placement out of the home

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Hi everybody. My son, age 13, is really not great with his primary caretakers - me, my mom, my dad, my husband. I've detailed his issues here but in brief he's rude, angry, he lectures us, he chastises us, screams at the top of his lungs at us usually a couple times per day, tells us no when asked to do something around the house or to do school work, tells us he doesn't have to obey us, tells us we have to obey him, and has about one episode per week of pushing one of us or blocking our pathway so we can't get to where we are going, as well as a few episodes per week of throwing things in anger and kicking things. For example tonight he was banned from my mom's house (we have two houses on the same property) for repeatedly swinging an umbrella into her ceiling fan earlier today, telling her he can do it if he wants to even if she told him to stop, telling her he wouldn't break anything and that he had to do it to "exercise" his arm, almost hitting her with it, so knowing he was banned he went to her house anyway and broke into her back yard (front door was locked) and as she stood by the back door telling him to go back home he broke the door open and slammed it into her several times until he got her far enough from the door that he could get in it and almost knocked her down. She is elderly and not very mobile.)

He's been homeschooled for the last 4 years, but he attends a lot of activities: drama, art, science labs, karate, woodshop, dance, cooking, CPR, babysitting certification, and there is a gym he goes to where he can stay for 6 hours at a time and do parkour, archery, fencing, knife throwing, and other things like that. Most of the other activities are for 2 hours, and drama is for 4 hours. He also has tutoring for 2 hours twice per week. He helps me in my home business when people come here to ride horses for birthday parties and whatnot, and of course we see him interact with other adults in the community. In all these circumstances he is never anything but totally amazing. I mean seriously amazing. I get compliments about him all the time. He is so sweet with small kids and so polite and a good conversationalist with adults. At the gym he goes to he even leads parkour classes with adults in them, and he's so encouraging and motivating and articulate and knows just when somebody needs help and he praises and gives constructive advice. Amazing.

He was also in a psych hospital for 3 days recently and they said he was the best behaved kid ever and he spent all his time trying to help the other patients. There was a girl there who'd been repeatedly sexually assaulted, and she had never consensually hugged a male, but when my son left, she wanted to hug him goodbye, her first. Amazing.

So, my question is about out of home placements. His counselor has heard all that goes on at home and she's actually seen him sort of mad, and she believes he needs to be out of the home. His counselor says that I'm an amazing mom and that I'm not doing anything bad to cause any of the issues. Not considering the logistics of who would decide, who would pay, etc, do you think that it's better for him in the long run if he was in an environment where for whatever reason he's acting and behaving better than he does at home? Like, to instill a habit? Or the converse, that being at home and feeling free enough to do the things he does is bad for him?

He says he's just acting when he's with other people, that he is afraid of how adults outside the family would treat him if he was his true self in front of them, and he says he doesn't want to go. I don't know if any kids would want to go, but does that make a difference? He says he can't use his fear of going and his desire to stay in the home to motivate him to behave better. He says he can't stop himself. But maybe that's good - maybe he should use that fear to behave better. Maybe that's good for him. Maybe that's sort of what we all do - we all have inhibitions based on what we think might happen if we behave in certain ways.

My mom is in chronic pain from gout and osteoarthritis and has heart disease. She can barely walk, she can barely use her arms and can't use her hands at all. My son is going to really hurt her if this doesn't stop. He hurt her today but he didn't knock her down thank goodness. You know how it goes for old people, they fall, they break a hip, and that's the end of that. But disregarding the issues of what is right for the rest of our family, what do you think about my outside the home placement question for my son?

After reading that, I'm wondering if part of the problem is that he's worn out and not coping. When does he have any downtime? If I was doing that much I'd be melting down too.

His issues could be autism but they could be the fact he's a teenager and teenagers
even well behaved ones hate too listen to their parents.

No one but a doctor can suggest placement.
Talk to the people who cared for him for the 3 days and find out what they did
Respite care might also be an option like just the weekends

I would suggest to stop homeschooling at least for while
your son might need structure that is in school since he's behaving at activities
I don't know if knife throwing in a gym is a good activity if he has anger issues
Is it encouraging him to throw things? Maybe an alternate gym would be better.

