Anxiety or Manipulation?

Nick didn’t go to school yesterday. Actually, lately, I feel like it is all I can do to get him to go to school. The reason why I gave him the day off, or let me rephrase that, let him stay home, was because he had a field trip. I clench my teeth at this because I really wanted him to go on this trip. It was to Boston and the State House and then to Castle Island. It would have been a wonderful learning experience. However, he was very nervous about going—for some reason—so I let him miss the event. I hate that he didn’t go, but I didn’t want him to associate a field trip and a fun learning experience with an anxiety attack.

Good mommy or bad mommy?

Sometimes a mom has only a few minutes to make a decision like this one, and sometimes it will be the wrong one, but at least it’s called doing the best job I can.

What really beat me up about this decision was that if I forced him to go he might have had a good time. He’s been on other field trips and they all turned out fine. Not forcing him gives him the option of not doing something that he should do and, thus, not helping him deal to overcome his anxiety during social events.

Now comes in a timely trip to his therapist yesterday afternoon, and she firmly agreed. We actually had a good conversation about when, and when not to avoid situations that cause anxiety. I brought her back to when Nick was in 5th grade and when he had his first anxiety attack. He was so troubled by something that happened in gym class (boys competing to win was, I think, the gist of it) that he would become anxious when he had to go back to gym. Unfortunately, his anxiety peaked to such a level that he hid under his desk at school and brought tears to his teacher's eyes. She called me and we had an emergency meeting with an autism therapist (a doctor who came out on a favor by me) to observe Nick. (This doctor was actually helping me with Meghan at her school at the time.) After spending time observing and talking with Nick, he discovered that when Nick was near the gym (or even near the doorway walking by the gym) he would panic and run as fast as he could away from the door and down the hall. The doctor told me that it was best not to have him attend gym until he was on medication for his anxiety. And medication was an absolute must.

Says who? Says that doctor, his therapist and his shrink…Yup, I got three opinions,
and keeping Nick from attending gym because it was a real trigger for his anxiety—at least until he was on meds—was the right thing to do in this case, because forcing someone to deal with this form of extreme anxiety, before he’s on medication and getting therapy to help work through the problem, could be like pushing him to the point of emotional breakdown.

So, henceforth we welcomed our dear friend, Luvox; the miracle drug that has helped Nick become capable of not only resuming gym class, but becoming a better participant in his classroom, to boot.

Note: not a drug pusher here, but, demonstrably, Nick needed to take the edge off of a debilitating anxiety disorder.

Now back to yesterday’s problem; I should have told him that he had to go on the field trip and not have allowed him to, uh-hum, manipulate me just because he didn’t want to go. And as for this newfound skill of manipulation, I must say: good for him, he’s becoming a creative thinker!! (Hey, looking for the positive in every situation, right??) But I must add to his credit, he doesn’t always avoid going on field trips or other events; in fact, he had a field trip last week and went along just fine. And he hasn’t missed an excess number of school days, either. Perhaps more than I would have liked him to miss this spring, but it seems that he has developed some additional anxiety issues that we are currently helping him work through. So I give him praise for dealing with the burden of anxiety, which I hope will help him become a stronger person in his adult life.

Here, I must give kudos to his teacher for helping me with his anxiety issues this spring! She’s been providing me with email updates and helpful ideas in alleviating his anxiety, including finding a quiet place for him to work when necessary, and even supplied him with a box of foam earplugs for when school becomes too loud.

And hey, it does take a village to raise a kid, especially a kid with ASD!!

Understanding anxiety click here.

Anxiety Disorder and Autism

As of the last week, or so, Nick’s anxiety has increased at school—and going to school, as well. About 3, or so, years ago, I had to take him to a therapist and a psychiatrist (for meds) to help him with a, almost debilitating, case of anxiety. We tried Luvox to relieve the anxiety and OCD, and it has worked, wonderfully, for these three years, and on a low dose, too. Just to reiterate, the OCD was like being hen-pecked with his perseveration about obsessive issues—like being nervous at school. I would hear: "I'm nervous in school, Mom" about 10 times just in the 20 minutes he would be getting ready for school. And my response? Well that was well practiced, too. I mean, if I didn't just say: "I know you are Nick," then he would get upset... apparently he just wants to hear those words--and nothing else--to help him through the issue...

