A medication called atomoxetine has been found to improve some of the aspects of Aspergers syndrome that mimic those of attention deficit disorder. Several studies have used the drug to reduce symptoms of irritability, social withdrawal and repetitive speech seen in this disorder.
Medications normally directed toward treating obsessive compulsive disorder have been tried in children with Aspergers syndrome who have shown obsessive and compulsive tendencies. While the medication doesn’t treat some of the core symptoms of Aspergers syndrome, it has been shown to improve OCD symptoms.
Antidepressants can be attempted in those Aspergers patients who suffer from secondary depression. The depression isn’t generally a part of the Aspergers syndrome itself but is found as a result of some of the distressing life circumstances often found in Aspergers syndrome. Many of these patients know that they do not fit in with others and while some prefer social isolation, others lament their lack of ability to get comfortable dealing with others. This and other issues of self esteem, etc., can lead to depression which is often manageable with antidepressant medication.
Finally, Aspergers syndrome patients often suffer from debilitating insomnia. While it’s best to use non-drug ways of controlling the symptoms, some Aspergers disease patients can make use of sleeping medication that doesn’t have to be addicting. Sometimes a short course of sleeping medication can get a patient back into a regular sleeping pattern.
Medications directed at anxiety may be necessary when the Aspergers patient suffers from nervousness or irritability surrounding their life situations. Aspergers patients can become quite distressed by things not being the same or as expected, and anti-anxiety medication can help with this.
In truth, there is no single medication or class of medications that works to treat many of the core symptoms of Aspergers syndrome. Some of the secondary or related symptoms can be effectively managed, however, with certain psychotropic medications.
The Aspergers Comprehensive Handbook
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Medication will help in very specific ways. Medication helps in reducing panic attacks, anxiety and aggression and explosive behavior. AS kids have restricted interests by definition of the disorder. They focus in on details on whatever it is they are talking about. Even with medication. But it helps to have the medication reduce some the stress. A good book to refer to for doses for AS kids is "Clinical Treatment of Autism" by Dr. Eric Hollander (From Mt. Sinai Autism Center) For example, AS kids start at low doses of Zoloft (25mg up to 50mg) or Prozac (10mg up to 20mg).
What else is needed is a different approach. Many activities need to be rehearsed in very small steps over years of exposures. And with a positive reinforcement plan. I have found Yale University Parent and Child Conduct Clinic very helpful. I have been trained by them on the phone over the last two years.
Here are some strategies:
1) Avoid stores with him until you can work on a behavior plan with him on this. When you have time, he needs to be taught to shop from a list, stick to a budget, ignore items he sees that are not on the list and that shopping is a reward to be earned by doing both. Tagging along with parents shopping is going to be irritating to him for a long time in the future.
2) Only pair him up with kids that are younger or not challenging personalities. Make the social activity predictable (movie, with defined snacks), or (park and a drink and chips we bring with) or (bowling 2 games and a snack and drink). Rehearse the social activity. And praise all positive behavior. Often as they get older, they will start to be able to be more flexible with peers.
3) Practice talking at meals about pleasant things that others are interested in. Don't allow dinners to be all special interests all the time. Practice at some meals taking an interest in the parent’s interests or other members of the family. This is a skill that takes time to develop. If he was shut out of conversation all day at school, then dinner may be his time to talk about his interests. It may have to wait until a less stressful time of the year to practice this skill.
3) Church is going to be difficult. All those people and the noise from all directions. It is an irritating place for many AS kids. My daughter goes to Sunday school (and I have taught the class for 8 years) not church services (except for Christmas and Easter when there is lots of music and we attend the children's mass).
I think parent's need support from a behaviorist. Parents of typical kids and teachers will not understand that these kids need very small steps and exposures to life in general.
Teachers and school staff will push too hard, it is only a certified behaviorist of autistic kids that understand behavior shaping is a slow process of gradual change with positive supports.
A better day for your son would be:
1) Lunch at his favorite place with you only. Agree on your limits ahead of time. The less limits the less irritated he will be. So pick an affordable place with food choices that you approve of.
Practice menu choices. Without a fight. Practice budget. When he can go to the lunch place without a meltdown over menu choices he is ready for your boyfriend to be there and then his son.
The goal of this exercise is to have a positive social experience. Don't expect to go to a busy noisy rushed
place at lunch on Saturday with a group of people and expect him to be well behaved. It all has to be rehearsed and practiced.
2) Find him a church setting where there is very small Sunday school groups for kids his age. Let the teacher know he needs support and understanding.
