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Conduct Disorder in Children with High-Functioning Autism and Asperger's

"My 12 year old son is diagnosed with high functioning autism and conduct disorder (also the suspicion of ADHD). Any other parents out there with this combination in their child? Any advice for us? This has been a very difficult road - with no end in sight. My husband and I are feeling both the physical and mental effects of the stress we have to endure on a daily basis. We are desperate at this point."

Although several studies have suggested an association between violent crime and High-Functioning Autism, few have examined the underlying reasons. All kids display oppositional or aggressive behavior from time to time, especially when they are upset, tired, or hungry. Oppositional behavior (e.g., arguing, lying, and disobeying) is a normal part of development for kids and  teenagers. When this behavior is frequent or excessive, affects the youngster’s home or school life, or violates the rights of others, a conduct disorder may be present.

Conduct disorder (CD) is the most severe psychiatric disorder in childhood, and occurs more frequently in boys than in girls. According to the U.S. Department of Health and Human Services, the disorder affects an estimated 1-4 percent of teenagers between the ages of 9 and 17 years. Young people with this disorder repeatedly violate the rights of others, and display aggressive, destructive, and deceitful behavior. Identifying the signs and symptoms of CD, and beginning treatment as early in life as possible, is essential in order to prevent the disorder and prognosis from worsening.

==> Parenting System That Stops Meltdowns and Tantrums Before They Start

What is conduct disorder?

Children with CD repeatedly violate the personal or property rights of others and the basic expectations of society. A diagnosis of CD is likely when symptoms continue for 6 months or longer. CD is known as a "disruptive behavior disorder" because of its impact on kids and their families, neighbors, and schools.

Another disruptive behavior disorder, called Oppositional Defiant Disorder ODD), may be a precursor of CD. A youngster is diagnosed with ODD when he or she shows signs of being hostile and defiant for at least 6 months. ODD may start as early as the preschool years, while CD generally appears when kids are older. OCD and CD are not co-occurring conditions.




The Best Way To Help Oppositional Children with Asperger's and High-Functioning Autism:

 

What are the signs of conduct disorder?

Symptoms of conduct disorder include:
  • Aggressive behavior that harms or threatens other people or animals
  • Destructive behavior that damages or destroys property
  • Early tobacco, alcohol, and substance use and abuse
  • Lying or theft
  • Precocious sexual activity
  • Truancy or other serious violations of rules

Those with CD or ODD also may experience:
  • Academic difficulties
  • Difficulty staying in adoptive, foster, or group homes
  • Higher rates of depression, suicidal thoughts, suicide attempts, and suicide
  • Higher rates of injuries, school expulsions, and problems with the law
  • Poor relationships with peers or adults
  • Sexually transmitted diseases

How common is conduct disorder?

Conduct disorder affects 1 to 4 percent of 9- to 17-year-olds, depending on exactly how the disorder is defined (U.S. Department of Health and Human Services). The disorder appears to be more common in boys than in girls and more common in cities than in rural areas.

Who is at risk for conduct disorder?

Research shows that some cases of CD begin in early childhood, often by the preschool years. In fact, some infants who are especially "fussy" appear to be at risk for developing CD.  

Other factors that may make a youngster more likely to develop CD include:
  • Abuse or violence
  • Crowding
  • Early institutionalization
  • Early maternal rejection
  • Family neglect
  • Large family size
  • Parental marital discord
  • Parental mental illness
  • Poverty
  • Separation from parents, without an adequate alternative caregiver

What help is available for families?

Although CD is one of the most difficult behavior disorders to treat, young people often benefit from a range of services that include:
  • Community-based services that focus on the young person within the context of family and community influence
  • Family therapy
  • Training for parents on how to handle problematic behavior
  • Training in problem-solving skills for kids and teens on the autism spectrum


Some child and teenager behaviors are hard to change after they have become ingrained. Therefore, the earlier the CD is identified and treated, the better the chance for success. Most High-Functioning Autistic and Asperger's children/teens with CD are probably reacting to events and situations in their lives. Some recent studies have focused on promising ways to prevent CD among "at-risk" kids on the autism spectrum. In addition, more research is needed to determine if biology is a factor in CD.

