Asperger's, Anxiety Disorder, and ADHD

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My son is 9 and we've been struggling for sooooo long.

In the 1st grade, he was diagnosed with ADHD and medicated. This didn't change things much.
In the 2nd grade, he was also diagnosed with severe Anxiety Disorder and medicated.
In the 3rd grade, he was additionally diagnosed with Asperger's.

He sees a counselor, a psychiatrist, and, at school, an Autism specialist.

He seems to have the classic social issues of Asperger's, fairly intense ADHD.. and the anxiety just amplifies both of these conditions. That said, for the most part he is a happy child..... he just doesn't "act right". The school has him in a social skills class and seems pretty good at addressing that aspect of his issues. However, educationally, they suck.

My son is not an Aspie math whiz. Math seems IMPOSSIBLE. He is now in the 4th grade and has only learned about half of any of the math processes they've tried to teach him. The school doesn't implement intervention until the child is below the 20th percentile. He's incredibly close. He only brings home math homework about once a week and each time we do it, I have to reteach it. I've requested extra homework and got some for about a week.

As a parent, I try so hard to work with him, but I'm frustrated and worried for him. He can't seem to memorize even the simplest multiplication facts. As he moves from one process to the next, he forgets the old ones he has learned. He has to add 5 + 6 on his fingers. He is now having to be put into a special group because he's forgotten how to do subtraction.. though if you give him a division problem, he can and will subtract it just fine! As far as I can tell, his math skills are at a 2nd grade level.

As a toddler, he seemed so advanced. He could do simple addition and subtraction. Everything kindergarden addressed he'd known by the age of 4, and then promptly lost.

The problem that I see is that his brain doesn't work like the other children's, yet I don't know how to address it... and apparently the school doesn't either. I don't know if the problem is his ADHD, the Asperger's, or a combination of everything. I can't afford a specialist or a tutor.

I don't know what to do.
I don't know why I think one of you can help me....
But I really don't know where else to turn.

1st through 4th grades, and again in 6th, were tough ones for us, when the challenges seemed, at times, like they would never be overcome.

And yet, they were. One. small. piece. at. a. time.

Not everyone is so lucky, I realize that; AS affects kids and families in very different ways, and some co-morbids are far more debilating than others. But you have to believe that what you are building with your child is worth it.

The real light in my son's life, and the reason I left 5th grade off the struggles list, have been his gifts. In 5th grade they shone for him, strong and bright. For a while. Enough to know they meant something.

So what I see missing in your post is a description of your son's gifts. If you aren't sure what they are, try to figure it out. Most kids seem to have a gift of some sort, and that gift ... it can be their life ticket. Sometimes it seems to be something as simple as an unusual ability to understand a pet. But even the small things can be used. Something to hang onto when life gets bleak. Something to grow and build from.

Kind of as a side, I do find it unusual how your son had so much regressive loss with numbers; have you been given any theories on that?

Also, a few of our families have had some success helping their kids be their better selves using natural supplements. Have you tried any of these? A search of the forum history would let you see what they've used, why, and how it seemed to help. Diet issues also can be covered, because food sensitivities can definitely make it difficult for your child to be their best self. Again, we have lots of threads on these and the experiences different families have had; none of it is a one-size fits all answer, just what happens to seem to work for one unique family. Have you gotten far into experimenting with or considering food issues?

Finally, many of our new parents find a lot of help reading a book one of our members wrote, free for download at http://www.ASDstuff.com

We have many members in the same boat you are. If nothing else, you'll have someone to cry over cyber-coffee with.

At this particular moment.... he has just mastered how to make the armpit fart! (He should be writing times tables!)
He always makes me laugh. He is kind and caring and compassionate.
He loves history. Mid-evil times and the civil rights movement seem to be his favorite.
He is a wonderful swimmer and will soon be preparing for competitive swim.
He loves rockwall climbing, skateboarding, rollerblading, and bike riding.
He likes (but has issues with) basketball.

He is great with puzzles. He speeds through them like a demon using both hands at once to place pieces.

He is a great kid, my life. I suppose I didn't mention his strong points because I am so incredibly troubled by is math difficulties. And I wouldn't be troubled if I didn't believe it was worth it. I am a struggling single parent... I can give him love, and I can make sure he gets the most out of his education. Those are the two most important jobs I have as a parent.

And no, no one is really addressing the number loss, except to put him in a special subtraction recap group.

I keep getting "he's not in crisis yet" from the school.

Forgive me for wanting to keep him OUT out of crisis!

