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Im sure like many others i found this forum while pouring over the internet searching for answers. My son (now 10) has been being treated since 7 and it started with a diagnosis of ADHD. They are now looking at defiant disorder due to his frequent at home only behaviour. They have changed his meds numerous times and each seems to only at best drug him but doesnt really help. After a while I began researching on my own and keep finding myself looking at Aspergers. I will give a brief synopsis and ask for your input. My goal is to ensure im doing whats best for my child and not simply allowing him to be medicated.
1. He is very intelligent and makes good grades. He effortlessly completes math assignments and NEVER does his homework.
2. He has never had friends and doesnt seem to care. Those occurrences when he came close only lasted a day or two. The one child that does play with him is several years younger and over the last couple of years he now avoids my son more.
3. When interacting with other kids on the street they tend to pick on him and its bothersome that he doesnt seem to realize what they are doing.
4. While at home he has his interests (video game/ tablet / legos) and that is all he is concerned with. If asked to do anything else it is an all out war.
5. When faced with discipline he doesnt really understand why and when pushed he only regurgitates what we said but has no real empathy.
6. He is at first glance verbally superior speaking in adult terms but im beginning to believe hes mimiking verbiage from television. He enjoys history and science channel and memorizes odd bits of information.
7. from an early age he experianced severe night terrors and has always had trouble sleeping normally. The night terrors are much less frequent now.
8. When he is at home especially after school he wants to just stay there.
9. He has tried numerous athletic activities and did very well but doesnt truly engage and quickly loses interest preferring his regular activities. In each instance he ends up bored and entertaining himself in seemingly immature ways.
10. He communicates well with adults if hes interested in the topic, but when talking to other children he only wishes to discuss his interests and seems to care less what they say or want to do. Not so much selfish but seems almost oblivious to them.
11. He was held back in Kindergarten due to social issues only, but they seem to have never caught up. While his grades remain consistently good, school behaviour has gotten rocky as he doesnt conform to the teachers changes and only wishes to do what is of interest to him. He says hes bored.

Given the seemingly endless failures of the medications im questioning the intitial diagnosis of ADHD and wondering about the defiant disorder as he seems to truly melt down and doesnt draw satisfaction or have purpose when misbehaving at home. Even when wrong he believes he is right! Thoughts?

I think it's definitely worth finding a developmental pediatrician or developmental psychologist who is trained to administer the ADOS (autism diagnostic observation schedule.) Someone who is certified to give this exam will have enough experience with autism (Aspergers is now classified as mild autism) that it won't get overlooked.

This book might be very helpful as well:
Parenting Your Asperger Child by Alan Sohn

And for the problems at home, here's a great book that helps you find solutions regardless of the label (the approach would be the same at home even though the examples are all at school):
Lost at School by Ross Greene

You make it sound a lot like ASD to me. In which case, treating him as having the other conditions may well have made things worse. I recommend experimenting, working with him on the assumption he is ASD, and then seeing if that improves things.

Some quick specific comments related to items above:
1. My son never understood the point of homework. If you know the material, you don't need the practice. If you are struggling with the material, homework is too overwhelming. Either way, it seemed pointless. For homework that fell into the previous box, we basically taught him the life skill called doing something just because it has value to someone else, and how all that eventually helps you reach your own goals. For homework that fell into the later box, we learned to visually separate the problems and also set a timer - ie if he could stay focused for a certain amount of time, he would get signed out of the rest. That way he knew exactly how long he would have to spend struggling with it. Now, in High School, he has mostly sorted it all for himself.
4. One thing to note is that transitions can be VERY difficult for and ASD child. Combine that with the fact that the school day (filled with unpredictable, annoying kids) is probably very stressful for him. So, he hides in activities he is comfortable with. If you need him to do other things, you will want to prepare him well in advance. "Tomorrow you have a doctor's appointment after school." "Today I will take you to the doctor at 4:00." "We leave for the doctor in 10 minutes." "We leave in two minutes." Seriously, that much preparation or more. Lots of warning time, lots of time to accept, prepare, and transition. Once he's locked into his head "I can't wait for tomorrow afternoon when I can finish building X," you are facing a mountain of disappointment when you try to disrupt the expectation. And not just disappointment, but lost momentum and trouble processing the disruption. He needs time and space to develop his own systems for handling that sort of thing.
5. I am not sure empathy is the right word here. But, it does sound like he is not really integrating your logic. I used to explain things a 100 different ways and repetitively until my son finally found some logic that made sense to him. That is a common problem. Their brains just don't work like ours, and our logic makes no sense to them. You keep at it calmly and keep trying to get him to understand the logic behind your rules and requests. Meantime, also be extremely specific and precise and literal in conveying rules, expectations, and consequences. Sometimes you will have to enforce a rules he truly does not understand the reason for, but hopefully he will be able to see the progression from your clear statements about the rules. What is a clear statement? "Wash your hands" and "did you wash your hands?" seem clear to us, but NOT to an ASD child. Instead, "wash your hands after you have used the toilet or touched something dirty" and "did you wash you hands after going to the bathroom right now?" And keep the rules simple, focus on the ones that are most important to you, since it is a lot of work to get the rules integrated for him. It is very, very important to pick your battles.
6 & 1 sound like pragmatic language issues and I strongly recommend you work with a speech therapist on that. The ones my son has had have been fantastic.

