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Undiagnosed and Misdiagnosed Aspergers

Aspergers manifests in many ways that can cause difficulties on a daily basis.

Here are some examples of what to look for:

• Being naive and trusting
• Confusion
• Delayed motor milestones
• Delighting in fine details such as knobs on a stereo
• Difficulty in conversing
• Difficulty with multitasking
• Extreme shyness
• Lack of dress sense
• Mixing with inappropriate company
• Not understanding jokes or social interaction
• Quoting lists of facts
• Unusual and obsessional interests

One of the worst problems is that you can never really understand what is going on inside your youngster's head. This makes it so difficult for you to understand his behavior. This can leave you feeling emotionally beat-up and completely useless as a parent. You may have to cope with crisis on a daily, hourly or even minute-by-minute basis.

Undiagnosed Aspergers—

Undiagnosed Aspergers is an issue that concerns me because so many kids have Aspergers and are struggling to make it in this world with very little help or resources. Just today, I met someone who said that it was suggested that their youngster had Oppositional Defiant Disorder (ODD) without anyone recognizing the other behaviors that are just as relevant.

There are many characteristics for Aspergers, but one thing that goes unnoticed is that there can be a secondary diagnosis clouding the picture and causing undiagnosed Aspergers. Many kids with Aspergers also have ADHD, for example. ADHD can cause behaviors that draw an excessive amount of attention, thus the undiagnosed Aspergers can be overlooked.

Commonly undiagnosed conditions in related areas may include:

o ADHD -- Undiagnosed
o Adult ADHD -- Undiagnosed
o Alzheimer Disease -- Undiagnosed
o Bipolar Disorder -- Undiagnosed
o Concentration Disorders -- Undiagnosed
o Epilepsy -- Undiagnosed
o Migraine -- Undiagnosed
o Schizophrenia -- Undiagnosed
o Stroke -- Undiagnosed

Undiagnosed Aspergers Leads To Life as an Outsider

For most of his life, Michael felt like an outsider. Restless and isolated, he was over-stimulated and uneasy around others. Finally, when he was 45, he was diagnosed with Aspergers, a syndrome that falls within the autism spectrum. The diagnosis came as a relief: Here, finally, was an objective explanation for some of my strengths and weaknesses

People with Aspergers often struggle to interact with groups and understand social norms. Michael describes himself growing up as a "very lost little kid" who acted out in school by making faces at teachers and being aggressive with the other students. His ability to connect to others didn't improve with age.

Music — particularly the repeating patterns of melody — provided him with a refuge from an early age. He remembers listening to his mother's record collection and experiencing a "passage into a world where everything made sense." He compares listening to music to watching clouds change slowly over the course of an afternoon.

As for his diagnosis with Aspergers, Michael says it has helped him accept the parts of his nature that are "not very changeable." Wearing eyeglasses, for instance, makes him feel like he is "being intimate with everybody on the street." As a result, he rarely wears them now — even though he received his first prescription for glasses when he was in kindergarten.

Misdiagnosed Aspergers—

Many kids with Aspergers are misdiagnosed as having ADHD with no investigation by medical professionals of the possibility of Aspergers. In one case, a child was treated for ADHD for years before anyone mentioned Aspergers.

Asperger syndrome can be a difficult diagnosis to make because there is no single test to detect it. An accurate diagnosis generally requires the evaluation of a team of professionals who are specialists in developmental disorders. In addition, the symptoms of Aspergers are similar to some symptoms of some other disorders. This can result in a delayed or missed diagnosis. For example, some people with Aspergers may be misdiagnosed with "mild" form of autism disorder. However, the two conditions are different and distinct disorders. Kids and adults with Aspergers may also be misdiagnosed with other conditions with some similar behaviors, such as obsessive-compulsive disorder (OCD) or attention deficit hyperactivity disorder (ADHD).

The other conditions for which Aspergers is listed as a possible alternative diagnosis include:

• ADD
• Autism
• Schizoid Personality Disorder
• Schizotypal Personality Disorder

Other Common Misdiagnoses:

• ADHD under-diagnosed in adults: Although the over-diagnoses of ADHD in kids is a well-known controversy, the reverse side related to adults. Some adults can remain undiagnosed, and indeed the condition has usually been overlooked throughout childhood. There are as many as 8 million adults with ADHD in the USA (about 1 in 25 adults in the USA).

• Bipolar disorder misdiagnosed as various conditions by primary physicians: Bipolar disorder (manic-depressive disorder) often fails to be diagnosed correctly by primary care physicians. Many patients with bipolar seek help from their physician, rather than a psychiatrist or psychologist.

• Blood pressure cuffs misdiagnose hypertension in kids: One known misdiagnosis issue with hypertension arises in relation to the simple equipment used to test blood pressure. The "cuff" around the arm to measure blood pressure can simply be too small to accurately test a youngster's blood pressure. This can lead to an incorrect diagnosis of a child with hypertension. The problem even has a name unofficially: "small cuff syndrome".

• Brain pressure condition often misdiagnosed as dementia: A condition that results from an excessive pressure of CSF within the brain is often misdiagnosed. It may be misdiagnosed as Parkinson's disease or dementia (such as Alzheimer's disease). The condition is called "Normal Pressure Hydrocephalus" (NPH) and is caused by having too much CSF, i.e. too much "fluid on the brain". One study suggested that 1 in 20 diagnoses of dementia or Parkinson's disease were actually NPH.

• Kids with migraine often misdiagnosed: A migraine often fails to be correctly diagnosed in pediatric patients. These patients are not the typical migraine sufferers, but migraines can also occur in kids.

• Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer's disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia.

• Depression undiagnosed in teenagers: Serious bouts of depression can be undiagnosed in teenagers. The "normal" moodiness of teenagers can cause severe medical depression to be overlooked.

• Eating disorders under-diagnosed in men: The typical patient with an eating disorder is female. The result is that men with eating disorders often fail to be diagnosed or have a delayed diagnosis.

• Mesenteric adenitis misdiagnosed as appendicitis in kids: Because appendicitis is one of the more feared conditions for a youngster with abdominal pain, it can be over-diagnosed (it can, of course, also fail to be diagnosed with fatal effect). One of the most common misdiagnosed is for kids with mesenteric adenitis to be misdiagnosed as appendicitis. Fortunately, thus misdiagnosis is usually less serious than the reverse failure to diagnose appendicitis.

• Mild worm infections undiagnosed in kids: Human worm infestations, esp. threadworm, can be overlooked in some cases, because it may cause only mild or even absent symptoms. Although the most common symptoms are anal itch (or vaginal itch), which are obvious in severe cases, milder conditions may fail to be noticed in kids. In particular, it may interfere with the youngster's good night's sleep. Threadworm is a condition to consider in kids with symptoms such as bedwetting (enuresis), difficulty sleeping, irritability, or other sleeping symptoms. Visual inspection of the region can often see the threadworms, at night when they are active, but they can also be missed this way, and multiple inspections can be warranted if worms are suspected.

• Mild traumatic brain injury often remains undiagnosed: Although the symptoms of severe brain injury are hard to miss, it is less clear for milder injuries, or even those causing a mild concussion diagnosis. The condition goes by the name of "mild traumatic brain injury" (MTBI). MTBI symptoms can be mild, and can continue for days or weeks after the injury.

• MTBI misdiagnosed as balance problem: When a person has symptoms such as vertigo or dizziness, a diagnosis of brain injury may go overlooked. This is particularly true of mild traumatic brain injury (MTBI), for which the symptoms are typically mild. The symptoms has also relate to a relatively mild brain injury (e.g. fall), that could have occurred days or even weeks ago. Vestibular dysfunction, causing vertigo-like symptoms, is a common complication of mild brain injury.

• Parental fears about toddler behavior often unfounded: There are many behaviors in infants and toddlers that may give rise to a fear that the youngster has some form of mental health condition. In particular, there is a loss of fear of autism or ADHD in parents. However, parents should understand that the chances are higher that it's part of normal development, and perhaps just a "cute behavior" rather than a serious condition. Although parents should be vigilant about monitoring all aspects of their child's development and mental health, they should also take care not to over-worry and miss out on some of the delights of parenthood. For example, a young child that screams when you open his car door to take him out, then makes you put him back into the car to repeat it, so that he can open the car door himself, is not necessarily showing signs of autism or OCD, nor indeed any mental illness. There is a small possibility that it's an abnormality (a chance that increases with age of the youngster), but it's also the type of behavior seen in many normal kids.

