PDD and aggressive behaviorMichelle, I'm sorry for what you are going through with your son. I can relate &it's hearbreaking because these little guys can be so aggressive but yet we know how sweet and loving they really are. My son has the same issues (he's 7) but they are somewhat contained right now. I'm sorry I can't help with the med question, but I know many others on this forum can (also check the archives for aggression). I did however do a lot of behavior therapy with my son which has helped a lot! Hopefully his school is already addressing reinforcement, but when behavior slips, it's usually because reinforcement has slipped too (usually accidentally). They may want to up his reinforcement schedule and maybe even give him some additional breaks during his day with some physical activities. there is a place in Omaha, Ne called Behavin' Day that specializes in aggression behaviors and many of the kids are on the spectrum. I've never been there, but I know some parents who have been there and have seen great results. If you are not close to OMaha, you could call them and see if they know of any programs in your area, or call a University psychology program close to you and see what you can find. Good luck and hang in there. You'll find lots of great support on this board! Chrissy I am new to this forum. I have a 10 year old boy named John. John started having grand mol seizures at age 8 months. He was on target for everything except language. It took until he was 3 years old to find a doctor who could put a stop to the seizures. Once the seizures were controlled he was able to start speaking. John has always been an easy, happy baby. Out of my four children, he was the easiest. After grade K, we started to see that there were other issues going on. When John turned 6 he was finally diagnosed with PDD. John was in an integraded classroom. By age 9 he was transferred to another school in a contained classroom due to behavior, hitting peers and teachers. That was last year. This year John is in another program and school. As John gets older his aggression has gotten much worse. In Oct John was put in the hospital for psychiatric behavior and stayed for 20 days. He returned to his home school but again the behavior is getting worse and he is getting bigger. We are now talking about sending him to a behavior school. John is a loving, caring, helpful boy but on the other hand when he gets upset he is verbally abusive and physically abusive to myself and siblings. John hits, kicks bites, pushes and spits at family and school people. John is on Effexor for anxiety, Depakote for a mood stabilizer and Abilify for aggressive behavior. We tried raising the abilify but found anything over 7mg he got lathogic, slurred speach, (he looked and acted stoned). Has anyone out there had their child on this much meds and still had very aggressive behavior? And, if so, have you tried a behavior program, such as a private school and/or place that specialize in children with PDD and behavior and aggressive behavior? As I said before, John is a wonderful boy and I want the best for him. I want him to have as normal a life as possible with the daily restraints. Michelle
Hi Jenni
John started little by little with his aggression. He was a very happy baby and happy up until he turned 5. Little by little his anger and aggressiveness grew. He is 10 as you already know. I just came from a meeting with an agency who provides HBTS (Home Based Theraputic Services) and after waiting about 2 years, we should be getting services in the next few months. Someone comes to your home and they help with the aggression and work on goals, like controlling temper, tieing shoes, social situations and on and on. I also have a meeting on Monday to have John go to a special school where they deal with behavior issues and work on strategies to help control mood. He is in a public school which has a theraputic class, but John has been too agressive and they are not trained to handle him. Hopefully this new school can help and get us on a better track at the same time, since it is staffed with hospital personnel, we can also tweek his med's if we feel it necessary. Is James on any med's for aggressive behavior? It will work out in the end, it just takes a lot getting there. This is what keeps me going. The most important thing to do is find out what services you have around your area and take advantage of them. Call Department of Human Services or your states equalent.
