remember to make time for your marriage. Even if the little guy spends the time in his room, have someone come watch him and take your husband out to dinner and a movie, or whatever you enjoy doing. If the marriage isn't strong, there is no way for the kids to be as strong as possible. Esp as it sounds like difficult child needs a full time at-home parent.

Taking care of difficult child INCLUDES being sure the rest of the family is taken care of, in my opinion. It is just so easy to forget.

 

[whatamess]

He is verbal. He doesn't even qualify for speech therapy anymore. It's that when he's overexcited or put in front of dr.'s or people he doesn't know, he becomes/chooses to be non-verbal. He is awesome on outings! Museums, zoos, restaurants, vacations- he's all about that. But he doesn't choose to interact with other people (strangers) during those outings, we are his cushion and he is safe/able to explore the world.
We tried Zoloft for anxiety and it made him scary aggressive.
When he hits people it is him being over-stimulated, going too far in rough play,doesn't know his pokes, hits, squeezes don't feel good to others.

 

[smallworld]

If Zoloft is the only medication he's ever tried for anxiety, you might want to try something else. There are a lot of choices out there.

 

[BusynMember]

Susiestar, I am not offended at all by your's or anyone else's posts. I am GRATEFUL to have your input. I know you guys aren't professionals, but you have the everyday life experience living day to day with your difficult child's-I think you guys have more insight than professionals.
As far as the therapist, he comes into our home and I stay in the same room or very close by for virtually every session. This scenario plays out with all people who come to our home (including grandma). We can't get a neuropsychologist evaluation or even see a therapist because difficult child will not interact/speak (we've tried). Every time we've gone to our lastest psychiatrist (probably 10x's), difficult child hides in his shirt and refuses to speak.

Take him anyway. His refusal or fear of communicating is VERY telling and will be a good diagnostic tool. in my opinion I'd forgo the medications until you take him to a neuropsychologist. Bipolar medications are very heavy duty (trust me--I've tested most of them and I would want to be sure my child was 100% positively bipolar before I stuck a kid with those drugs.) If they are needed, they are, but I'd want to be SURE!!!! Many of the medications I've tried through the years made me feel awful, some spaced me out to the max, some just made me feel worse. To me, he sounds like there is a great shot that he is Autism Spectrum Disorders (ASD) and not bipolar. in my opinion it's a good idea to have the neuropsychologist evaluation before starting with the heavy drugs. Little kids are too young to know if they feel horrible because of medication and we, as parents, sometimes think they are "better" when they are no longer acting out--but it could be that they are NOT better, but are doped. I've had this happen to myself so I know. But being an adult, I can tell the doctors what to do with the medications that are doing more harm than good. I do it sweetly .
in my opinion your son's reaction to others indicates more Autism Spectrum Disorders (ASD) than anything else. Bipolar for me is very unrelated to what's going on around me. I can be having a great day and suddenly plunge. Sounds like your little guy is upset by changes and interactions with people. That's different.
See a neuropsychologist. You may need a referral. Insist. By the way, regular therapists are inaffective for Autism Spectrum Disorders (ASD) kids. You need one who is specific to Autism Spectrum Disorders (ASD) kids. They do not respond to regular behavioral methods nor do they attach to their therapists or talk to them. Their issue IS communication. Most need other interventions more than talk therapy anyway. Take care

 

[susiestar]

I agree to try the neuropsychologist again. How does he do in school? Have you ever left him at school or daycare?

He may be overstimulated and not know that he is hurting others. That is NOT bipolar. Bipolar is different, they act out for very different reasons. I agree that Autism Spectrum Disorders (ASD) is likely the answer, and that autistic spectrum specific interventions are needed. I would actually like to see what a developmental pediatrician had to say about him. I think it would be very helpful to work with one. The one we saw had kids who did not interact with him, but HOW they didn't interact was helpful to figuring out what was going on.

I think SSRI medications are a bad choice for kids. SOOOO many of them spin out of control, or are totally disinhibiting that it is scary for them and for everyone else. My easy child daughter was trialed on prozac and on zoloft. Each of them made her seem almost high as a kite. She actually seemed more high than anything else. When we talked about it after the medications wore off she said she felt so out of control it was scary. But at the same time she didn't know how to express how she felt.