So, I asked his teacher if she’s noticed an increase in anxiety at school—and that I would be calling his doctor to see about finally increasing the dose—I mean let’s face it, he’s only on 50 milligrams and went through 2 growth spurts since starting the meds (he’s now 5’7, and 14 years old), so I thought it just has to be the meds, but I just got this e-mail from his teacher…

I'm thinking part of Nick's anxiety is that we are planning a practice
lockdown drill. We don't know when it will be happening, and he is very nervous
about the whole process. We have stressed to him that it's just practice so we know
what to do in the event of an emergency. We have practiced them within the
classroom and they have talked about them in each class he attends. Until the
practice lockdown passes, an aide has been walking with him to his classes, rather
than going independently, to help with his anxiety. I'm hoping once we have the
practice lockdown, Nick's anxiety will be alleviated, as I'm not sure there will be
another practice one this school year.

Other than the lockdown, nothing else has changed here at school. He was slated to do the Pledge of Allegiance on the intercom this week which he has been practicing for months and really excited about, but has decided not to do it this week, he's just too nervous about the lockdown. Maybe he can try again later in the year.

Something to mention to the doctor; however, I’m also experiencing more frustration at home.. So I think I will be upping his meds… Tough call!

Any thoughts?

Good Therapy

My son sees a therapist with me every month because he is on medication for his anxiety—Luvox, which has worked well for him. The therapy appointments are wonderful and I highly recommend it for any child on the autism spectrum. It’s a place where he can discuss his feelings and mine too (Yeah, I sneak stuff in, too—don’t you know it!!), but it’s also a good exercise in social skills and one-on-one interaction. And, also, since we only see her once a month, we can actually see and monitor Nick’s improvements in communication.

The therapist is someone who has spent her career working with kids and adults on the autism spectrum, so she is very familiar with Nick and his disorder—which is vital to a good patient/therapist relationship, obviously—otherwise, the therapist would probably hang herself due to all of Nick’s narrow-minded interests and perseveration tendencies (Oh, don’t I know it!!). This 60-something year old therapist doesn’t mind talking about superheroes once in a while, but she would like to change the subject and does…to help teach him good communication manners. But Nick’s clever—I’m telling you, because the last time she tried this trick, he found an in: He wanted to talk superheroes (I knew he did—I could tell that he was bursting at the seems to ask her about the latest superhero movie that she saw (or didn’t see) and why, why for the 100th time doesn’t she like Batman and Spiderman??) but she changed the subject to science and then the weather came up and BINGO, Nick’s eyes blew open and the smirk shined through (and I knew he was up to something) and he said I saw lightning the other day! And the therapist was thrilled and asked him to tell her all about lightning, and he said it was like flash---ah, Flash Gordon—that is!! (aka, superhero)

Ugh!! We all laughed.

Aah, it's Sooo good to watch someone else try to do the mothering!

Autism/AS Emotions Run High--What to Do?

On a different forum someone broached the subject about the myth that children with Autism or Asperger Syndrome are not emotional or prone to emotion, which is--of course--refuted by parents of children with the disorders. Giving an example is that a child with AS can become very overwhelmed when his schedule is disrupted or changed in anyway and will express himself by crying or becoming very frustrated. The question was asked: What to do to help a child deal with his/her emotions when life takes a disrupting turn?

My son, who is diagnosed with a mild form of autism, has had much of the same issues, especially a few years back. He would become so overwhelmed with a change in his schedule or the mere ‘not knowing’ what comes next in his day, would set him off to such a high level of anxiety that I just had to intervene with meds. I am not a parent who is prone to abandoning any other type of coping therapies (e.g., OT, breathing exercises, yoga) but his anxiety was so significant that we needed to turn to a clinical psychiatrist and psychologist for answers. He has been (and is still) taking Fluvoxamine (Luvox) for about 2 years now and it has worked tremendously. Again, I am not a parent who “pushes” meds on anyone and I am not stating that this is the only alternative, but for Nick it was the only alternative remaining and necessary to relieve his anxiety so that he could relax at school just enough to concentrate on his work without worrying so much about his schedule. Shortly after taking the meds he actually admitted to me that he felt better and his teachers had mentioned that he actually started participating in class.

Mind you, he is on a very low dose, only 50 mg taken every night, and we have kept it this way through two growth spurts and he (so far) does not seem to require more. Our strategy is that we will wait and see how things progress before increasing the dose—in essence, slowly weaning him off of the drug if he is not requiring it any longer.

Personally, I think his success has been due to a comfortable school classroom and setting coupled with the medication’s ability to take the "edge off" for a boy who is prone to a higher level of anxiety than, let’s say, the norm.

Has anyone found meds to be helpful or just plain necessary?