3)Melatonin tablets are very helpful for relaxing AS kids at bedtime. This really works. The Mayo Clinic recommends them an hour before bedtime. I forgot the dose I use for my daughter, look at the Mayo Clinic web site on Asperger kids and medications. It has made a huge difference for my daughter. She use to get very anxious and had a busy mind at bedtime. Now she is asleep within an hour.
4) Follow this plan: One outing a day, one place, and allow 1 hour or more. Don't rush him to leave. Give him a warning. Offer a small reward if he leaves calmly when it is time.
There is so much to share about parenting an AS child. This is a rushed summary, and I am rushing through the details. But it is meant to give you an idea of the strategies that work. You will find a behaviorist very helpful. Yale was affordable for me. $75 for 45 min and I did get some money from insurance back.
23 comments:
My husband and I have been struggling with our sons bad behaviour for too long now. He is 7 and has aspergers syndrome. We have 2 younger children than him age 3 and 1 and have another child due in April. We are concerned because our son is always hitting, scratching and annoying his siblings.
He is anxious and stressed about the smallest things from going out in the car to having to share a toy or the tv. He constantly worries about stuff when we tell him everything is okay. We are so over it and were wondering what kinds of meds are out there for kids with anxiety that have aspergers?????
He does get social skills classes but this doesn't seem to be helping enough.
My almost 11yo DS was diagnosed w/ Asperger's at age 8. It was a long process where we went through agony w/ the school system, struggled with different therapies, etc. He is now in 5th grade and in a special classroom. At the beginning of the year, he was excellent. The teacher was so surprised at the positive change in his behavior. But, in the past couple of months, his behavior has once again regressed. Last week, he missed 2.5 days of school because of 2 separate incidents. We are at our wits-end, since he will be leaving behind his special class next year when he goes to Middle School (which doesn't have special programs).
The school has been pressuring us for years to get our son medicated, and I have pushed back every step, since medication and it's long-term side-effects terrify me. However, I am starting to worry that the side-effects may be less harmful than if he continues as is. I also worry that he is starting to go through puberty, which makes him even more unpredictable.
My son is 9 years old and has had a diagnosis of Aspergers for a little over a year now. He was diagnosed ADHD/Sensory Integration Disorder at age 5 and eventually properly diagnosed at age 8. Everything was going well for him until the begining of this school year (4th grade). He began to regress. Last Thursday I had the worst day of my life....I had to hospitalize him when he completely quit sleeping and went into what they are describing as a manic episode. He is still there (a psychiatric childrens hospital). I have been told this is common for Aspy kids but was NEVER prepared for it. They took him off the Vyvanse and put him on Abilify.....he is still there and will probably spend a total of 12 days. The change is incredible. I tell you all this to prepare you because I was not. Get your kids help now of you are dealing with agression, regression, and defiance. I have done everything by the book....therapy, meds, etc. I know the frustration, but take a deep breath, hug your child (if he will let you!) and call a psychiatrist. GP's are great but not really on the same page in my opinion. Good luck....
My son has always had problems since he was a baby. Finally when he was in fourth grade the doctor began to believe me and put him on strattera (he was diagnosed with ADHD with inability to focus - he is not hyperactive) and an anxiety disorder. He had a grand mal seizure (supposedly due to the strattera - per the ER).
He is now in the sixth grade, has been getting in trouble every day and his grades are steadily dropping. I have gotten him with a therapist and she says he is a child with aspergers.
I am trying to get him in with a medical doctor who specializes with aspergers but until then my son has two symptoms that I need to be able to find a way to help him with until he sees the doctor. One symptom is that his hands shake (sometimes you can visually see and sometimes you cannot). This of course causes handwriting problems. The other symptom is stomach issues. He either has stomach pains that are pretty troublesome in that they wake him up or he has to come home from school or he has diarrhea that gets him in trouble for having to go to the bathroom quite frequently.
Is there anything I can do until he gets in with the specialist??? Help!!
This has been amazing to read. My daughter has Aspergers and ADHD. She was on Abilify for a while but she got quite overwheight on it, AND although it worked wonderfully in the beginning, it made her more defiant, angry and violent in the long run.
She's now on Lamotrigin, an anti-convulsant normally given epileptic people and it workes wonderfully. She even has times when she's easy going! She also takes a small dose of anti depressants. As a scientist myself, I feel I can safely say that medications can help our Aspies, even though they do not work on the syndrome itself.