My kiddo has been dealing with a lot of anxiety issues at school. Someone else here recommended Freeing Your Child from Anxiety (Powerful, Practical Solutions to Overcome Your Child's Fears, Worries, and Phobias) by Tamar Ellsas Chansky. That book really opened my eyes to how much anxiety can affect children, and what it mean for children on the spectrum. It had some great strategies on how to support your child.

I would consider getting a re-evaluation, or second opinion, from someone that might have some insight with the educational disabilities aspect of things. Maybe there's still a piece of the puzzle missing?

This is my first day here. I have not gotten to look around very much, but I most certainly will.

...............You're going to make me cry..
The school psychologist first diagnosed him with ADHD. His pediatrician (a doctor I truly trust) agreed with that diagnosis, but advised me to take him to a counselor when he no longer felt comfortable dealing with the meds. At this point, my son was 7, weighed 60lbs, and was on 72mg of Concerta daily.

The counselor did a HUGE 2 day assessment on my son and confirmed the ADHD diagnosis, but added the Anxiety diagnosis. I started asking questions about autism but didn't really get any answers. While he was a very nice man, I opted to search out a different counselor as I felt that his focus was not the same as mine. My son and I have our issues, but we are very close and as a family function very well. This counselor wanted to focus on the home and smooth out the little bumps while I was hopeful my son would get the tools to deal with the people outside our home who don't get him and understand his needs.

We had to go to a psychiatrist at this point to deal with the meds.. By now I had been talking to others and investigating online, when I met the new psychiatrist I wanted to know why everyone was certain that Ben had ADHD and not Asperger's. Most of Ben's ADHD symptoms could also be assigned to Asperger's or Anxiety. He TOTALLY shut me down. Gave the the "Shut up, your just a parent, I'M A PROFESSIONAL!" Actually, I remember verbatim what he said, "We know your son has extreme anxiety issues. It's apparent after spending 20 minutes with your child that he is a classic example of ADHD. He might have some Asperger's thrown in there, but there's no cure for that..... so let's just worry about what we can fix!" He prescribed 25 of Zoloft and told us to come back in 2 months.

Then... Then I found an amazing counselor! On our "interview" visit, I told him all of my concerns, what made me question this and that, and everything in between. I told him about being shut down by the shrink, and he said, "If you want your son screened for ASD, all you have to do is ask the school. No one ever told you that?" Within a week I had a meeting scheduled with the school. Roughly 2 months later, the school psychologist diagnosed my son with probable ASD. His new counselor has diagnosed him with Asperger's..... and funny, once I had those people on board.. The psychologist was willing to accept the Asperger's diagnosis.. He was like, "OK, he's got Asperger's." Can I say "Asshat" here?

So when you say "second opinion".... yeah, it makes me want to cry... and actually, I tried to get a referral from those doctors to the CDRC to get a more extensive evaluation and diagnosis... and every single one of them said I don't need it. (except the counselor, but he can't make that referral)



I tried several different herbal/natural supplements before allowing the doctor to prescribe the first meds for ADHD. I actually started trying these a year or two before Ben was ever diagnosed with anything. There was one that seemed to work a bit initially, but quickly lost all affect. I do give him OMEGA-3's as those are supposed to help with the ADHD and memory... but to be honest, I don't see much benefit from them other than that they are good for him.

As far as we know, Ben isn't allergic to anything but grass pollens. I have thought several times about having him tested for allergies. I had heard that gluten allergies/sensitivities can cause ADHD-like symptoms, but to behonest.... I've gotten a bit weary of being shut down. Doctor's don't seem to like parents asking a lot of questions or questioning treatment methods. I'll have to suck it up and make the call to the pediatrician. He's a damn good doctor... and I guess the worst he can say is no.

You have both suggested reading materials to me, and I will definitely get on it... but I've just looked at the clock, and it's almost 4:30 am.. and my son will be up in about an hour...
Is it common for Aspie kids to abhor sleep, or is that an ADHD thing? LOL Actually, getting him to bed is no problem... Getting him to stay up until 10:30ish so that he'll sleep past 5am... THAT is the challenge.

(It used to be worse... as a toddler, he'd refuse to go to bed before 11 and be up as early as 3:30.)

I appreciate the advice given and anymore you have to offer. I will follow up and check out the reading material. But most of all, thank you for hearing me. I came to you in tears and don't feel quite so weepy anymore.
Thank you!