We trialed it to help deal with panic attacks. She eventually was given buspar and for during the panic attacks she had atarax or xanax. The xanax dose was teeny tiny, and only for the few weeks until the buspar took effect. After that they were not as bad and the atarax (an antihistamine sometimes used prn for anxiety) was effective.

I think maybe if you can use some prn medications when he gets so overstimulated then maybe the other things like brushing can start to work. It is just a thought.

Otherwise he may need to trial an antipsychotic like risperdal to calm him down so that he isn't hurting others. As he gets bigger he CAN start to become dangerous and at some point he will get to be big enough to really cause significant long term damage to someone, whether he means it or not. My difficult child caused permanent damage to my left hand when he was almost 12. He feels a lot of guilt even now, 5 years later. I am hoping he can shed the guilt at some point. It does no good for him, and I do not hold him responsible. He was ill. To me it is the same as when I got the stomach flu from him vomiting on me when he had it. The risks of parenting, Know what I mean?? But HE feels guilt.

 

[whatamess]

Just tried this last month to get him in for a neuropsychologist. evaluation and they won't take him until he's 'stable'. Well, I tried to get in to that hospital/clinic so they could help me get him stable, it's like a neverending circle of frustration.
I wrote a thread a week or so ago about his school history, basically teachers from preschool up would cross the line with him (dragging him across the room by his shirt because he wasn't attending to the lesson, grabbing his cheeks to force eye contact, refused lunch, held/yelled by police liason officer at age 5 (1st day of K), restraint/seclusion at another school for 3 years among other things, so school is a bit of a problem. I kept him home 3 years and tried going back part time with him this year-went great when it was for short periods with trusted people, but when we went to 1/2 days with- an inexperienced teacher the restraint/seclusion began again.

 

[whatamess]

I am really trying to differentiate between his regular 'high' mood/anxious/adhd and distinct periods that he is 'superhigh' and wild-eyed. His Occupational Therapist (OT), school diagnostician, in-home therapist and I have seen him 'superhigh' and it is a whole different state of being for him and exhausting to watch. My husband thinks it is sensory related.

 

[susiestar]

It seems he may have reason to be afraid of strangers, esp with the way he was abused at school. I didn't tie that thread with this one, for some reason. I am slow sometimes.

Poor guy. He must really be terrified. Is there a developmental pediatrician that might help? Or an autism clinic? I don't know where you live, but the schools are terrible. I would be reluctant to send ANY of my kids to school in that school system.

I think you may have to use medications to calm him so that you can find a way to let him know all strangers won't abuse him. Otherwise this might truly last for years. The longer it lasts the harder it will be for him to ever learn to trust.

I would think about homeschooling if I was in your position. We homeschooled my daughter for the first part of first grade. Her kdg teacher advised me to. Most of the other kids in kdg that were girls were going to the local private school. She would have been in a class with 9 boys who were all related and who were all vicious. They were probably abused, but that wasn't MY problem. In kdt they started working to distract the teacher and whatever aid was there (6 of them required 1:1 aides, but the school only provided 2 part time aids - and they were spread over 3 classes!). Once the adults were distracted, another boy or 2 would pull a girl into the coatroom or bathroom and stick his hands down her pants. It was hideous. For kdg we moms started taking turns helping in class so there was always someone on the lookout for this in each classroom. We re-enrolled her after we moved out of state.

So he may not function in a classroom until he gets some help. I hate to tell you to look to medications, but it sounds like you have tried everything else. Have the docs and tdocs at least trained you to restrain him so neither of you gets hurt? This way he wouldn't hit the other kids at least. But maybe it sends him into panic attacks that are out of this world. All I can do is throw things out htere. If they work, only you will know.

 

[whatamess]

You guys are so sweet. We are ok. We have come to know this as our family's normal (not saying it is normal or that we aren't stressed about it). The last time I had to restrain difficult child was the first week he went back to school 1/2 days in April, he was so stressed. We can ask him to chill out in his room or guide him there or attempt to distract him from poor choices- it can be exhausting, but it isn't like that 24/7. He's a great sleeper (another reason I'm afraid to try more medications -it seems like they all have sleep problem side effects), he's a great eater, and a curious fellow. We definitely have some good times. I'm really trying to figure out how to get him functional at school if at all possible. Everyone in the district is on high alert to his issues and our position (having lawyer and advocate involved), so now is the time for us to try to make it right for him if it ever can be in a school setting.

