Re: Asperger Syndrome, Anxiety and comorbid conditions.

July 10, 2010

My son was diagnosed with OCD, ADHD, and Bipolar. This past few months, we have realized that he has Aspergers. I wonder now if the other things are manifestations of the Aspergers. He is also very sensitive to red coloring and he loves Cherry poptarts. We just have to keep him away from it. He is 14 so it is not always easy.DeanaSent on the Sprint® Now Network from my BlackBerry®From: "baileybear64" <baileybear64@...>Sender: Date: Sat, 10 Jul 2010 07:35:25 -0000< >Reply Subject: ( ) Re: Asperger Syndrome, Anxiety and comorbid conditions. so in a nut-shell, are you saying the co-morbid conditions only presented when his anxiety was not under control?I have noticed my son tends to be more OCD, ODD etc when anxious (after being ground down by bullies at school). When more relaxed, these things fade away, and life is easier. He also reacts badly to food chemicals, including some natural ones (which can make him act like ADHD, ODD etc).We haven't gone down the med track yet as his anxiety seems situational, not everywhere in his life.Miranda>> I decided to start a new topic but this kind of is a spin-off of the other recent aggression thread.> > My son has had a lot of impulse control problems in the past. I think impulse control may develop later in kids with AS. Kids with AS have sensory issues and anxiety that probably contribute to it.> > I started my son on anti-anxiety medication when he was 7. He was in a very bad school that was making him completely miserable. During this terrible time 's aggression skyrocketed but it improved when 's lexapro started to take effect. The aggression has been decreasing steadily since left that school. He went to another school in our district for a couple of years while we were in TX and they were doing a great job. Then we moved to NH and gets much more in the way of services than ever before and everyone is great with him. So we haven't seen a lot of aggression for the last two years.> > This year we realized that behavior was not the main issue any more at school. Now attention is more a problem. So we started on Intuniv which has done a lot of his attention as well as also affecting his mood and anxiety. We decided maybe the intuniv would be enough for the anxiety so started to gradually wean off the lexapro. After school ended we lowered 's dose by half.> > This was going well for a couple of weeks. Then started camp. He gets camp as his extended school year so he can practice social skills. He has 1:1 support and I expect taxes pay for it. Last year had a great time during his 4 weeks at camp. This year we did okay the first day and the second day was terrible. hit someone and had to be restrained in order to keep him from hurting someone. He hit another child because she was cheating at a board game. Later when came home he was still upset and at one point during the evening he was extremely upset with his sister for not answering the phone. I've NEVER seen him get upset about something like that. When this was going on I was upstairs and Rayleigh came up to tell me had taken a knife from the butcher block and was threatening her with it! OMG. When I got downstairs the knife was away again and he was calm but that was too scary. I decided maybe this was partly because of anxiety. 's neurologist agrees with me so we put him back up to the higher dose and will keep it that way at least until our next visit with the neuro.> > Yesterday had the higher dose and went off to camp. He takes it at breakfast. He had a great day yesterday. I haven't had any calls today so I think he's doing fine today as well.> > I haven't mentioned much about comorbid conditions but I did want to say that we saw a doctor here once who was a developmental pediatrician who specialized in Asperger Syndrome. He know a lot more than any doctor I've ever encountered. He was able to answer questions no other doctor understood. He told me that kids with AS sometimes show symptoms of comorbid conditions because of anxiety or a bad environment and when the environment changes or the anxiety changes then the comorbid thing goes away. I told him I thought maybe we'd had this situation and explained to him that once seemed to be having psychotic episodes. He said he saw a man on the ceiling who said he wanted to kill 's sister. was convinced this was real and was very scared. This happened right after started doing math in the regular classroom instead of the special education room. His special ed teacher felt that would be better off going back to the special ed room so that's what we did. Once we did that the psychotic episodes never happened again. This asperger specialist said my story was a perfect example of what he meant. So sometimes fixing something very concrete will help with comorbidity.> > I don't think many people are aware of this so I tell this story every now and then just to make sure other people find out about the possibility.>

July 10, 2010

We didn't really recognize how anxious was until he was in a school that

made it worse but really it was affecting all areas of his life. His social

skills improved when we treated his anxiety. An amazing number of things

improved that we didn't realize might be affected.

