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Hi Again

Looking for some insight or information, My son age 12 has been diagnosed with AS, ADHD, ODD. Took him for his weekly review, now they are suggesting OCD or possible schizophrenia, or the onset of it.

He hasn't been diagnosed by local Autism service but has been privately awaiting assesment from the local Autism Service, a 2 year waiting list I did a little research and it said that schzophrenia in children is very uncommon, it does run in both our families, my mother, father, sister nephew, and uncles and aunts, my partners mother only recently diagnosed at 69 years and his brother.

As I have great knowledge of how this effects people's life I am extremly concerned, I dont feel my son is schzophrenic any suggestions or information to confirm what I am saying would be helpful.

We have had such a great battle with so many different opinions it just makes it all so confusing and unsure how to manage him. The system is just so inadequate and all the differnces of opinions turns everything from school, services, supports into a nightmare. I know I am not alone

I don't have info but I don't know how your family does it. I hope they are taking lots of medicine not so they aren't violent, but I am sure I wouldn't want to hear voices talking to me. Hope you are able to learn fully what your son has.

thanks that made me Parents have passed away, do support my sister and her children, don't live with my aunts and uncle, but do have mother in law and brother in law with us.

Mother in law also has chronic heart disease she cannot look after herself neither can her son. But they will move into their own home soon. They are from egypt so lots of changes for us all. I can deal with all that easily enough from time to time feel like I am cracking up. But for my son not knowing exactly makes it so hard to try and manage.

Yeah different diagnosis mean he may need different options whether he needs medication or help in school whatever. I am just hoping you find out soon and are able to help. You should like a really good parent who just wants the best for their son no matter how it goes.

In other words, your son is a difficult emotional basket case and they don't know why so they are tossing acronyms at him and hope one sticks.

First I'd like to say I have my doubts that AS and ODD can exist together. The reason for this is, people with AS usually try very hard to follow rules and usually don't not follow rules simply because they don't want to...they don't have the ability to navigate the situation of being in trouble, they don't have the social skills for it, so when someone with AS get's in trouble, it's usually catastrophic for them. They usually end up getting a far worse punishment than most people because most people can navigate such situations to some degree. So people with AS usually prefer to stick to rules as much as possible. Most people with AS usually take solace in the concept that there is an absolute right and an absolute wrong.

If someone with AS does not follow rules, it's simply because the rules are requesting something of them that they can't provide, or they misunderstood, or they have concluded that something about the rule is illogical and they are actually doing wrong by following it.

A person with ODD just hates being told what to do. They will not do something just to assert their independence and autonomy. They get a thrill out of this.

I think you should demand the reasoning for each acronym they have tossed at your son, in list form. These disorders have specific diagnostic criteria. If they can't provide you with a list of reasons which match the criteria and then gives you the "well, he just seems" type blah blah blah then then they might as well be contacting the spaghetti spirits for answers and looking for water with sticks.

Thanks Chronos,

he received the diagnosis of ADHD, ODD before the AS, I suppose I would have said that he refuses to do what asked of him constantly. But you have made it very clear and I am getting an understanding, He will say to to me if I make a promise I wont break it, he told me it would crush his heart! He always ask questions and needs requests to be explained over and over (illogical to him). And of course he can't lie and that makes him angry, but he can stay quiet about events unless I ask him.

I have to say that when the private psychiatrist gave him the diagnosis of AS did drop the ODD. He didn't give a clear reason other than I don't think it is, so I was still a bit confused.

The difficulty for me is that psychiatrist lives a 4 hour journey one way, thats why I was hoping to deal with the local services but they seem to be inadequate.

I feel AS, ADHD and possibly other disorders need to figure them out, is the correct diagnosis for him. I also think AS etc for the other members of my family but they were left unsupported. I am not sure if I am correct but if AS is left unsupported could it lead to Schzophrenia developing?

Thanks for clearing up ODD for me, I can indentify with all you said and it makes sense.

Annmaria

9quote="Annmaria]I am not sure if I am correct but if AS is left unsupported could it lead to Schzophrenia developing?


Annmaria[/quote]

AS can present in a similar fashion to some schizophrenia spectrum disorders and most modern assessments are designed to suggest or rule out a schizophrenia spectrum disorder when AS is suspected. By the DSM-IV diagnostic criteria, one cannot have a diagnosis of AS and a schizophrenia spectrum disorder, however this is not the case by some diagnostic criteria used elsewhere, such as in the UK, and there is certainly no known biological reason why a person couldn't have both. It's thought that stress hormones play a role in the development of schizophrenia and people with AS to tend to be stressed more frequently and more severely than the general population, and there are certain genes associated with an increased risk of schizophrenia and possibly AS, however , however many genes related to schizophrenia are found in the general non-schizophrenic population and it's a bit impossible at the moment that having AS predisposes one to schizophrenia. More research needs to be done. As things are now, when a person with AS goes on to develop schizophrenia, in the US, the AS diagnosis usually vanishes and it's just assumed the symptoms presenting as AS were latent, or prodromal schizophrenia.