 

[BusynMember]

What, he isn't manic in my opinion. He is anxious, which is a huge red flag for Autism Spectrum Disorders (ASD). Again, not saying it is, but see a neuropsychologist. I've never EVER heard of a neuropsychologist saying "he has to be stable..." I'd find another one. That one sounds like a yahoo . Manic is not when the child is the most agitated. That's fear related acting out. The more anxious an Autism Spectrum Disorders (ASD) kid is, the more they pace, or vocalize in strange ways, or stimulant (rock or bang their heads) or seeks stimuli by bouncing or squeaking or doing whatever makes them feel better. A BiPolar (BP) kid most likely wouldn't do this because BiPolar (BP) kids have more knowledge of social norms. Autism Spectrum Disorders (ASD) kids do not until they are taught or until they mature--if they are high functioning enough to "get it" (sort of) on their own.

Sadly, it's common for Autism Spectrum Disorders (ASD) kids to get thrown around at school. They act so strange and seem to act out for no reason that a teacher can understand so they chalk it up to defiance and get livid. I was very lucky that L. never acted out at school, however there is a Pervasive Developmental Disorder (PDD)-not otherwise specified boy who goes to school with my daughter, and when he loses is (because he does), the entire school whispers about what a bad boy he is and how "mentally ill." He's not mentally ill. He's autistic and the teachers have not a clue how to handle him. He has a 1-1 aide who is often so bad with him that I cringe. She thinks that normal behavioral methods such as time outs or charts will work with him. The charts work sometimes, when he is calm. The time outs scare him so he goes into a rage and throws his desk (not that uncommon really) and kicks and fights so that he's not isolated or put in a corner, which he can't tolerate.

I've spoken to his father, just sort of sitting back and listening and he has a good handle on his usually sweet and very bright son. But he refuses to let him go into any sort of special classroom and the kids tease him at times. He, like most Autism Spectrum Disorders (ASD) kids, can not control his frustration and goes ballistic on the kids. I'm sure he looks manic, but he's not. He's Autism Spectrum Disorders (ASD).

 

[whatamess]

Midwest Mom-thanks to you and Susiestar and the others for continuing to check back on this thread and reply. difficult child is diagnosed Autism Spectrum Disorders (ASD). Autism Spectrum Disorders (ASD) and bipolar can occur together, can't they? My difficult child's 'high's' can be triggered by anxiety, but they can occur for no discernable reason as well. Last week, he was high flying for two days and no stressors to be found, we even attempted some of his fave things and he was uncontainable- I just want to know is this normal Autism Spectrum Disorders (ASD) behavior or is this sensory related or really a manic state (on top of Autism Spectrum Disorders (ASD)). He went 'manic' after coming off strattera in the spring-two weeks of pure energy (and destruction). He had a bad time with Zoloft- both I've read can cause adverse reactions if given to a bipolar child. Maybe I'm trying too hard to pinpoint it to bipolar, but it just seems to go beyond what is Autism Spectrum Disorders (ASD)/adhd. I don't know. Thanks gals.

 

[BusynMember]