Parents or other caregivers who notice signs of CD or ODD in a youngster or teenager should:
  • Find family network organizations.
  • Get accurate information from libraries, hotlines, or other sources.
  • If necessary, talk with a mental health or social services professional, such as a teacher, counselor, psychiatrist, or psychologist specializing in childhood and teenager disorders.
  • Pay careful attention to the signs, try to understand the underlying reasons, and then try to improve the situation.
  • Talk to other families in their communities.

People who are not satisfied with the mental health services they receive should discuss their concerns with their provider, ask for more information, and/or seek help from other sources.


4 Crucial Mistakes in Dealing with Oppositional Behavior:



How to Identify Conduct Disorder in Your High-Functioning Autistic or Asperger's Child—

Step 1—Learn about the risk factors for developing CD (e.g., having a parent with a mood disorder, ADHD, substance abuse disorder, or CD). A history of abuse or neglect, exposure to violence, inconsistent or excessively harsh discipline, poverty, and overcrowded living conditions are other risk factors for CD.

Step 2—Take note of any aggressive behavior (e.g., bullying, threatening, or intimidating others). Autistic kids with CD often initiate both verbal and physical fights, and have a history of violence and cruelty toward people and animals. More serious signs of aggressive behavior include the use of weapons and a history of sexual assault.

Step 3—Consider whether prior destructive acts were intentional or unintentional. While all kids have the potential to damage property due to carelessness or reckless play, kids with CD deliberately cause damage to the property of others.

Step 4—Watch carefully for other signs of CD (e.g., lying, theft, truancy, substance abuse, serious rule violations, and precocious sexual activity). High-Functioning Autistic and Asperger's kids with this disorder may also experience symptoms of depression, have poor relationships with family members and peers, and experience significant academic difficulties.

Step 5—Speak with your youngster’s teacher to get her opinion, and discuss your youngster’s symptoms with a mental health professional who specializes in disorders of childhood. Read all you can about the symptoms of CD so that you are better able to identify the symptoms in your youngster.


==> Videos for Parents of Children and Teens with ASD


COMMENTS:

