Bizarre Behavior Paxil 07/10/2007 California Child With Asperger's Syndrome Becomes Unmanageable on Paxil
Summary:
Paragraph 27 reads: "His mother took him to a Bay Area psychiatrist, who diagnosed him with severe anxiety and attention deficit disorder. Various medications were tried. Paxil took away his inhibitions and made him impossible to manage, and a psychostimulant he was given made him hear voices, Keri Rodgers said."
http://www.modbee.com/local/story/86737.html
Asperger syndrome is a form of autism, and education about it is in the early stages
By KEN CARLSON
kcarlson@modbee.com
last updated: October 07, 2007 04:24:06 AM
The High Five
One thing Chad Busch likes to do is ride on a tube behind a boat as it skims across Modesto Reservoir.
Like many teenagers, he reads Harry Potter books cover to cover, enjoys video games and thinks about college and a career in the high-tech world.
But the junior at Beyer High School is different in other ways, such as his monotone voice and his difficulty in making emotional connections with peers.
The socially withdrawn 16-year-old can become deeply absorbed in reading a ketchup bottle or plumbing a subject that catches his attention, and his mother restricts his computer time or she'll lose him for hours.
When he was a small boy, his parents arranged a play date, and instead of playing with the guest, Chad went upstairs to read, said Sue Rodgers, his mother.
Teachers didn't know what to make of his outbursts in class, and he had a history of tearful meltdowns at school because of a disorder he was unable to control. In addition, his odd behavior made him a target on the playground.
"Junior high was pretty much the worst three years I have ever had," he said recently, noting he was teased constantly and bullied.
Today, Chad has a small group of friends and will tell others he has Asperger syndrome -- if he thinks they will understand.
According to psychiatric literature, Asperger's is one of the autism spectrum disorders. The "spectrum" refers to a group of disorders with varying degrees of symptoms.
Children who suffer from Asperger's, sometimes referred to as a mild autism, are on the higher-functioning area of the spectrum and don't have the speech and learning delays of classic autism.
Their intelligence is often above average, but they know nothing about the social and emotional ways of relating to people. They lack the eye contact, facial expression and body language of social interaction.
The sound of a balloon bursting or even the sensation of a shirt collar on their neck can send them into a tantrum, as they are overly sensitive to sound, texture and light. Informed parents talk about their children's "perseveration": They focus on one or two interests and talk about them incessantly.
Tasha Poslaniec of Modesto said her 12-year-old daughter, Zoe, knows all about the rock band The Who. "She can give you the entire discography of The Who and everything to do with them."
"If you are not talking to her about something she is inter- ested in, she doesn't have much to say to you," Poslaniec added.
It's believed one in 400 children has Asperger's, which is far more prevalent among boys than girls. Many grow up to become functioning adults who live in isolation. Autism disorders are occurring at an alarming rate, with as many as one in 160 children affected.
Karen Mitchell, a mental health clinician for Stanislaus County Behavioral Health and Recovery Services, said Asperger's wasn't identified as a learning disorder until 1994, and only in the past few years has awareness grown to where it's diagnosed locally.
"We have become aware of this disorder fairly recently, and there isn't that much going on in terms of services for caregivers," Mitchell said.
County mental health and Sierra Vista Child and Family Services are leading an effort to educate parents, caregivers and professionals about the syndrome. Starting Oct. 18, educational sessions in Modesto, Turlock and Salida will focus on the characteristics of children on the autistic spectrum, as well as clinical interventions and available resources.
The emphasis will be on Asperger's and what are considered other mild forms of autism. Organizers also want to establish a support group for parents, so they can get to know each other and create social groups for bringing their children together.
Sue Rodgers is like many parents of Asperger's children who struggle to find an explanation. She knew Chad was different when he was 2 or 3 years old; it wasn't until he was in the fourth grade that he was properly diagnosed.
Chad started reading at age 2 and before long was acquiring an encyclopedic knowledge of the subjects he read about.
But it was troubling that Chad would become frustrated at preschool and hit and bite other children more frequently than one would expect, she said. As a social worker, Rodgers was trained to be objective about the different aspects of her son's nature.
"At 5 or 6, he would tell you anything about red blood cells," said Keri Rodgers, who is Sue's partner. "It's incredible that he was interested at that age and could read a book and give you any facts you wanted to know."
Chad shared his knowledge with anyone who would listen. On the other hand, he had no interest in what others had to share.
His mother also was concerned about his clumsy motor skills, which kept him from riding a bike until he was 10, and his extreme irritability.
While returning from a camping trip at Modesto Reservoir, someone sitting next to him in the vehicle touched his leg slightly. He threw a fit, crying for 45 minutes, even after they stopped to try to calm him down.
At school, he disrupted class by blurting out answers and paying no attention to the rules, and school officials would call his mother to pick him up after his meltdowns. He created a scene in the second grade when he became convinced a rainstorm was spreading germs that would sicken his classmates.
His mother took him to a Bay Area psychiatrist, who diagnosed him with severe anxiety and attention deficit disorder. Various medications were tried. Paxil took away his inhibitions and made him impossible to manage, and a psychostimulant he was given made him hear voices, Keri Rodgers said.