Schizophrenia spectrum disorders do not always involve psychosis. In the latent or prodromal stages of schizophrenia, a person may simply appear withdrawn. Schizoid personality disorder can resemble AS but people with this disorder actually have a blunted, limited range of emotions rather than just a limited range of emotional expression, they have an inability to connect to people and usually harbor a degree of paranoia and mistrust of people, worrying that others have malintentions of them. People with schizoid personality disorder generally prefer to be alone, and occupy themselves in a fantasy world they have created in which they're normal.

People with schizotypal personality disorder may display the social awkwardness of those with AS, but they tend to have some degree of delusion while at the same time maintaining a functional level of lucidity and still seem generally sane. They may believe they have some divine purpose in life, they might be convinced they are an alien hybrid or harbor a strong belief in the metaphysical beyond that which the average person might harbor. These are the people who identify as vampires, and psychics, the people who become gurus and cult leaders with cult followings. David Koresh might be an example of this. Possibly Silvia Brown however she claims to see dead people which would be a hallucination and place her closer to schizophrenia itself.

Why do they think your son may have schizophrenia?

My son has thoughts that he going to hang himself at school and this is causing panic attacks, He has this problem going on for a long time he replaces the thoughts with new ones but each one last for some time. He has always wanted to die even when he was very young, he would sleep in our bed, claming that a ninja was outside his door and waiting to kill him with a sword. We got through this recently, it was very difficult to change this behaviour and get him to sleep in his room.

He is obsessed with death, threatens to kill himself everyday, most days he repeats this on many occassions. when he was not on medication we found it very hard to manage he did attempt to hurt himself on a number of occassions, he also slaps himself across the face when he is upset or to get my attention, sometimes he is serious when slapping himself other times he is laughing, but a strange laugh. He is on strattera this does not allow him to have the dark moods. But he will still express that he is sad but cannot express why. He ask me how come he wants to die he doesnt know why.

He would complain that he was been bullied at his previous school and his new one, and again he is unable to tell me why or what happened, just keeps saying he is been bullied, but the school dismissed this, he feels no one likes him and that he is a weirdo.

I am not sure what the criteria is for schizophrenia but he does seem to meet the criteria for AS.

He has a Elevated memory, processing speed above average, low comprehension. His speech and language results were Social-Communication Developmental Questionniare (Univeristy of Cambridge): strong indicators of ASD Emerging Perspective taking Receptive language-impairment: semantic type. He got his AS diagnosis from these results and other information gathered.

I can only suggest that they are looking at schizophrenia because of family history, the thoughts he is expressing to see if there are his own. It could also be OCD. He has never claimed to hear voices, I am not sure if he has hallucinations sometimes the way he expresses his thoughts can seem like that. But then when you get clarity its not, not sure if that the language problem. He also repeats things from the television, he is very repetitive.

Thanks

People with OCD usually worrying about things they least want to do. A person with OCD might think "What if I killed myself?" because in the mind of that person this would be a horrible thing and the OCD causes them to doubt that they wouldn't do it, even though they know they never would and have no actual desire to do so.

Alternately you might also have someone who does not have OCD, but worries about killing themselves because they fluctuate between wanting to kill themselves and knowing they shouldn't be thinking such things and knowing that is not a good solution but they worry when they fall into a darker mood that they will kill themselves. Much like those with bi-polar disorder fret over what they might do when they go into a depressive state.

What is the context in which he threatens to kill himself and does his fixation with death extend beyond?

What might actually be at the crux of your son's problem, or a least a driving force, is his inability to communicate enough detail. Low verbal IQ isn't unusual in people with a high performance IQ.

I don't know that I can be of any more help in sorting out his diagnosis, but I do think he might benefit from training that focuses on helping him identify and communicate his feelings. This could be as simple as taking him to see a moving then asking him about it, how the characters felt and why, or something more structured. You might also look for alternate ways that he might be good at communicating with.

Comprehension usually refers to the part of the test that asks people how they would respond in certain social situations. Most people have some innate sense of this, however this can be acquired through analytical means and it's not unusual for adults with AS to acquire very good comprehension skills by thinking the situation through logically....that doesn't mean they can implement them though.

