asd and odd

[spedrunner]

How typical is it for children to develop odd as they get older/mature?

A student of mine for the past three year is on the spectrum. He is verbal, used pecs initally (when he was in preschool) and has gravitated towards speech and asking for his needs and wants, as well as simplistically identifying his feelings (this is very tough for him but he has certain strategies to help)

anyway, he has recently stopped a gluten free diet and been on medication (paxil)  

The beginning of the year was great, however things have slowly gone down hill and now his is just defiant more than ever. He is also big and strong.

I am sure there are tons of factors that ar involved (the diet, the meds etc)

I have spoken with the parents and told them my concersn, they say he is not acting any different at home, however mom informed me that the other night, while she was at work, and dad was in the basement, "S" escaped out the window along with his 2 year old brother and was later found by their neighbor who happened to see them playing "batman"

So it def seems as if he has little supervision or demands (which has also been admitted to me by both parents they try not to "upset" him"

Yes i realize a l ot of this is out of my control, but I just want to know if how I am dealing with it , is best

I am being firm and requiring him to do what I ask of him and not giving up on it. Some days putting his jacket on has become a 20 minute battle, ending in frustration and tears. I hate to see him get upset, but he knows what is expected of him, we have talked about it, he has done it for years 

However he "cuts" me off when I am speaking or giving directions, flat out tells me "NO!" when I ask him to do something, if i say "black" he says "white". it is a constant battle

I do give him choices and let him control certain things but I also want and need him to realize that he can NOT control everything in life and has to follow the rules, esepcailliy since next year he will be moving over to the middle school

what are your thoughts and successes dealing with ODD?

any tips or suggestions will be gladly noted !

[auntie]

Apr 16, 2015 17:59:10 GMT -5 spedrunner said:

How typical is it for children to develop odd as they get older/mature?

Not very.

ODD can be comorbid with ASD, but IMHO, what people assume is ODD is more of an ASD behavior- being stuck, a heightened sense of injustice, an inability to understand the socially constructed hierarchy that puts adults "over" children in precedence, the delay in social and emotional maturity that is equal to 1/2 a child on spectrum's chronological age. Especially that last one, it takes a certain amount of bandwidth to "be bad"- a six with ASD is really operating in terms of a young three.

A student of mine for the past three year is on the spectrum. He is verbal, used pecs initally (when he was in preschool) and has gravitated towards speech and asking for his needs and wants, as well as simplistically identifying his feelings (this is very tough for him but he has certain strategies to help)

That's good.

anyway, he has recently stopped a gluten free diet and been on medication (paxil)  

Probably because GF doesn't bring anything to the party. I don't believe in GFCF as an approach for the vast majority of those on spectrum. I have never seen any refereed journal articles that showed conclusive evidence that it's effective. In 15 years of knocking around Autismworld, I would guess about 10-15% of the families who do the diet report some improvement- of course none of them were willing to forego their IFSPs or IEPs and all the SLT, ABA, OT and specialized instruction they bring to the party- so it's likely they're seeing improvement from more proven approaches. 

Paxil is an interesting choice. It can treat anxiety, depression and help with perseverations and inflexible behavior. Of the SSRIs, it is notorious for being the worst for suicide ideation and withdrawal symptom. It's also the least weight neutral from what some of my friends suggest. 

Any SSRI can cause activation or disinhibition if the dose is too high for the child. A lot of people with ASD are very sensitive to medication and do best on what would be subclinical doses for other people. There is also the possibility that the Paxil has triggered a form of bipolar; it's rare but can happen. I know two people with family hx of bipolar who developed it when given an SSRI.

The beginning of the year was great, however things have slowly gone down hill and now his is just defiant more than ever. He is also big and strong.

A couple things could be happening. One could be that he started school in a honeymoon phase and is just over it. Or it could be his IEP isn't addressing his needs in some way to promote appropriate behavior in a proactive rather than reactive manner.