Autism Spectrum Disorders (ASD) kids are also sensitive to medications. MY son became truly manic on Prozac. You don't have to have bipolar to get manic on antidepressants. Does your son ever get depressed?
My son seemed constantly manicky. That made me suspcious too. He didn't seem like a sad kid. Anxious, yes. Strange, YES!!!! Meltdowns? Yes, short ones. But he didn't spend a lot of time too immobile and lethargic to function or sad. Frustrated, absolutely. But not depressed. Yeah, it can be very hard to tell the difference. That's why you may keep needing to evaluate him as he gets older and more stuff shows up.
Does he engage in imaginative play? Many, many, if not most, BiPolar (BP) kids are VERY creative. I used to play with my dolls until I was eleven years old. I put them to sleep each night, and I really wondered if they were real. I covered them. I fed them. I had a whole little family in my room. I wrote stories from age two on. I had an imaginery friend named Tandy. I was known at school for being a dork but the kids did appreciate my creativity very early on, even if they thought I was immature and strange.
Autism Spectrum Disorders (ASD) kids tend to have little and limited imaginery play and get obsessed with the darndest things, such as the alphabet, geography, radios, lightswitches, you get my drift. And they don't really converse. They monologue at people with annoys kids who want to have a conversation. Their eye contact tends to be "iffy" to poor, especially with strangers. BiPolar (BP) kids can make good, strong eye contact and hold a give-and-take conversation.
Just a few of the differences. I still think a neuropsychologist evaluation would help you figure out what is going on. If he has both Autism Spectrum Disorders (ASD) and bipolar, as he gets older you will know it. If he doesn't, his moodiness will improve with interventions.
Ripserdal is one of the most common medications prescribed for spectrum kids who have freak out when frustrated. They gave it to L., but he reacted badly to it.
I'd keep evaluating him every other year just as if he had some sort of low grade fever that you couldn't pin down. It's not really all that different. Psychiatry is just guesswork. Autism Spectrum Disorders (ASD) is neurological, but there is still no blood test to confirm it. Ditto for bipolar. You really need a sharp diagnostician.

 

[whatamess]

Thanks Midwest Mom for your insight. difficult child does not seem depressed, but in last two years has definitely become irritable. Not regular crabby, but the littlest thing will set him off when he's in irritable mode- he stubs his toe -->blames the chair, someone tries to look at his book --> 1/2 hour rant, his brother changes the channel -->freak out! He isn't like that always, but during these irritable phases look out.
I know he has Autism Spectrum Disorders (ASD), so some things that would go with bipolar with a 'typical' child would look different with a bipolar/Autism Spectrum Disorders (ASD) kid (I'm assuming).
Again I appreciate everyone's input as I sort this out. Thanks for your patience, you've all given me a lot to ponder.

 

[gcvmom]

difficult child does not seem depressed, but in last two years has definitely become irritable. Not regular crabby, but the littlest thing will set him off when he's in irritable mode- he stubs his toe -->blames the chair, someone tries to look at his book --> 1/2 hour rant, his brother changes the channel -->freak out! He isn't like that always, but during these irritable phases look out.

Depression in kids looks a lot different than it does in adults, and irritability is one of the hallmarks. I can't imagine why someone who is Autism Spectrum Disorders (ASD) could not also be bipolar, or have a mood disorder resembling that.

You can hunt forever for the right diagnosis, but I think what will tell you the most is when you start to try to treat his symptoms and see how he responds. Unfortunately, trial and error is all we've got to figure out what works.

 

[susiestar]

Sadly, a LOT of what Autism Spectrum Disorders (ASD) kids react to seems hugely obvious to them and for no reason to others watching them have these irritable times or the rages and blowups. They don't see the world the same way we do. They have different rules for how the world works. They make up their own rules for what makes sense TO THEM.

If the toys r us commercial comes on right before the show comes back one time, the Autism Spectrum Disorders (ASD) kid may figure that it will always and forever be that way. So they do something else during a commercial, listening for just htat one ad so they know the show is coming back. Then they realize they missed 5 minutes of the show because the ad didn't come on. They get irritated. And the world seems much scarier because the rules are not being followed.

This is one example. But it applies to every minute of life for an Autism Spectrum Disorders (ASD) child. It helps to try and see the world in light of what they are thinking. I am sure you are already good at this. Margeurite is AMAZING at this. If she weighs in she has a way of figuring out what was the though process. She has given me many a lightbulb moment over Wiz' thinking (he is my difficult child). You might look for some of her responses on other threads.

I have faith that you will figure it out. Always, always follow your instincts. You probably already know this, but they will help you every time. I made a couple of really major mistakes with my difficult child. ALWAYS because I ignored that gut feeling, that little voice that gave me advice different than what the experts or the other family members said. Watch for that trap and you will navigate this mine field we call raising our kids.