At 6, we put our son on Strattera, AWFUL, he had the worst episode of behavior we have ever seen....it is also supposed to be very dangerous for boys physically. Our son has been on abilify for the past 5 years...it has helped, but we think he needs something different. I would love to know more about Lamotrigin and how the switch went and why you chose it...
My 13 yo son had been incorrectly diagnosed as bipolar and was put on Lamotrigine a few years back. We noticed a vast improvement about 2 weeks in. Once he received the Asperger's diagnosis his medication counselor talked about titrating down his dose to eventually get off it. We went to a lower dose and it only took about a week to realize how much he benefits from Lamotragine. He takes 1/3 of the total dosage before school and 2/3 at night. I find he is less defiant and more in control and family and extended family noticed the difference. He also takes Zoloft for depression and a very small dose of natural melatonin to help him get to sleep at night. As my son has gotten older and has started puberty dosing for some of the meds has changed.
I went back and forth with whether or not to try meds for my daughter. I finally thought, ok we will start it and not tell the school and see if anyone notices a difference in her behavior. After about a week, a lunch supervisor at the school saw me and told me, to my dismay " Wow, what are you doing different, you daughter is a different kid." I didn't tell her( advice from my dr- "it's none of their business. If she has bad behavior they will be asking whether or not she got her medication.") After that, how could we not continue to give it to her. It was a hard decision but the best. Risperdal- the miracle drug for us.
Our daughter is almost 5 and has been through SO much. She has been diagnosed with Sensory Processing Disorder, ADHD, Oppositional Defiance Disorder, Mood Disregulation and possibly Aspergers. However, they tell me she is too young to be diagnosed with AS. After much deliberating we decided to try medication. They started with Intiniv but she had so much anger and aggression 'and extreme heightened emotions. We than switched to Abilify and this was Aweful!!! Same response but times 10. We currently have her on Respridol and it is wwonderful so far, she is calmer and is actually sleeping. She still has her personality but seems to have more control. She still struggles with some defiance and impulses but it is an improvement. We understand their is no "cure" for all of her special needs but the medication has definitely helped us have a little room to catch our breath and survive.
Does anyone have any information as to wether a 4 year old can be diagnosed with AS this early? Also have any of you heard of an MRI being helpful in seeing how their brain is responding and getting a more clear Dx?
Thanks and God Bless to all you strong families with Special ones!
4 is not too young to be diagnosed with AS. Our son is 7 and it took us until he was 5 to get the diagnosis that we already knew (I'm a Licensed Clinical Social Worker). We recently started him in Celexa for his anxiety, he has both seperation and generalized anxiety. We should be able to tell soon if it is helping. We had concerns about side affects with Risperdol (weight gain, tremors...) any feed back?
Reem El Zahaby could u please list some of these medications .
April 28 at 12:11pm · Like
Brenda Garza We tried several....prozac, zoloft both for the ocd symptoms...neither helped much. Did a bunch of the adhd ones and all I can say is HELL!
We just started abilify (he's 8) and it has been our miracle! It would take forever to list everything it has helped with. His teacher noticed the difference and I didn't tell her about it. Our home is calmer and life with siblings is easier.
April 28 at 1:55pm · Like
Candice Mays I use Risperidone and Concerta for my son. It really has worked great. If for some reason I needed to change the Risperidone I would try Lamictal for sure.
April 28 at 2:03pm · Like
Kylie Bathman- Ahumada
I have five children 2 with asbergers and my daughter suffers more from it , I tryed melatonen at night but she didn't want to take it , so I just learne to except and deal with each and every day as it comes , but medication aside , iv tr...See More
April 28 at 3:51pm · Like
Brenda Garza we also removed ALL artificial dyes, flavors, and preservatives. we saw a big difference in behaviour and a decrease in migraines as well. it wasn't as hard as i thought it would be, nor as expensive with a fresh and easy nearby. its well worth a try for a month. i HAD to try it before i went back to meds. it just wasn't enough by itself, but it may be for someone else.
April 28 at 11:40pm · Like
Feeling emotional over finding this site and reading all the posts,.. I am a mother of 4 children,.. three of which are special needs and my eldest having just been diagnosed as having Aspergers (Others: Spectrum autism,.. and MR). Her behavior over the past 11 years has gotten increasingly more difficult and have finally decided,.. that whether I like them or not; right now may be a good time to start her on medication. Tried them on her when she was much younger and the results scared me away for years (this of course before this diagnosis). (Classic social disorders, OCD, insomnia, lack of empathy and hyperactivity being within her diagnosis.) After reading your many posts, I do in fact feel much more relieved and confident in my decision to begin her on them. Thank you all,.. even though am new here just hearing all your insights has helped me tremendously with a severe internal struggle. Keep up the wonderful work,.. both at home and here,.. E.
