Cycles

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I posted a thread in the Adult Autism forum and thought I'd ask here since I'm a parent as well.

I have a 10 yr old with ASD (high functioning). He was diagnosed 5 months ago. My biggest challenge with him is understanding his mood cycles. I'm not sure how much of it is strictly related to Autism or if it's all to do with food trigger. He has a few food sensitivities: milk, food colouring, msg, oranges.. and we're in the process of testing other items as well.

Anyway, he functions quite well for the most part. He requires a lot of redirection, prompts, "teachable-moments". He's in a socials skills group at school because he has difficulties with that. Having said that, he is doing much better this year with his peers, and something I'm very happy with.

The problem is when he goes through a rough patch of time, approx 1week-1month, give and take, where EVERYTHING is a challenge. He becomes quite aggressive at a drop of a hat. He swears, screams, throw things. His tantrums can last an hour or so and it's exhausting. Homework time is a nightmare, even when it's minimal, and even when he knows a preferred activity is given once it's done. He does not manage disappointment well at all!! Transitions can be a big problem en route to morning daycare. Then, one day, it's all over with. He's back to "his" normal self and I am able to manage, help, support him with ease.

Is this a common ASD trait? Do people with ASD go through these mood phases?

For the longest time, this was the sole reason we didn't accept the diagnosis of Asperger's for my son, because I assumed that it was a set of behaviors that stayed constant all the time.

There are kids, like my son, who are really good at "faking it" and suppressing their frustration for lengths of time - until about this year, my son would have two to five major "incidents" per year, have really bad weeks associated with those incidents, and seem fine for the rest of the time. While the incidents were always attributable to something, (sometimes it took a lot of detective work to figure out what set it off - but invariably it was some issue with change: schedule change, teacher change, etc.) it was never consistent - and never a trigger that hadn't occured at some point during the time when he was OK.

When we finally got an accurate clinical diagnosis from people who knew what they were doing, they told us that many kids are able to hold it in for huge lengths of time, and then all their frustration will come out at once - one therapist likened it to "holding a beach ball under water." We've been working with DS through this behavioral center for a while...and his behavior appears worse, but actually it has just evened out (and is slightly better overall - though the explosiveness has been greatly reduced.)

So, no - I don't think it's unusual nor that it necessarily means there is something else besides ASD going on - although in my son's case, they didn't rule out a concurrent anxiety disorder (which is what I had thought was causing the ebb and flow in behaviors.) The key difference is that my son responded best to treatments designed for autistic kids, and not that well for treatments designed to address only mood disorders.

Thanks mom. Same with my son. He didnt respond well with treatments for mood disorders either. He was put on several different medications to help with this but regardless what he was on, he would still cycle. In fact, the meds made things more challenging. I don't know if my son "fakes it" to be honest. I just think if he's on, he's on. If he's not, he's not. It's my biggest worry because as he's getting older, the problems are becoming more serious. I can't imagine what this would look like when he's an adult.. and the consequences are equally as serious and out of my control!

It's been a rough couple of weeks. I have partially attributed it to the chocolate he's eaten. Sounds odd I know but it sure did have that "cause and effect" appeal. Since he's sensitive to milk, milk chocolate doesn't help. He's been drinking rice milk since he was three and several people noticed a marked difference in him when he was taken off the cow's milk. It may also explain why November has been the hardest month of the year for the past 3 years. Halloween. He never liked candy because it was too hard for him (sensory) so I would only allow him to have the chocolate bars and certain chips. When he was little, he used to trade in his halloween candies for a bag of dollar store trinkets. But now that he's older, he hasn't been interested in the little toys .. which is why November has been a problem in the last few years.

Anyway, I'm thinking his school feels that I'm just blaming yet another thing. First the meds, now the food. It's stressful when you get an email from the teacher saying that my son has anger problems at home.. especially when he's typically a happy kid when he's not in this cycle.

