Our Eight Year Old ‘Puzzle.’
There have been a lot of changes lately with Boy Wonder’s presentation, so much so that we are feeling that we need to get to know him all over again.
Boy Wonder’s usual pattern was one of hyperactivity, giddiness and impulsivity with quick fire anger thrown in when he didn’t ‘get it,’ or felt persecuted. This formed the meltdowns which could be horrific and lengthily. He would get what we called ‘head fuzzed,’ where he couldn’t process and would then flit from one thing to another. This would also lead to impulsive and often dangerous behaviour like climbing high and jumping or running into traffic. Boy Wonder’s ability to play with more than one child ( the dreaded group of three!) put us on tenterhooks as it was only a matter of time before it failed, with the younger child being the one he wheedled out. He would go to sleep eventually but wake up many times in the night and be wide awake from 4-5am onwards!
This was hard work but we knew what to do. We had techniques to manage Boy Wonder’s anxiety, impulsivity and behaviour. We knew the triggers and could divert early or at least prepare for the outcome if this wasn’t an option. But now things have changed ……
Boy Wonder has a diagnosis of high functioning autism ( Asperger profile) ADHD, anxiety disorder and sensory processing disorder to name a few on his list. Due to the complexity of his condition he is medicated for his sleep, anxiety and for ADHD. He has been on medication for nearly two years now, although it has had to be increased in recent months due to the changes that I will elaborate on. Over the years we have tried the GFCF diet, homeopathy, and massage which either have made no impact, caused distress or highlighted other difficulties due to their process. For example, massage caused Boy Wonder to become uncomfortable with the actual close contact and the sensation of the oil. Therefore the deep pressure therapy was lost.
More recently we have embarked on private assessments from an Occupational Therapist and an Educational Psychologist who have started to highlight things more so, specifically around Boy Wonder’s heightened senses and learning style. It is early days but we are hopeful that their intervention will prove helpful and provide him with the much needed intervention.
So, back to the changes. In the last six months there have been some noticeable changes in Boy Wonder’s presentation. He is still hyperactive, giddy and impulsive before medication in the morning. This is at a heightened level but goes away until late evening which is the longevity of the ADHD medication. So this change can be explained somewhat and the display of hypermania in the morning is a reassuring proof that this medication is providing a much needed function. However, Boy Wonder’s sleep has practically become non existent. We struggle to get him to sleep as he can’t switch off and if he does go to sleep he is shouting out and jerking ( body spasms) for the first couple of hours. We are then needing to wake him in the morning for school after only a couple of hours rest. He is also incontinent every night which hasn’t improved in the last year.
During the day Boy Wonder will be very fidgety, chew his fingers or clothing and appear panicky. He panics over the slightest things, usually perceiving that he has done wrong. He then calls himself bad and self harms by hitting himself in the face or banging his head. ( and then panicking over the injury if he has hit his head against a wall,) He complains throughout the day of having tummy ache and feeling sick with occasional headaches. This sometimes prevents him from going to clubs and on one occasion, school as he was exhausted. In the evenings Boy Wonder will take himself off to his room and watch / play Minecraft for hours ( if we let him) or watch football. He explains that Minecraft gives him happy spirits and takes his anger away. The outward displays of anger are less as are the meltdowns. However when they do come, they are more intense and a lot harder to manage.
As with the majority of parents with children who have additional needs, we want to make sure that we are helping him in the right way. He does have an excellent medical team around him that are working with us on this but the growing reality is that Boy Wonder may be presenting with more complex mental health problems than originally thought. Either that or his current diagnosises are strengthing with age and are becoming more substantial.
We are given a lot of books to read by Boy Wonder’s Clinical Pyschologist. In one of them it talks about autism and co morbid ADHD and explains that the typical long term routine and structure applied to children with autism falls flat with a co morbid ADHD as the ADHD constantly challenges the routine. Heigtened anxiety also dampens the ADHD presentation in some situations I.e school, as it takes over due to its intensity. Food for thought it seems. We still have a lot to learn.