My now 12 year old son was diagnosed 2 years ago now...it took us 2 years of testing to get him diagnosed but that's a whole different story...lol
Anyway...his Psychiatrist asked if we wanted to try meds. At this point we really had no choice as he wasn't functioning at all. Home was awful...don't even talk to me about school. Anyway she put him on Risperdal the M-tabs so his weight gain wouldn't be as bad since that is a side effect.
He was a totally different kid within 2 weeks. We were awe struck and still are. We have 4 kids and he is by far the most polite, sweetest, generous and thoughtful of them all:)
this has been helpful mau 14 year old aspie hit puberty and we are looking into meds. Thanks
please HELP!! My son is now 18 ..I have been trying to get proper dianosis since he was 6...thats anouther LONG story. How ever he was diagnosed "borderline" aspergers(???) three years ago. He has a BIG issue with types of foods he will eat, he has Never had red meat in his life will only eat breads, only one type of mac and cheese, chicken in nugget form only and one certain brand name peanut butter, green beans,and very few other foods. I am at my witts end I give him vitamins but I think it is still damaging his body and health. He was taken to the er yesterday from school he had face numbness and paralisis and stiff and cramped and screaming in pain from his elbows down..no help from er dr's it went away in about an hour and he was sent home with a follow up to his dr. I think its due to nutrition . Has anyone else had eatiing issues and is there a medication for it !! ???
Yes she is 13 now. She eats only certain kind of foods. I can count on my hand the vegetables she eats. No foods that are mixed like a taco. A taco shell only has cheese in it. She is a meat eater. But no salads,tomato, or stuff like that. I was told to prepare food for the family but to always have something she will eat. Can't get her to try any different foods. She takes a multi-vitimin. I've learned to accept her the way she is. I don't fuss about it. She one kind of turkey chili and one type of can soup. She learns differently,processes differently, and eats differently. Don't we all.
My son is on Abilify, Concerta, and Lamictal. The Abilify and Concerta help him a lot – abilify with his oppositional behavior and the Concerta with attentional deficits. I’m not sure if Lamictal is doing anything – he has only been on it for a couple months. What are the meds that your son is on?
Very recently, our son asked us about getting on an anti-depressant. I need some guidance about meds.
Our 18 year old with very high functioning aspergers is in his senior year at a school for kids with learning differences. He's doing fine academically but continues to struggle with anxiety and depression...it's hard to know which comes first or if they are separate issues. He doesn't cope well with stress/anxiety...I see a pattern of withdrawing from situations that appear to be going very well for him from our persepctive, but which present too much anxiety for HIMSELF. For example, he will just quit an activity that he has loved for a long time and in which he has done very well when it comes time for him to assume or continue in some leadership role. This happened in sports (very gifted baseball player), ROTC type program, and an Explorer type program. Additionally, he is a very rigid thinker and rule follower which I'm sure complicates his anxiety level around some of the structured activities he enjoys when things haven't gone the way they "should" or when other kids aren't following the rules. He can be very stubborn too...after making a decision that he won't do something anymore, it's almost impossible to get him to change his mind through reason. We believe that his anxiety anticipating things is very high...for example, on the day of the test last year he refused to take the ACT. Similarly, he has driven fine for the past 2 years with his permit, but he just will not go and take the test to get a real drivers license when we suggest taking him.
He has also done some cutting, and this has been situational rather than continuous behavior (for example, after a breakup with a girl). As parents, we see anxiety more of the issue than depression since he's upbeat/content during the summer and vacations. He has also successfully held a very part time retail job during Christmas and summer breaks that requires dealing with the public and other employees, but no stressful responsibilities. The feedback we get from his coworkers is incredible. But even in that, we usually have to push him to go back "I won't know the answers to customer questions", he says, because stock changes so much between the times he works.
Except for a brief crisis period when he was 15, he's not been on any meds as we tend to want to go "natural" after seeing some worrisome facial tic development during that brief time (all resolved once off meds). First, I see this as positive in that he is self advocating for himself. His current counselor is a P-LCSW who has had a lot of experience working with kids with aspergers. In private discussion with him, he is in agreement that a med might be helpful. But we want to maximize the chance that the first med he takes is the best choice. Since the issues with our kids on this Board are often very similar, I'm asking any of you that have young adult children for your feedback about meds that have helped in the areas I've described above. (or ones that have serious negative side affects too please). I know nothing about meds. I apologize to whomever this might offend, but I put more trust in the experience of the parents on this board than I do the suggestion of a new psychiatrist who isn't a specialist in aspergers.
