Teenaged son - ASD, OCD and now anxiety - questions

[TryingToUnderstand]

I have a 14 year old son. He is an awesome kid! He has some great gifts but also has some obstacles to overcome or to learn to live with the best he can. He is very gifted in math and science, which works well as he just loves both.

The obstacles... He has been diagnosed with mild autism spectrum disorder, OCD, and fine motor delay. He has many of the difficulties you can imagine a teenager with these diagnoses as having, however he does have a few really good friends.

He was recently also diagnosed with 'Anxiety, NOS, with features of panic'. I understand this can go hand in hand with his other 'stuff' but I want to ensure I am being the best advocate I can be for him. So, here are my questions:

1) A week after the doctor explained the test results to me, I don't understand what they really mean. I've searched online and can't find the answers. He was given a self-report RCMAS test. It says scores greater than t=50 are significant. His scores were:
Defensive: T=52
Total Score: T=52
Physical: T=61
Worries: T=48
Social: T=50

Can anyone point me to a site or explain to me what each category means and what his results mean?

2) My son's dr. recommended certain accommodations for him at school. I will be pursuing them. Is there anything that anyone recommends for accommodations at school AND is there anything that has helped you to control your anxiety level that I can provide for him?

3) (Thought of one more)... Is there anything else that I could be doing to help?

[Kuma]

I have a 14 year old son. He is an awesome kid! He has some great gifts but also has some obstacles to overcome or to learn to live with the best he can. He is very gifted in math and science, which works well as he just loves both.

The obstacles... He has been diagnosed with mild autism spectrum disorder, OCD, and fine motor delay. He has many of the difficulties you can imagine a teenager with these diagnoses as having, however he does have a few really good friends.

He was recently also diagnosed with 'Anxiety, NOS, with features of panic'. I understand this can go hand in hand with his other 'stuff' but I want to ensure I am being the best advocate I can be for him. So, here are my questions:

1) A week after the doctor explained the test results to me, I don't understand what they really mean. I've searched online and can't find the answers. He was given a self-report RCMAS test. It says scores greater than t=50 are significant. His scores were:
Defensive: T=52
Total Score: T=52
Physical: T=61
Worries: T=48
Social: T=50

Can anyone point me to a site or explain to me what each category means and what his results mean?

2) My son's dr. recommended certain accommodations for him at school. I will be pursuing them. Is there anything that anyone recommends for accommodations at school AND is there anything that has helped you to control your anxiety level that I can provide for him?

3) (Thought of one more)... Is there anything else that I could be doing to help?
Hello and welcome to the forum. I admire your desire to be well informed so that you can be an effective advocate for your son. Although I participate on this forum largely because of my own anxiety, I have also dealt with some issues my teenage son had, and been through the testing, school accommodations process, etc.

Regarding RCMAS, one thing you might find helpful is to read the RCMAS manual. You probably can get a copy of it from the person who administered the test. But if not, you can get a copy here: http://www.wpspublish.com/store/p/2934/revised-childrens-manifest-anxiety-scale-second-edition-rcmas-2

I am late for an appointment now, but if you want I can send you some additional information regarding interpretation of RCMAS. But I suspect the Manual will give you what you are looking for.

One thing I would suggest is that you not look at your son's anxiety in isolation. As your post suggests, there is very likely a nexus between your son's anxiety and the other challenges that he is facing. Treating the individual component parts of a condition sometimes causes one to miss the big picture. So I think it makes sense to evaluate, and treat, the anxiety as part of the management of his overall situation. Ideally, you would have one psychiatrist or therapist with substantial experience dealing with children and teens on the autism spectrum, who can deal with the various related issues, including compulsions, anxiety, etc.

Regarding school accommodations, it is hard to recommend specific ones, because it is so individual. To me, the first question is whether the public school (assuming that is where your son is) can serve his needs effectively, or whether he needs an alternative setting (private education). If he needs private education, then you may have an issue of whether the school district will pay for it. (I am assuming you are in the United States; if not, the situation may be very different). That can be a battle, but it is sometimes worth fighting. If he will be in the public schools, then you may want the services of an educational consultant or an educational psychiatrist who can recommend appropriate accommodations (through an IEP, if you are in the United States), and can also support your request for those accommodations with the school district. Alternatively, your son's treating psychiatrist or therapist may be able to serve this function. Such a person can serve two purposes: to help determine what accommodations are necessary, and then to help advocate for them, to the extent necessary.

I hope this is somewhat helpful. I am sorry that I don't have more time to write now. If you want to continue the dialogue, post again and I will try to provide some further thoughts -- or others can too.

Best wishes

[Goomba]

Its been a little while since I have studied the RCMAS, so don't take my words verbatim, but from what I remember...

The overall purpose of the test is to assess the anxiety levels in children, and I believe it has a large focus on school settings. Each category is a measure of how anxiety is impacting the individual in that area.

Defensive - I think is like to the degree the child lies, or has other intuitions to protect themselves from anxiety/other issues.

