John's Status

I'm sending this to let you all know before Friday's meeting what we found out at Riley today. We saw Dr. Posey in the autism clinic. After talking with us for almost 3 hours, here's what his thoughts were:

1. John is more toward the autism side of the spectrum than Asperger's. This, primarily because his communication skills are not that fluent (doesn't ask about how other people are doing; often doesn't answer direct questions, etc.)

2. Dr. Posey feels that what we've been seeing behaviorally lately could be better attributed to autism than say, Oppositional Defiance Disorder. He considered that as a diagnosis but felt it doesn't apply well because John doesn't have the prevalent irritability and anger that usually accompany that. He feels that the misbehavior we've been seeing lately at school is more due to autism in that he's testing the boundaries. John has a hard time respecting rules that he thinks he can get around (but we knew that!) And something like yelling at the principal is more of an autistic behavior in that he gets upset but has difficulty drawing the line where he should stop.

3. He didn't feel bipolar was an applicable diagnosis because we don't see obvious frantic energy or lethargy at any particular times.

4. He thinks that Tenex would be a good next medication to try. We need to take him off Strattera for at least a week before we'd start the Tenex. Tenex is known for being better at slowing down hyperactivity and impulsivity and not as good with focus issues. We're not sure which way to go with this. If we do start it, it will be after next Friday's endoscopy in Cincinnati so that we don't confuse our food trials.

5. He's also referring us to an autism and behavioral therapist at the clinic. She may have some different ideas on how to work with him.

Dr. Posey will be contacting Amy and Sharon to get more information from them. I'll let you know what we decide about the medication change and what we find out after meeting with the behavioral therapist at Riley. I don't know when that will be.

I look forward to meeting with you all on Friday. Thank you for all your help.
-Carolyn