About the bipolar kid/prozac mania. I honestly think it is in ALL kids. Some do OK on these medications (strattera is this class of antidepressants, it just also works on ADHD). Some only do okay on certain ones and not others. But many do not tolerate the SSRI/SNRI medications at all. I think parents of kids with bipolar are just more connected and more aware. They saw this and realized it because the medications were used with their kids first. Or because they are more connected on the web. So they started talking about it and many of their kids reacted. Then it was given as a "rule of thumb" that if your child was manic or reacted taht way on these medications, then they were BiPolar (BP). I actually fired a doctor for telling me that Jess was BiPolar (BP). Refused to listen to the fact that unless it was "her week" of the month (and she started having PMS symptoms at about age 4 - docs said her system is just sensitive and women have cyclical cycles from birth but they don't react with periods until later) she never had a mood swing. And her "monthly mood swings" always got better with 2 pieces of dove dark chocolate. Not with the milk choc she loved, but with the dark. I am the same way.

She is so clearly NOT bipolar that even suggesting it just because she reacted that way to prozac is laughable. But anyway, I think it is a far more common reaction than people know, and common to people, not just kids. But in kids it seems especially common. That is my take on it anyway.

It sounds liek you have a great feel for this. Keep listening to that instinct and I have faith that you will come up with whatever he needs.

 

[BusynMember]

One last word on all this .
Kids CAN have both disorders, however, from what I've seen in my autism group (about 150 kids) the doctors are too quick to add the label. Many of us have discussed this. Many of the kids have been on the heavy duty stuff--Depakote, Lithium, Seroquel, Risperdal, Zyprexa, the SSRIS etc..when the source of our son's irritation is again Autism Spectrum Disorders (ASD). These kids do not do well with change (the television channel is changed which interrupted their watching it and they freak out). My son talks to his television upstairs. When he's playing videogames, he will say stuff like, "Mario, that was really dumb!" Daughter, hub and I laugh affectionately. Now that can seem to be bipolar psychosis as in "he hears voices." His psychiatrist was convinced he did. He doesn't.
What L. said to me is, "I talk to me because nobody else is there." He also said, "I talk out loud because I can understand better that way." I asked if he hears voices in his head and he said, "Yes. You just talked to me and I heard your voice." The kids are very literal.
I guess my own opinion is, I would wait. I wish I would have waited before I loaded my son up on drugs. He started medications at age three. His medications included: ritalin, adderrall (oy, what a disaster), concerta, risperdal, zyprexa (both disasters with huge weight gain in a short period of time), Prozac (he got psychotic on this), trilpetal (crankier than ever), lithium (peed in his pants every night, weight gain), seroquel (weight gain), depakote (cranky, HUGE weight gain), Topomax (hyper, cognitively dulled) and I'm sure I skipped a few. They did dope him up so he seemed calmer. He didn't learn much because he was so dopey.
There are kids who NEED these medications and must put up with the side effects. Your son may need one medication, such as Risperdal. My son did better without medications. He's been medication free since he was 11 and he's almost sixteen now. And he is clearly not bipolar. His temperament is evened out and he is very even-keel. Autism Spectrum Disorders (ASD) kids can change. Bipolar kids get worse. And their triggers are different. And their moodswings are different. They aren't triggered by the televison being changed. They just get depressed because they do. That's what bipolar is. Shifting moods. You don't really need a trigger.
Depression IS different in kids. I acted irritable and cried a lot, but it was very obvious to my parents that I was sad. I overheard them talking several times about how sad I was--why was I so sad? Was it them? Autism Spectrum Disorders (ASD) kids are more frustrated in the moment when things change too quickly or things are moved around or they can't do something. It doesn't last.
Use your mommy gut, as Susie said. I wish I'd used mine. Don't let anyone here, including me, influence you. Trust yourself even beyond the doctors because, sadly, as one who had to spend ten years getting bogus diagnoses before bipolar, and seeing my son go through the same wrong diagnosis garbage, I've learned to question even the best professionals. Our neuropsychologist, who had worked ten years at Mayo Clinic, said to me, "Mayo makes mistakes all the time. There are no blood tests. We give you are best guess."
I appreciate his honesty. In my son's case, he is definitely Autism Spectrum Disorders (ASD). But once he got that bipolar diagnosis. it was very hard to shake. Even the neuropsychologist was afraid to take the diagnosis. away from him. I had to say, "Let's try him off medications" and then I had to do it. He is clearly not bipolar, unless bipolar goes away.
Good luck. You have a long journey ahead of you and my best advice to you is to trust YOUR instinct and don't do anything you're uncomfortable with--also in my opinion it's best to go slow, wait, and see. Good luck for the hundredth time