Thanks for the reply Zette. Ive been reading and researching for months and keep coming back to same conclusions and basically asking, am I looking in the right direction. I guess its my gut saying somethings not just "right" As a public servant I deal with kids and people all day everyday, and know my sons mannerisms are just not normal. when he hugs, he gently pats as to avoid contact. (when asked or prompted) He chews his shirts all the time leaving holes in them for no reason. Ive mentioned it to the Psychiatrist and felt dismissed. Im not fond of labels but if he needs treatment I want it to be appropriate to his needs.

WOW DW thank you for the clear advice. It seems so simple to me...brush your teeth....clean your room...pick up your clothes. All of these result in an outburst. redirection is like throwing gas on a fire. It seems as if all he see's is that he has to stop what hes doing. On one occasion after a lengthy plea to do his homework we found a two page math worksheet. I convinced him to just sit down and do it. it took him 4 minutes ( i counted). Preparing to scold him, I checked the work (had to use a calculator) and it was correct, every last problem!. Im trying to talk with my wife (also adhd and some other alphabet stuff) and she doesnt see it and blindly trusts the Doctor.

DW, you should seriously consider writing a handbook for parents of Aspie children and teens.

I wish my folks had had the benefit of that kind of insight when I was a kid. You actually seem to "get" (to a great extent) the differences in NT logic and AS logic, in a way that most people never do and are unwilling to even attempt, and that Aspergians themselves are usually unable to adequately articulate.

I know how you feel. My son was also first diagnosed with ADHD, then the docs threw in mood disorder NOS (not other wise specified as he is too young to specify it), A couple years ago while at my wits ends with every thing I knew we were missing something... something big. AS was it. His doc had said there was a possibility that he had AS the first time she ever saw him, but wanted to wait and get to know him before making that big of a diagnoses. In your post you described my son almost to a T. I do get what you are feeling and and going through. Hang in there. DW's post in my opinion was spot on for some techniques for working with your son. Feel free to pm me anytime.

I just wanted to wish you luck. I have an 11 year old DD that has some of the traits you listed. It can be tough finding the help that you need.

Glad to hear my post is useful. I wish I had more time but I've got a work deadline in less than a week. Still, we have a ton of great resources here at Wrong Planet so please do read around and try out some of the suggestions.

My son was a shirt-chewer, too. Chewing is a stim, (self-stimulating behavior) a way to focus and center oneself. ASD kids NEED to do this in order to think clearly and avoid melting down. The more your son chews, the more stress he is under and, yes, even happy events could be stressing him out, so don't discount it when you see a lot of stimming doing something you thought he would like. BUT, you might be able to divert the stim: many families find straws work for their kids. And my son used to like having bunny carrots with his homework.

Getting a spouse on board can be the most difficult part. We've all been there, done that, too. I sold my husband by telling him I wanted to experiment with a few ideas I had picked up on sites like this, and explained the logic behind them. He thought I was nuts but he agreed. Once he saw the improvements in our son, the changes stayed.

I can try to help more in a week or so if you'd like.

Glad to hear you feel that way. I think I am my own strange in-between ASD and NT. Maybe that helps.

When I read your post it was like reading my son's bio. He is now 20. He is an extreme loner but doesnt care. He has always got on better with adults. He quotes lines from British TV shows & has a hilarious sense of humor. He never struggled at school despite doing no homework, but struggled when he went away to college. S atteded all classes with enthusiasm but could not organize his workload & refused to ask for help.still does actually.

My advice is to love him whatever & accept that you are doing your best. Things will always work out, warts &all!

S is 20, lives at home, volunteers & has a small part time job. He is truly charming & an asset to our lives.

Keep strong & good luck.