• Post-concussive brain injury often misdiagnosed: A study found that soldiers who had suffered a concussive injury in battle often were misdiagnosed on their return. A variety of symptoms can occur in post-concussion syndrome and these were not being correctly attributed to their concussion injury.

• Undiagnosed anxiety disorders related to depression: Patients with depression may also have undiagnosed anxiety disorders (see symptoms of anxiety disorders). Failure to diagnose these anxiety disorders may worsen the depression.

• Undiagnosed stroke leads to misdiagnosed aphasia: BBC News UK reported on a man who had been institutionalized and treated for mental illness because he suffered from sudden inability to speak. This was initially misdiagnosed as a "nervous breakdown" and other mental conditions. He was later diagnosed as having had a stroke, and suffering from aphasia (inability to speak), a well-known complication of stroke (or other brain conditions).

The Aspergers Comprehensive Handbook

Aspergers Summer Camps

The Learning Camp
Vail, Colorado, USA
Camp Type: Residential
Phone: 970-524-2706
The Learning Camp delivers twelve years of building confidence and academic success in males and females 7-14 with ADD, ADHD, Dyslexia and other learning differences. Located in the Vail Valley of CO…

Camp Kodiak
McKellar, Ontario, Canada
Camp Type: Residential
Toll-Free: 877-569-7595
Phone: 705-389-1910
Integrated, non-competitive camp for kids & adolescents with & without ADHD, LD, NLD, & AS. Social skills & academic programs, 50+ sports & activities, professional staff, 2-to-1 ratio, lakeside cabins...

Camp Caglewood
Suwanee, Georgia, USA
Camp Type: Residential | Day | Adult
Toll-Free: 800-979-2829
Phone: 678-405-9000
Camp Caglewood provides weekend camping and day trip programming for kids and adults with special needs...

Camp Discovery
Pacific Palisades, California, USA
Camp Type: Day
Phone: 818-501-5522
Camp Discovery is an outdoor day camp for kids ages 3 – 10 with mild or moderate special needs. Camp Discovery offers a 1:3 therapist to youngster ratio. All of our therapists have special training to...

Social and Sensory Camps
Campbell, California, USA
Camp Type: Day
Phone: 408-871-8711
The Lighthouse Project offers a wide range of summer camps for high functioning kids with Nonverbal Learning Disorders, Asperger's, high functioning Autism, and Attention Deficits...

Camp Buckskin
Ely, Minnesota, USA
Camp Type: Residential
Phone: 218-365-2121
We have been helping young people with AD/HD, LD, and Aspergers to become more successful since 1959. We offer instruction in both traditional camp and some academic activities in our scenic Northwoods…

Oregon Trails
Redmond, Oregon, USA
Camp Type: Residential
Toll-Free: 888-458-8226
Phone: 828-697-6313
Hiking trips for adolescents with Asperger's syndrome or ADHD take place in the Redmond, Oregon area...

Winston Preparatory Summer Enrichment Program
New York, New York, USA
Camp Type: Day
Phone: 646-638-2705 x 688
Winston Preparatory Summer Enrichment provides students with the unique opportunity to participate in an individually designed program aimed to enhance academic skills. Each student receives daily…

Frontier Travel Camp
Miami Shores, Florida, USA
Camp Type: Travel
Toll-Free: 866-750-CAMP
Phone: 305-895-1123
Summer travel program for those with special needs. With quality staff and accommodations, Frontier travels throughout the United States, Canada, Europe, and elsewhere…

Kinark Outdoor Centre
Minden, Ontario, Canada
Camp Type: Residential
Toll-Free: 800-805-8252
Phone: 705-286-3555
The Kinark Outdoor Centre is a program of Kinark Child and Family Services facilitating skill development, social recreation, family enrichment and adventure based programs for kids and families ...

Summit Camp
Honesdale, Pennsylvania, USA
Camp Type: Residential
Toll-Free: 800-323-9908
Phone: 570-253-4381
Sumimt Camp & Travel offers camping for males and females with attention, social, or learning issues...

Camp Huntington
High Falls, New York, USA
Camp Type: Residential
Toll-Free: 866-514-5281
Phone: 845-687-7840
Camp Huntington is a co-ed, residential, seven-week program for kids and young adults with a variety of special needs. Our program is designed to maximize a youngster's potential and develop their…

Trek
Seattle, Washington, USA
Camp Type: Residential
Toll-Free: 888-458-8226
Phone: 888-458-8226
Northwestern adventures for kids with Asperger's, NLD, ADHD, or other social skills needs...

Camp Kirk
Kirkfield, Ontario, Canada
Camp Type: Residential
Toll-Free: 1-866-982-3310
Phone: 416-782-3310
Camp Kirk is a wholesome experience for kids with learning disabilities and/or ADHD, and those with incontinence or enuresis(bed wetting) difficulties set in the beautiful Canadian countryside...

Ko-Ach Adventures
Temagami, Ontario, Canada
Camp Type: Residential | Tours | Family | Adult
Phone: 647-298-1860
Ko-Ach Adventures provides meaningful summer programming to young people and young diagnosed with Autistic Spectrum Disorder, Aspergers Syndrome or a mild to moderate developmental delay...

Turn-About Ranch
Escalante, Utah, USA
Camp Type: Residential
Toll-Free: 866-280-1764
Phone: 435-826-4240
Real ranch. Real values. Real change. Turn-About Ranch is a working horse and cow ranch for adolescents...

Charis Hills
Ingram, Texas, USA
Camp Type: Residential
Toll-Free: 888-681-2173
Phone: 325-247-4999
Charis Hills is a Christian, co-ed, residential summer camp which helps kids with learning differences build confidence and find success. We welcome kids with ADHD, LD, ED, and Asperger’s...

Camp Connect
Bridgewater, Massachusetts, USA
Camp Type: Day
Phone: 508-697-7557
For Kids & Adolescents with Asperger's Syndrome, High Functioning Autism, and related challenges...

Turn-About Ranch
Lake Saranac, New York, USA
Camp Type: Residential
Toll-Free: 888-458-8226
Phone: 828-697-6313

Talisail
Northwestern, Washington, USA
Camp Type: Residential
Toll-Free: 888-458-8226
Phone: 888-458-8226
Talisail is a sailing program for adolescents (13-17 y/o) with Asperger’s, high-functioning Autism, or ADHD/LD, and takes place in the world-class waters of the San Juan archipelago in Northwestern Washington…

Camp Akeela
Thetford Center, Vermont, USA
Camp Type: Residential
Toll-Free: 866-680-4744
Phone: 802-333-4843
Camp Akeela is a co-ed, overnight camp in Vermont. Within a well-rounded and traditional program we emphasize the social growth of our campers, many of whom have been diagnosed with Asperger’s Syndrome…

Camp Northwood
Remsen, New York, USA
Camp Type: Residential
Phone: 315-831-3621
Providing quality programming to a coed population of 165 kids in need of structure and individualization. The Camp Northwood program is oriented toward a population of learning challenged/ADHD...

Talisman Programs
Zirconia, North Carolina, USA
Camp Type: Residential
Toll-Free: 888-458-8226
Phone: 828-697-6313
Talisman Programs are designed specifically for kids and teenagers with ADHD, learning disabilities, Aspergers, and similar social and behavioral needs. Our activities focus on building confidence...

Summit Travel
Honesdale, Pennsylvania, USA
Camp Type: Residential
Toll-Free: 800-323-9908
Phone: 570-253-4381
Sumimt Camp & Travel offers camping for males and females with attention, social, or learning issues...

Camp Kennebec
Arden, Ontario, Canada
Camp Type: Residential
Toll-Free: 1-877-335-2114
Phone: 613-335-2114
Camp Kennebec is an inclusive residential camp for kids with various learning disabilities, ADD/ADHD, Tourette Syndrome, ASD, and other social and behavioural exceptionalities. Camp Kennebec offers...