I think the absolute worst for us is that 's aggression flares when his

anxiety goes up. I just can't think of anything worse than hearing my child

hurt someone else intentionally because he was angry and anxious. When his

anxiety is less his anger is also less. Sometimes anxiety gets expressed in

anger. gets in fight or flight mode and I guarantee he doesn't go the

flight route. It's always fight for him. He's big now. He's over 115 lbs and

he's taller than I am. He could hurt someone.

had a challenging day yesterday but he had a GREAT day. What I mean is

that there was a boy at camp who was intentionally upsetting and eventually

HIT . didn't retaliate. He walked away and let the adults handle the

situation. For some reason 5 mg of Lexapro isn't enough for these things but

10mg seems to help stay calm enough to make the right choices. This is so

much more important now that looks more like an adult.

According to the developmental pediatrician we saw, Lawrence Kaplan, kids with

AS can develop what seems to be co-morbid conditions and that unlike how those

other co-morbid conditions typically present themselves (not affected by the

environment) they go away when anxiety goes down. It's a weird thing. So

had what appeared to be a psychotic episode but nobody knows for sure. It's

hard to tell because the problem went away when the environment changed. If

we'd treated with some anti-psychotic we might have introduced a TON of

other issues and really not known that he didn't need the anti-psychotic meds.

I would say that if in an environment that is agreed by all to be what a kid

needs and something doesn't disappear then maybe anxiety isn't the cause or

maybe the anxiety requires medication. Nothing is ever clear-cut with these

kids but definitely exhibited behavior consistent with what Dr. Kaplan has

observed before. He worked at Yale with Dr. Volkmer who is a leading asperger

syndrome researcher. He has seen a lot of different kids with AS and really

does seem to have more understanding of exactly what is happening than any other

doctor we've encountered.

Dr. Kaplan has moved out of this area and is now in another state. I think he's

in Wisconsin. If you are looking for a Dev. Ped in Wisconsin, I recommend

seeing Dr. Kaplan.

Miriam

> >

> > I decided to start a new topic but this kind of is a spin-off of the other

recent aggression thread.

> >

> > My son has had a lot of impulse control problems in the past. I think

impulse control may develop later in kids with AS. Kids with AS have sensory

issues and anxiety that probably contribute to it.

> >

> > I started my son on anti-anxiety medication when he was 7. He was in a very

bad school that was making him completely miserable. During this terrible time

's aggression skyrocketed but it improved when 's lexapro started to

take effect. The aggression has been decreasing steadily since left that

school. He went to another school in our district for a couple of years while

we were in TX and they were doing a great job. Then we moved to NH and

gets much more in the way of services than ever before and everyone is great

with him. So we haven't seen a lot of aggression for the last two years.

> >

> > This year we realized that behavior was not the main issue any more at

school. Now attention is more a problem. So we started on Intuniv which

has done a lot of his attention as well as also affecting his mood and anxiety.

We decided maybe the intuniv would be enough for the anxiety so started to

gradually wean off the lexapro. After school ended we lowered 's dose

by half.

> >

> > This was going well for a couple of weeks. Then started camp. He gets

camp as his extended school year so he can practice social skills. He has 1:1

support and I expect taxes pay for it. Last year had a great time during

his 4 weeks at camp. This year we did okay the first day and the second day was

terrible. hit someone and had to be restrained in order to keep him from

hurting someone. He hit another child because she was cheating at a board game.