If he's an older kid, as I recall you teach K-3rd or there about, you could be seeing the onset of puberty. Some kids with developmental disorders hit puberty at earlier ages than their well developing peers. This is more likely if he's a big or overweight kid. Is his skin breaking out? Do you notice body odor? Some kids on spectrum will reveal bipolar around puberty. Another common comorbid around the intermediate grades/puberty is depression. Depression in boys looks confrontational, irritable and uncooperative. 

I am sure there are tons of factors that ar involved (the diet, the meds etc)

It's never one thing. There are all the developmental phases typical kids go through as well as the ASD stuff. 

I have spoken with the parents and told them my concersn, they say he is not acting any different at home, however mom informed me that the other night, while she was at work, and dad was in the basement, "S" escaped out the window along with his 2 year old brother and was later found by their neighbor who happened to see them playing "batman"

Kids with ASD elope. Especially if they've got some idea in their head (fantasy boys especially). I wouldn't judge the parent if he threw in a load of laundry and his kid too that opportunity. FTR, I've never lost my kid, but his scoutmaster and 4th grade teacher have. You don't want to get that call from the school saying "Is DS with you?"

So it def seems as if he has little supervision or demands (which has also been admitted to me by both parents they try not to "upset" him"

I hear this from a lot of teachers and DS's psych. DS's awesome resource teacher in 4th-6th came to be the RELA teacher because she'd burned out of a middle school ABA-style classroom and parents who don't follow through with the program. LOL, she wasn't happy when she transferred and found out she was getting a kid with Aspergers. DS's psych has turfed kids whose parents don't follow through- he has an 18 month wait list.

But I get that sometimes parents don't challenge their child because it's a lot of work and upsets their entire household. I imagine this could be a scenario where dad isn't as bought in as mom and where neither wants to spend their limited "family time" with a kid who is ramped up.

Yes i realize a l ot of this is out of my control, but I just want to know if how I am dealing with it , is best

I am being firm and requiring him to do what I ask of him and not giving up on it. Some days putting his jacket on has become a 20 minute battle, ending in frustration and tears. I hate to see him get upset, but he knows what is expected of him, we have talked about it, he has done it for years 

Totally makes sense to hold him to clearly stated and positively expressed standards. He can do this. Lots of kids on spectrum can behave to higher standards where they're expected. Are you using visuals proactively so he can follow what's next? They would allow you to dial back his reaction to being told what to do. It's a funny thing, but just pointing to the visual schedule for what's expected next can take the fight out of him. If he does get angry, it might be at the chart instead of the mean teacher.

However he "cuts" me off when I am speaking or giving directions, flat out tells me "NO!" when I ask him to do something, if i say "black" he says "white". it is a constant battle

Do you have itinerant support you can pull in?

When was he last evaluated? It might be time to revisit this if the behavior is new. Depression or even more maturity could be driving this behavior. 

I do give him choices and let him control certain things but I also want and need him to realize that he can NOT control everything in life and has to follow the rules, esepcailliy since next year he will be moving over to the middle school

If I had to guess what is driving this bus, I might put my money on anxiety. The timing of his behavior going to shit, the Paxil and the looming transition to middle school. 

My son went through a pretty significant depressive episode in 6th grade (final year in elementary here). TBH, the transition to middle school scared the shit out of him. Bigger school, lockers, multiple teachers, new mean kids- our district does a great job with transitioning to middle school- they deliver practice lockers to the elementaries, many of the music and theater productions are hosted their, they do a tour and a separate field day at the middle school in 6th.


But the teachers undermine the ease with which kids transition at every turn. Even DS's best teacher made constant veiled threats about how "at the middle school, teacher won't help you <fill in the blank>" or "when you get to middle school, they will expect you to  <fill in the blank>. His classroom teachers were even worse with the picture they painted. I used to emai lDS's resource teacher/IEP custodian weekly to ask he to STFU about middle school. She'd try for a couple days , but it was like a mantra. We did a triennial toward the end of the year that clearly showed that DS was clinically depressed and anxious even breaking through his medication and CBT. His teacher felt terrible because the school psych called her on all the dire predictions she was making as exacerbating it.

what are your thoughts and successes dealing with ODD?

