Disastrous at decision making

A report released today by the Kings Fund reports that mental health patients are at risk due to budget cuts. I've been listening to Radio 5 Live about it. It occurs to me that many people may not know that quite a few mental health conditions are comorbid with autism - that is that they are common occurring conditions.

Phobias, depression and bipolar disorder are often described with autism, in fact 70% of people with autism experience some type of mental health issue.  Studies have shown that in individuals with autism about 30% have Obsessive-compulsive disorder (OCD) and anxiety disorders in children with ASD has been reported to be anywhere between 11% and 84%. 

Our son Anthony is seven years old and was diagnosed with ASD three years ago. As he has developed and grown we have noted that some of his issues are not simply ASD and he has a few comorbid conditions.  We have recently been referred to the Children's and Adolescents Mental Health Services (CAMHS) for an Attention Deficit Hyperactivity Disorder but more because we found him becoming anxious about making decisions or decisions he had made.  It wasn't really until we were referred to CAMHS that we considered he could actually be suffering from a form of anxiety.

Anthony can have difficulty making the most basic of decisions.  Do you want to go to the park; would you like vanilla or strawberry cream, would you like to sit in the front seat or the back seat of the car?  Anthony just can't decide and he very quickly becomes very anxious about it. His voice becomes short and he seems to sort of shake.  Imagine having to make all these decisions for your child because they can't cope with it.

Anthony and the other kids from his class at school get sent home with reading books.  When they have finished with the book they take it back to school and swop it for a new one.  Last night we finished a book and asked Anthony if he would like to take it back to school to get a new one OR keep it and re-read again.  This simple decision completely floored him.  Pressing him for a decision only makes the situation worse.

Anthony can also regret decisions he made years ago or decisions that were made for him.  Out of the blue he'll cry and say that he was 'wrong' and he did want to go to the cinema and not the playground.  On investigation he'll be talking about a decision he made months ago.

We are due to see CAMHS next week to help him and us provide strategies to help him with this.  In the meantime, we are trying to give Anthony notice of when he's going to have to make a decision. Time to process what it is and help him by talking through his worries and about repercussions of his decision to relieve anxiety he may have about this. If you have any experiences we'd love to hear them.