Getting an additional family therapist might help.

Revaluate your reward system and stresses is there anything in the home that can be causing him stress?
Do you have too little structure, too many things. Do some lights bother him, sounds, smells?
One thing I did to remove stresses was to pare down clutter.

With the umbrella maybe he need misdirection first as in getting him involved with something else.

If the reverse were happening -- if he was in public school and exhibiting this level of violence there, but perfectly behaved at home -- I think we'd all be saying pull him out of school and find another setting. If you do decide to seek a residential placement for him, don't beat yourself up and feel you have "failed". You are trying your very best to give him what he needs to survive and thrive in this world, and for some kids that may include a time outside the family home.

You definitely need some heavy-duty help as long as he is at home. He's seeing a counselor, how much is that person doing to help the family make changes?

I suspect there is something to the other comment that your son is exerting a huge amount of energy to be well-behaved outside the home. He may have no energy left to control himself at home, but it may also be the case that he's developed some very maladaptive expectations about how much the other family members should put up with.

You're in a very very tough spot, and my heart goes out to you.

This kid just has way, way too much on his plate. Too many activities, plus schoolwork, plus helping run the family business, plus puberty (which is its own category, I think). It would be difficult for an NT child to keep up with all of that, much less a child with ASD.
1. He needs a safe, comfortable place to relax without anyone bothering him.
2. He needs time to spend in that place, doing whatever he enjoys. I'm talking about hours per day, not fifteen minutes now and then. This isn't a luxury - his brain NEEDS this. Think of it as an "activity" if you like; it may not seem like a constructive use of time to you, but it is essential for him.

I am so sorry you are faced with this incredibly difficult decision.

I, also, had a son who held it together in public (mostly) and let us have it in private. I was terrified of what would happen to him if I allowed his violent behavior to continue, and we wound up paying crazy amounts of money for RDI therapy largely because they ask you to videotape your interactions with your child - because I thought it somehow was my fault and that if a therapist could pinpoint what I was doing wrong, they could fix it.

I don't think anybody here can answer this question for you. I would ask you this: what are YOUR thoughts? It seems like this is an outside idea, and I can't really tell if you are asking because the idea makes you uncomfortable and doesn't feel right or if you're asking because it sounds to you like it might work but you feel guilty about being let off the hook (and don't. Parents who look for answers are good parents.)

I will say this: many kids who are violent suffer more from rigidity than other kids on the spectrum - somewhere here there is a study that outlines it. As their flexibility increases, their rigidity (which, if you look at your son's behavior, sounds right) decreases.

My son stopped hitting us at around 11, and although we still have angry outbursts, they are fewer in number and in intensity - physical violence hasn't happened in the last 3 years (he is fourteen.) While I do believe that a major part of my son's change was developmental (and that is something to think about - what is your son's unique developmental trajectory, and how will placement relate to that?) we did do some things that helped: first, we bulit a scaffold to make sure that his life was as predictable as possible (he went to public school, so you may need to moderate this as you can control more variables than we could.) If there was going to be a change in his day, we warned him about it as soon as possible and explained to him that changes sometimes make him "feel weird," but that it would be OK, things would go back to normal and the feeling would eventually go away. Finding ways to make him feel safe in what was, for him, a very confusing, arbitrary, and painful world were very important.

We cut activities to one or two per week, including therapy groups. Being social, even in sports, came at a very high price for my son, one of our therapists likened it to holding a beach ball under water...eventually it's going to come out at someone with force. The more stressed he was, the better behaved he was outside the home and the worse it was once he got home with us - because he felt safe at home to let out all his fear and frustration. It took us a while to see and understand this.

We also got him pragmatic speech therapy, which while it didn't directly have anything to do with the rigidity, did help address his confusion with communication: although he had a college-level vocabulary, we had not realized that due to his deficit in social speech use, he was only understanding about 70% of what he heard, and didn't always verbalize the things other people needed him to say. Just understanding this difference helped my son significantly.