You must be exhausted. You will get it all straightened out eventually. I'm just worried that your kiddo has been diagnosed by morons who don't know what they are talking about. It would suck if the meds that are supposed to be helping him are really making him more off. I don't know....I've had quack doctors too. It really sucks. You think you should be able to trust their opinion, but you still also need to follow your gut.

ADHD symptoms are definitely comorid with Aspie stuff. However, with behavioral techniques, a balanced sensory diet, and some creative thinking there is a lot that can be done. I'm not saying your son isn't ADHD....I'm just wondering if you should trust the diagnosis from people who didn't catch ASD in the first place, ya know?

You are doing the best you can. You will figure it out! *hug*

Doctors do seem to prefer things they can "treat," don't they? But as parents we need to know the label to help us know how to parent. Parenting an AS child is different than parenting an ADHD child. A friend of mine just went through the same thing, spending a small fortune that ended up in an ADHD diagnosis, only to have school say, "actually, we'd like to look at AS." Until she told me about that, she hadn't known my son was AS, but after 5 minutes of talking she was feeling pretty solid about the school's suggestion. Still, it is totally, totally overwhelming trying to get it all figured out, isn't it? I'm so far down the road that sometimes I forget, I've gotten so busy with the "dealing" part, but it was a rough time.

It is my understanding that medication can help with anxiety and severe ADHD but otherwise isn't really indicated. I guess doctors don't like it when they can't hand you an RX. But there is soooo much that can be done to help an AS child, just not stuff that gets picked up at a pharmacy. It's all touchy feely and hard work done by parents, mostly.

Some AS kids do experience regressive patterns but I am still concerned about the math loss. I would feel more comfortable if someone had pinpointed that and at least tried to explain it. Without that effort, I worry that there is something else affecting your child that could be important to identify. I'm not suggesting at all that the AS diagnosis be challenged; but I am wondering if there is an additional co-morbid that needs to be labeled.

Meanwhile, remember that your funny child can make a life off his gifts, even if math is always a challenge. Did you know that the actor who plays Harry Potter has a learning disability? Can't tie his shoes. His parents let him try out for movies because he was good at it and needed something to grab onto. My smart and bright son couldn't write for the life of him in those early elementary school years, and we had to scribe for him for most of his language arts work through 5th grade. He has now, by 8th grade, mastered keyboarding and editing and we no longer have to: a major hurdle we weren't sure at times could ever be overcome. But it has been. He can't spell worth beans, but the world has spell check. And for math, there are software programs as well. Your son will learn a work around if he has to. Definitely keep on it, get the school to help him all they can, but don't freak out about it. His life will go on.

It is too bad that the schools can't really jump on something if it's not in crisis, but that is the way it seems to be. We, as parents, are what prevents it from reaching crisis.

Anyway, I feel like I'm rambling. My mind's a scramble; I type here as a "diversion." Hang in there, OK?

I agree with the poster who recommend considering a fresh look at your son's diagnoses. While ADHD is frequently comorbid, a recent study showed that 63% of OTs who assessed kids for sensory issues, found that their adhd symptoms were actually being caused by sensory issues rather than adhd wiring. And if the meds showed little effect then shouldn't the doctor have reassessed him at that time? My understanding is that they should show significant improvement IF they are actually ADHD and are on the right meds.

Has your son been assessed for SPD by an Occupational Therapist?

Agreed. It's an important base to cover if it hasn't been already covered.

Even when the ADHD, ASD, and anxiety are co-morbid, you can make huge progress by mitigating the sensory environmental issues, and also by encouraging the child to use stims for self-calming (time and place appropriate, of course).

A month or so ago, I had a total "flip-out" with the psychiatrist. I was questioning the meds, and how ineffective they seem to be for such a high dose, and talking about some of my son's behavioral issues that are continuing.. and the doc was like "Ohhh I can give him another med to help with the meltdowns."
I freaked out. I told him to quit trying to pump my kid full of his worthless meds and there was no way in hell I was going to let him prescribe anything else until he talk to someone who actually KNOWS my child. I insisted that he speak with his counselor and teacher before he even suggest additional meds. (At this point, he saw Ben for 15 minutes, once every 3 months... And Ben will not speak directly to the psychiatrist. - which is weird...as usually Ben doesn't quit talking to even take a breath and has no concept of "strangers" everyone is a "friend-not-yet-made".) I also mentioned some of the other non-medication treatments that I've read about online and asked why none of the damn doctors ever talk to me about them. It seems to be meds or nothing.... he promptly discredited all of the treatments I'd heard about.