Physical - Deals with anxiety around physical implications (Ability, health, etc)

Worries - The degree of which excessive worrying is present and contributes to/is caused by anxiety

Social - The degree to which social anxiety is present. This can range from class participation, and peer interaction, to anxiety around leaving the house.

Total score - Essentially the average of the scores, though there may be a variant that deviates the score some from said average.

Everyone experiences some anxiety, the test aims to identify who experiences it in a problematic way. From what I remember, I thought 40-60 was a "healthy" range. If the doctor told you anything above 50 is significant, either the test has been revised, I am remembering incorrectly (Sorry thats not much help), or he is suggesting that it may be worth investigating. Significant does not equate to problematic, and often suggests that the area could develop into something more serious later , is worth investigating to make sure problems are not present, or otherwise hold some form of clinical insight.

But, again, from what I remember -

40-60 was considered a healthy range. Below 40 indicated a suspicious aversion to anxiety and suggested some sort of inability to manage that part of themselves...similar to shutting that part of the self down. Above 60 suggested an anxiety issue was present, and above 70 suggested a more severe issue.

If the scale has been adjusted to 50, I would venture to guess (but encourage clarification from the actual doctor) that the 52's suggest anxiety may be present in these areas, but not yet to a large degree. In terms of educational and clinical awareness, it may be "significant" enough for those who are working with your child to keep in mind. 48/50 are fine. The 61 suggests more anxiety in the physical area (but not awful), and that does make sense when considering the fine motor delay. Its really just a gauge of where the child is at, and how professionals should begin to focus their efforts.

[needtogetwell]

I have a 14 year old son. He is an awesome kid! He has some great gifts but also has some obstacles to overcome or to learn to live with the best he can. He is very gifted in math and science, which works well as he just loves both. The obstacles... He has been diagnosed with mild autism spectrum disorder, OCD, and fine motor delay. He has many of the difficulties you can imagine a teenager with these diagnoses as having, however he does have a few really good friends. He was recently also diagnosed with 'Anxiety, NOS, with features of panic'. I understand this can go hand in hand with his other 'stuff' but I want to ensure I am being the best advocate I can be for him. So, here are my questions: 1) A week after the doctor explained the test results to me, I don't understand what they really mean. I've searched online and can't find the answers. He was given a self-report RCMAS test. It says scores greater than t=50 are significant. His scores were: Defensive: T=52 Total Score: T=52 Physical: T=61 Worries: T=48 Social: T=50 Can anyone point me to a site or explain to me what each category means and what his results mean? 2) My son's dr. recommended certain accommodations for him at school. I will be pursuing them. Is there anything that anyone recommends for accommodations at school AND is there anything that has helped you to control your anxiety level that I can provide for him? 3) (Thought of one more)... Is there anything else that I could be doing to help?

Hello Trying,
Boy do I understand where you are. My 15 yr son is ASD, but a bit more to the mild-moderate range.

If you don't mind a couple of questions I may be able to point you in the right direction.

When was the ASD diagnosed? (What age was he).

Has he become worse, agitated, angry since puberty?

Is he transitioning schools?( is he already in high school or is he going this fall?

These are the quickest ones I can think of off the top of my head, and I do have some ideas.

BTW, where are you located?

You are doing absolutely the right thing getting educated about all this. It can be complicated, but hang in there, you are by far the best advocate your son will ever have.

Cheers!
Pam

[TryingToUnderstand]

ASD was diagnosed about 4 years ago. He was 10.

He has learned to deal with the outward showing symptoms somewhat. When he's starting to feel anxious in the classroom, he sits on his hands to avoid stimming (tapping his fingertips together while counting). The problem with this is that he can explode with stimming when he gets home.

He has had moments of agitation that I would bet are from puberty but for the most part, he is very calm. He does not like when anyone breaks the rules. He hasn't had much trouble with bullying but has seen others be bullied. Each time, this threw him right over the edge. He is very social justice minded and anything that could be perceived as sexist, racist, homophobic, or picking on anyone for any kind of a difference gets him agitated.

He is transitioning to the public high school this fall. He had been at a charter school since kindergarten. This is why *I* am anxious. The charter school was wonderful with accommodating him and would put accommodations in place without needing to go through the whole process. The high school is big with big class sizes, giving a lot more room for someone to be acting up in the classroom.

We're located in Northeastern Minnesota.

[needtogetwell]

Sounds like you have a wonderful boy there.

I would suggest that if there is a special education department in the new school you get in touch with them as soon as possible. Explain your concerns, and ask what accommodations can be made for him.

If he trends to stim when anxious, maybe there is a sensory room in the school where he can go if he needs to take 10-15 minutes to gather himself. Whatever that stim is for your son, he should be allowed to do as it tends to be a mechanism for kids on the spectrum to calm himself. I know with my son the stimming is in the form of bouncing on a yoga ball. Whatever works.

I think that you will get a great deal of help through the special education department of the school, just ask for it. Your son may not need a special placement but having access to the support will make his high school transition much smoother.

Going to high school is stressful for typically developing teens, and a bit more for kids on the spectrum.

I wish you all the best.