We're having trouble with these "cycles" now too. This past week my daughter has been very aggressive. When I try to prompt her to work on her homework she refuses, gets very angry, and two days ago she started throwing things and when I sent her to her room she proceeded to destroy her room while crying. Then, this morning she awoke in a better mood than usual. I am perplexed by the mood swings!

My daughter is also sensitive to certain foods but she didn't have any Easter treats so I don't know if it's something like school winding down, or the day off school, or what? I am going to start journaling the swings to see if there's something I am overlooking. My daughter's therapist mentioned the dreaded "Bipolar" which I am always leery of because my daughter does have so many of the other symptoms. But then again, so many of them overlap with AS, so it's hard to tell. One of the symptoms in mania is getting really "into" a certain project and my daughter does this to an extreme. She also has pretty severe separation anxiety which is another symptom.

Hi Grace,

My son was "tested" for bipolar as well. And by that, it means they gave him an anti-psychotic drug. If he reacted positively, the conclusion was positive. If he reacted negatively, the conclusion was negative. The fact that he handled stimulants better than the anti-psychotics implied that he does not have bi-polar.

As for your daughter, it doesn't have to be the sweets. I came across a potential list of foods that's been related to behaviour:
milk products, potatos, tomatos, peppers, peas, beans, eggs, and citrus fruits

After we test out the dairy free dark chocolate (im pretty certain the milk choc is a trigger), we're going to test the cheese and see if he reacts. Unfortunately for us, this list is what we typically eat .. yikes.

With my son, we found that the biggest stressor was a problem with pragmatic speech. He had a not obvious but significant difficulty understanding what people meant when they communicated with him, and difficulty expressing himself in a way that others could understand. On a given day, this was mildly annoying for him - but over the course of several months, he'd get progressively more and more frustrated until he exploded (and, yes, the exploding could be over the course of a week, or as long as a month - one thing about being explosive is that nobody wants to talk to you and they leave you alone, so for him there was a degree to which it worked out.)

This isn't to say that every kid's pattern involves pragmatic speech - but I wouldn't be surprised if this type of pattern indicates ongoing, low-level stress that finally becomes intolerable (note - I'm not a doctor - this is just a guess.) I would take notes as to what was different when your child goes from explosive to calm, rather than just when they go from calm to explosive, which is what most people do. Make sure you note not just your child's behavior, but environment both physical and social, and other factors like physical symptoms, overall health, schedule changes, family problems, etc.

I should add - I think if food allergies are a concern, you might be well-served to see an allergy specialist and ask for a "double-blind allergy food challenge" test. This test makes certain that there is no confusion over which foods are allergens, and the degree to which they affect the child, and thus prevents families from having to follow a difficult diet without being certain which foods are the cause of concern.

Thanks mom,

Speech is a problem for him as well. He has the ability to talk but his perception of what's been said is often misinterpreted. The avoidance tactic you speak of is bang on. He usually falls apart agressively after he doesn't get what he wants.. but I've never been the one to give him everything he wants and he knows that. So why he tantrums during these cycles, is still confusing and frustrating for me. Another example is around homework and I guess his brain is fully loaded that he can't take on anything that requires mental focus?

Interesting point about the explosive-to-calm. What is different is: a completed assignment, task. If he gets really out of hand and it's close to bedtime, I just send him to bed (as I did last night). This morning I had him finish his homework which was to write 5 sentences. We had problems this morning as well. If I lower the homework expectations, I'm worried that once he's out of this cycle, he's going to expect me to lower the expectations always .. I don't want to open up a can of worms.. which is why I had him finish it this morning. Having said that, once I'm back to work full time (May) I won't be able to use this as an option. Another difference is having a distraction that works. Giving him his Nintendo DS when he's boiled over, helps.. or it has been. The last time I tried it, it escalated his behaviours because he wasn't "winning" the game. This method was working for a couple of months though.

I've tried the process of ellimination diet before. I have a pretty good understanding on how it works so I don't feel the need to have an allergy specialist involved. I spoke with a dietician once before, years back, and she had no clue in what I was talking about so I decided it was just easier for me to tackle this thing on my own .. after doing some extensive research.