 

[whatamess]

Thanks for all the time you've spent on this thread. I have printed off a chart from the 'Depression and Bipolar Support Alliance' to track difficult child's sleep, severity of mood episodes, overall mood, anxiety symptoms, etc. I think it will give me a clearer picture. Instead of all the bad stuff staying forefront in my mind, I'll be able to see how often he is functional and even-keeled. I'll take it to our next psychiatrist appointment (if we can ever arrange to get in to see a new one-that's a whole 'nother thread).

Thanks again everyone for your support. It helps so much to get different perspectives.

 

[susiestar]

What an excellent idea! You are very right that charting him mood with that form will give you unbiased (as much as anything is) data about how often and how severely his moods change. It will truly let you see a "big picture" of what is going on.

You have gotten some great advice and insight, esp from the moms who are bipolar. I think MWM has such valuable insight now that she and her difficult child are both correctly diagnosis'd. I agree with her that sometimes docs are too fast to give the mood disorder label. Though there ARE docs who refuse outright to give kids a diagnosis other than "mood disorder - not otherwise specified" or just depression. Too often depression is noted because the observer thinks the child is just "happy" instead of manic. This leads to a scary round of antidepressants that sends the child cycling out of control. AD's also send non-bipolar children on wild mood changes - often even seeming high or drunk!

Your difficult child is lucky that you and your family all take this in stride as "just life". in my opinion it makes difficult child feel more "normal" and that is a good thing!

Hugs!!

 

[Marguerite]

Charting sounds like a good idea, even if he doesn't have bipolar as well. We aqlways recommend keeping a good (and long-term) diary on our kids.

ON the subject of "hearing voices" - that same thing actually happened to Wendy Lawson, an Australian social worker and author on the topic of autism and Asperger's. In her book "life Behind Glass" she described how when she was in her late teens and her parents were so worried about her, a psychiatrist asked her, "Do you hear voices?" and she answered, "Of course I do. Doesn't everyone?"
On the basis of that response, she was committed to a locked psychiatric ward for a number of years. And of course, it was as MWM described - all she was saying was, "You HEAR voices, of course. You don't SEE them!"

Kids with Pervasive Developmental Disorder (PDD) are so literal-minded and you have to be so careful how you question them.
That is also importantwhen you're trying to find out what happened - if your quesiton prompts the answer the child is likely to give you the asnwer they think you want to hear.
For example, difficult child 3 after an incident with another kid at school. The other kid goes to the teacher and says, "difficult child 3 just ran up to me in the playground and hit me, no provocation."
The teacher then turns to difficult child 3 and asks, "Did you hit Johnny?"
difficult child 3 replies, "Yes, I did."
difficult child 3 may not tell the teacher, unless he asks, that Johnny actually had been taunting difficult child 3 for an hour beforehand and had finally begun poking difficult child 3 with a stick, then began punching difficult child 3 in the stomach, before difficult child 3 finally hit him back. difficult child 3, who knows it's wrong to hit, knows he did the wrong thiing to hit back and so is expecting to be punished. He doesn't think about the fact that he was provoked or that the other kid also deserves to be punished.
A better way to question the boys (both of them, separately) would be - "Tell me what happened. Now what happened after that? And next?" until you get the whole story, unprompted and untainted.

difficult child 3 often told me of an incident at school (backed up by a witness) but when I reported it to the teacher, difficult child 3 would come home the next day saying, "I really did think Johnny had deliberately tripped me up, I could have sworn I saw his foot come out as I was running past and he had a grin on his face. But Mr X said that because I'm autistic I often don't see things right and I misunderstand; he told me that it didn't really happen tat way because Johnny said I just fell over my own feet. So it must be true, because Mr X told me so."

Kids with autism can misinterpret a situation but their analytical, impartial report is rarely wrong. They certainly won't see something that isn't there.

Marg