Successful medication options related to "special topics"?

Our son, who is in kindergarten,is making some really great strides related to speech development and initiating more social interactions with peers, but his preoccupation/obsession related to doors (needing them closed)takes so much of his attention that it really limits how much he can participate and learn in the school setting.
We are hesistant to use the medication/drug path, but are wondering if there are any medications that have been shown to be successful in reducing these "special topic" behaviors so that kids with ASD's are able to focus on more productive subjects. It is hard to tell if his need to close all doors is related to anxiety or something else altogether. Thanks for any info/suggestions you can provide.

Hi gnss, and welcome to IAN.

I'm so sorry to hear that your son is having a difficult time with interfering behaviors right now. It is always discouraging to see that happen, especially when he was making good progress.

You are right that there can be many reasons for outward behaviors, and part of the challenge is to figure out what is going on so that you can address that. In your case, finding an insightful psychiatrist may be one path - someone who can tease apart all the elements. They might ask: Is the obsession with doors like a special topic, as in, your child just loves absolutely everything about doors and finds it hard to think about anything else (just as other children with ASD might focus on dinosaurs, or Star Wars, or legos)? Could it be more obsessive-compulsive, as in, he just NEEDS the DOORS CLOSED, like another person with OCD might need to wash their hands over and over? If so, is that tied to other anxieties?

There are medications that help people with anxiety, with obsessive-compulsion, and with focus. Figuring out which mix of issues is going on and finding a medication that helps is what psychiatrists do. To find a good one, it is often helpful to either ask your pediatrician or to ask other parents in your local area who have children with similar needs: who is known to be good in your area? If you don't know any local parents at this point, you might look for local autism or developmental disability groups, or the local chapter of the Autism Society of America: http://www.autism-society.org/site/PageServer?pagename=community_chapters

Also important to consider: is your child's classroom setting appropriate? Is it too overwhelming, sensory-wise, or socially, or academically? If he were in a smaller class, with a different environment, would he be able to focus better/feel less anxious or whatever the issue might be?

I understand your hesitation to go the medication route. I felt the same way when my son was younger, and it is common for parents to feel that way. For some children, however, medication can help. Generally, medication is considered when issues begin to interfere with learning and with quality of life.

I hope other parents will share their experiences here. What obsessive or special topic-related behaviors have interefered with your child's learning? What helped?

I took my son to a Pediatric Nuerologist today and she suggested Celexa for his OCD behaviors. I am very hesitant to give him medication when so few have had good studies about the efficacy and safety in children with ASD's.

My pediatrician has a PDD-NOS son and another friend has an ASD son and both are taking Celexa and have both said they found it extremely helpful with these OCD behaviors and some social anxiety as well.

The question is how much does his behaviors interfer with learning, are there other alternatives that could be used to reduce that anxiety.

In my opinion, medication is going to be a last resort if all else fails. Right now I don't think my sons behaviors are interferring with his school work. However I am going to discuss this with the IEP Team next week as we plan for the summer and next year. I'd like to know if there is anything they think interferes with his learning ability before I make a decision on medicating him.

I've been reading a lot on Celexa, to educate myself and came across a website designed for those with ASD and their families, there was a good deal of teenage to young adult ASD individuals who commented on their own experience taking an SSRI like Celexa. check out www.wrongplanet.net. I found it interesting to read the posts from those with an ASD on their own experiences.

My son's overiding interest is ... wait for it.... cleaning! Washing machines, vacuum cleaners, mop and bucket - they are his favourite activities. Imagine! A 14 year old son who likes to keep the floor under his bed clean and the cupboards tidy! For a parent whose child does not have ASD it probably sounds like a dream come true, but I am sure all of the parents reading this will understand the real difficulties it poses. It has impacted upon his learning as he would not sit in class and complete any work, preferring to be taking tissues out of a box one at a time and wiping the school desks. We have had to limit this behaviour/interest by saying, "when you have finished such and such, then you can sweep the leaves/clean the windows/vaccuum the rug." It is really hard some times as you cannot get him off the thought of cleaning, and he will then repetatively check that the planned cleaning is going to happen. I've never considered medication and did not know there were options (other than being aware that there is treatment for anxiety). I'm interested to lean more about the use of medications in managing this issue.

Medication should be the last thing to use, and in my opinion only if the obsession is putting the autistic person or others in harms way. One of the things that Dr. Temple Grandin talks about is how using obsessions when learning about other things can lead to growth in other areas and even interests beyond the obsession.

I know this video is very long but it is worth watching because it covers this topic and many others.

http://www.youtube.com/watch?v=bgEAhMEgGOQ

After our last IEP meeting, I made the decision to put my son on Celexa. I read a lot and talked to several parents who had their children on this medicine.

My son's anxiety and OCD tendencies were really affecting his ability to get through a day at school.

We are only on the second week of the medication and I have already seen a great improvement in my son. His speech is clearer, louder and much easier to understand, he is putting together sentences in ways he never has before. He is interacting with his peers more than ever. Usually he is sitting in his rocking chair and either playing on the game cube or watching another child play when I would pick him up from daycare. Everyday this week, I have walked in and he has been playing with his peers. His daycare teacher is amazed!

I have noticed a significant decrease in the self stimulating behaviors like rocking, stemming, etc. He is less whiney and doesn't freak out when people are around him like he was.

So far I have to say this seems to be helping him in ways I never imagined. We are slowly increasing the dosage each week until we reach a level that works for my son.

I was very hesitant about medication, but now I realize that if I can reduce the outside interferences and make it easier for him to cope, then I have to give him that chance.