Blooming Acres
Oro Station, Ontario, Canada
Phone: 705-487-3076
The Blooming Acres summer Camp is a therapeutic agricultural, recreational and vocational experience for kids, teenagers and adults diagnosed with Autism, Asperger’s Syndrome and other related…

Circle of Friends Social Skills Camp
Marietta, Georgia, USA
Phone: 770-352-9952
Day camp for social skills training and friendship development for kids with special needs…

Extreme Sports Camp
Aspen, Colorado, USA
Phone: 970-920-3695
Extreme Sports Camp is an overnight summer camp in Aspen, Colorado, where older kids with autism spectrum disorders can safely engage in sustained physical activities and find personal growth through…

Ranch Camp at Down Home Ranch
Elgin, Texas, USA
Phone: 512-856-0128

HI-STEP Summer Social Skills Program Camp
Somerset, New Jersey, USA
Phone: 732-873-1212
HI-STEP (formerly Stepping Stone) Summer Social Skills Program / Camp in New Jersey may serve as Special Education Extended School Year (ESY) program…

Camp Health Hope and Happiness
Seba Beach, Alberta, Canada
Camp Health, Hope & Happiness is the only camp in Alberta that accepts, and provides programs, for individuals who have any type and any degree of disability or illness…

Confidence Connection
Wellelsey, Massachusetts, USA
Serving kids ages 4-12, with Autism/PDD, Asperger’s, developmental and speech/language delays…

The Monarch School Summer Program
Houston, Texas, USA
The Monarch School offers a 5-week summer program with an emphasis on Executive Functioning, Relationship Development, Academic Competence, and Self-Regulation…

Camp Maple Leaf
Wallingford, Vermont, USA
A FUN summer day camp experience (ages 8-17) that teaches social/ relaxation skills to individuals diagnosed with Nonverbal Learning Disabilities, Asperger's Syndrome, PDD, and HFA…

Summer Sensations
Columbia, Maryland, USA
Sensory Motor Full Day Camp carefully designed for kids with sensory processing differences…

Mitchell's Place
Irondale, Alabama, USA
Mitchell's Place developed out of one family's need to provide their son with comprehensive treatment that would address his specific needs and enhance his many strengths…

Rock Climbing Social Skills Group
Huntington Beach, California, USA
Rock Climbing Social Skills Group

Sense Abilities For Kids
Leesburg, Virginia, USA
Our Special Needs Summer Camp offers kids of all abilities to explore their world using touch, movement, body awareness, sight and sound…

St Francis Camp on the Lake
Jerome, Michigan, USA
St Francis Camp serves the needs of our special campers aged 8 - 80. We are located near Jerome MI...

Camp Rise Above
San Diego, California, USA
Camp Rise Above is a specialized summer camp for kids who don’t enjoy the typical summer camps with 30+ kids and low supervision. Our camp is a small group environment where every youngster receives…

Expressions at George School
Newtown, Pennsylvania, USA
Expressions is a day camp designed specifically for males and females ages 7-15 with High Functioning Autism, Apserger's Syndrome, Nonverbal Learning Disabilities and other similar social challenges...

Wediko New Hampshire Summer Program
Windsor, New Hampshire, USA
A 45-day therapeutic residential program that provides academic instruction, experiential education, group therapy, family therapy, milieu therapy, and psychiatric consultation to kids aged 6-18…

YouthCare MGH
Charlestown and Westwood, Massachusetts, USA
Founded in 1969, YouthCare offers a fun-filled seven-week therapeutic day camp for kids through age 14. Each camp day consists of recreational activities as well as therapeutic groups and…

Gulf Islands Film and Television School
Galiano Island, British Columbia, Canada
Intensive weeklong and monthlong media production programs for young people & adults. Students produce short films in teams of four. Rural island off the west coast of B.C.

Advantage Riding Academy
Merrimac, Massachusetts, USA
Horseback riding from the therapeutic to advanced level…

Spectra Academy
Montclair, New Jersey, USA
This is a new program for kids and adolescents with Asperger’s disorder, high functioning autism and those with related social pragmatic difficulties aged 8-14. Kids in this spectrum need…

Camp CARD NE
Ogunquit, Maine, USA
A SUMMER CAMP FARM EXPERIENCE FOR SOCIAL SKILL DEVELOPMENT CAMP CARD NE is a social enrichment program for kids with an autism spectrum disorder…

Camp Maple Leaf
Wallingford, Vermont, USA
A fun camp experience that focuses on social skills and leisure/relaxation skills development for kids and adolescents diagnosed with: Nonverbal Learning Disabilities Asperger's Syndrome…

SL Start
Boise, Idaho, USA
Day camp providing Developmental Therapy and Intensive Behavioral Intervention to kids 3-12...

Cincinnati Occupational Therapy Institute
Cincinnati, Ohio, USA
Summer experiences for kids with sensory processing disorder and other sensory and motor problems...

Camp STAR Summer Treatment for ADHD
Highland Park, Illinois, USA
Camp STAR is an evidence-based DAY camp for kids with behavioral, social and emmotional issues run but clinical staff from the University of Illinois Chicago, and NCYS North Shore Day Camp…

Camp New Connections
Belmont, Massachusetts, USA
Camp New Connections is a Summer Pragmatic Language Program for kids and adolescents with Asperger's Disorder, PDD-NOS, and Nonverbal Learning Disabilities...

Camp Excel
Allenwood (Wall Twp), New Jersey, USA
Camp Excel is a specialized summer camp for kids ADHD and others with Social Skills Challenges. We focus on developing social skills and the social awareness necessary for better relationships...

92nd Street Y Camp Bari Tov and Camp Tova
New York, New York, USA
92nd St. Y’s nurturing day camps for developmentally disabled kids ages 5-13. Bari Tov offers 1-to-1 supervision, while Tova provides a small group structure at our beautiful upstate campground…

Achieve Fluency Learning Camp
Stamford, Connecticut, USA
AFLC is a summer camp for kids with and without special learning needs age 4-12. Our unique program offers kids a great opportunity to receive special attention for their language, academic…


Children with Autism Making Progress
South Pasadena, California, USA
C.A.M.P. is based on the fundamental belief that kids with autism experience life with a super sensitivity unlike typically developing kids…

Conduct Disorder in Children with High-Functioning Autism and Asperger's

"My 12 year old son is diagnosed with high functioning autism and conduct disorder (also the suspicion of ADHD). Any other parents out there with this combination in their child? Any advice for us? This has been a very difficult road - with no end in sight. My husband and I are feeling both the physical and mental effects of the stress we have to endure on a daily basis. We are desperate at this point."

Although several studies have suggested an association between violent crime and High-Functioning Autism, few have examined the underlying reasons. All kids display oppositional or aggressive behavior from time to time, especially when they are upset, tired, or hungry. Oppositional behavior (e.g., arguing, lying, and disobeying) is a normal part of development for kids and  teenagers. When this behavior is frequent or excessive, affects the youngster’s home or school life, or violates the rights of others, a conduct disorder may be present.

Conduct disorder (CD) is the most severe psychiatric disorder in childhood, and occurs more frequently in boys than in girls. According to the U.S. Department of Health and Human Services, the disorder affects an estimated 1-4 percent of teenagers between the ages of 9 and 17 years. Young people with this disorder repeatedly violate the rights of others, and display aggressive, destructive, and deceitful behavior. Identifying the signs and symptoms of CD, and beginning treatment as early in life as possible, is essential in order to prevent the disorder and prognosis from worsening.

==> Parenting System That Stops Meltdowns and Tantrums Before They Start

What is conduct disorder?

Children with CD repeatedly violate the personal or property rights of others and the basic expectations of society. A diagnosis of CD is likely when symptoms continue for 6 months or longer. CD is known as a "disruptive behavior disorder" because of its impact on kids and their families, neighbors, and schools.

Another disruptive behavior disorder, called Oppositional Defiant Disorder ODD), may be a precursor of CD. A youngster is diagnosed with ODD when he or she shows signs of being hostile and defiant for at least 6 months. ODD may start as early as the preschool years, while CD generally appears when kids are older. OCD and CD are not co-occurring conditions.




The Best Way To Help Oppositional Children with Asperger's and High-Functioning Autism:

 

What are the signs of conduct disorder?

