Autism and Grief

So I'm wordy. I was going to answer in the comments, but it's too long for a comment I think. So I'm putting it here and linking to it. Ha.

Question:

Anonymous wrote:

My son, who is 10, was diagnosed a few months ago with PDD on the higher end of the spectrum, and ADHD. We tried concerta, which made his emotions off the wall! That is where my problem lies. In early 2012 his father passed away over in Afghanistan. So his emotions are already off the chart, just very hard to deal with sometimes. Between my husband and I, we were always able to manage his ticks and other behaviors. Without my husband, I feel as though my son is getting worse. He has numerous ticks, he's very hateful, his attitude is extremely bad, and just so much more. I guess my question is, is this behavior change I'm seeing in him part of him having PDD, or would you think it's more from him losing his father? He did pretty well in the first year of his dad's passing, then just after a year, is when I really started to see a change in my son. I'm also having trouble finding a behavioral pediatrician that accepts our insurance. So, he's not been seen by a Dr since the diagnosis. If you have any suggestions, it would be appreciated, I'm at a loss on what to do.


Answer:

Many variables here... Sorry it's long. When the moods hit, my suggestion is to try to get him into one of his special interests.

GRIEF I'm sure is a variable, and it takes years to get over something like that. Talking is good for grief, so always promote letting him talk about his dad and reliving some memories, but on his terms. When it comes to the subject of death, faith is a great comfort. Whatever your beliefs, try to lean on that in the most logical way possible. Dealing with grief is a real spiritual journey for anyone, and younger children are not really abstract thinkers until they hit high school. Anytime you see an opportunity (or get creative) to help overcome the cognitive obstacle (his age) to help him find some sort of enlightenment on the subject of death, go for it.

When I lost my dad, I did a lot of soul searching, which involved reading about a lot of religions and beliefs. The Jewish religion, I learned, is the source of the 7 years bad luck with a broken mirror. The old school people believed that the mirror was a reflection of your soul, and to look into a broken mirror reflected a broken soul, and they believed it took 7 years for the soul to heal. I fully believe that it does take 7 years for the soul to heal (average), and losing a loved one like a father or husband takes about 7 years. Like in the movie Uncommon Valor, you don't really accept it, but you learn to make peace with it.

Now in the 7 years that followed my father's death, I was crazy. A different crazy than the one that ails me now. It was more of, "I crashed my car into the bridge and I don't care. I love it." kind of crazy as opposed to now, which is more of a, "This bridge is creeping me out what if I crashed into it with the kids in the car? I can't handle this thought. Wait a minute. Why am I on this bridge? I was supposed to turn left 3 miles ago. Where was I going again?" Anyway, I'm just saying grief changes a person. It's a long process. It will make you crazy for a little bit. This is about you too, not just your kid.
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On PUBERTY, the fact that his rather isn't around is going to make it harder. Boys really need a man at this point in their lives to help them navigate their manliness. If you can find a friend of his father's to act as a godfather/big brother, that would help him out a lot.
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With autism (PDD), SOCIALLY, it is usually worse 7th and 8th grade because of all the other kids and their puberty. It's a rough couple years for anyone, and autism heightens everything. Add grief to the equation... yeah. There will probably be at least one a-hole kid who will say, "At least I have a dad." My nephew has been told that among other things at least 10 times by several kids in the last month (he's in 7th grade). These kids make the lowest blows they can, and they have no idea the impact it has on others.

Remember back when he was learning to talk? His behavior probably improved as his language did. Like a lot of the bad meltdowns from that age spawned from the communication frustration. You didn't know what he wanted. He couldn't tell you. I know that was a pretty arrogant assumption to make, and I'm aware I could be way off base. Regardless, for many on the spectrum, that repeats for social skills. Middle school years are the years when kids becomes mean and bipolarish and start to figure out their identities in the social world. It's a game those on the spectrum, even the most social of them, do not naturally play, but once they realize all the kids are doing it, they try to jump in, usually looking for at least one or two best friends. Their behavior gets worse through the learning process. Kids making fun of you and back stabbing friends or the loss of loyalty and trust in a friendship, those replace the grunting for a blankie or popsicle. It's a new anxiety and frustration. Those feelings are heightened in autism.

SO, the sooner you can help him build social skills to maneuver through this rough world he's about to hit, the better off he will be. You may try to find some online or make some up on your own, but create social settings like a word problem in math and ask how he would handle it, giving him pointers and your expectations. Give him some hard ones, when kids are mean. When they call him the R-word. Let him know what to expect. Don't let those kids have the upper hand with the element of surprise. You may also look into different occupational type therapies. I talk to my nephew a lot about military bearing. Middle school is rougher than BMT.

If he's in the autism program... This is a tough one. Usually, there's an autism room or special ed room. The kids will make fun of that, and that will fuel behavior issues on his part. But if the teacher and program are really good, and he's not annoyed by special ed kids, they are a great escape from the other kids. But you want to keep the IEP because it gives you more control over the school. You probably want to start thinking about the stuff you want to add to it, to give you more options and control when things get ugly.

You also want to find working coping mechanisms. Things that calm him down. You will need to be able to quickly identify those things and turn to them, but don't make it obvious. You want to find things that work in the school too. Like head phones are great for my nephew. He can't have them in school, and his second biggest problem in school (number one being social) is the noise factor when he's trying to work.
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Sorry so long. Like I said, a lot of variables, and this is too important to half a-word. I'm not a shrink either. I did experience losing a lot of close family members one year and I have a lot of first hand experiences in PDD/Aspergers, so grief and autism have become special interests.

Be cautious with the meds. Once you go down that road, it's hard to get off of it. My nephew's mom was pretty determined about going down that road in search of the magic pill to cure his autism. It made things much worse. Topamax did quite a bit of damage, especially once they added Intuniv to his cocktail. He went from Asperger's to Bipolar Pscyho with some Aspieness pretty fast and didn't improve again until we weaned him off the Topamax. He would have been better off not starting any mind meds.

Now that I'm blogging the answer, I want to add, if Concerta didn't help, it's possible he doesn't have ADHD. Hyperactivity is sometimes common with autism, and it's different than ADHD. Some shrinks haven't gotten that memo yet. Maybe they will with the new DSM.