Does he actually have an ODD dx or are you playing doctor?

any tips or suggestions will be gladly noted !

[spedrunner]

yes he has been diagnosed with odd

interesting about the depression, I never thoguht of it that way, seems like his behavior is really demonstrating signs of depression (that you describe)

The middle school aspect concerns me more for him, the school district is known for its "roughness", the students I mean, I am afraid he says the wrong thing or uses the wrong tone and will get himself in trouble with other students

he is due for eval again end of the month. I spoke with his parents and he is also going to the dr again and I gave her my observations and concerns that she will bring up regarding his meds. She did tell me that his regular dr. moved and she has only been refilling his meds, he has not actually seen a psychiatrist for months

As far as gluten free, i go back and forth. I think diet overall affects any child and adult. Processed sugary food vs. wholesome food, big difference (for myself personally!) So its just another thing along this time line

Also, mom mentioned he is getting genetic testing done in july? I have no clue what this means, are you familiar with this auntie?

[spedrunner]

also, puberty is def apparent. He is so emotional, it breaks my heart, this also leads me to think it may be depression. he has such terrible mood swings, I can not imagine what mental stress he is going through I know from experience my brother was autistic and suffered from being bipolar as well, he would go through terrible spells of anxiety and irritabilty, he was jumping out of his own skin

[auntie]

I know a few boys who were initially given an ODD dx who has ASD. It was usually the case where someone more familiar with HFA took that away and replaced it with a mood disorder like depression or bipolar. IME, it's a rare kid this age on spectrum- especially one who isn't mainstreamed- who has the Theory of Mind to effectively push buttons or be vindictive.

Don't count gluten as inherently unhealthy unless a person has celiac.

IME, the middle school was the most proactive about looking out for kids who might be outsiders/different. DS had more scapes in both elementary and high school, TBH.

I hope you and the rest of the team can get to the bottom of what is driving this and find a way to help him. He's lucky to have you looking out for him.

[spedrunner]

How old is your ds now? 

You have been such and asset and inspiration to all and I can't even begi. To imagine what you and your family have been through



ps.  Saw your beautiful rings on ml. The blue? Which stone is that ? I loveeeeeee aquamarine and blue !!

[auntie]

Thanks for the kind words.

DS is 21; he's a junior at Temple. He carries an AS/ADHD?GAD dx with dyslexia as a kicker. As impaired as that sounds on paper- he's fairly capable. He drives, works PT and is working towards some form of independence. It was a unique challenge to parent a child who has one leg in the mainstream world and one outside of it. It still is, in a lot of ways parenting an adult who enjoys all of the rights that comes with is the hardest thing I've ever done. At 21, his emotional maturity is closer to that of someone 16-17 which means leading him to make the right choices has to be done with real tact.

The ring is a blue topaz; it does look pretty close to my aunt's beautiful aquamarine which is appraised for about $2K (She's demented and I'm her back-up guardian to her sister so I have seen a lot of the documents associated with her assets) My ring was under $100. I have a bunch of Pandora stacking rings to wear it with. They're great for wearing with jeans or travel.

[spedrunner]

wow! Your son is such an inspiration! he has come so far!! and temple! Goooooooo kiddo! <3

Your rings were under $100? Really? oh I love the pandora stacking rings. I have a bracelet that I just can not wear (it irritates me) I was thinking about the stacking rings bc they are more "me"

enjoy this beautiful weather!

[lifeisinteresting]

A few slightly off topic thoughts. I know this is an older child but a few things resonated with me.
You mentioned a 20 minute fight to get his jacket on. That's a problem. Whatever technique you are using is not working. I would be very angry to find out a teacher was arguing with my child for 29 minutes about a jacket. Talk to a therapist and work out a new plan. There is a way to do this without fighting. Simply asking and being punitive or shaming or reprimanding is not accomplishing your goal. You need training in positive reinforcement and you don't know what his reinforcers are.
He says black when you say white. Does this upset you? I understand this is a life skill this child needs to grasp to get through life but right now in your class can you let this go and provide him with autonomy when you can and press issues that are important? ( don't disrupt class, don't stand up when it is sit down time, don't run away?)
Also is a BIP in place? Request one. I think this will benefit this student and decrease your stress to.