Symptoms of conduct disorder include:
  • Aggressive behavior that harms or threatens other people or animals
  • Destructive behavior that damages or destroys property
  • Early tobacco, alcohol, and substance use and abuse
  • Lying or theft
  • Precocious sexual activity
  • Truancy or other serious violations of rules

Those with CD or ODD also may experience:
  • Academic difficulties
  • Difficulty staying in adoptive, foster, or group homes
  • Higher rates of depression, suicidal thoughts, suicide attempts, and suicide
  • Higher rates of injuries, school expulsions, and problems with the law
  • Poor relationships with peers or adults
  • Sexually transmitted diseases

How common is conduct disorder?

Conduct disorder affects 1 to 4 percent of 9- to 17-year-olds, depending on exactly how the disorder is defined (U.S. Department of Health and Human Services). The disorder appears to be more common in boys than in girls and more common in cities than in rural areas.

Who is at risk for conduct disorder?

Research shows that some cases of CD begin in early childhood, often by the preschool years. In fact, some infants who are especially "fussy" appear to be at risk for developing CD.  

Other factors that may make a youngster more likely to develop CD include:
  • Abuse or violence
  • Crowding
  • Early institutionalization
  • Early maternal rejection
  • Family neglect
  • Large family size
  • Parental marital discord
  • Parental mental illness
  • Poverty
  • Separation from parents, without an adequate alternative caregiver

What help is available for families?

Although CD is one of the most difficult behavior disorders to treat, young people often benefit from a range of services that include:
  • Community-based services that focus on the young person within the context of family and community influence
  • Family therapy
  • Training for parents on how to handle problematic behavior
  • Training in problem-solving skills for kids and teens on the autism spectrum


Some child and teenager behaviors are hard to change after they have become ingrained. Therefore, the earlier the CD is identified and treated, the better the chance for success. Most High-Functioning Autistic and Asperger's children/teens with CD are probably reacting to events and situations in their lives. Some recent studies have focused on promising ways to prevent CD among "at-risk" kids on the autism spectrum. In addition, more research is needed to determine if biology is a factor in CD.

Parents or other caregivers who notice signs of CD or ODD in a youngster or teenager should:
  • Find family network organizations.
  • Get accurate information from libraries, hotlines, or other sources.
  • If necessary, talk with a mental health or social services professional, such as a teacher, counselor, psychiatrist, or psychologist specializing in childhood and teenager disorders.
  • Pay careful attention to the signs, try to understand the underlying reasons, and then try to improve the situation.
  • Talk to other families in their communities.

People who are not satisfied with the mental health services they receive should discuss their concerns with their provider, ask for more information, and/or seek help from other sources.


4 Crucial Mistakes in Dealing with Oppositional Behavior:



How to Identify Conduct Disorder in Your High-Functioning Autistic or Asperger's Child—

Step 1—Learn about the risk factors for developing CD (e.g., having a parent with a mood disorder, ADHD, substance abuse disorder, or CD). A history of abuse or neglect, exposure to violence, inconsistent or excessively harsh discipline, poverty, and overcrowded living conditions are other risk factors for CD.

Step 2—Take note of any aggressive behavior (e.g., bullying, threatening, or intimidating others). Autistic kids with CD often initiate both verbal and physical fights, and have a history of violence and cruelty toward people and animals. More serious signs of aggressive behavior include the use of weapons and a history of sexual assault.

Step 3—Consider whether prior destructive acts were intentional or unintentional. While all kids have the potential to damage property due to carelessness or reckless play, kids with CD deliberately cause damage to the property of others.

Step 4—Watch carefully for other signs of CD (e.g., lying, theft, truancy, substance abuse, serious rule violations, and precocious sexual activity). High-Functioning Autistic and Asperger's kids with this disorder may also experience symptoms of depression, have poor relationships with family members and peers, and experience significant academic difficulties.

Step 5—Speak with your youngster’s teacher to get her opinion, and discuss your youngster’s symptoms with a mental health professional who specializes in disorders of childhood. Read all you can about the symptoms of CD so that you are better able to identify the symptoms in your youngster.


==> Parenting System That Stops Meltdowns and Tantrums Before They Start


COMMENTS:

•    Anonymous said… 13 yr old with aspergers and adhd
•    Anonymous said… Having answers doesnt change your little fellows . He is the se boy . Find all the good traites to his syndrome and concentrate on intervention. I have a beautiful 8 yrs old boy and the stress i felt has lessoned as i can now get help . All the best.
•    Anonymous said… I feel your pain we have a 10 year old adopted daughter that we are lost with
•    Anonymous said… I'm there with you--my 10 year old son-who isn't CD but ADHD- is like a light switch--just a flip of the switch and he's like a different child--angry, 'mouthy', etc. But, like the light switch, can switch right back and be the calm, pleasant boy we know.
•    Anonymous said… It is a difficult road, but it will get better.
•    Anonymous said… It really does get better. Really, it does. I met my stepson 4 years ago and he has come such a long way. I went from having to pretty much follow him everywhere he went to make sure he was safe and not running away to now he can walk to school with the other kids. We still have our moments but they are so much easier to deal with. Consistancy is the key!
•    Anonymous said… Maturity does wonders, but we wouldn't have survived and made it in public school, until he was a junior, without medication. We treated the anxiety of Aspergers and later dealt with the ADD for school goals. He is a white food eater so any food approaches were not available to us. Early on we had many incidences of out of control emotion and frustration....Prozac and Abilify finally stabilized our son. Home school allowed us to remove the ADD meds...he works cooperatively at his pace. He is now 17....and has grown out of his control issues and reactive behavior.
•    Anonymous said… My 13 year old has Asperger's and ADHD, diagnosed when he was 10. Best advice I can give is keep a consistent schedule. Post checklists and schedules everywhere to keep everyone accountable. Limit computer/TV/game system time. We are also in weekly therapy for assistance with coping with anxiety, social groups, and on medication for the anxiety and ADHD, both at very low doses.
•    Anonymous said… My 7 year old daughter has just diagnoised with Adhd and aspergers. It is not easy we are still learning at this stage it is a hard journey and I am sure it is just the start. X
•    Anonymous said… My 8 year old son was diagnosed with ADHD and ODD at 5 years of age and has had a diagnosis of HFA. After working with Autism for 30 years. His diagnosis was no surprise. Unfortunately there is not a lot of support for our HFA kids. How ever sites like this makes you realise your not on your own. And you can pick up lots of information from parents in the same boat.
•    Anonymous said… My daughter turned 17 in sept, i also found out finally that she has ASD aswel xx we have our ups an downs, but I wouldn't changer her x
•    Anonymous said… My son 15 has exactly same condition. It's been few ups and down, but he is doing very well now. He is in mainstream high school. Message me in here, if you like to chat. It's helps to talk about it. We've been there. This journey will continue forever, however, not all bad
•    Anonymous said… My son has adhd asd language prossesing disorder.spd age 11
•    Anonymous said… My son has been dignosed with a regulatory disorder it where he acts out 7 different disorders which are aspergers adhd add and autism and sensory and other ones but the one he shows the most is aspergers and autism if anybody out there has any tips to get them to listen to you when needed I have tryed many different ways to get him to listen to me
•    Anonymous said… My son is 16. Undiagnosed as yet . Takes forever in UK. He probably has Asperger's. Is very bright. Model pupil at school. At home very uncommunicative. Doesn't eat with the family. Anything that upsets him leads to a retaliation. He has cut electric leads to my radio, thrown my clothes round my room, broken raw eggs including shells into cooked pasta, thrown an egg against granite splash back, poured a bottle of cooking oil down the sink. This morning went down to find he had thrown uncooked mince into the sink and broken off wooden trim in my kitchen. I have sought help by speaking to CAMHS , the mental health dept for kids, but he has refused to go to appointments and when someone came to the house he kicked off when they left. We are quite religious but never ask him to join us in prayer. We call him for meals and I try and make food he likes or stock up on pizza, quiche , cheese pasties....whatever. The trigger yesterday was that I forgot to get quiche. I have been told to talk to him that he has to learn to control his emotions. We all feel upset must learn not to act out our frustrations. My added problem is that my 2 year old has been diagnosed with a very rare muscle condition and needs a great deal of care equivalent to a baby of 6 months. I have 2 other kids aged 14 and 9 who are being squeezed out because of the needs of their siblings. So I try and make special time for them. Communication is the main problem with my eldest.
•    Anonymous said… My son is almost 12 so I've been there. It does get better. We used medication for about 2 years to help him clearly think. We used concerts because it had the least side effects and is out of the system in 12 hours. When we decided to homeschool we stopped the meds and started using essential oils. It is very important to have the same or close to the same routine every day. Don't surprise him with something last minute or it will cause a meltdown. We also did family therapy for a while to help him realize getting so angry was his choice not something we were doing to him. He still has some ego issues and if he feels he is right there is no telling him he is wrong. He totally compares with Sheldon off the big band theory. It does get better just keep you're head up and make sure you let him know when something isn't exceptable.
•    Anonymous said… Need more details! Do you mean following your instructions and directions? Or acknowledging your voice when you are simply trying to gain his focus? What does he do in those situations and what have you tried? Then I can share my insight with you, would love to help. Ty
•    Anonymous said… Pathological demand avoidance , conduct disorder call it what you want .... Life is miserable and tense!
•    Anonymous said… Same. My son is 7, but I hope he doesn't get conduct disorder. He's got some pretty serious angry outbursts.
•    Anonymous said… There is a clear link between aspergers, add, and odd and allergies Still trying to work out what it is
•    Anonymous said… Yes 2 out of 3 of my sons have autism. My 12 yr old has autism, he is verbal and high function. My 11 yr old has Aspergers and ADHD. It also is a daily struggle, but it has been a long road to get to this point. They do talk therapy , IEP'S and medications for anxiety, depression, hyperactivity and inattention. Overall with these interventions, love and support they are progressing daily...but it can be a daily struggle. Feel free to private message me if you would like any advice. Best wishes
•    Anonymous said… I am looking in to the option of homeschooling but many disagree.
•    Anonymous said… I often wonder if there aren’t so many more undiagnosed kids out there judging by the amount of children who are disruptive in certain ways & who also show signs of Aspergers.
•    Anonymous said… It depends. Everyone’s different, but my son works best one on one, full attention... work done on computer / tablet He so smart and knows it, but anxiety issues don’t let him get it all out until comfortable . Of course include times of socialization, time with peers( if you can) my son likes his alone time mostly. Advocate helped.
•    Anonymous said… My son 16 yr ASD ADHD + ODD. Always remember that your child is a complicated combination. Every specialist letter about our son starts with "Ben is a very complex boy..................". When attending therapies or looking for strategies to help your child remember, to consider each condition has an influence on your childs behaviour. Over all what we find with our boy is that the ASD (aspergers) makes him anxious, timid, routine driven and socially awkward at times. The ADHD overides this sometimes, he can be forward, busy, loud and in your face. The ODD makes him reluctant and suspicious to follow instructions blindly, he questions everything and clashes with peers and teachers. But all together he is funny, loving, smart, friendly, helpful, great with younger kids, I could go on and on. But as I said my advice is always keep in mind his multiple conditions because what works for one doesnt work for the other, you have to become a detective and work out what suits your child in particular.
•    Anonymous said… My son had a late diagnosis finally,after all the years of stress, problems at school,ect( too much to list) at12 yrs old. He is 14 now. We still have our days,he’s going into HS but home schooling works best. Getting an advocate was on of the best things we did. And having his 504 plan and IEP /ARD in order is key!!
•    Anonymous said… Not specifically, but I have a child diagnosed with ADHD and ODD (as well as a few other things) and is suspected of being on the spectrum, but they're not comfortable diagnosing, yet. I also have an Aspie who can be rather aggressive and mean and when he was 12, I had to give him more freedom through the day in order to have a calmer, more agreeable child in the home. What helped the first child (ADHD, ODD) was dietary changes. I took her to an integrative medicine doctor and got a full work up, as we'd been told for years that she had no allergies, etc, and I just couldn't believe she would behave those ways unless something was going on in her body. I was correct and we had to put her on a special diet. It's like night and day. She's so much gentler and kinder and cooperative now. Less hostile, less anxious (we also found out she has an anxiety problem, which the dietary changes also helped). Interestingly enough, my Aspie also has dietary issues. They both have bodies that find it hard to detox on a standard American diet, no matter how healthy it is. They need to mostly eat foods in their natural states or as close to it as possible. Ms. ADHD has confirmed methylation issues (possibly MTHFR mutation, but we haven't tested for that, yet...the integrative medicine doctor tested for methylation pathway blockages without needing to do a genetic test). I truly believe that behavioral issues in children are directly related to a biological cause, if we find it. I don't mean simply a different neurological type, but an actual biological cause (usually in the gut, check out info on the gut-brain connection). I hope something I shared helps. Good luck!
•    Anonymous said… One of our biggest struggles is the uneducated people who assume and judge, it’s sad. But my close family members rule!!!!!
•    Anonymous said… What I really want to say is, when my son doesn’t want to go, Cries, gets sick, has anxiety... goes to Nurse, misses class, teachers are not on board ..calls to come get him and it happens all the time. It’s What’s best.. homeschool.
•    Anonymous said… Yes, our son has both. The high functioning ASD proves to be more of a challenge to manage than ADHD. The only advice we have is that both parents doing the same things in terms of management & working together. We find one parent dealing with a problem/meltdown works-not both parents. We take it in turns so we give each other a break. We just take each day as it comes-cos we never know when our son may need extra support. We did buy ear defenders which have worked well for him. Look after yourselves too. And don't beat yourselves up if you get it wrong now & again-this is a constant learning curve & every child is different. Good Luck, but bet you're already doing great xx
•    Anonymous said… Yes. With those same challenges. Private violin lessons , art and Planned one on one with a friend. Also , school counseling, OT, He still has social challenges.
 

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The Warning Signs of Aspergers

Moms and dads should ask their youngster’s doctor for referral to a developmental pediatrician for assessment if there are concerns with any of the following...

Communication Red Flags:
  • Loss of any language or social skills at any age
  • No babbling by 11 months of age
  • No response when name is called, causing concern about hearing
  • No simple gestures by 12 months (e.g., waving bye-bye)
  • No single words by 16 months
  • No two-word phrases by 24 months (noun + verb – e.g., “baby sleeping”)

Behavioral Red Flags:
  • Compulsions or rituals (has to perform activities in a special way or certain sequence; is prone to tantrums if rituals are interrupted)
  • Lacks interest in toys, or plays with them in an unusual way (e.g., lining up, spinning, opening/closing parts rather than using the toy as a whole)
  • Odd or repetitive ways of moving fingers or hand
  • Oversensitive to certain textures, sounds or lights
  • Preoccupations with unusual interests, such as light switches, doors, fans, wheels
  • Unusual fears

Social Red Flags:
  • Avoids or ignores other children when they approach
  • Does not play peek-a-boo
  • Doesn’t make attempts to get parent’s attention; doesn’t follow/look when someone is pointing at something
  • Doesn’t point to show things he/she is interested in
  • Doesn’t respond to parent’s attempts to play, even if relaxed
  • More interested in looking at objects than at people’s faces
  • Prefers to play alone
  • Rarely makes eye contact when interacting with people
  • Rarely smiles socially
  • Seems to be “in his/her own world”

Are you wondering whether or not your pre-school aged youngster has Aspergers (high-functioning autism)? Take this simple little quiz:
  1. Are they attracted to shows like Wheel of Fortune or Jeopardy?
  2. Are they fascinated with numbers and letters?
  3. Do they lack the ability to play "with" other children interactively?
  4. Do they like to line objects up in rows?
  5. Do they like to watch the same movie over and over again?
  6. Do they seem unafraid of things that they should be afraid of?
  7. Do they shun away from being touched or arch their back when held?
  8. Do they spin objects around and around?
  9. Do they walk up or down stairs always leading with the same foot?
  10. Is it hard for them to make eye contact or they simply don't?
  11. Is their speech repetitive, like an echo?

If you notice some or multiple signs in your child, write them down. Your concerns and observations are of great value for your pediatrician or professionals who are trying to diagnose your child.