After me getting a bit belligerent, and crying a lot, he actually decided to decrease Ben's dose of Concerta with the idea that it might be contributing to his anxiety. He also discussed waiting til summer and trying a non-stimulant medication. Those are ideas I like.


That is exactly why I've kept pushing the issue. There IS a difference.. just not significant. At home, 36mg of Concerta is perfect... However, it's not a good level for school. His impulsivity and inability to focus are just too much. What I keep getting from the doctors is that the other "issues" make the ADHD difficult to treat...............*shrug* makes sense... There IS a difference....

Ben was assessed by an Occupational Therapist during his ASD screening (they didn't find him to have any real fine or gross motor skill issues), but (and I hope I don't seem too dumb here) what is SPD? I'm not sure I don't know what it is.. or if I'm just not used to seeing it referred to by it's acronym.

Ben does seem much more hyperactive when he is anxious. At home, just he and I... he really doesn't do too badly. If I take him out into a situation he isn't accustomed to, or around people he's not familiar, there is no controlling him or rationalizing proper behavior to him. At home, we might have issues if he has friends over and there is a miss-communication. (One of his best friends has quite severe Asperger's.... therefore LOTS of miss-communication.) We had to drop out of Cub Scouts because I just couldn't handle the stress anymore. He loves Scouts but absolutely cannot behave for it. It doesn't help that there is an adult and another child in the group with which he just CANNOT get along with. (When Ben feels that he's been "wronged" it doesn't matter if it's an adult or child, he simply blows up and screams and yells and "puffs up". Ben has NEVER hit out of anger (or self-defense) he just "puffs up" and gets in the person's face and screams and yells and is completely uncontrollable.)

He doesn't seem to have any sensitivities to sounds (except startling, unexpected sounds scare him briefly), textures, foods... anything like that... but when in a "high anxiety" state he obsessively "needs" his back scratched and will climb all over me or manipulate himself and my appendages until he gets what he wants..... to the point where, if I refuse, he will get on the ground and beg me to just rub his back with my foot.
**and in this family we define "need" as .... "I will die if I don't get it." **
***I should add, before we started the Zoloft, he did have issues with the necks of his shirts. He constantly tugged on them as though they were uncomfortable, even after we moved to tag-less shirts***

I've lost my train of thought. I really appreciate all of your input. It's nice to hear from people who've been down this road and great to get new ideas for this perpetual "run-around" I'm in.

Thank you!

Almost everything in your last post is very typically AS and, yes, we do feel there are strategies for it. I have to run off to work but I strongly recommend you read Trackers book if you haven't yet. Free at asdstuff.com. Hopefully other posters can get busy discussing some of the strategies here.

SPD is Sensory Processing Disorder, and it's only just recently becoming widely understood and accepted as a legitimate issue. Most kids with AS are believed to have some degree of SPD. Your description sounds to me like he has it- but I'm not a professional. I would recommend 2 things - first, get the book "Raising a Sensory Smart Child" and read it right away. Second, find an OT who is experienced in assessing kids with spd - it's important that you confirm this with them before employing them (most private insurance or employers' insurance will cover some amount of OT).

If your son has significant sensory issues, they may very well be the root cause of most of his ADHD-like issues, and you may be able to remove his adhd meds and diagnosis entirely. But more than that, you may be able to implement strategies that actually WORK for him. Be aware though, that there is no pill for spd - it's a lot more work to properly manage and treat SPD than it is to give a kid a pill so just be prepared that you as the parent will need to implement a lot of fairly time-consuming activities (and you'll need an IEP that accommodates many of the same strategies at school). But for us it has been well worth it, because we see the results in our son's behaviour and his happiness.

HOLY CRAP-COOKIES!

I am reading "Congratulations! Your Child is Strange". WOW! I'm in the section "Thinking Differently" and so totally see my son. This explains so much! Everyday I pick Ben up from school and ask, "How was your day?" Standard answer is "Good". Which leads to me asking, "What was good about it?" and when he can't answer I ask what he learned... I've gotten to where I ask "what made you laugh?", "what made you angry?", "What made you happy?", amazed, confused, interested you, etc.... The answer is always "Nothing" or "I don't know".

I always figured I wasn't asking the "right" way. The only time I get an informative answer is when he's upset about something.

