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Dr. Michael
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience:  Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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My son is 15yrs old. He is a very good student, makes straight

Customer Question

My son is 15yrs old. He is a very good student, makes straight A's. Have noticed for at least a couple of years now he just doesn't interact socially with visitors to the home or with the family, unless he is just told he has too. He very rarely talks to us, unless it is about the subject he is presently very knowledgable about---like trains when he was in 2nd to 4th grade, WWII and military weapons from 5th through 8th grade, followed by now basketball NBA. I can ask him a questions and he will ignore me, I have to remind him I've asked a question and need an answer. He will enter his grandparents home and leave without saying hello or goodbye, unless reminded to do so. when he meets someone new, when I introduce them he will look everywhere but at them, won't offer to shake their hand and I at times have to remind him to say hello. He knows better, because he wasn't taught this way. He has only one friend that he visits or comes to the house on occ. Doesn't want to do anything extra at achool or get involved. Always wants to go through the drive-thur instead of going in to eat. Thought it was just a phase. Worried now about him ever getting a drivers license. He won't even go into a store to buy himself a softdrink. Have wondered if he is depressed, but then thought it is a long depression. I've wondered about a degree of autism, but nver said anything out loud, until my boyfriend and I were talking and he mentioned it. His dad and I have been divorced for 12 years and I thought he adjusted well. I think at times he may feel left out or less loved than his younger brother by his dad, due to his dad buying his younger brother motorcycles, but then not buying him any gifts of even close value. I have mentioned this unfairness to his father, but never to him, my son. He has never seemed like the other children; not having many friends, always obsessed with his topic and feeling like everyone else should be too. My ex-husband says it sounds like a mood disorder. He eats and sleeps normal, grades are still great, doesn't get in trouble at school. Doesn't really seem any different over the past few years-I just thought he would grow out of his behavior. Don't laugh--I wondered about asperger's, my ex-husband said it didn't sound anything like it. I'm not sure where to take him. Though the insurance we can get 4 free visits with a counselor. I am wondering can that do any harm. She wants to talk to both of us together, but I am not sure I want him to hear everything I have to say and it seems like a lot of stuff, worried she won't hear everything and steer us is the wrong direction and make things worse.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Michael replied 2 years ago.
Hello. I believe I can be of help to you with this issue.

Your son should be evaluated as his behavior could be depression or more likely, Aspergers. I suspect you are 'right on' here. The social isolation, social anxiety, obsessive preoccupation, signs of high achievement in topics, seeming lack of social awareness and the subtleties of communication (e.g., not recognizing the need to shake hands, not laughing at sophisticated jokes as other teens might). A general 'counselor' is not what you need. You should spend these visits with a Ph.D. or Psy.D. clinical psychologist who can do a proper, formal assessment with standardized psychological testing if called for. The assessment may call for a formal intellectual assessment, standardized testing for mood disorders, and there are standardized ways of evaluating Aspergers. Only psychologists are trained to do this stuff properly. What do you think?
Customer: replied 2 years ago.

What I have read about asperger's, shouldn't we have known about it sooner? Were we just oblivious when he was younger? He was very smart and in a small school with less than 20 students per classroom. Thought when he got to move to the larger school he would run into more children "like him". I think i will cancel the appt with the counselor and look into one the psychologists I have found in our area. I have also found a adolescent psychiatrist--should you only be referred to a psychiatrist? I would like or prefer him not to be on any meds--you think that is likely? Is it usually difficult to treat or help? I would hate for him to feel sheltered or shut in forever. Thank you for reviewing this situation and sharing your thoughts/opinions.

Expert:  Dr. Michael replied 2 years ago.
Within about a year, the American Psychiatric Association will probably completely strike the term Asperger's Syndrome from the manual of classification and diagnosis. It will be replaced by something that captures both autism or autistic disorder and Aspergers., the Autism Spectrum Disorders. This means that you wouldn't have necessarily found out about this sooner, if this is a mild variant of the autism spectrum. The point is that if your son has Aspergers, his problems are conceptualized as lying on a very long, broad and expansive autism spectrum or continuum.

I would wait to see what the assessment by the psychologist turns up. There will be in most cases, little need for any medication except for management of some common symptoms that occur in everyday life for both typical kids and those with Aspergers----primarily anxiety reactions and symptoms of depression. What your son really would benefit from is engagement with a social support network of other children with a similar problem, social skills training programs for people with Asperger's, etc. So this will be a life-long challenge for him and over time and as he matures, new developmental challenges will face him. And of course he and you will be shifting from one challenge to the next e.g., his social interest and awkwardness with girls, as he hits puberty. One of the best things you can do for him it to continue to find out what his strengths are cognitively, visual-motor assets, etc., and keep him using these to pursue accomplishments e.g., chess club or math club or music----whatever individual activities will promote this. So a psychiatrist would make sense if your son needs medication, but frankly the child clinical psychologist would know more about everyday behavioral management and developmental programming for your son. You are on the right track in naturally 'assuming' that your son would perhaps do best if he could connect with other children 'like him'. If not now, then when he gets older, he would really appreciate a social skills training program, and support group setting for persons with Aspergers.

I hope this information is helpful to you. Feel free to let me know how this eval turns out if you wish and I can lend another opinion or lead to your efforts to help your son. He is fortunate to have such a loving, interested parent.

Please click on the green Accept button at the bottom of the screen. Thanks.
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience: Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
Dr. Michael and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
Sorry I didn't get on my computer yesterday.
Expert:  Dr. Michael replied 2 years ago.
Thanks. Let me know if I can be of further help.

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