Yes, I didn't mean to imply it was the sweets. We are on the Failsafe diet so she has a very restricted diet. We have been through the elimination diet and are pretty confident what she is reactive to. She is highly reactive to artificial dyes and flavors, BHA and BHT, as well as MSG and artificial sweeteners. That is interesting about the anti-psychotics. I have never heard that the effectiveness of meds are used as a diagnostic tool. I am currently reading "Bipolar Kids" and finding the descriptions fit my daughter really well. If she didn't also have the pragmatic issues, ToM differences, and coordination issues I might be likely to believe she was misdiagnosed with AS. It's just hard because it is not often that you find violent behavior with AS so I struggle to understand why this behavior occurs, and why it is even getting worse at times. I go above and beyond to make sure she has the supports, therapy, time to relax, etc but these outbursts seem to "come out of nowhere" and take me by surprise. I think she is just so agitated by "keeping it together" due to anxiety that she explodes. When we attempted SSRIs it made it so much worse and even brought on worse side effects such as debilitating OCD behaviors and thoughts. I am really worried about how I will deal with this when she is older and stronger.

I've been working with children with ASD for the past 8 years and have to say, many of them have behavioural issues like this. They were more lower functioning so I attributed it as being frustrated with the inability to communicate, since most of them were non-verbal or had very little language output. They were also younger and my son is now an intermediate and being high functioning, I'm kind of out of my element. Classic Autism, I am very familiar with but Aspergers and High Functioning, not so much. I understand the differences but when it comes to certain behaviours from my son .. I need clarification.. which is what brought me here. I'm surprised you dont think violent behaviours is common for ASD.

SSRI's were the last meds my son was on and holy man! His dosage wasn't even that high and he had a rough reaction. His school started questioning my parenting abilities because of some of the things that were going on. Once we decided to take him off, I had to have a meeting with them to explain the nature of the meds and why he was reacting so much.

You know, I was reading a bit about vaccinations and a lot of the food sensitivities both our children have, are actually used in the vaccines!! How about that..

My son has had violent behavior, and a number of other ASD kids in his social skills class have had them as well. I think it's actually fairly common, though unquestionably not universal.

Not sure that I was clear before: I guess what I meant by explosive-to-calm was not what calms him down when he's explosive in the immediate sense, but after he ends an explosive period and goes into a period of calm for a length of time - for instance, with my son and the pragmatics issues, people leave him alone and he's isolated after an explosion: that's what's different. He needs the isolation to calm down and reset - but it was difficult to figure this out because the explosions seemed to come out of nowhere, and it didn't occur to us that people leaving him alone was significant.

My daughter is actually very high functioning. She is hyper verbal although she did have a language delay. She had no words at all until about age 2 and a half. She hides her stims quite well, has only minor tics that are more socially acceptable (sniffing and throat clearing), and actually one on one with an adult she is quite sociable (when she wants to be) and extremely eloquent and smart. She can be loving and sweet and can actually seek out attention and affection from those she knows. She is amazingly proficient in math and puzzles but struggles with reading. Anyway, I say all this because when you juxtapose all that with the times when she becomes aggressive and violent towards others and the way that these moments can be brought on so suddenly and seemingly without provocation, it's alarming. With my daughter it has always been that she runs hot or cold-never in between. Sometimes I feel like I'm walking through a mine field and I worry that I too often try hard NOT to provoke her-almost as if I am in fear of her. Actually I am in fear of a meltdown because we have had some VERY BAD ones, the kinds where it takes me weeks to get over the depression and futile feelings of helplessness. As parents we seek help from the doctors and therapists but no one lives with us, experiences it with us, and sometimes I think no one would BELIEVE it if they did see it. On good days I think everyone's wrong, she'll grow out of it, she'll be fine, and on the bad days I wonder if she'll end up institutionalized and how would I ever be able to deal with that? I guess that's why were all here on WP, because who are you actually going to say these things to in real life? Who else would understand?