Later when came home he was still upset and at one point during the evening

he was extremely upset with his sister for not answering the phone. I've NEVER

seen him get upset about something like that. When this was going on I was

upstairs and Rayleigh came up to tell me had taken a knife from the butcher

block and was threatening her with it! OMG. When I got downstairs the knife

was away again and he was calm but that was too scary. I decided maybe this was

partly because of anxiety. 's neurologist agrees with me so we put him back

up to the higher dose and will keep it that way at least until our next visit

with the neuro.

> >

> > Yesterday had the higher dose and went off to camp. He takes it at

breakfast. He had a great day yesterday. I haven't had any calls today so I

think he's doing fine today as well.

> >

> > I haven't mentioned much about comorbid conditions but I did want to say

that we saw a doctor here once who was a developmental pediatrician who

specialized in Asperger Syndrome. He know a lot more than any doctor I've ever

encountered. He was able to answer questions no other doctor understood. He

told me that kids with AS sometimes show symptoms of comorbid conditions because

of anxiety or a bad environment and when the environment changes or the anxiety

changes then the comorbid thing goes away. I told him I thought maybe we'd had

this situation and explained to him that once seemed to be having psychotic

episodes. He said he saw a man on the ceiling who said he wanted to kill 's

sister. was convinced this was real and was very scared. This happened

right after started doing math in the regular classroom instead of the

special education room. His special ed teacher felt that would be better

off going back to the special ed room so that's what we did. Once we did that

the psychotic episodes never happened again. This asperger specialist said my

story was a perfect example of what he meant. So sometimes fixing something

very concrete will help with comorbidity.

> >

> > I don't think many people are aware of this so I tell this story every now

and then just to make sure other people find out about the possibility.

> >

>

July 10, 2010

I live in Australia. I do think if my son needs meds, it will be fro anxiety

rather than ADHD (the psyhologist intially thought he had ADHD - I think he has

some ADHD features,but not his main issue)

Miranda

> > >

> > > I decided to start a new topic but this kind of is a spin-off of the other

recent aggression thread.

> > >

> > > My son has had a lot of impulse control problems in the past. I think

impulse control may develop later in kids with AS. Kids with AS have sensory

issues and anxiety that probably contribute to it.

> > >

> > > I started my son on anti-anxiety medication when he was 7. He was in a

very bad school that was making him completely miserable. During this terrible

time 's aggression skyrocketed but it improved when 's lexapro started

to take effect. The aggression has been decreasing steadily since left

that school. He went to another school in our district for a couple of years

while we were in TX and they were doing a great job. Then we moved to NH and

gets much more in the way of services than ever before and everyone is

great with him. So we haven't seen a lot of aggression for the last two years.

> > >

> > > This year we realized that behavior was not the main issue any more at

school. Now attention is more a problem. So we started on Intuniv which

has done a lot of his attention as well as also affecting his mood and anxiety.

We decided maybe the intuniv would be enough for the anxiety so started to

gradually wean off the lexapro. After school ended we lowered 's dose

by half.

> > >

> > > This was going well for a couple of weeks. Then started camp. He

gets camp as his extended school year so he can practice social skills. He has

1:1 support and I expect taxes pay for it. Last year had a great time

during his 4 weeks at camp. This year we did okay the first day and the second

day was terrible. hit someone and had to be restrained in order to keep

him from hurting someone. He hit another child because she was cheating at a

board game. Later when came home he was still upset and at one point

during the evening he was extremely upset with his sister for not answering the

phone. I've NEVER seen him get upset about something like that. When this was

going on I was upstairs and Rayleigh came up to tell me had taken a knife

from the butcher block and was threatening her with it! OMG. When I got

downstairs the knife was away again and he was calm but that was too scary. I

decided maybe this was partly because of anxiety. 's neurologist agrees

with me so we put him back up to the higher dose and will keep it that way at

least until our next visit with the neuro.

> > >

> > > Yesterday had the higher dose and went off to camp. He takes it at

breakfast. He had a great day yesterday. I haven't had any calls today so I

think he's doing fine today as well.

> > >

> > > I haven't mentioned much about comorbid conditions but I did want to say