Is it ADHD or Aspergers?

1. Discuss your concerns with your youngster's teacher. Kids who have ADHD and Aspergers often act very differently at school than they do at home due to over stimulation. Your youngster's teacher can offer important information that can lead to a proper diagnosis.

2. Notice if the youngster can stay focused under certain circumstances. Kids with Aspergers can sit still for long periods of time if they are interested in something. For example, they can still to watch a movie they are interested in or stay focused on a computer activity they enjoy. Kids who have ADHD will have trouble focusing on an activity even if they are interested in it.

3. Observe your youngster's behavior. Is your youngster's erratic behavior an everyday thing or is it in response to a traumatic event? All kids are hyper sometimes but a divorce or the death of a family member can cause kids to act out. Generally, if the behavior lasts for more than six months, it may be due to a disorder.

4. See how the youngster responds to medications and other behavior modification treatments. There are a number of medications to treat kids who are hyper active. But generally, you can find a medication to help calm a youngster who has ADHD. Kids who have Aspergers will not be calmed by medications such as Ritalin and Adderall. This is a big red flag since nearly every youngster who is diagnosed with Aspergers is initially diagnosed with ADHD.

5. Understand the differences between ADHD and Aspergers. Kids who have Aspergers typically engage in repetitive behavior, have a hard time dealing with change and are so inner-focused that they may appear to be self absorbed. Kids who have ADHD have a hard time focusing and sitting still but tend to be more aware of their surroundings than kids with Aspergers.

The Aspergers Comprehensive Handbook

Parenting Kids with Both ADD and High-Functioning Autism

"My son was originally diagnosed with ADD (age 4), but now they say he has 'high functioning' autism and ADD (age 6). What is the main difference between these two conditions, and is it possible to have both?"

Most kids don’t receive a diagnosis of High-Functioning Autism (HFA) or Asperger's (AS) until after age 5 or 6 (around the time they start public school). Usually, they are diagnosed with Attention Deficit Disorder as preschoolers. Part of the reason for this is that pediatricians routinely screen kids for ADD – but not for autism.

Another reason is that an HFA kid's social impairment becomes more evident once he or she starts school. Finally, pediatricians are reluctant to label a youngster as "autistic." It is okay - and even a badge of honor - to have a “hyperactive” youngster, but it is another thing entirely to have an “autistic” youngster.

Pediatricians make their diagnoses based on the kid's behaviors. Since kids with ADD and HFA share similar behaviors, the two can appear to overlap. However, there is a fundamental difference between these two disorders. HFA kids lack what pediatricians call "social reciprocity" or Theory of Mind. Theory of Mind is "the capacity to understand that other people have thoughts, feelings, motivations and desires that are different from our own."
Kids with ADD have a Theory of Mind and understand other people's motives and expectations. They also make appropriate eye contact and understand social cues, body language and hidden agendas in social interactions. HFA kids don’t!

Kids with ADD respond to behavioral modification. With HFA, the disorder is the behavior. Both kinds of kids can tantrum, talk too loud and too much, and have problems modulating their behaviors and making friends. Both are “social failures” to one degree or another – but for different reasons.

The youngster with ADD knows what to do – but forgets to do it. HFA kids don’t know what to do. They don’t understand that relationships are two-sided. If an HFA youngster talks on and on in an un-modulated voice about his particular interest, he simply doesn’t understand that he is boring his friend and showing disinterest in his friend's side of the conversation. On the other hand, the youngster with ADD can’t control himself from dominating the conversation.

An HFA youngster can appear unfocused, forgetful and disorganized like a youngster with ADD, but there is a difference. The ADD youngster is easily distracted, whereas the HFA kid has no "filter." The HFA youngster sees everything in his environment as equally important (e.g., his teacher's dangling earring is as important as what she writes on the blackboard).

The HFA youngster doesn’t understand that he doesn’t have to memorize the entire textbook for the next test. He doesn’t "get" such rules. HFA kids tend to get anxious and stuck about small things and can’t see the "big picture." On the other hand, kids with ADD are not detailed-oriented. The ADD youngster understands the rules – but lacks the self-control to follow them. The HFA kid doesn’t understand the rules.
 
==> How to Prevent Meltdowns and Tantrums in Children with Autism Spectrum Disorder

The unfocused ADD youngster is "nowhere," but the highly-focused HFA “fantasy" youngster is somewhere else. "Fantasy kids" retreat into a world of their own making, a world where everything goes the way they want it to. They play video games for hours or retreat into books and music. Their daydreaming and fantasizing resembles the behaviors of non-hyperactive kids with ADD.

Obsessive-compulsive HFA kids live a world they create from rules and rituals. Like ADD kids, they appear preoccupied and distracted – but for different reasons. They appear distracted because they are always thinking about their "rules" (e.g., Did I tie my shoelaces right? Did I brush my teeth for 3 minutes?).

Some researchers estimate that 60% to 70% of HFA kids also have ADD, which is considered a common comorbidity of HFA. Other researchers say that the two disorders can’t exist together. Still others insist pediatricians have it all wrong - and that the two disorders are the same. The real problem is that there is no hard science. No one knows exactly how slight imperfections in brain structure and chemistry cause such problems.

For this reason, getting the right diagnosis for a youngster who exhibits behavior problems may take years of trial and error. Diagnosis is based on observation of behaviors that are similar for a myriad of disorders. The tragedy is that the youngster often doesn’t receive the correct medications, educational strategies, and behavioral modification techniques that could help him function on a higher level. He falls farther behind his peer group and loses ground when he could be getting appropriate treatments.

Psychiatry has made great strides in helping kids manage mental disorders, particularly moderate conditions, but the system of diagnosis is still years behind other branches of medicine. On an individual level, for many parents with children on the spectrum, the experience can be exhausting.  




==> Has your child been diagnosed with both ADHD and autism spectrum disorder?  Then you will want to borrow from these parenting strategies that address this combination...


More resources for parents of children and teens on the autism spectrum:
 

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Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.

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COMMENTS:

•    Anonymous said... Add is part of asd. That's why so many kids are diagnosed w add before they get an actual diagnosis of high functioning or aspergers (my daughter was finally diagnosed w aspergers after about 3 years of an add diagnosis)
•    Anonymous said... ADD/ADHD and ASD are not the same. They are each mutually exclusive disorders, yet they can also be comorbid. I have two with ASD, yet neither of them have ADD/ADHD.
•    Anonymous said... I fought for my son to not have the ADD label because when I saw the test a lot of the questions they asked where his asd. My paediatrician said I had to take out the asd and answer the questions but it is not that black and white. I agree with Michelle if they can sit and concentrate they are not ADD.
•    Anonymous said... I personally believe that ADD/ADHD has been overdiagnosed for many years and now it seems that many PCP's/Pediatricians are diagnosing Asperger's without doing any Psychological testing leading to it now being overdiagnosed as well. These are not even Developmental Pediatricians who do not have the credentials and training to diagnose ASD.
•    Anonymous said... In kinder the school said my son was autistic. Since he was very verbal, I thought he was just ADHD. Now, I know he is aspergers and so much more of his sensory issues make sense now.
•    Anonymous said... My 11 yr old had adhd first and now aspergers
•    Anonymous said... My 4 (almost 5) year old dr says he is hyperactive disorder but does not have the attention defecit. His preschool is suspecting aspergers but his dr doesn't want to do any testing for that until after we start medicating him. He too will snap right to attention if the subject interest or benefits him.
•    Anonymous said... My son can concentrate but only to a certain point before he gets unfocused. It's hard for him. He was initially dx AHDD and later ASD with AHDD. AHDD came at age of 5 and ASD at age of 12 after multiple problems with school, bullying and behaviors which interfered with his school and life. He still takes meds for concentration and mood stabilizers for some of the mood swings. I have to say it has been a challenging road. But once you figure out what to do for them it gets a little easier. My son is now 17 and soon graduating high school. In some parts he acts his age and in others he acts like he is 12. I try to focus his attention on becoming an adult and college, but he needs a lot of hand holding. I do believe the two disorders exists amongst themselves. He is no longer hyper but surely very forgetful and unorganized.
•    Anonymous said... My son has a duel diagnosis of ADHD and Aspergers.
•    Anonymous said... My son has Asperger's and ADD diagnoses but I don't agree with the ADD. He is definitely able to concentrate for hours if it's something he likes to do and we have tried medicines in the past for attention problems and they made little to no difference for him.
•    Anonymous said... my son has been diagnosed as adhd at about 5. around 8 years old Aspergers was noted and he was officially diagnosed as having both.
•    Anonymous said... My son the same Maria. He has adhd and aspergers.
•    Anonymous said... My son was diagnosed with high functioning Aspergers when he was 4. This year, now he is five, they said he also has ADD. I was told ADD typically always comes with AS. I don't exactly know what my opinion on that is. Yes, my son has trouble consentrating and likes to move around a lot. And that is something I work with him on. I don't know if he really needs that extra label and I do know I am not going to medicate him just to do so.....listen to your intuition. Unfortunately, you will have to do the research as the medical field is highly uninformed (IMO).
•    Anonymous said... Personally I think they over diagnose add. But the 2 are very similar. Except those with add, cannot concentrate on anything, whereas those with Aspergers can concentrate on something they are interested in.
•    Anonymous said... Since our children are around the same age, mine will be six soon, and they have the same diagnosis, feel free to message me and we can talk more.
•    Anonymous said... The two are very different, very very different. The best person to ask is someone who specializes in this. Your child's doctor or specialist will be able to explain to you what the differences are in relation to your child. All aspergers/autism is different so it's impossible to guess what your child is like in that respect. It's possible to have both and my son has many friends who have both. ADD doesn't usually have social issues, sensory issues, and so many other typical ASD issues.
•    Anonymous said... Without sounding like I'm accusing anyone, because I'm not, I think many ASD kids get misdiagnosed with ADD because they are so hard to discipline that they can sometimes just be wild little things. ASD kids don't pay social penalties for anything so they lack a lot of self discipline that NT people learn very early. And traditional discipline doesn't always work. I know if I send my son to the corner he just makes up stories and reads them to the floor and he loves doing that.
•    Anonymous said… My son was diagnosed with ADHD at 7. Typical ADHD meds only made his problems worse, and it wasn't until I saw a checklist of Asperger traits that it clicked "that is him!" Now, at 10, he finally has an "accurate" diagnosis. Beth Ann, I understand where you're coming from. My son is very high functioning and can appear neurotypical in many settings. He even fools me sometimes, until something happens to remind me that no, I'm not dealing with a "typical" child here. That is THE hardest thing for me as his mom.
•    Anonymous said… My oldest wasn't dx'd till 3rd grade but he also has add. We just thought he was immature and a little eccentric as an only child. He hit all the normal milestones. We realized it was something more but bounced a lot of letters around. After some research by his psych and us we all agreed on aspergers. But what do I do with a kid who appears neurotypical and not the full blown vs of autism?
•    Anonymous said… After it took myself, 2 nurses and the doctor to pin my 3 year old son down for a strep test and him coming up with a bloody mouth would she finally have a consultation with me about aspergers. He has major sensory issues. at his last dental cleaning it took 5 of us to hold him down. after his diagnosis, he is in pt, ot and speech. it has only been a month but am starting to see a little improvement.

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Aspergers Plus ADHD

Question

My daughter is 9 and has ADHD and Asperger's. She takes Methylphenidate twice a day so that she may focus at school, but when the second dose wears off she becomes uncontrollable. She is loud & completely disobedient. I have a 6 year old son also and am a single mother. I am at my wits end. I feel like I have tried everything and nothing works. She talks back to me always. There is not one time that I ask her to do something that she doesn't argue back. Please help me :o)

Answer

It sounds like she does fine until her meds wear-off. We’ll start there…

Have you tried sustained release forms of ADHD medication, or one of the long acting stimulants?

Sustained release forms of these medications have the benefit that the medication is often still working after school, as your youngster is trying to do his homework. The sustained release pills must be swallowed whole (except for Adderall XR).The long acting stimulants generally have the duration of 8-12 hours and can be used just once a day. They are especially useful for kids who are unable or unwilling to take a dose at school.

At least 80% of kids will respond to one of the ADHD stimulants, so if 1 or 2 medications don't work or have unwanted side effects, then a third might be tried. It can help if you are aware of the different medications that are available. Stimulants are considered to be first line treatments, and antidepressants are second line treatments and might be considered if 2 or 3 stimulant medications don't work for your youngster.

Here is a list of long acting stimulants to explore with your youngster’s doctor:

• Adderall XR— Adderall XR is approved for use in kids over the age of six years, although regular Adderall can be used in younger kids from 3-5 years of age. Adderall XR is a sustained release form of Adderall, a popular stimulant which contains dextroamphetamine and amphetamine. It is available as a 10mg, 15mg, 20mg, 25mg, and 30mg capsule, and unlike many of the other sustained release products, the capsule can be opened and sprinkled onto applesauce if your youngster can't swallow a pill.

• Concerta— Concerta is a sustained release form of methyphenidate (Ritalin). It is available as a 18mg, 36mg and 54mg tablet and is designed to work for 12 hours. Teens can take two 36mg tablets to get to a dose of 72mg. Like Adderall XR, it is only approved for kids over the age of six years.

• Daytrana— Daytrana is a methyphenidate or Ritalin patch. The patch is available in 10mg, 15mg, 20mg, and 30mg dosages, which are worn for about nine hours at a time on a youngster's hip. The medication in your youngster's system then continues to work for a few more hours once you take the patch off, although you may have to figure how the patch works best for your youngster. One benefit of the Ritalin patch, in addition to working well for kids who don't like to take medicine, is that it gives you a lot of flexibility. For example, on some days your youngster could just wear the Daytrana patch for a few hours and on other days he could wear it a little longer if he has extra homework (as long it doesn't interfere with bedtime).

• Focalin XR— An extended release form of Focalin, with the active ingredient dexmethylphenidate hydrocholoride, which is also found in methylphenidate (Ritalin). It is available in an 5mg, 10mg, 15mg, and 20mg capsule.

• Metadate CD— This is also a long acting form of methylphenidate (Ritalin).

• Ritalin LA— This is is a new long acting form of methylphenidate (Ritalin). It is available in 10, 20, 30, and 40mg capsules. Unlike the other long acting forms of methylphenidate, the Ritalin LA capsules can be opened and sprinkled on something if your youngster can't swallow them whole.

• Vyvanse— The latest medication to get approval to treat ADHD is Vyvanse, a long acting stimulant that is similar to Adderall. In fact, its main ingredient is lisdexamfetamine dimesylate, a derivative of one of the ingredients in Adderall. Initially available in 30mg, 50mg, and 70mg capsules, newer 20mg, 40mg, and 60mg capsules should be available soon.

Side effects of stimulants can include a decreased appetite, headaches, stomachaches, trouble getting to sleep, jitteriness, and social withdrawal, and can usually be managed by adjusting the dosage or when the medication is given. Other side effects may occur in kids on too high a dosage or those that are overly sensitive to stimulants and might cause them to be over-focused on the medication or appear dull or overly restricted. Some moms and dads are resistant to using a stimulant because they don't want their youngster to be a 'zombie,' but it is important to remember that these are unwanted side effects and can usually be treated by lowering the dosage of medication or changing to a different medication.

Here are several points to keep in mind with regard to medication for Aspergers and High-Functioning Autism:

• Anti-Depressants May Be Needed— While many kids with Aspergers present with hyperactivity, there is a tendency for teenagers to suffer from depression. There are various reasons why depression may be so common. For example, teens with Aspergers generally want to fit in socially. They can become depressed when they fail to fit into society's molds or norms or can't grasp the importance of its rules. Depression may also hit as they deal with anxiety and obsessive behaviors.

• Consider non-Medical Therapies— There are several therapies that are proven to be effective in treating and improving behaviors in children with Aspergers. Behavioral therapies help the child learn to cope with obsessive tendencies, deal with tantrums, cope with anxiety or control angry outbursts. Social skills classes help them to understand more of the back-and-forth nature of communication. Speech therapy can help them understand different uses of language. Occupational therapy improves the clumsiness or lack of co-ordination problems.