Re: Anonymous 11-30-11
Your son is asking for help. Please give it to him. Natural is good in it's place, but this isn't it. Antidepressants can help greatly. So can anti-anxiety meds. Every kid is different so it would be impossible to give you an exact recomendation. If you can choose a child psychiatrist. The cutting really concerns me. He's not just asking for help, he's begging.
My child has a high IQ, but his social skills,school work and his behavior was a challenge. I have been praying to the Lord Jesus Christ and with his help I found an ingrediant that is changing my sons life. It first helped him with his stomach, then ...well the list goes on. All this was because his stomach was not working well and his body was lacking protein. This shake will change your child's and your life for the better. Thank Jesus for this shake.
Give it to your child EVERY morning( at least M-F). Let him/her drink 1/2 to all of it. You will see some changes every 9 weeks. I call it the:
Saldiver-Keller Aspergers Shake:
3- small spoons lentils cooked**
2- organic eggs (white only)
3-4 - strawberries
few - blueberries
Mix these ingredients in a Magic Bullet or one similar.
Then add:
1- banana
fill- it with crushed ice (or whole)
some -milk for liquid
Mix it again until it is all mixed.
** heat water, then add lentils 1/2 a bag. Simmer for 30 mins. Put it in a tupperware for daily use.
I can empathize with you on this one. My daughter was hard too. She is not as bad now since she is a little older (14). Medications can help...a lot. My daughter started Abilify and it changed our lives for the better. I cried and told the Dr "Thanks for giving me my daughter back!" Her ADHD meds help a whole lot too. For us, meds are not a complete fix but it is better. We tried to go off the Abilify and that was just ugly. We have her on an allergen (wheat, egg, peanut, rye, buckwheat, pecan and cherry) free diet too. If she eats those things that she is hypersensitive to then her symptoms return with a vengeance.
Counseling has helped to a whole lot too. She sees a psychologist once every 1-2 weeks. She goes in alone and spends about an hour in there. I don't hound her about what they talk about. I just ask how it went and did you talk about anything interesting. The answer is always "fine" and "no" but at least she knows I'm interested. If we are having a problem at home, I'll discuss it with the psychologist before she goes in. She doesn't like that but it usually helps. Every once in a while I got into the appt with her if we need to talk about something together.
Strict rules and consequences/rewards have helped us too. We have to be strict with the rules. She does understand "just this once". It is either yes or no, on or off and never in between. Consequences and rewards have to be immediate with her and they can't be long term. One (maybe 2) days of no electronics is the usual consequence. She doesn't comprehend a week long punishment. Same thing with rewards. She can't do the 'if you do this for a month (or even a week), you'll get XYZ'. I usually try to set goals for anywhere from 3-5 days and I reminder her frequently without making it an actual reminder. She recently got to go paint pottery if she did her own self care (bath, brush teeth twice daily) without me reminding her every time. I would say something like 'I can't wait to go to As You Wish with you...I sure hope we get to go!'
It almost sound like he needs to spend more time with his dad. Does he get to spend time there and is dad making him follow the rules while he is there. Boys at that age really need their dads and if he is not getting the attention that he needs from his dad it will cause behavior problems.
Use the obsession to your advantage and see if you can broaden the obsession. Treat him to a trip to the mustang dealership to see other mustangs. Look up facts about the mustangs, get a model car to put together...
Things are better for us...meds, diet, therapy and age have helped us.
To Anonymous from 9/7/11 - Did they check your son to see if he had been hyperventilating? My 13 yr old AS son has been in the ER 3 times this fall with panic attacks where he hyperventilated and described the same thing, numb face, severe pain in his hands - running up his arms etc. They checked an arterial blood gas (not a fun blood draw) to figure it out.
We've done so many meds at this point and none have worked well. Going to try working with a new psychiatrist in a couple weeks. Hopefully this MD will have better ideas as to how to treat.
Good luck to all AS families to get through those daily challenges. Happy Holidays to all.
My son was put on zoloft 1/2 a 25 mg tab. He is 8 ysr old & 67 lbs. After all the other medication he was put on it made him worse. Now the 1/2 a zoloft tab is helping. My daughter has the brother she has always wanted. My son is happy once again. My problem is the dr. wants him to take a full pill. I can not understand why? If 1/2 works magic why change it untill he grows & puts on weight. Any input would be appreciated. Thanks!
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