My 8 yo son was diagnosed with ADHD last fall. He has done great on Concerta and Ritalin. He is doing much better in school and our home life has improved somewhat.
I have had this nagging feeling that something else was going on so asked my pediatrician. He referred me to a woman who has a PhD in OT. She hears what is going on and refers you to other specialists. She referred us to a nutritionist (my son has always been an extremely picky eater, the meds have made this more of a challenge), a social skills group and for OT. Again, my mama gut wasn't comfortable with this. I felt like we were treating symptoms and behaviors without really knowing what was causing them.
Some of his behaviors/quirks are:
being rigid in his thinking. He can get very upset if things don't go the way he expects. This has gotten much better with meds but is still an issue. Example: he hates shoes with laces because he wants the loops to be the exact same size. struggles with friendships. He has friends at school but isn't really sought after. He can be bossy and can get angry with his friends. He doesn't shrug things off like other little kids. This makes him nervous because he doesn't know what to do. He has a hard time being wrong. Things tend to be black and white to him. Very few gray areas. He doesn't pick up some social cues, although he does in some areas. Example: if he and his friends get silly, he doesn't know when to stop, even after they have. He gets very nervous easily. He will proceed with activities even if he is nervous but you can see him just fight being anxious. If he is home, his anxiety can cause him to meltdown and have a tantrum. You can't reason with him until he has calmed down.All that being said, he is a sweet kid, can show empathy, understands that their are consequences to actions, wants very much to please us and his teacher, and loves to learn.
We took him to a child psychiatrist who is in the middle of evaluating him based on our concerns. He has spent three sessions with him, is going to have one of his associates do a school observation, has spoken with his teacher, OT therapist and pediatrician, and has spent considerable time talking with my husband and I.
The paths he is going down is anxiety and Aspberger's. We are shocked by this because even though he struggles with social relationships, he can give/take in conversations, uses eye contact, he can be literal in his thinking but does appreciate sarcasm, and has varied changing interests.
Can anyone give me some advice as to what to ask? Has anyone else seen this type of behavior and can point me in a direction to do some research?
{{{{hugs}}}} I think you should trust your gut. Your description sounds like PDD-NOS or Asperger's to me. The therapies you are having him do are exactly the right thing to do. Social skills that most children just pick up from their environment need to be taught explicitly to Aspie or PDD children. You might want to look up Social Stories. This will help to teach what to do in specific social situations. You may want to find a social skills group to involve him in. That involves role-playing different social dilemmas with other kids his age. Another idea is to find an Aspie or PDD-NOS message board like this one and see what information they have there.