challenging behavour

[gilly3]

hi ,can you help???,my autistic son is becoming increasingly challenging,(biting,spitting,scratching,kicking,and generally wreaking havoc.my heart is breaking for him,we have managed up until now,but this is the first time i have ever truly felt,that we can,t carry on at this level,iam desperate to keep my family whole,but don,t know how anymore.i also have a 2yr old daughter and a 5yr old son,who get v frightened at times.if anyone is or has experieced similar,have you any advice,handling,drugs or other???thanx

My ds became quite aggressive towards me a few years ago so I know how awful it is. He has improved with medication. He now takes rsiperidone and it has helped him feel less anxious which has also helped him to be calmer and less aggressive. You will probably need to see a psychiatrist to discuss all the options though.

Hi again Gilly. Your situation sounds awful and I do hope you get good advice on here. I'm not sure if I can add much but have you spoken to your social worker about this and stressed just how difficult things are? If I were a social worker, I would be worried about you but also about child protection issues if your younger two are at risk. Do you think he could harm them?

My son is on Risperidone too - a small dose - and it is helpful though not dramatic. Keeps some of his anxieties at bay. That is a commonly used drug in ASD and has shown to be effective for some (a miracle drug for a few I've heard). He was prescribed Risperidone via the psychiatrist who is part of the CAMHS team who deal with children with severe/moderate disabilities.

What help have you sought and got so far?

We used Risperidone too. We were so desperate and it did calm him down.Now aged 16 he has just come off it completely. School did a lot of work with him to help him control his anger. He also suffered a lot from anxiety as donkeyderbys DS.I would recommend trying it because the alternative is so much worse.

hi Gilly, my ds is 10yrs and bites, nips and scratches. I have another 2 ds age 12 and 8, and it does have a big impact on them. My ds is on risperidone as others mentioned, this was initially to calm him down and make him sleep. As he's been on for over a year now doesnt make much difference so have just seen paediatrician who has now recommend that we try strattera for daytime as well as risperidone for nights. I also got onto social worker who managed to get my son extra respite, i currently get 5 hours every 2nd saturday and my ds also gets 21 nights per year in respite centre. if we are going through a bad spell i sometimes manage to get extra nights in respite centre, because this behaviour does get you down and has effect on the whole family. I would suggest you speaking to paediatrician, and social worker. My son goes to sn school and teachers/nurses there are also great help. Good Luck :)

Can only say I'm in the same situation with my DD and it sucks, we give Melatonin as her violence tends to peak in the three hours around bedtime and this has helped. We're discussing Strattera at the moment with paed but I don't know how much impact this has on aggression as opposed to anxiety. Good Luck

I would also suggest considering medication, Risperidone changed our lives. It didn't turn DS into a "vegetable" and he still had outbursts but much less and much shorter. You do need to review it regularly which I found a great benefit, to have the opportunity to assess and discuss DS with a Consultant Paediatrician or senior Psychiatrist. When his behaviours returned people were very willing to suggest the medication was causing it but I had to remind them that those behaviours were WHY he was on the medication, it just needed reviewing. We had email contact with our Paediatrician and now do with the Psychiatrist (CAMHS) we see.
You should also look at the Challenging Behaviour Foundation www.thecbf.org.uk

Hi Gilly my two have been/are like this.
Have you recognised any signs which might trigger the meltdowns? Might be worth keeping a diary- or at least a mental log oin your head- when he has them.
E.g is the telly too loud, has something upset them prior to the attack, did you cut the toast the wrong way in the morning...and so on. Could be something which to us is trivial but to a child with autism or similar is a nightmare.
My younger son is now on Ritalin cos we just simply couldn't cope with his tempers, he's been on it for about 3 yrs now (plus clonodine more recently) and we have noticed a marked improvement, came immediately. (He fell off the tumble dryer and didn't lash out at me, a first, but allowed me to cuddle him)