•    Anonymous said… 13 yr old with aspergers and adhd
•    Anonymous said… Having answers doesnt change your little fellows . He is the se boy . Find all the good traites to his syndrome and concentrate on intervention. I have a beautiful 8 yrs old boy and the stress i felt has lessoned as i can now get help . All the best.
•    Anonymous said… I feel your pain we have a 10 year old adopted daughter that we are lost with
•    Anonymous said… I'm there with you--my 10 year old son-who isn't CD but ADHD- is like a light switch--just a flip of the switch and he's like a different child--angry, 'mouthy', etc. But, like the light switch, can switch right back and be the calm, pleasant boy we know.
•    Anonymous said… It is a difficult road, but it will get better.
•    Anonymous said… It really does get better. Really, it does. I met my stepson 4 years ago and he has come such a long way. I went from having to pretty much follow him everywhere he went to make sure he was safe and not running away to now he can walk to school with the other kids. We still have our moments but they are so much easier to deal with. Consistancy is the key!
•    Anonymous said… Maturity does wonders, but we wouldn't have survived and made it in public school, until he was a junior, without medication. We treated the anxiety of Aspergers and later dealt with the ADD for school goals. He is a white food eater so any food approaches were not available to us. Early on we had many incidences of out of control emotion and frustration....Prozac and Abilify finally stabilized our son. Home school allowed us to remove the ADD meds...he works cooperatively at his pace. He is now 17....and has grown out of his control issues and reactive behavior.
•    Anonymous said… My 13 year old has Asperger's and ADHD, diagnosed when he was 10. Best advice I can give is keep a consistent schedule. Post checklists and schedules everywhere to keep everyone accountable. Limit computer/TV/game system time. We are also in weekly therapy for assistance with coping with anxiety, social groups, and on medication for the anxiety and ADHD, both at very low doses.
•    Anonymous said… My 7 year old daughter has just diagnoised with Adhd and aspergers. It is not easy we are still learning at this stage it is a hard journey and I am sure it is just the start. X
•    Anonymous said… My 8 year old son was diagnosed with ADHD and ODD at 5 years of age and has had a diagnosis of HFA. After working with Autism for 30 years. His diagnosis was no surprise. Unfortunately there is not a lot of support for our HFA kids. How ever sites like this makes you realise your not on your own. And you can pick up lots of information from parents in the same boat.
•    Anonymous said… My daughter turned 17 in sept, i also found out finally that she has ASD aswel xx we have our ups an downs, but I wouldn't changer her x
•    Anonymous said… My son 15 has exactly same condition. It's been few ups and down, but he is doing very well now. He is in mainstream high school. Message me in here, if you like to chat. It's helps to talk about it. We've been there. This journey will continue forever, however, not all bad
•    Anonymous said… My son has adhd asd language prossesing disorder.spd age 11
•    Anonymous said… My son has been dignosed with a regulatory disorder it where he acts out 7 different disorders which are aspergers adhd add and autism and sensory and other ones but the one he shows the most is aspergers and autism if anybody out there has any tips to get them to listen to you when needed I have tryed many different ways to get him to listen to me
•    Anonymous said… My son is 16. Undiagnosed as yet . Takes forever in UK. He probably has Asperger's. Is very bright. Model pupil at school. At home very uncommunicative. Doesn't eat with the family. Anything that upsets him leads to a retaliation. He has cut electric leads to my radio, thrown my clothes round my room, broken raw eggs including shells into cooked pasta, thrown an egg against granite splash back, poured a bottle of cooking oil down the sink. This morning went down to find he had thrown uncooked mince into the sink and broken off wooden trim in my kitchen. I have sought help by speaking to CAMHS , the mental health dept for kids, but he has refused to go to appointments and when someone came to the house he kicked off when they left. We are quite religious but never ask him to join us in prayer. We call him for meals and I try and make food he likes or stock up on pizza, quiche , cheese pasties....whatever. The trigger yesterday was that I forgot to get quiche. I have been told to talk to him that he has to learn to control his emotions. We all feel upset must learn not to act out our frustrations. My added problem is that my 2 year old has been diagnosed with a very rare muscle condition and needs a great deal of care equivalent to a baby of 6 months. I have 2 other kids aged 14 and 9 who are being squeezed out because of the needs of their siblings. So I try and make special time for them. Communication is the main problem with my eldest.
•    Anonymous said… My son is almost 12 so I've been there. It does get better. We used medication for about 2 years to help him clearly think. We used concerts because it had the least side effects and is out of the system in 12 hours. When we decided to homeschool we stopped the meds and started using essential oils. It is very important to have the same or close to the same routine every day. Don't surprise him with something last minute or it will cause a meltdown. We also did family therapy for a while to help him realize getting so angry was his choice not something we were doing to him. He still has some ego issues and if he feels he is right there is no telling him he is wrong. He totally compares with Sheldon off the big band theory. It does get better just keep you're head up and make sure you let him know when something isn't exceptable.
•    Anonymous said… Need more details! Do you mean following your instructions and directions? Or acknowledging your voice when you are simply trying to gain his focus? What does he do in those situations and what have you tried? Then I can share my insight with you, would love to help. Ty