We had all kinds of other systems that we used - if you search in the Parenting Index there are several sections that have our stories and the stories of other parents. The main thing was to reduce confusion in his world as much as possible, and to view his behavior as a kind of barometer for what was working and what wasn't. Sometimes it helped us to realize that "developmental delay" means just that; his behavior is like that of younger children - some people here say 1/3 less their chronological age, so when you framed my 11-year-old's behavior as the behavior of a kindergartener or first grader, it made more sense and seemed less frightening.

I would also urge you to get a second professional opinion if you can: you obviously know placement is not something to enter into lightly. I would want more details on what placement would mean, how the therapist thinks it would be better for your son than at home, what they will do to serve his needs better. Make sure you ask an autism specialist; most professionals outside that specialty DO NOT know the right way to handle kids on the spectrum (from sad experience) and can steer you the wrong way. You want a developmental pediatrician or a pediatric neuropsychologist.

I think the key is in this. Unfortunately, if he lives outside of the home, at some point all the negative energy WILL have to break its way out, and you could see something more frightening than you already have. While placing him elsewhere may be a good way to keep your mother and other family members safe, it will not "cure" the problem, just temporarily bury it.

I strongly urge you to find the sources of his stress, the cause of all that negative energy, if there is any possible way. Maybe he is too busy. Maybe he is in constant sensory overload. I don't know what the cause is, and finding it, I know, can be like looking for a needle in a haystack. But that is the only way to "solve" the issue in a permanent way.

One thing to look at is everything that has happened in the 24 hours BEFORE each incident. Even things he enjoys may be stressful for him, so don't discount something as a potential trigger just because he loves it.

Since he doesn't want to leave, I think you could use that factor as a wedge while he is home. My idea would be to create a "safe" room for him, where he can not do any damage, and tell him that he should put himself in that room whenever he feels the urge to be violent or destructive. Have things in there he can safely destroy or punch, so he can release some of that energy when working to self calm, too. Maybe he can help you design the room. Tell him that learning to use the room is necessary to keep the other family members safe and, thus, a condition of staying in the home. Tell you don't expect him to figure it out overnight, but that if you don't see progress and effort then, for the safety of the family, you may have to find another place for him to live, which you really don't want to do, because of course you love him and want him around - just not his violence and destruction.

And work on all the other areas MomSparky mentioned, as well.

I can't imagine being in a position to have to think of this as a possibility. I am so sorry.

I know someone who had her son placed. The truth of the matter is, he was much better afterward, and when he came home to "visit" he handled it much better.

I don't know if I would ever be able to do it, but I have been at this long enough to know you should never think you know for certain what you would or wouldn't do if you were in someone else's shoes.

Thanks everybody. I'll write a quickie clarification. Those activities I listed are not all done at the same time. They were given as examples of things he's done over the years in which he's been away from me for a period of time and has been amazingly well behaved. At any given time he does a couple things. He's homeschooled and we don't do very much academics because he hates it, so a typical week looks like:

Monday: Feed chickens, go to woodshop for 2 hours, read in the car on the way, feed cats at home, clean litter box. Free time the rest of the day.

Tuesday: Feed chickens, go to the gym where he stays for 5 hours. There he hangs out with other kids for part of the time, participates in classes for part of the time, leads classes part of the time. Read in the car, maybe. Feed cats.

Wednesday: Two hours of academic tutoring in the home with a tutor. Feed chickens and cats.

Thursday: Just like Tuesday.

Friday: Drama class for 4 hours, reading, go to a coffee shop for some academic work, feed cats.

Saturday: Just like Tues/Thurs

Sunday: Just like Wednesday

Once per week i can sometimes get him to unload the dishwasher, maybe take out garbage, maybe something else. It used to be also that two or three times per week we'd sit down for academics but he's been refusing that for months. We usually do "academics" in the car, in the form of discussions augmented with him looking stuff up on the internet as we drive.

As for helping with the family business, he's not required to. He comes out maybe once per month to the barn when there is a birthday party going on and helps for a while. This is one of the things he loves to do.