[spedrunner]

Apr 30, 2015 9:21:14 GMT -5 lifeisinteresting said:

A few slightly off topic thoughts. I know this is an older child but a few things resonated with me.
You mentioned a 20 minute fight to get his jacket on. That's a problem. Whatever technique you are using is not working. I would be very angry to find out a teacher was arguing with my child for 29 minutes about a jacket. Talk to a therapist and work out a new plan.


Well. That's the thing.  My classroom is safe.  I know he wants the control and I can certainly modify and do things so that they are much less demanding but my problem with that is outside of my classroom he will not get that.  Does it upset me? Sure.  I want to know what he is thinking.  I want to be in his head.  I want. To understand all the time.  Am I upset he won't out his jacket on when I ask him? No.  I can get him to put his jacket on I know what works but I also want him to be able to put his jacket on In another room or another environment in a more socially acceptable way.  I have taught him alternatives to communicating when he does not want to do so,etching.  He knows the expectations but recently has began opposing things that are not his way all the time.  


I get it. We use positive rein for ement all the time and it does work. I just want him to have the skills to use outside if a safe place bc the world is not that safe


There is a way to do this without fighting. Simply asking and being punitive or shaming or reprimanding is not accomplishing your goal. You need training in positive reinforcement and you don't know what his reinforcers are.
He says black when you say white. Does this upset you? I understand this is a life skill this child needs to grasp to get through life but right now in your class can you let this go and provide him with autonomy when you can and press issues that are important? ( don't disrupt class, don't stand up when it is sit down time, don't run away?)


this is is all part of it.  The jacket is just an example. If he would say "I don't want to pit my jacket on" that would be good enough! However he is reverting to screaming and crying to try to get his way which he knows is not acceptable.  

Also is a BIP in place? Request one. I think this will benefit this student and decrease your stress to.


there are just so many other factors that play a role so I am uncertain as to what the problem really is.  Is it my expectations? Am I not clear enough? Is it hirmonal z? Medication related? Is he picking up things like crying from his baby brother bc he sees whe. He cried he can easily get what he wants? So I am just trying to get to the bottom of things so I can truly help him.  Yes I have reached out tik the child study team as well as his parents.  We talk daily. No we are working on a plan .  

[lifeisinteresting]

The explanations you give above in my post are the hallmarks of autism and lack of or difficulty generalization. Can you get a special education teacher, bcba or other to work with him? Or you?

[hopecounts]

May 1, 2015 13:08:35 GMT -5 lifeisinteresting said:

The explanations you give above in my post are the hallmarks of autism and lack of or difficulty generalization. Can you get a special education teacher, bcba or other to work with him? Or you?

She is a SpEd  teacher.

[spedrunner]

yes, i realize this. i am a special ed teacher. I also had a brother that was on the spectrum and grew up with it first hand, so I am completely aware that it is part of autism, however I have also had this student for 3 years and this is something new for him. I have exhausted all means and feel like it is something ELSE besides autism, like something related to medication and/or hormones

His iep states ODD however i have not really seen much if any of it in the past 3 years until now. With his recent dietary changes, medication, new brother , etc, etc, etc there are too many factors to just say "Oh its just him on the spectrum"

Just trying to figure out how to help this little guy out, because I see he is def in distress

[hopecounts]

May 1, 2015 13:08:35 GMT -5 lifeisinteresting said:

The explanations you give above in my post are the hallmarks of autism and lack of or difficulty generalization. Can you get a special education teacher, bcba or other to work with him? Or you?

Also I hate when things are blamed as 'just being autism'
Behavior is communication, this is a change in behavior, the right thing to do is try to figure out what's going on/what's prompting the change so it can be addressed properly.
If it is just ASD, then so be it but there is no harm in looking at this and seeing what's happening and figuring out what if anything can be done to help him do better.