I'm of the opinion that most people with AS have the ability to learn comprehension by the time they are in their teens.

I don't quite understand how this is 'wanting to die'. If he wanted to avoid the ninja, that would mean he wanted to stay alive, right? Granted the ninja wasn't real, but the monsters most young children imagine under the bed aren't real either.

The persistence of delusions like the ninja into later childhood might be contributing to the possible schizophrenia diagnosis.

I don't think it's really clear if it's a delusion or just a typical childhood fear.

He would alway express that he wanted to die, then it progressed to wanting to kill himself. He also said when he was at school he would have thoughts of a man with a knife that wanted to kill him. He said the man wasnt real it was just in his head. He doesnt say these things any more. But he does say that he has thoughts of hanging himself at school, and he can't get rid of them and then it causes him to have panic attacks.

He used to pull a knife and show me that he was going to stab himself, we had to bring it undercontrol and he doesnt do it anymore. But now he makes hand gestures of hanging himself, stabbing himself, shooting himself and cutting his throat.

Every time he/us manage to stop one behaviour he replaces it with another.

Hi thought I'd pipe in, not sure if it's any help though. ((((((((((( annmaria)))))))))
hugs for you and your family, you must be besides yourself with stress at the moment.

I'm a bit all over the place at the moment, sorry.

As you can see from my signature I have a 12 year old with a colorful lot of dx's. I have also had moments when I seriously thought my 12 year old was schizophrenic. My mother developed late onset schizophrenia and then ultimately committed suicide nearly 9 years ago now, J was about to turn 4 when it happened. My mum was a huge part of our lives we practically lived with each other (she lived next door). J did a lot of very bizarre things, when he was younger he used to talk to his school bag, he would tell me that his bag could talk back to him. He would mumble to himself and make little hand gestures, he was withdrawn from other people especially kids.
I was panicking. It wasn't until much later that J was able to explain to me that he knew his bag couldn't really talk it was all just a fantasy that he had made up based on a children's tv show.
There have been many other times that I have thought something more serious was going on with my baby. J went through a long long period where he would have what I would call night terrors or at the best really really bad vivid dreams. Dreams that would confuse him, scare him and would carry over into day light. He was convinced that zombies and vampires were out to get him, there were times that I couldn't even console him because he believed I was one of them in disguise. He to refused to sleep in his own bed out of fear, he refused to go to the bathroom alone out of fear. I tried everything I could think of to convince him that none of it was real. Nothing worked. It wasn't until late one night he started panicking again, he woke me up, telling me that the living dead was going to get him. I don't know why I didn't think of it before , but I told him that there were no living dead or vampires etc etc because other wise it would be on the news and it wasn't on the news so it was all in his imagination. It worked! It must of appealed to his very fact based logic (I'm guessing why it worked) He was still scared for a long while but he would then reason it out with me. What I also did was to stop having the news on when J was around and I stopped letting him view or play violent games (for a long long time) I discovered my son is very susceptible to what he see's and hears, it can take on a reality for him. At this stage J only had an ADHD dx, it was not long after all this though that he got the AS dx.
Two and a half years ago J got the rest of his dx's. J was going through a really rough time his previous school weren't acknowledging his AS or ADHD at all, he had no friends (he thought he did but these kids were actually being bullies) I moved J out of that school and he started at another school. Everything came to a head. J started talking about global warming, he was turning all the power switches in the house off, he was panicking big time. Everything he said and did revolved around a imminent global meltdown. He was angry with us for not taking it all seriously enough. He came to me one night with his ds stylus in his hand (pen like thing) and was swirling it and taping it in between clutching his head and saying "make it stop" he was also chanting something, I can't recall what. He had been in his room doing this for some time before he'd come out to me. I tried to just take it off him but his mood got much much worse. He eventually stopped but was exhausted by it all. So back to the children's mental health team we went.
I always thought ocd was things like hand washing and counting steps etc, I never really thought that it could be thoughts and ideas as well. By the time we'd finished our stint at the children's mental health unit J had 5 dx's. It took an entire team of pediatricians, psychiatrist's,
psychologists and social worker's as well as consultations with J's school, myself and J weeks to come to their findings. Every part of J was scrutinized, teased out and analyzed. Initially I was shocked and doubtful as to all the diagnoses. I see it all now, but it's only when I dissect him that I can pick each dx on an individual basis. Now, J is just J.
He used to do other things (hasn't done them in a while thank goodness) but they were a very clear indication to me that his stress levels were beyond what he should have to deal with. He used to tell me he was a waste of space, he may as well be dead, we'd all be better off without him. He would punch himself in the head, slap himself, dig his nails into himself and smash his head on the walls. There was no reasoning with him during these out bursts, in fact it would make it much much worse. I used to have to just watch and stay close where he could see me. J had such a low opinion of himself that he thought he deserved to be punished, my intervening made him feel even lower=now he thought he'd made mum sad. J used to also do things like, refuse to enter the classroom, telling me he was scared but laughing at the same time, this really confused his school. J just didn't know how to respond appropriately, (he still does this sometimes).