The thing about down time with him is that is when he really explodes. If we are on the go all day and having a lot of rush rush he does very very very well. This is very typical of the kids with the Pathological Demand Avoidance sort of autism. They do better with novel circumstances, interest and intrigue, and some sort of reason other than a person telling them to do something. The days he has a lot of free time are the days he can really have major meltdowns.

So I know and totally understand why people might think he needs down time, but what he needs is to learn how to handle down time. He will follow us around screaming at us to find something for him to do. Most everything we suggest he'll scream NO about. Sometimes we can get him to veg out in front of the TV - he's actually doing that more now that he's not doing as much academics. But he has tons of available down time that he doesn't know what to do with.

As for him being a teenager, none of these issues are new. He's been the same since preschool age. As a toddler he was inhibited and very autistic-seeming. He missed an official diagnosis because he was capable of showing love to family members. All the same issues of sometimes hitting us, sometimes tantruming, needing to be in control of everything (conversations, our facial expressions, where we sit at the dinner table, when we can and can't touch him or sometimes even look at him, screaming when mad, berating us and lecturing us, not wanting to do school or chores) have all been the same since age 4. Since he reached the age of 11 or so, most people we meet who didn't already know us say oh, he's just becoming a teenager, but no, nothing is different.

He doesn't even have typical teenager things like slamming the door and spending time alone. He will sometimes slam the door when he's mad but he slams it toward us and stays with us because he won't go anywhere alone. He still wants me to dress him, he wants to sleep with me at night, he wants me to brush his teeth (when he agrees to brush them)... He's not teenager-y at all yet. Emotional development tests he's had done have scored him in the age 2 to 5 range.

We've had a counselor for a year then a new one for two years, and both said that they reached a wall with him because he won't work on anything he's learning. He can talk in the session about coping mechanisms and can make a list of things he can do when he gets mad to help him not lash out, but then when he gets mad he won't do any of the things he's agreed to do. He has also refused all their assignments (like write a list of what happened this week that made you mad, draw a picture of things in your life that you like - anything and everything they've assigned him to do, he won't do. At home. He will do them with the counselor in the session.) Both counselors and both psychiatrists he's had have said he'd do better in an out of home placement OR with a full time in home aide. I'm not sure how to get one of those.

The not working on things he learns in counseling, not really understanding the antecedents to his outbursts, not understanding the consequences of treating us the way he does, are all very typical of the Pathological Demand Avoidance syndrome. These kids are experts at social mimicry and they can bamboozle diagnosticians with their seemingly advanced social abilities. But those of us who know them well know that they are performing at a level way beyond their actual understanding of what's going on. It's like hyperlexia. He is acting in a way that is beyond his actual comprehension of what's really going on. Hypersocialality. Not a word, but it should be.

So back to my original question. If a kid behaves better away from home, is that a reason to send him away from home? Is it good for him to be in a better habit? Is it bad to be in a habit of being so mean and controlling? I know there are other considerations, namely my sanity and my mom's physical health. But just thinking about habits and routines of behaviors, do you think it's bad, so to speak, to "let" it happen over and over and over by letting him stay in the environment where it keeps happening?

I agree with your instinct that it's not healthy to allow bad habits to continue. And that a child who will not/cannot tolerate any parental guidance and direction, heartbreaking as it is, must back down and accept you are in charge or be offered a chance to learn in a different environment. I would sacrifice having my child home. We are the adults, we have to make the decisions best we can. What your child wants is a consideration, but it doesn't sound like you feel he can change in his current environment.

This is no one's fault.

Thanks thanks thanks again everybody. I am not sure why I'm asking - I am still caught up in the realization that he's more disabled than I ever thought. I had always been thinking as he got older he'd get better. I don't want him to be away from home but I want what's best for him and if he behaves better elsewhere then maybe he should be elsewhere for more of the time, or all of the time.

