This is part 8 in a series about two children on the autism spectrum. You can read the rest of the series by clicking here. Today Jen, from Anybody Want a Peanut, and I will be talking about the topic of medication.
About a year ago, we had several false-starts with medications to try to help with some impulsivity and aggression, as well as sleep. Melatonin had stopped working even in pretty high doses, and Moe was both having trouble falling asleep and waking several times a night. We believed this was getting in the way of his ability to learn, and the whole family was struggling. We hoped better sleep would also have positive impact on behavior and allow him to possibly attend school and be safe around his sister. We started with Tenex, and eventually tried Clonidine and Intuniv (I may have that order wrong). All of these had initial positive effects, but after a couple of weeks seemed to make things much worse. Moe was actively aggressive in a way we had never seen and we stopped the medications. I swore never again and we took several months off.
But earlier this year, around the time Moe’s back molars came in, he started having serious aggressive and self-injurious behaviors. When he started banging his head so hard he gave himself large bumps on his forehead, we knew something had to be done. And even when the teething pain stopped, the behaviors continued. We found a new, much more knowledgeable doctor, and eventually agreed to try Risperidone, which has helped tremendously. Although we still deal with aggressive behaviors, they are greatly reduced and the SIBs have all but disappeared. This class of drug, however, can have serious side effects so we watch very closely.
Risperdal has also helped with sleep although we do still have to give melatonin a few times a week. Moe still has some aggression and impulsivity that we track for patterns. He has a lot of hyperactive behaviors, especially late in the day, but want to address this more with activity and exercise before we try different medication.
We do not use other biomedical or dietary interventions with Moe. We have so much to track and manage already, and to us, the evidence is not strong enough to add another level of complexity to the mix.
Connor has been on medication for ADHD since he was 4 years old. While I understand that medication is a touchy subject for many people, and it was an incredibly difficult decision for us to make, his quality of life was impacted enough for us to pursue this option.
His attention-span is so short and he has extreme difficulty paying attention and following along in class. The ADHD meds have helped him a great deal, although when they wear off he is almost more hyper than he was to begin with. That’s known as rebound, and it makes for very tense homework sessions in the evenings. The alternative is even worse, because it would mean that he couldn’t get through the school day. What works best for Connor currently is an extended-release med in the morning and a shorter acting med in the early afternoon.
In addition to ADHD meds, he also began taking a medication to help curb the aggression. Risperdal was ineffective, and we worked with his doctor until we found one that worked for him, which is Lamictal. It’s generally a medication for seizures, but is used off-label for aggression. It seems to help give him the ability to pause and consider his actions rather than just instinctually lashing out when upset. It has made a huge difference in his behavior at school and his ability to get along with other kids.
Of course, medication is a very personal decision to be made together with your child’s physician. Usually medication isn’t the only approach that people use. For instance, Connor goes to a social skills playgroup every week, and has for years. They help build up skills in a group setting, teaching them how to understand and express their feelings in appropriate ways, as well as many other skills regarding making friends, having conversations, taking turns, etc.
We hope you’re enjoying the series and finding it worthwhile to learn about how two children on the spectrum can be so unique. We’ll be back next Tuesday with the final topic before our wrap-up, which will be about social skills.