“My stomach hurts, my head hurts, I don’t feel good…” familiar complaints of many kids who don’t want to go to school some days, right? The challenge is to identify what is real and what is an excuse, what they need to push through and when to keep them home. I remember telling both of my kids, as long as your grades are good, if you need a day off, I would rather you be honest and ask for it, then pretend to be sick. If you could do that, then I would have no problem letting you have a day off here and there. I gave this option primarily to take the burden off of me to have to tell if they really were sick or just wanted the day off. I am very naive and I know myself well enough that I will always err on the side of keeping them home, also because arguing with them is not worth the fight and I want to believe them. I also had set the standard that if you re not throwing up, have diarrhea or a fever, then you have to go to school. I thought I had covered all of my basis. Once again…WRONG! Jessica’s stomach hurt all the time. She constantly complained of headaches, to the point that I had taken her to the pediatrician and he did a CT scan just to rule things out. There were no fevers, etc., but there were a lot of tears. In addition, both of my kids seemed to get STREP throat or a croupy cold/cough multiple times from November to February since middle school (but there were fevers and coughs to confirm these illnesses).
Eventually, what I realized is that these complaints were symptoms of a bigger problem. Jessica was a good student and overall liked school academically. But the social piece, feeling invisible, lonely and overwhelmed was bigger than she could manage. Her complaints were real but they were not connected to a medical illness, they were connected to her mental health. Kids who experience high levels of anxiety or depression will often have these physical complaints. It is not because they are trying to manipulate you as the parent or try to get out of things (which is what I initially thought), but it is rather a sign (at least for Jessica) that she is extremely stressed, anxious or depressed. In addition to the somatic complaints, Jessica was irritable and isolating when she was at home, but she continued to plug through school, even though she was missing a lot of days (there is that perseverance!). We began having many conversations that started with,”I believe that you don’t feel well, but you have to go to school..you will feel better when you get there.” And sometimes she did feel better once she got on campus, but more often than not, as I would later find out, she didn’t feel better, she just sucked it up, held it in and let it all out when she got home, does this sound familiar to anyone? So as far as her teachers saw, Jessica was happy and participating in class, but outside of class, she was sitting alone in a band room full of kids, not talking to anyone. This eventually led us back to the psychiatrist and new medication.
I will speak more specifically to therapy and medication at a later time. What I will say here is that any medication change is slow, there are side effects most of the time and medication that works for one person may not work the same for another. Also, if the psychiatrist is not treating the right diagnosis, then all hell can break loose! It is common for kids on the spectrum to have co-occurring diagnosis such as anxiety, mood disorders or attention issues. It is often difficult to identify which symptoms are actual separate from ASD and which are actually a separate diagnosis.
Being Jessica's Mom: Growing up on the Autistic Spectrum 