The outbursts are almost always ONLY when we place a demand. Sometimes he gets overwhelmed from life issues in general (pants don't fit right, can't find what he's looking for, etc) but those are not usually too awful because he's more likely to accept help (but not always, and he does often blame me for things like him dropping something, he'll say it's my fault because I distracted him or something like that.) The bad outbursts are when I ask him to do something that he doesn't want to do. I have been backing off all expectations to try to get him calmed down and it's better, but I'm not sure how good it is for him to live for weeks or months (or years) on end doing only what he wants to do. If other people are around, or if it's a rare time that he gets intensely interested in something, he can do all kinds of cool stuff. So my question is I guess which is better, let him do nothing, or hire people to come around or to house him who can motivate him to be competent.

He doesn't seem to suffer any ill effects from keeping it together socially. He is usually better after a long event, and much worse on days we are just hanging out at home. I think because he worries when we're home I might place a demand on him. So I feel somewhat strongly that in a residential placement he wouldn't ultimately have a big blow up from the stress. But I'm not positive, of course.

As for going to a room when mad or trying to stop it before it happens, it's so so so hard. He won't leave the room, he won't leave my side, but he doesn't want me to do anything that he can articulate. He'll scream "DO SOMETHING TO HELP ME NOW" and I'll say OK, should I do this or this or this and he'll scream "GET AWAY FROM ME, NO, I HATE YOU." If I try to touch him, he punches me. If I say I'll leave so he can be alone, he freaks out and follows me or blocks my path. I mean seriously, I'm at my wits end with this. I have no idea what to do in the moment. I can sometimes use some humor but often it makes him mad. The thing that's actually helped is three times I've started crying, and that got him out of it all three times, but I don't want that to be a habit. It's like a domestic violence relationship - he flips out, I cry, he apologizes and says he won't do it again, but then he does. Hours later or the next day. And that's can't possibly be good for him.

As we've talked about tons in counseling, he has no ramp up period, it's just wham, super mad. Afterwards he can talk about it but he can't come up with anything we should try, and doesn't like any of my suggestions. He says when it's happening, he's not in control of his body or his words or actions. He says he's like a little person shoved into a closet and this other person has taken over and he's trying to get the other person to stop but he won't stop.

He has been in on the discussion for the last year that he might have to live elsewhere for a while. He says that when he gets mad, he doesn't care about that, he can't make himself care. He also seems to have some cognitive issues with understanding it. For example, during his IEP meetings which he's been present for, and in talks with me, he's heard that I've been considering putting him back in regular school since he refuses academic work with me. He used to say no, please, and then it switched to I understand but don't want to, and then we had a meeting at the public school and they encouraged him and said he'd like it and he said OK he'd try it, and I talked later about how this play was the last one he would be in with the homeschool program and how he can pick some evening activities but he won't be able to do as many, etc etc, and he was sad but said he understood. Then a couple days ago when he had his play, afterwards he said "next semester they are doing such-and-such" and was all excited, and I gently reminded him that he's going to be in regular school now and can't attend the homeschool drama class, and he lost it - sad, crying, he didn't realize that was happening, he didn't remember our conversations, etc. That sort of thing happens a lot. I'm starting to draw pictures for him again like when he was younger to help him understand what's going on.

Anyway I mention all that to illustrate how he hasn't been able to use any of that information to modify his behaviors. Even though he says he wants to.

I've hired a gal who used to teach special ed for a private school to come to our house and do some sessions with him going thru the Mind Up middle school book and an anger workbook. He won't do anything with me - I can't get him to listen to a social story or draw a picture or go thru those two books or anything. We can have discussions but often when he suspects I'm trying to explain to him things about the brain or ways people can try to control themselves he gets mad. He just doesn't want it to come from me.

We see a pediatric neurologist on Monday so maybe that'll have a good result. The regional center can't get to him for 6 weeks.

Thanks for all the input.

Your son may have a variation that is beyond my ability to give decent advice. So many things you wrote about are totally flipped from how they are with my son and so many of the kids I've advised on here.

You say he seems to thrive with change in routine? Things that are new? Would he agree with that statement?

If so, maybe a change would work. One the reasons I am so strongly for looking for all solutions OTHER than an out-of-home placement is how negative out-of-home experiences were for many members of this forum. The loss of routine and familiarity was devastating for them. But is it possible that this is all flipped for your unique child? I suppose it is. But, then again, if he has the emotional maturity of a 5 year old, that would seem to work against the idea. I can't imagine having to make this call and having your set of facts and circumstances.

