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    Need a listening real question...
    Indiaguerita posted:
    Raymond has been self-injuring again during times of aggression and when he is very upset. (Raymond is my four year old with Autism.)

    I found him in his room about two days ago silently punching himself extremely hard, in his beautiful little face.

    It makes me so sad and I feel inadequate as a mother.

    Poor little guy. I'm want to tell him that I am doing the best that I know how but that won't help him not hurt himself.

    I have been crying at night again and I'm not a big crier.

    I need help. We have an appointment scheduled with his psychologist but the soonest they could squeeze us in was April.

    Roy Benaroch, MD responded:
    I wish I had a good answer for you, Laura, even if you didn't have a "real question".

    Self-injurious behavior can be very difficult to extinguish with a behavioral approach. My understanding is that distraction and keeping hands busy otherwise might help, but then again if Raymond is doing this when you're not around, how could you distract him?

    You've probably asked yourself this already, but are there routines that have been disrupted, or new challenges for Raymond that might make him feel overwhelmed? Is he getting enough sleep and exercise time?

    There are medications that might help, but of course these can have side effects and it's a difficult decision to make. Hopefully you are working with a good team including perhaps a neurologist, child psychiatrist, or developmental pediatrician with the expertise to help you through this difficult time.

    I wish you and Raymond the best.
    Lainey_WebMD_Staff responded:
    Hi Laura,

    You are not an in inadequate mother. Parenting is very difficult but more so when a child has behavioral difficulties. Love your beautiful son. :)

    I agree with Dr. Benaroch, try to find things that will keep him busy.
    Emmyl responded:
    I haven't got any words of wisdom, but your post broke my heart. I love my son so much, I can't imagine what you must be going through. Please know you've got people out here in Webmd Land that are thinking about you and praying for you.

    Boyzmomee responded:
    Where do you live? In California we have regional centers that can help with obtaining ABA, respite and other services.

    Have you contacted your local school district? There are all kinds of services that are available. Please call them right away.

    Right now I am managing cases of children with developmental disabilites including autism.
    Indiaguerita responded:
    Thank you all for your responses. I really appreciate it.

    Dr. Benaroch...the only things his dad and I can come up with is that he has had a couple snow days from school...and that did disrupt the routine. But...that was almos two weeks ago and we're back to our schedule.

    Also, in this particular scenario...he had lost a game of Uno and was very upset. However, an antecedent to this kind of behavior is not always so obvious to his dad and me.

    We do have a neurologist and psychologist. His neurologist wants to put him on Klonodin (spelling?) but I am just not ready for the type of medicine. He's only four years old. He just seems too little for that kind of medicine.

    I live in Kansas. He is currently attending a private school with an integrated classroom of neurotypical children and non-typical kids. There is a paraprofessional in the class and he receives occupational and speech therapy through the school program. He does have an IEP. His progress is great...but still behind his age group.

    Kansas does not have much in the way of respite programs. There are not even many support groups. I have been searching for some support groups locally and have been fairly unsuccessful.

    Thank you again for everyone's support. I am glad to hear that people care enough to respond.


    (Sorry for the delay in response...I don't have internet at home right now.)
    Boyzmomee replied to Indiaguerita's response:
    My son has been taking Clonidine with good results, Do you know what kind of medicine it is?
    Roy Benaroch, MD replied to Boyzmomee's response:
    Boyz and Laura, it's unfortunate but some of these meds have similar names and that can be confusing!

    Clonidine (also called 'Catapres') is an old medication once used to treat high blood pressure. It can be used to treat impulsivity and emotional outbursts, and a long-acting form was recently FDA approved to treat ADHD. It can cause fluctuations in blood pressure, so needs to be taken regularly and the dose adjusted slowly. It can be sedating, especially at first. Overall, though, it's quite well tolerated and has fewer side effects than many other meds.

    Klonopin (also called clonazepam) is kind of a long-acting Valium, used sometimes to treat anxiety, certain kinds of seizures, or sleep disorders. I don't think this medicine is probably what the neurologist suggested.
    seeit2 replied to Indiaguerita's response:
    Laura - I'm an early childhood special ed teacher and I've done ABA therapy for years...have you discussed the self-injurious behavior with your OT? He/she may have a sensory therapy that might help stave off some of these episodes. This may at least be a temporary solution until you get in to see the behaviorist.

    I've seen kids do this kind of thing and even when they are not my own I found it very upsetting. {{HUGS}}.

    Boyzmomee replied to Roy Benaroch, MD's response:
    My son takes Clonidne for the sedation as Adderall keeps him up.

    Many of my autistic clients take it for the same reason.
    Indiaguerita replied to Roy Benaroch, MD's response:
    I checked the neurologist's report...It was Clonidine that he recommended. If the Clonidine did not work...he suggested that we switch to Zoloft or Risperdal.

    I declined to medicate him at that time. Raymond is too little for those kinds of medications, in my opinion. I don't judge anyone who chooses to use them...but we decided, solely because of his young age, that we would rely on ABA therapy as much as can. In the future, if the aggressive behaviors or self-injury behaviors are not being eliminated by ABA, then we can consider medicine.

    Thank you for responding. I appreciate your time.

    Indiaguerita replied to seeit2's response:
    Deb -

    Thank you for your response. I really appreciate it.

    I do need to talk to his Occupational Therapist. It's been since September since we had the IEP written. I will call her and schedule an appointment with her. I need to ask his teacher if she sees any of the behavior that I am seeing at home. (I would do that today, but the kids are having a snow day, thanks to "snowpocolypse.")

    I am looking into getting a weighted vest and a weighted blanket. I think those might help Raymond a lot. When I rub his head he calms down. (But that does not always work.)

    Indiaguerita replied to Boyzmomee's response:
    I heard Clonidine causes significant weight gain. Was that true for your son?

    What about other side effects? When did your son start taking the medication? What are you using Clonidine to treat? (What behaviors?)

    phoenix31674 replied to Indiaguerita's response:
    They use the weighted blanket on my nephew (4) at his school. It helps him calm down while there. He just started there this school year. He's not aggressive or self-injurous, but just gets very upset about being at school even though they provide him with much needed therapy. Hope it helps you.
    Boyzmomee replied to Indiaguerita's response:
    No, he has not had any problems with weight.

    My son has ADHD. He takes Adderall in the morning and Clonidine at night. The Clonidine helps him relax and go to sleep. (The Adderall makes it difficult for him to fall asleep.)

    My son started on Adderall at age 6 and Clonidine a few years ago when the Adderall dosage needed to be upped a little.

    My son is doing wonderfully at age 13.

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