Finally, a doctor at Stanislaus Behavioral Health Center in Modesto diagnosed him with Asperger's. The three medications he takes now are working well, they said.
"I am grateful to have the medications available," Keri Rodgers said. "Before, he was miserable. He still has his moments. But it is moments, not days."
Sue Rodgers is a social worker for a foster parent service, and Keri is a mental health nurse, so they are better equipped than most parents to try to obtain services for Chad. They also are raising Sue's two other children in a two-story home in northeast Modesto.
Poslaniec said she didn't know what to do as a parent when the slightest thing would trigger a tantrum in Zoe. She compares Asperger's children to an exposed nerve -- just about any stimuli is unpleasant for them.
She endured the looks people give when Zoe would throw herself on the floor of a grocery store and scream. Family members suggested she should do a better job with discipline, she said.
Poslaniec advises parents of autistic children to educate themselves in special education law so they can gain accommodations at school. For children with disabilities or emotional problems, school districts are required to work with parents to develop plans addressing their educational needs.
"No one is going to hold your hand," Poslaniec said. "You are going to have to push for every single service you get. Even then, you have to stay on top of it to make sure it's done."
Zoe tests at the genius level, her mother said, but is overwhelmed in a classroom with more than six or seven students.
Poslaniec persuaded the school district to put her seventh-grader in a class for emotionally disturbed students at Ustach Middle School. She is in the class with seven boys -- not the best situation, mom said -- but Zoe is getting one-on-one counseling in social skills.
One training course for kids with Asperger's is called pragmatic speech. It teaches them to read emotions on the faces of other people and other nonverbal cues that they almost always miss. In the past year, Zoe has slowly developed skills in coping with social situations and unfamiliar settings, Poslaniec said.
Keri Rodgers said Chad got help from an occupational therapist in elementary school. He couldn't sit still at his desk to concentrate on math. The therapist suggested a weighted vest, that is, a vest with sandbags in the pockets. When Chad wore the vest, it settled him and he finished his math problems.
Chad is now in a resource class to improve his handwriting and organization. Even though he can ace his homework assignments, he forgets to turn them in or can't find them among the papers stuffed inside his backpack, his mother said.
She has maintained structure in his life with lots of contracts and reward systems, and by putting lists of chores on the refrigerator at home. Multitasking isn't his forte, so he is given one or two chores at a time.
Chad has a small group of buddies with whom he shares an interest in computer games and Magic: The Gathering cards. He wants to attend college and go on to design video games. He draws out story lines for the games he envisions.
Poslaniec worries about putting her daughter in mainstream junior high, a setting hard to navigate in the best of circumstances. Experts say that's the time depression starts setting in for Asperger's children, when they start realizing they are different and are not making friends the same way as their peers.
Zoe has one friend, an autistic boy whom she sees at parties attended by her mother and stepfather. They have dry conversations about subjects such as rock bands or meat-eating wasps, Poslaniec said. Otherwise, she makes sure Zoe has a book or drawing paper to occupy her at parties.
Poslaniec is considering an alternative route to get Zoe through school. She may have her take the high school equivalency test so she can attend junior college early, where she can study what she wants.
Mitchell said the education system and mental health community is becoming more aware of the milder disorders on the autism spectrum. For some time, parents seeking a diagnosis for their children were referred to a clinical psychologist in San Jose, and in recent years, county mental health has brought him to town to provide education.
Parents who don't have insurance can consult their pediatrician and may talk with a school site administrator, as the children probably are having issues at school, Mitchell said.
The county has some assistance for families in the Medi-Cal program.
"The problem is, the kids on the milder side of the autistic spectrum don't fit the county mandate unless they have anxiety and depression," she said. "We can treat the anxiety and depression, but the developmental piece no one is really tackling."
Regina Hedin, director of the Stanislaus County Special Education Local Plan Area, said a continuum of special education services is there for individuals ages 3 to 22 who meet the eligibility criteria. The Stanislaus organization works with school districts in the county, except Modesto City Schools, which has its own similar group.
Parents need a diagnosis from a clinician, and the district may try to verify that the best methods were used in the diagnosis.
"Asperger's is an interesting diagnosis, because each child who receives the diagnosis can really look different," Hedin said. "With the milder forms of autism, I do believe clinicians are becoming more aware and there is more awareness in education, although we need to continue with that."
The clinician will outline areas of need for the child, and a team, including the child's teacher, the site administrator and special education staff, will work out a plan with the parents.
Hedin suggested that parents who run into roadblocks keep working with the school district.
Some students with behavioral issues may need more attention at what's known as a "nonpublic" school. In this more restrictive setting, the students have a regular curriculum and are taught social skills with an aim to return them to main- stream education.
Most of the kindergarten through eighth-grade students at the Sierra Vista Learning Center in Turlock are on the autism spectrum, and the East Valley Education Center in Oakdale has a class for autistic high schoolers.
Sue Rodgers said she believes some children with Asperger's are so difficult in public their parents have resorted to home schooling. Now that people are more aware of the disorder, affected parents are recognizing the characteristics in previous generations of their family.
Poslaniec said her father is a brilliant science writer who lives alone in New Zealand.
"He shut other people out," she said. "I don't want my daughter to isolate herself."
Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com