Brother, Undiagnosed Asperger's

[E. J.]

Four years ago, I realized that my younger brother probably had Asperger's syndrome. He's fifteen now and has never been diagnosed. He knows that the rest of his family thinks he has Asperger's, but he finds that offensive. (We have tried to mention the impressive accomplishments of people with Asperger's, to no avail.)

My mom is afraid that getting him diagnosed would "label" him, and she does not want to limit him in that way. But she is also having serious problems with his behavior. He's smart but lazy, which makes homeschooling him difficult. (She is concerned that he would be bullied in an institutional school setting.) My mom is an extremely sensitive person with a lot of health problems that leave her exhausted. My brother often has meltdowns when she confronts him with assignments that he hasn't completed, and he lashes out at her, accusing her of "cheating." She thinks that he hates her. I'm less convinced that he actually hates her, although he certainly resents it whenever she requires him to do something that he doesn't want to do. Even if he knows his real feelings about her--and I'm not sure he does--he doesn't talk very much, and I really doubt he would share them. (My mom is under the impression that people who love each other always hug, say nice things, etc., which I don't think is necessarily true, but can't talk her out of believing.)

With his academic problems and difficulty relating to other people, I think he needs to be diagnosed and receive therapy so that he will be able to function as an adult. Unfortunately, money is an issue. My family probably has enough money to keep us from getting him discounted therapy, but not enough to cover the cost out-of-pocket. (I've got separate insurance through my job, but the rest of my family's insurance is awful. It barely covers basic doctor's bills, let alone anything like therapy.) Is there any way to get help for my brother that will not involve a huge price tag?

 

[NateSean]

Only a licensed psychiatrist can give him the diagnosis. Unfortunately, even if you get him evaluated, there's a chance that you'll have to go through about forty different evaluations before someone gives him the diagnosis you are satisfied with. I had seen an untold number of professionals before one was willing to stick me with the diagnosis.

How to go about doing it on the cheap depends on where you live and what laws are in place that offers assistance to parents of children with behavioral issues. For example, if your parents were to get a referral from the school's psychologist, they might be able to go through a community healthcare program that might have psychiatrists on tap that will work for a sliding scale.

The other thing to consider, however, is the small caveat of the fact that your brother doesn't have to play along with your parents. Yes, they are his parents and legally they can make decisions for him, but he still has free will and therefore doesn't actually have to cooperate. It's possible he'll even put on enough of a façade that the psychiatrist doesn't think there is anything wrong with him, thus causing more aggravation and a mounting pile of bills to go with it.

(We have tried to mention the impressive accomplishments of people with Asperger's, to no avail.)

The reverse of this happened with me. Like your brother, I wasn't appreciative of the diagnosis. It seemed unfair to me that all, or most, of the "symptoms" were things that other people got away with, so why did it make me so different? I would try to site people who did the exact same things they were accusing me of, but instead of conceiting that yeah, they probably didn't have Aspergers, they made comments to the effect of, "Well see, there you go, they probably did have Asperger's and you should be happy about it."

I'm not trying to shove my viewpoint down anyone's throat, but I hope that you take into consideration that your brother probably doesn't want to be compared to people that he will likely never meet and has no reason to identify with. A power struggle isn't going to help anyone and if you force the issue, that's all he's going to see it as.

 

[E. J.]

It isn't having him diagnosed, per se, that matters; I'm with my mom on that. Who cares whether he accepts a label for himself? No one has mentioned Asperger's to him in a very long time, because we found out that trying to discuss it with him was not helpful. The problem is that he can't deal with life very well, and he has problems dealing with everyone--family members and non-family members. One example: someone will greet him, and he will not respond. I will try to offer him a reasoned explanation of why it is a good idea to respond when someone says hello to you. He ignores it, because he thinks that anyone who sees a problem with ignoring people who greet you must be overreacting. I could give many, many more examples. Again, no one mentions Asperger's to him when we try to explain basic rules of politeness. His viewpoint on politeness--as best as I can understand it--is other people only find his behavior confusing because they are weird. Right now he is communicating largely by grunts, at least at home, so knowing exactly what he thinks is difficult. (Sometimes I can get him to talk if I'm sufficiently sarcastic; we share a rather warped sense of humor.)

I'm aware that the diagnosis process can be long and unpleasant--that's one reason why we didn't attempt it when we first guessed the reason for some of his struggles. As far as I'm concerned, if there was another way to help him without a diagnosis, I would be completely fine with that. (I doubt he would be capable of acting as though he was neurotypical, however--I think most psychologists would realize that he functioned differently pretty quickly, even if they got the diagnosis wrong.) To be clear, though--he is being homeschooled, so I'm not sure that a school psychologist's referral would be an option. The school district we live in doesn't have very good special education services. It can't even afford buildings for all the students--a lot of classes meet in trailers--let alone decent special education services.

 

[AsheSkyler]

Teenagers and autism certainly don't mix well when the autistic one already has anti-social problems to begin with.

It sounds like you're in a small town. Is there a farm or something nearby? Some place willing to let him work with animals? There's been several cases with everything from epileptics to autistics to criminals who've emotionally benefited from walking a dog or grooming a horse. Him being homeschooled opens up his free time a good bit if he can be responsible enough to work an animal into his school routine.

 

[tree]

E. J.