You aren't a bad parent for (a) wanting to figure out how to solve things, even if that means doing some things others don't believe they would do, (b) needing to keep other family members safe, and or (c) sometimes making the wrong call. As parents, our job is to gather information, pay attention to our child so we come as close to knowing what he needs as possible, and using that information to make decisions we believe will be in the child's best interest. Perfection is not part of the job description, and you don't have to get an "A" to figuratively pass the course.

What you DO want to do is avoiding making commitments you will be hesitant to back out of should proof arise that you've made a bad decision. In that case, that might mean: don't put in a one year advance payment that you can't afford to lose. Don't choose something so far away that you can't pull him out with a 4 hour notice. And so on. Be prepared to have your eyes and ears open and change your mind if necessary. My biggest regrets were the times I didn't change a situation for my son despite knowing it really needed to be changed, and just sticking things out because the alternatives seemed too complicated.

I would also look into getting a full time aid in the home. That sounds like an interesting alternative to me, and one that would leave doors open.

I really do wish you luck and am sorry I can't give a more leading answer.

Thank you! Yes, it is quite different from typical spectrum kids. He thrives on novelty. He does get very very upset if there was something happening that he wanted to happen that then doesn't. But if something happens - if a kid shows up for a lesson and he hadn't realized I was going to have a younger kid that day, he'll bounce out of the house all happy and helpful. If an animal gets hurt, if one of the elders has to go to the hospital, if something breaks, if a dog poops in the house, lol, any of that is likely to get him into fix-it "I'm the boss" mode. If I say guess what, we're going to your uncle's house, or we're going christmas shopping, he'll jump up all happy. If he's enjoying free time on his computer he will often not want to go places with us - that's the only time he acts independent as far as not needing to be with me at all times - but he'll get off the computer if something really wacky happens.

I'm not sure it's really positive, because after reading about pathological demand avoidance, I can see that when these things happen, he likes to use them to take charge and boss us around. He wants to do things his own way, and he often tells us that he's in charge of us, that he doesn't have to do things the way we want him to, etc. The PDA kids have a confusion about their roles as subordinates, and he definitely does. If we ever ask him to throw away his garbage or pick something up he's likely to say no, and why should I, and he'll often say that if we are allowed to give him commands that he's allowed to give us commands too, or that if we remove privilege due to a behavior that he's allowed to take away stuff we like too (just for spite, he'll even say just to get even, not just as a punishment.) He also is in semi hot water from time to time at the gym he goes to for trying to be in control. But (so far) all he does is complain to me about that - he hasn't said anything rude to them.

So being around others means he doesn't try to be in control nearly as often, and doesn't verbally bash and berate the adults when he's unable to be in control. Maybe that'll change as he's around other adults more often, such as now that he's starting regular school, or if he went to a residential facility, I don't know. He was very much in control a few weeks ago when he was admitted to the inpatient psych ward. He organized rec activities and even provided "counseling" to the other patients. The staff was very impressed and didn't see it at all as his way of avoiding his own issues.

I think if I let him be in control of everything we do at home, he wouldn't ever get mad or have a meltdown. As he gets older he'll need to figure out how to be employed, but it's not an entirely bad skill to be able to take charge. It's just not super appropriate at a young age.

It does seem like a better idea for him to not be at home.

Can you, or have you explained to him that because you know it's important to him to be in charge you won't be doing your job as a parent if you and he fail to work together so he has the education necessary to be in charge of anyone as an adult?

I really feel for you, having been there - I think what I have learned is that, while it LOOKS like a domestic abuse relationship, it isn't a congruent situation. More likely, what is really happening is that he's trying to explain to you what is going on with him the only way he knows how. I don't think this is the same as permitting him to learn bad habits.

We went the route of counseling with my son, too - and it did us zero good. I think you are spot-on about "social mimicry," but think about what that must feel like on his end: sort of like a tourist with a phrasebook being expected to speak perfect English. If talking is the method you are using to sort everything out, THAT may be why you aren't getting anywhere: your son is mimicking, but not communicating. I remember when I first cried, I got the same reaction as you did from my son - and I realized that I'd been doing him a disservice by hiding my feelings; he couldn't interpret social signals that people were trying to hide. You need different tools to communicate with him.

