I'll Take Asperger's, ADHD and Generalized Anxiety Disorder for $100, Alex

So, we're here again....  I met with the child psychologist who gave us a second opinion on Noah's diagnosis(es) this morning.  This particular doctor did more extensive testing: social/emotional, educational, parent feedback, feedback from Noah, and so on.  We sought out this doctor because even after Noah's original diagnosis of Asperger's, we still suspected ADHD and we wanted to rule out any other learning disabilities.  We were also looking for some suggestions to help Noah.

I liked this doctor immediately when we first met her last month.  She is a mother of 5, a Christian who is deep in her faith, soft spoken and easy to work with.  I later found out she's a former school psychologist fed up with the school system, now working part time for the university we took Noah to.  I felt confident with the choice that was made for us (when I called to make the appointment, we were assigned a case worker; I was not given a chance to choose who Noah saw, so I have God to thank for this one!).

Anyway....

Dr. B confirmed the diagnosis of Asperger's.  She also confirmed my suspicions of ADHD (sometimes being right isn't always a good thing...) and also added a diagnosis of Generalized Anxiety Disorder.  Because anxiety is part of Asperger's, I asked her how she could differentiate that the anxiety he's experiencing is beyond what is encompassed with his Asperger's.  She showed me the scales that Noah and I both filled out, telling me that anything above 65 indicates a significant issue.  Most of Noah's scores were 80 or above.  I also asked how ADHD and Asperger's are differentiated, because they have so much in common.  Again, she showed me some of Noah's scores on the Brown's ADD Scale, as well as Noah's self-reports and a few other things that were tested.  Noah definitely qualifies for the diagnosis.  My poor son.  Thankfully, she did find any learning disabilities.  She had many positive things to say about Noah, for which I was grateful.  She found him to be very insightful, aware and bright for his age.


So, what do we do now?  Now I find Noah a counselor.  His low self esteem, the beginnings of depression and anxiety are all reversible and treatable.  Dr. B indicated that Noah is very bright, insightful and aware for his age and believes that because of those characteristics, he will respond well to counseling, along with the proper type of behavior modifications and "brain retraining."  I need to help Noah learn to change his thinking about himself and see himself in a more positive light.  Integrating him in more extracurricular activities that he excels at and likes are also part of increasing his self esteem and decreasing his anxiety.  As for Asperger's and ADHD, those are pretty much lifetime issues--but they are still treatable and manageable.  There is counseling, behavior modification and "brain retraining" for those as well.  Social skills training is another good thing.  I'm still trying to find a mentor for him (young adult or high school age), to help reinforce some of the things we're working on, to model appropriate behaviors and so on.  Then, of course, there's medication.  Noah and I go back to the developmental pediatrician next week.  I'm going to push for a continued increase in Noah's Paxil and I'm hoping that with the added diagnosis of GAD, she'll be more amenable to a higher dose.  I'm also going to push for something to help Noah with the ADHD.  We have to be careful here because traditional stimulants tend to have the opposite effect on persons with co-morbid AS.  They can actually make things much worse in these children.  I'm hoping this doctor will be willing to try new things.  I'm still trying to set up an appointment for Noah with another doctor because I'm really not pleased with how things are going.  She's very conservative, which I want, but I also want someone is willing to try new things: conservative, yet aggressive, if that makes sense.  I've found out about two psychiatrists who specialize in treating "children like Noah," so I've been trying to get Noah on at least one of their wait lists.

So, how do we all feel about this?  I wish I knew.  I hate being right.  In some ways, it's a relief to have answers and a plan, but I'm also heartbroken for Noah.  He's a resilient kid, but just how much can one child take?  When I told him, it was the same flat response I've come to expect:  the typical Aspy response, if you will.  I didn't tell him about the GAD because it will literally just give him one more thing to worry about.  I tried to talk with him about our plan, the nice things Dr B had to say about him and that it's going to be okay, that we'll get through this.  He tuned me out (typical response) and began asking about dessert.  Sometimes he takes some time to process these things, then comes back later with thoughts and questions.

I guess that's all for now.