•    Anonymous said… Pathological demand avoidance , conduct disorder call it what you want .... Life is miserable and tense!
•    Anonymous said… Same. My son is 7, but I hope he doesn't get conduct disorder. He's got some pretty serious angry outbursts.
•    Anonymous said… There is a clear link between aspergers, add, and odd and allergies Still trying to work out what it is
•    Anonymous said… Yes 2 out of 3 of my sons have autism. My 12 yr old has autism, he is verbal and high function. My 11 yr old has Aspergers and ADHD. It also is a daily struggle, but it has been a long road to get to this point. They do talk therapy , IEP'S and medications for anxiety, depression, hyperactivity and inattention. Overall with these interventions, love and support they are progressing daily...but it can be a daily struggle. Feel free to private message me if you would like any advice. Best wishes
•    Anonymous said… I am looking in to the option of homeschooling but many disagree.
•    Anonymous said… I often wonder if there aren’t so many more undiagnosed kids out there judging by the amount of children who are disruptive in certain ways & who also show signs of Aspergers.
•    Anonymous said… It depends. Everyone’s different, but my son works best one on one, full attention... work done on computer / tablet He so smart and knows it, but anxiety issues don’t let him get it all out until comfortable . Of course include times of socialization, time with peers( if you can) my son likes his alone time mostly. Advocate helped.
•    Anonymous said… My son 16 yr ASD ADHD + ODD. Always remember that your child is a complicated combination. Every specialist letter about our son starts with "Ben is a very complex boy..................". When attending therapies or looking for strategies to help your child remember, to consider each condition has an influence on your childs behaviour. Over all what we find with our boy is that the ASD (aspergers) makes him anxious, timid, routine driven and socially awkward at times. The ADHD overides this sometimes, he can be forward, busy, loud and in your face. The ODD makes him reluctant and suspicious to follow instructions blindly, he questions everything and clashes with peers and teachers. But all together he is funny, loving, smart, friendly, helpful, great with younger kids, I could go on and on. But as I said my advice is always keep in mind his multiple conditions because what works for one doesnt work for the other, you have to become a detective and work out what suits your child in particular.
•    Anonymous said… My son had a late diagnosis finally,after all the years of stress, problems at school,ect( too much to list) at12 yrs old. He is 14 now. We still have our days,he’s going into HS but home schooling works best. Getting an advocate was on of the best things we did. And having his 504 plan and IEP /ARD in order is key!!
•    Anonymous said… Not specifically, but I have a child diagnosed with ADHD and ODD (as well as a few other things) and is suspected of being on the spectrum, but they're not comfortable diagnosing, yet. I also have an Aspie who can be rather aggressive and mean and when he was 12, I had to give him more freedom through the day in order to have a calmer, more agreeable child in the home. What helped the first child (ADHD, ODD) was dietary changes. I took her to an integrative medicine doctor and got a full work up, as we'd been told for years that she had no allergies, etc, and I just couldn't believe she would behave those ways unless something was going on in her body. I was correct and we had to put her on a special diet. It's like night and day. She's so much gentler and kinder and cooperative now. Less hostile, less anxious (we also found out she has an anxiety problem, which the dietary changes also helped). Interestingly enough, my Aspie also has dietary issues. They both have bodies that find it hard to detox on a standard American diet, no matter how healthy it is. They need to mostly eat foods in their natural states or as close to it as possible. Ms. ADHD has confirmed methylation issues (possibly MTHFR mutation, but we haven't tested for that, yet...the integrative medicine doctor tested for methylation pathway blockages without needing to do a genetic test). I truly believe that behavioral issues in children are directly related to a biological cause, if we find it. I don't mean simply a different neurological type, but an actual biological cause (usually in the gut, check out info on the gut-brain connection). I hope something I shared helps. Good luck!
•    Anonymous said… One of our biggest struggles is the uneducated people who assume and judge, it’s sad. But my close family members rule!!!!!
•    Anonymous said… What I really want to say is, when my son doesn’t want to go, Cries, gets sick, has anxiety... goes to Nurse, misses class, teachers are not on board ..calls to come get him and it happens all the time. It’s What’s best.. homeschool.
•    Anonymous said… Yes, our son has both. The high functioning ASD proves to be more of a challenge to manage than ADHD. The only advice we have is that both parents doing the same things in terms of management & working together. We find one parent dealing with a problem/meltdown works-not both parents. We take it in turns so we give each other a break. We just take each day as it comes-cos we never know when our son may need extra support. We did buy ear defenders which have worked well for him. Look after yourselves too. And don't beat yourselves up if you get it wrong now & again-this is a constant learning curve & every child is different. Good Luck, but bet you're already doing great xx
•    Anonymous said… Yes. With those same challenges. Private violin lessons , art and Planned one on one with a friend. Also , school counseling, OT, He still has social challenges.  

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Crucial Strategies for Parents of Challenging Kids on the Autism Spectrum

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