In fact, my own son was so frustrated with doing group work in pragmatics that his social worker decided to have him journal about social situations instead. Turns out, he's made huge leaps now that he has time to reflect on what he has observed and strategize about it. My son just can't "talk things through," it's not how his mind works - getting the words formulated to get out of his mouth and keeping track of tone of voice and facial expressions distracts him from everything else. He needs to gather his thoughts. Some kids can't write, some draw - there are lots of pictorial social stories out there for that reason. Even if they are hyperverbal, they may need some of the same tools nonverbal autistics use.

I also recognize the need for novelty - in myself. I have a very hard time with "down time," and repetitive tasks are significantly more difficult for me than they seem to be for everyone else. It's another wiring thing; I've tried to find ways to compensate, but the reality is that housework is pretty agonizing and the only tool I have is to grit my teeth and get through it - much easier to grit teeth in your 40s than in your teens. Pile rigid thinking on top of that and you have a tantrum cocktail right there. Add to that the fear of being unable to accurately express what you need or understand what other people need from you...your son is managing a lot.

Some of the techniques we learned with my son were to create written contracts of how he was going to behave and how we were going to behave - when we started out making those, we sat at different computers and emailed each other the discussion. We switched our thinking from adult>child superior>subordinate and told him that we were approaching things as a team, and we laid out the expectations for each team member (he also didn't think about things hierarchically, so this worked well for him.) This was a sea-change for us as parents, and we had a hard time with it, but the more we do it, the more it works.

We then picked ONE behavior to work on (we started with hitting) and we agreed on consequences - for my son, for hitting, it was losing half a day of screen time and no touching the person he hit for a full day. The idea is consequences follow naturally and are solely in his control, so we learned not to say "because you _________ now you don't get _________" but to quietly say "that's against the rules" when he had a setback, and then say nothing until he asked for screen time, etc, and say quietly, "I'm sorry, but you didn't earn that today." This took a lot of time and practice - we were a whole family of raw nerves, but since I have practice gritting my teeth, I did so and we got through it and it got easier and easier as time went on.

We had taken away all his access to any kind of violent toys or media or anything, and we explained that this would stay in place until he had successfully kept from hitting us for a full year. We would quietly, out of his view, record the date of any setbacks so he could find out where he was if he asked us (it is a temptation to use the "writing it down" as a punishment, but it doesn't send the message that he is responsible for the consequences.)

Things got a little worse before they got better, but I will say that we changed significantly more than my son did.

I know you are concerned about your mother's safety, but I would wait the six weeks for the full autism consult before you make a decision about placement; we learned so, so, much from the testing, and finally figured out how to do things differently. That said, if you can qualify for or pay for an aide, I think you deserve some outside help, don't you?

Perhaps, for the time being, you could put all your focus on "not hurting grandma" and less on everything else while you are waiting? He needs your help to stop lashing out. Tell him you are going to help him stop hurting his family; you are going to find a way to teach him how to stop himself, and you are going to help stop him until he learns how. (I am guessing he is desparate to hear this from you; it took a while for my son to believe me, but eventually, he did - the poor guy didn't want to do those things, he just didn't know how to stop.) It may help you to rank his problem behaviors from 1 to 5, where 1 is the worst. Work on the 1s, and just do what you can for the other things for the time being.

Also, if you're going to talk to him about what you plan on working on - write it down in a short, bullet-pointed list.

I also wanted to give you this article, because I've been there and when we are in it, we tend to underestimate the toll it takes on us: http://momnos.blogspot.com/2011/02/asd-and-ptsd.html and this corollary article: http://autismsedges.blogspot.com/2011/0 ... t-may.html

Even though this comes to you in a child-size package, this is not a small thing you have taken on. It is profoundly difficult, and I want you to know I understand that. I do also believe, from what you've described here, that your son has many strengths - and once you figure out how to help him use them to offset his difficulties, things will get better.