hi,my son is nearly 13 now,we tried risperidone quite a few years ago now but it didn,t seem to make much difference,don,t know wether we should look at it again?.we saw his doc on friday ,and he told us to contact the physch,who gave us a drug called(zyprexa velotab),which is a anti physchotic,have any of you tried or heard of it?.he has slept for two nights in arow and does seem a bit calmer today,although still havivg the odd outburst,the downside it is affecting his epilepsy meds,has had 5 tonic clonics and lots of small jerks in the past 24 hours,and he hadn,t had a t.c in nearly 10 days.we havn,t given it tonight,and as i type this my h is lying on the bed with him trying to get him to sleep.
my son never sleeps through the night,so this part of it is a bummer.thankyou for your advice i really apreciate it.donkey d,hi again,yes we are lucky we have a great team behind our son,social worker,doc,physch,but we have really struggled with respite in and out of the home,as he hurts so much,but we have had some good news,we have been offerd once a fortnight weekend respite,not far from home with avery experienced team,which should start after easter,so hopefully it should ease the pressure .the other two have learnt very quickly to put themselves behind us,or they are getting used to being lifted over the stable door.i know its not great but ,if theres an adult nearest ,he will always target the adult.i do worry about them,but i am very torn between them ,and how to do the best for all of them.unpa 1,we know that certain sections of dvds can trigger outbursts,he has never been that affected by his enviroment as such,it does seem to be more of a frustration thing with him,he doesn,t talk as such,uses pecs and some basic signs,but if you don,t get it first time it can be explosive,and other times there doesn,t seem to be any reason,although his epilepsy is a big factor.thanx again for your advice.sorry this one, was longwinded.xx

unpa1,could you tell me a bit more about clonodine,i,ve not heard of that one?also london girl,what is strattera?thanx davros will do.x

Gilly, fantastic news about the respite. You deserve it. I'm so pleased for you. There comes a point where if you don't get help, you could sink as a family: no good for you, your son or the social services budget.

My son is a very poor sleeper too and is on Melatonin and Valergan Forte which has really helped with, but not cured, his sleep disorder. However, I'm not sure if you can use Valergan forte when a child has epilepsy. Pharmacists usually seem to know more than psychiatrists about drug combinations!

Hi Gilly
Clonodine is actually a tablet to lower BP but they've discovered that with certain conditions ( my boys have FXS and autism) that is helps improve concentration as much as anything.
Of course it has its downsides (i'm sure it doesn't help with the bed wetting as it smooths the walls of the heart and therefore I think it probably also smooths the walls of the bladder meaning he pees the bed/himself even more.
:)

hi donkey d,my son has been on melatonin for three years now,will get him to sleep ,but won,t keep him asleep,he can be awake an hour after falling asleep then we will go all night like that,he was awake all night last night ,but that was due to seizures.have not tried valergan,have heard of it though,i will ask about it thanx for info and good wishes.xxunpa1,sorry for being ignorant ,but what is fxs,and i again will ask doc about clonodine,it always helps to know whats out there,so thanku too.my son is really tired today,so its not been too bad today.xx

Hi Gilly. I've given up on the melatonin cos my elder boy is the same; gets him to sleep for about an hour and then he's awake as usual on n off all night.

I remember trying the valergen years ago with both boys and yes that did work better. It's also like an anti histomine so it stopped themn scratching themselves at night n cleared up the excema. That was a bonus.

hi unpa1,it sounds like i should consider giving valergen a go,as my son gets scoriosis in his scalp due to wearing a protective hat for epilepsy,as you say that would be great for him to stop him scratching.the only thing is ,am i right in saying valergen can make you drowsy during the day?we give our son melatonin holidays,take him of for two weeks ,then put him back on,rather than up the dose,but not really that much of a success in the long term.xx

Valergan can give you a 'hangover' and I suppose it could make you feel a bit knocked out during the early part of the day. I think it's a matter of weighing up the pro's and cons. No drug is without side effects but what are the 'side effects' of your son - and you - never getting enough sleep? The Hanson Trust deals with sleep - may be worth a look on their website.

Valergan Forte is the strong stuff. We've had plain Valergan but it hasn't been effective. Even then, my son often wakes up in the night - it isn't a miracle cure.

thanx donkey d,will look at the hanson trust.x