When J got all his dx's he was put on medication (I didn't want him medicated but he was in a bad way) he was put on Lovan for the anxiety and Strattera for the ADHD. Both meds combined have helped to lower his stress levels, which in turn have lowered the OCD and the tourettes. He still has anxiety and ocd and adhd, but it has taken the edge off everything. Cognitive behavior therapy was also tried but at that stage wasn't working. I have done a lot of work with J at home. I made up cards that he could carry with him when he gets really stressed. Simple cards with instructions for what he could do if he was starting to feel stressed, his teachers had the same cards, they were instructed on what words to use and what to do (it had to be consistent). Another thing I did was to divide a page into thirds length wise. Down one column I wrote school, home, homework, Jack (his autism teacher), mum, J, etc then I asked him to draw a stick figure type face to describe how he felt about each item. His drawings were an eye opener as to just how stressed he really was. We then talked about each face and wrote beside each face his responses. Eg school = scared, bad, prison, confused. Home= happy, safe
I took this information with me to his mental health appointments, it really helped them understand what was going on. Then for about 2 years we had a white board stuck on his bedroom door, J was asked to draw how he felt on it every morning and then again after school. This helped me understand his moods and gave me an opening with him to talk about and explain emotions.

J is at an age now, and a lot of work has gone into it. Where he will openly tell me he is paranoid, he just wants everyone to like him. If he feels he has upset someone or done something wrong, he must be a bad person. He still gets stuck on his thoughts, he still feels compelled to act on his impulses etc etc. The medication though and lots and lots of work and lots and lots of down time have helped.

Sorry my post was so long, not sure if any of it has any relevance to you and your situation. Just thought I'd share, something about your posts have struck a cord with my unique little family.

cheers aurea xoxox

Hi aurea

I can indentify with all you have written, My son is the same always feels bad if he thinks he has upset me, he always thinks that I am angry with him at times I do get angry but mostly its frustration.

I can accept the label AS but schizophrenia scares me, I grew up in care but would go home on holidays and sunday. My mother illness impacted on all of us terribly she had many stays in hospital and her behaviour was bizzare and very hard to understand as a child. My biggest fear was that I would develop the same. My father also a schizophrenic and an alcholic on medication he was stable he did have breakdowns from time to time his illness didnt impact on me as much as my mothers not consciously. But my mother on medication was never really stable.

My brother at 17yrs commit suicide he was always so unhappy and my son unhappiness brings that all back to me. My brother was the youngest and I was his older sister and always looked after him but I could never make him feel ok. We had lots of good times but internally he was a mess. Again he did not get the support needed and all his problems were blamed on our family circumstances. I feel still that the local services look at the circumstances and not the child, things really haven't changed since I was a child. Its like reliving my childhood except this is my son, and my daughter diagnosed with ADD I feel a lot more is going on for her but she manages. I am still waiting to get the services on board for her she is 15yrs.

I still feel my son isnt schizophrenic, he is sociable and has friends and this is very important to him. At times he does question wheather they are his friends but he has always been invited to parties, sleep overs etc. He would come back very stressed but it didnt stop him the next time. He is a great athlete and at any sport, he is know in that circle and other kids are in awe of his abilities but he doesnt see this. He finds it stressful but will always go to training, games and events of course if he doesnt perform well he is overly upset but I can talk him down.

Your post has really helped me, my son has a review tomorrow I will see what they are saying. I have to say that I didnt realise how close or they overlap the symptoms of AS and schizophrenia until I research it now. I suppose I never looked up schizophrenia as I have a life time experience of living with it.

Thanks very much

Annmaria
xxx

[quote="Chronos"]What is the context in which he threatens to kill himself and does his fixation with death extend beyond?

Hi Chronos

not sure how to answer the above maybe you can explain it to me.


Thanks

Annmaria

Does he just randomly threaten to kill himself or does this occur when he gets upset about something? It he just fixated with killing himself and someone killing him, or things such as what happens to the body after death, graveyards, etc?