I'm sorry you are going through this Michelle. I have a 3.5 year old and he is very aggressive/violent as well. I get notes from pre-school all the time. I'm worried that it won't improve like your son.Hi, I'm new to this board too and I feel your pain! Chase is 11 and big for his age. He is non verbal but for the most part very social and sweet. He has been on lots of medications since he was 5. In the last year and a half he has become much more aggressive. After a particularly bad episode in the car a couple of weeks ago where he grabbed my hair with both hands and pulled, pinched, bit etc. (almost causing an accident) I was FED UP with his meds. I could tell he was agitated because of a loading dose of his medication. With the doctor's blessing, I took him off ALL medication for a 10 day trial period. I was SO surprised! He was so much calmer than I anticipated, and his aggression is much less. It is still there though, when he gets frustrated he tends to react physically because he can't communicate. I am preparing to do some radical dietary changes. Just remember, medication can be a two edged sword. I don't have all the answers but I am seeing a happier boy off meds and I never dreamed this would be possible!  Your original question was are there meds especially for aggressive behaviors in autism? The answer is yes. There is one medication that has been approved for use with autistic kids and it addresses aggression. Risperdal. It is an atypical neuroleptic and there are other types of meds in this category, including the newer Ablify and even some newer ones. Risperdal is the only med ever approved for use for aggression in autistic kids, but others work. It's just that Risperdal has been around long enough for there to be plenty of evidence of its efficacy. It significantly reduces aggression in over 80% of those kids who take it. HOwever, it causes significant weight gain in almost all of those. My own son started on Risperdal at age 8 to control severe Tourette's tics (Risperdal works well for this, too). The tics remained under control unti puberty hit. Also, aggression occurred at puberty due to testosterone surges. Our psychiatrist, who is a reknown expert in autism, calls them Cycles of Rage. They are common in autistic male adolescents. My son's Risperdal needed to be raised to address this. The increase worked (it took time). That was about 4 years ago. He has not been at all aggressive since we got to the proper dose. He is also on Buspar to control the anxiety that brings on the tics and on Tenex for hyperactivity because he can't take typical ADHD drugs due to the Tourettes. THis cocktail gave us back our sweet, cooperative son. Well, not only the cocktail, but behavioral therapy in school and parent training to continue those behavioral interventions at home. But the behavioral therapy did not work at all until the meds were optimally adjusted. Then it worked wonders. He is 16, 6'2", nearly 300 muscular pounds (he swims regularly) and is cooperative and hasn't had an aggressive episode at all since the Risperdal was finally raised to 6mg. Hope this answers your question. However, there is not way to tell what will work for YOUR son unless he is seen by a doctor who is an expert in autism and has lots of experience medicating teens on the spectrum. Dear Chase's mom:
That was extremely brave of you. John is on Depakote 125 mg each - 3 a.m. 2 at noon and 3 p.m., Effexor 75 mg a.m. and Zyprexa 2.5 mg p.m.
In the past when we started to wean him off, he got more aggressive right away. How was it for Chase? Did you start to see a benefit right away and did it lessened or was it the same until he was totally off med's and med's were out of his system? How long did it take to get him off meds? When he does get aggressive now is it worse then before, or better? How often does he get aggressive now since he has been off compared to before?
I want to do this but I am so worried things will go extremely bad. I have three other children 2 boys, 6 and 9 and one girl, 12. When he gets abusive he takes it out on them the animals and myself. My husband usually gets the verbal abuse only.
I did put a call into the doctor regarding starting the decrease of the Depakote. Good luck to you and I guess we will find out the doctor's thoughts soon. Thanks. Michelle
We started taking John off Depakote on Thursday. As of Sunday he is off two Depakote. So far so good. My son is 7 has the same very aggresive behavior he has also been diagnosed with more then PDD also has Bi-Polar, ADHD he is on abilify, depakota, lithium and seraquil. I still had to pull him from school and home school him the last month the aggression got so bad, the school told him they would call the police and since I pulled him his aggresion has calmed down alot. Good luck.i am sorry to hear that, i know it can be tough. my brother can be very agressive, if he gets mad he pushes people down and he screams and is very loud, what i do to calm him down is just sit next to him and just say it will be ok it will, and just get him to calm down.I would take him to a child psychiatrist who is an expert in autism. Testosterone starts surging in boys by about age 9. This is the hormone of aggression and ASD kids are often VERY sensitive to it. At adolescence there are often "cycles of rage." This is exacerbated in kids who have significant communication issues because they can't even express their frustrations. My son's rages (they started at about 11 or 12) were VERY severe and they were only stopped by Risperdal, the only medication specifically recommended for kids with autism (tho other meds work). I'd see a good doctor.
We already did the Risperdal then Abilify now Zyprexa. We raised these and all it did was make him slur his speech and look drugged. This is why I am trying the off medication plan. He has been on Depakote since age 3 for seizures and has been on this plus more since. There has been no seizure activity in about 4 - 5 years. I want to see what my John is really like. If this does not go well, we can always start fresh. Thanks, Michelle  I really mean that. I just know that for my son, he has done better off of it and a few months ago I just would not have believed that could be true. |
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