• Diet and Vitamin Treatments Improve Symptoms— Nutritional deficiencies and mal-absorption problems are common in Aspergers children. Many parents report success with a restricted diet or adding vitamin supplements. Other parents report success with the gluten and casein-free diet or a low-sugar, low-yeast diet. It is best to get a blood or stool test to check for any food intolerances or vitamin deficiencies. Consult a nutritional therapist if you want to go this route. After testing, some common vitamins that Aspergers children often use include: B vitamins, zinc, magnesium, Vitamin C and cod liver oil supplements.

• Medications for Anti-Anxiety or ADD/ADHD are Useful— Anxiety and stress are usually elevated in Aspergers children and teens. They often require medications to cope with the anxiety. Children with Aspergers also struggle with concentration, hyperactivity, focus and attention. Medicines to target ADD or ADHD have proven useful for Aspergers. There can be side effects with new behaviors showing up, however, so any medication use needs to be closely monitored.

• There Is Not Just One Medication— While many of the symptoms of Aspergers can be treated with a variety of medications, there is not one magic pill for the syndrome. Aspergers children and teens often lack proper social skills, have obsessive tendencies and can be clumsy or awkward. Some medications can be used to improve specific behaviors associated with Aspergers, such as anxiety, hyperactivity or attention deficit.

My Aspergers Child: Preventing Meltdowns and Tantrums in Aspergers Children


COMMENTS:

•    Anonymous said... I feel your pain.... I have 3 with ASD and complex behavior challenges including ADHD. Maybe there is a different dose that is more time released ? I am about to go the med route for my daughter. She is so difficult and has been since she was 1.5... She is six now. Ugh it's so draining!!!
•    Anonymous said... I'm familiar w this. Repeat every request and or argue for every little thing.
•    Anonymous said... We have three rules for our family. Each one has a clear consequence. By making these clear then following through discipline is simplified enough that we can spend most our energy on positive interactions with our son. Two years on this approach and he's got himself so much under control that he and his therapist weaned him off all meds. In his case he would take all the emotional power we would give him, so we just had to take the emotions out of correction and give him very clear expectations and hold him calmly to them. Then, we did all we could to let him know we adore and enjoy him just the way he is. In the end my belief is that the work is Gods inside our kids hearts, so prayer is the best thing you can do for your kids, but schedule, routine, clear expectations, calm correction, and happy parents are things that can benefit every family.
 
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Aspergers, ADHD, and ODD

Question

My 8 year old Aspie also has ADHD and Oppositional Defiant Disorder [ODD]. I can deal with the ADHD and the Aspergers …it’s the ODD I am having a hard time with. How do deal with it and what works with dealing with this disorder? What do you do as far as discipline? We are at our wits end with this part of his diagnoses and would love some advice.

Answer

Aspergers (high-functioning autism) is often not be the only psychological condition affecting a particular youngster. In fact, it frequently coexists with other problems such as:
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Bipolar Disorder
  • Depression (Major Depressive Disorder or Adjustment Disorder with Depressed Mood)
  • Generalized Anxiety Disorder
  • Obsessive Compulsive Disorder
  • Oppositional Defiant Disorder (ODD)

Oppositional Defiant Disorder, also known as ODD, is a psychiatric behavior disorder that is characterized by aggressiveness and a tendency to purposefully bother and irritate others.

DSM delineates the criteria for ODD as follows:

A. A pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of the following are present: often loses temper, often argues with adults, often actively defies or refuses to comply with adult requests or rules, often deliberately annoys people, often blames others for his or her mistakes or misbehavior, is often touchy or easily annoyed by others, is often angry and resentful, is often spiteful or vindictive.

B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functions.

C. The behaviors do not occur exclusively during the course of psychotic or mood disorder.

D. Criteria are not met for Conduct Disorder, and if the individual is age 18 years or older, criteria are not met for Anti-social Personality Disorder.

Facts on Oppositional Defiant Disorder—
  • 15% of ODD kids develop some form of personality disorder
  • 20% of kids with ODD have some form of mood disorder, such as Bipolar Disorder or anxiety
  • 35% of these kids develop some type of affective disorder
  • 50-65% of ODD kids also have ADD or ADHD
  • 75% of kids with Oppositional Defiant Disorder above the age of eight will still be defiant later in life
  • Kids with CD and ODD are also at high risk for criminality and antisocial personality disorders in adulthood
  • Many of these kids have learning disorders
  • ODD is more common in boys than in girls before puberty
  • ODD is reported to affect between 2 and 16 percent of kids
  • Once kids enter adolescence, it is extremely difficult for moms and dads to change the ODD behavior

Symptoms of Oppositional Defiant Disorder—

Kids with ODD show defiant, hostile, and negativistic behaviors lasting at least six months, of which four or more of the following behaviors are present:
  • actively defies or refuses to comply with adults' requests or rules
  • argues with adults
  • blames others for his or her mistakes
  • deliberately annoys people
  • is angry or resentful
  • is spiteful and vindictive
  • loses temper
  • mean and hateful talking when upset
  • often being touchy or easily annoyed by others
  • seeking revenge

Causes of Oppositional Defiant Disorder—

There has been no systematic research into the causes of ODD; however, there are two theories as follows:

• Learning Theory: ODD comes as a response to negative interactions. The techniques used by moms and dads and authority figures bring about the oppositional defiant behavior.

• Developmental Theory: ODD is really a result of incomplete development. For some reason, ODD kids don't master the tasks that other kids master during their toddler years. They get stuck in the toddler stage (2-3 years old) and never really grow out of it.

Treatment of Oppositional Defiant Disorder—
  • Cognitive-Behavioral Psychotherapy to assist in problem solving and decrease negativity
  • Family Psychotherapy to improve communication
  • Individual Psychotherapy to develop effective anger management
  • Parent Training Programs to help manage behavior
  • Social Skills Training to increase flexibility and improve tolerance to frustration with peers
  • Stimulant Medication is prescribed only when ODD is accompanied by another disorder such as ADD or ADHD

Treatment is particularly important because kids with ODD are also at high risk for criminality and antisocial personality disorders in adulthood.

What Moms and Dads Can Do—
  1. Avoid power struggles.
  2. Build on the positives.
  3. Establish a schedule for the family that includes specific meals that will be eaten at home together, and specific activities one or both parents will do with the Aspergers child.
  4. Exercise and relax. Use respite care as needed.
  5. Give effective timeouts.
  6. Give the youngster praise and positive reinforcement when he shows flexibility or cooperation.
  7. Limit consequences to those that can be consistently reinforced and if possible, last for a limited amount of time.
  8. Manage your stress.
  9. Offer acceptable choices to your Aspergers child, giving him a certain amount of control.
  10. Pick your battles carefully.
  11. Prioritize the things you want your youngster to do.
  12. Remain calm and unemotional in the face of opposition.
  13. Set up reasonable, age-appropriate limits with consequences that can be enforced consistently.
  14. Stay involved in things other than your youngster with ODD, so that your youngster doesn't take up all of your time and energy.
  15. Take a break if you are about to make the conflict with your youngster worse. This is good modeling, so be sure to support your youngster if he decides to take a time-out to prevent overreacting.
  16. Try to work with other adults that are involved with your youngster, such as educators, coaches, and your husband or wife.

What Teachers Can Do—

It is important for educators to be aware of the disorders that their students are suffering from. Educators may or may not see symptoms of ODD at school. Even if the symptoms are not present at school, it is helpful to know what the moms and dads are dealing with at home. The more you communicate with the family and understand the situation, the better you will be able to help.

Click here for a complete parenting-course on how to deal with the Aspergers child who also has Oppositional Defiant Disorder.

My child has been rejected by his peers, ridiculed and bullied !!!

Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

How to Prevent Meltdowns in Children on the Spectrum

Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

Click here for the full article...

Parenting Defiant Teens on the Spectrum

Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

Click here to read the full article…

Older Teens and Young Adult Children with ASD Still Living At Home

Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

Click here to read the full article…

Parenting Children and Teens with High-Functioning Autism

Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

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to read the full article...

Highly Effective Research-Based Parenting Strategies for Children with Asperger's and HFA

Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

Click here for the full article...

My Aspergers Child - Syndicated Content