I think maybe I need to focus less on getting a productive answer than just simply having a give and take conversation. I am not so good with the social skills either and really really suck at small talk. I know that he tries to have the conversations. He will ask me "How was your day mom." but the conversations just dwindle after a few minutes. Every time that happens it's like I feel the conversation slipping through my fingers and don't know how to revive it. Then, a few minutes later, he will ask me the same question... Sometimes I get frustrated with the repetitiveness, but maybe I should just be happy he's making the effort.

And work on my own conversational skills. How in the hell can he learn to interact properly if I can't freaking do it?

Hi, don't know how helpful I'll be or if in deed I can offer any help at all. I can offer support.

I have a 12 year old dx'ed with AS,ADHD (combined type), OCD, generalized anxiety disorder and tourettes. My son in no genius, in fact his most difficult subject would be maths he is a few years behind. My son currently takes half a 20 mg tablet of Lovan for his anxiety, and he takes Strattera for the ADHD and OCD. We have been offered more meds, but I didn't want the ones he's on in the first place, so I am certainly not adding any more. I have been told by a couple of doctors that ADHD meds will only take the edge off by about 10 percent.

We have done so much work on my son's maths skills he really should be a math wiz, but he's not. I even considered that perhaps he has the numeric version of dyslexia, we have never tested this though. What I have found is that when stress increases so do the symptoms of everything else. It's also very hard sometimes to get others to understand, they start to say things like "your son wasn't doing this before, so he is manipulating you/us". "he is just trying to avoid it", "he can do this stuff because he is clever at x y z"

My theory is, maths doesn't come naturally for my son. He has been in lots of remedial maths focus groups and he knows this and this has added to his anxiety. It has gotten to the stage now, that even handing him a maths work sheet or saying it's maths time his anxiety amps up. With the heightened anxiety it's hard to retain information and to focus on the task at hand. I'm not as concerned as I used to be, because like your son for some reason he can do some of the maths questions/problems when they are taken out of the focus group.

It was suggested to me by a wonderful person on this board, to teach my son how to use a calculator, because after all the chances of him actually sitting down and working his shopping/banking balance/budget out manually later is virtually non existent. I put this information to my son's teachers last year, whilst they didn't go along with it entirely, they did make a calculator available to him, they also had the times tables charts laminated and left on his desk. The pressure was taken off him. Now I'm finding, my son is telling me this year that maths is one of his favorite subjects, (he still isn't up to the speed of the other kids, he's still years behind) but more information is being retained because he is less stressed.

If only I had known years ago what I know now my oldest son would be a lot better off. I have a 21 year old son who has never been dx'ed (but I'm fairly certain he is on the spectrum). My oldest son has severe learning difficulties, he is years and years behind his peers. His short term memory is virtually non existent. For years when my oldest was at primary school, both my mum and I would do lots and lots of remedial home work with my oldest, he would "get it" then get to school or the next day would come and every thing he learnt was gone. I had no idea that he might be on the spectrum, so no interventions were put in place, just lots more pressure by drilling this info in his head. All the pressure and stress this caused must have been unbearable at times. Very little of the info we drilled into my oldest son has been retained.

Sorry I'm waffling now, not sure if anything I've said will help at all.

Thank you aurea!

I am beginning to accept that there are no "answers", but every experience and idea helps.. even if it's just reaffirming that I'm not the only mom in the world struggling with this.
I am currently reading one of the books recommended to me (written by one of the members here) and finding it to be one revelation after another. (Also find myself evaluating some of my own quirks and issues....... perhaps that's normal... but I find myself thinking "s**t, I do that..... crap... that's me too!" hmmmmmm?)

One thing that I'm wondering is.... well, I've been concentrating on trying to get him to memorize his multiplication tables... (He can multiply with a calculator and with a times tables chart)(I'm not quite ready to give up trying to teach him without a tool... I feel like I just need to find out HOW to teach him)... but I'm thinking that I'm going about this all wrong. Basically, I'm asking him to memorize all these problems and figures with no logical rhyme or reason to him.

He does need to learn his count-bys... It makes sense to me that if he can memorize the 2's, 5's, and 10's... with effort, he should be able to do the inbetweens.. it's just harder... maybe....?
As for multiplication, maybe I can get him to memorize the steps... not a gazillion different problems, but one set of steps that will allow him to figure out any problem once he knows his count-bys.
If the problem is 6 x 5 = ?
1.) What is my easiest count-by number?___ (because he has a hard time understanding you don't have to go 6, 12, 18, 24, 30)
2.) How many groupings do I use? ____
3.) Count-by ___ to ____ places.
4.) That is the answer...

Or something like that....
It's worth a try at least.