How do I repair things after shouting at my teenager in public?

I’m in Aus and yes, it’s relatively easy to admit for investigations and yes, they’d be done under a light GA. And yes, in a ND child the yield is low, but children with autism can still have rare, progressive neurological conditions.

It’s not the tics that would be concerning, it’s the rapid and severe regression, going from ok to 4 hour meltdowns with self-harm and new-onset faecal smearing.

If you and his team are confident that a virus has resulted in dramatic regression including faecal smearing that’s all that matters.

Just scanning through some of these responses and I am so sorry OP, you are being amazing taking the time to reply to them! I only have one 15 year old son and I still struggle to keep it together and not swear my head off at him. I think you have done nothing awful -
ww’ve all been there. You sound like an absolutely amazing mum
doing her best in bloody awful circs with no support? I’m amazed you haven’t lost it a hundred times before this point. Please be kind to yourself, you sound like you are doing everything you can and I hope posting on here has helped you process what happened. I’m so sorry that you don’t get more support, one day of respite is not enough. Your Ex is not doing enough. You are doing everything, and unfortunately as you are their safe place they can behave how they want with you so
you get the brunt of everything. You have obviously done an amazing job with DS1 as aside from his behaviour and attitude towards you, he sounds hugely sociable, confident and independent….and perhaps happy? That’s a wonderful position to be in and down to the foundations you have built. I’ve got no advice but just wanted to remind you how brilliant you are doing in such challenging situation and to not beat yourself up. Sending love to you.

I agree. Here he would be admitted and have all the stuff. Some of the absolutely over the top ones - like looking for rare neurotransmitter conditions in CSF that has to be put on ice and run to the lab 🙄. And only then would the neurologist say, that yes, it’s all likely just a virus and puberty.

But children with autism can also have progressive neurological conditions and it’s a dramatic and unusual regression.

Let it rest for now, you both need to process. You have apologized and hes taking his time, as any of us might, to firgive and be ready to move on. A grand gesture of some sort might help. Something to make him feel important special- can the grandparents mind rhe youngest for any period of time to free you up?

I am glad you are accessing therapy. Make sure you are getting the most out of it that you can - focusing on you and what you can control If you can’t control it, feeling bad about it is pointless and you can’t control what DS feels. This is not selfish; this is reality.

You can find ways to improve your relationship with him that are not focused on making him do what you want (forgiving you. He may, he may not. You can’t control it.).

I have an almost teen with the same diagnoses. AuDHD and Tourette's. I've also spent a lot of time around children with the same diagnoses. An element of regression with meltdowns is common with puberty. Tics can also increase - age 12/13 is often the peak.

I've never heard of such a huge behaviour change just being attributed to puberty though. Or is the smearing deemed a tic?

Personally if the same thing happened to my son I'd not be happy with puberty as an answer,.especially after a virus starting it all (albeit it isn't clear if the tourettes was a new thing post virus or just got much worsr).

I think you mean ECGs, not EEGs, to be fair.

Seems odd to me that paediatric neurology agreed that was wasn’t a single neurological infection/process/lesion that needed to be ruled out when a child who was doing pretty well suddenly developed regression to the point of faecal smearing and head banging meltdowns for hours at a time.

If none of this is embellished I think you need to push for an organic screen. Make sure there’s not a progressive neurological disorder that has been attributed to a virus, tell him he’s begun smearing.

Have you any experience of ND because it doesn’t seem like it ?

I'm trying to understand how a child who smears their own faeces, can't be left with anyone but op and seems to have very limited understanding as none of his behaviours are his fault can possibly be able to go into a busy airport shop alone and then run back out to tell tales on his brother.

Yes, but children get viruses all the time. That kind of dramatic regression would have or should have resulted in a full organic work up.

I’m a paediatrician, I’ve requested imaging, metabolic screens, EEGs for less. Maybe after everything has come back clear it’s reasonable to say that yes, going from functional to smearing faeces and 4 hourly meltdowns has occurred because of a virus, but that would be a diagnosis of exclusion.

Can’t win here OP. One minute you’re being advised to pack DS1 off to live with his dad and the next you’re accused of palming him off on people. Batshit.

OP updated somewhere that he had a viral illness, after which Tourette’s was diagnosed. His motor and vocal tics are severe. OP also says she works with his medical team which includes a neurologist and psychologist. I would have thought that between them they’d have the diagnosis covered.

And the faecal smearing, don’t forget that. That degree of regression from doing ok to 4 hour head banging meltdowns and nightly faecal smearing is very dramatic. All within a year as well.

Did that degree of deterioration not engender a hospital admission? Ruling out progressive neurological conditions, brain lesions?

ETA : because if he hasn’t had an MRI, LP and an EEG he should have. Unusual to go from doing well - “nothing extreme”, as you say, to nightly faecal smearing.

So what are you suggesting ? That OP is making it up ? There’s nothing unusual about anything she’s said. Some days will be easier to manage than others and he won’t have a meltdown if the sensory triggers aren’t there - OP has already explained what those are and what the result can be.

So how do you suggest that OP recruits someone else to share the care of DS2? I really can't remember ever being quite so incensed by any thread on Mumsnet as I have been by this one. The absolute cuntiness of so many of the responses that centre around what OP should be doing, without any understanding that she has so little room for manoeuvre is absolutely appalling. And frankly, why should she tie herself in knots trying to accommodate a little shit who spent half the week telling her to fuck off and regularly rebuffs her efforts to give him more 1 to 1 attention - I certainly wouldn't!

OP is doing the best she can in very challenging circumstances with very little outside support, so telling her that it's ludicrous for her to be DS2's only safe person is risible. I'm sure she would agree it's untenable, but let's face it - no one else is going to do it until the day OP is so broken and burnt out that she needs care too.
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