And Now a Suicide Threat!!!

[RWHangel]

First of all I would like to say this calm down.... CPS is messed up in alot of ways I have 3 run ins with them and the last one was bad enough they had to report it but didn't take difficult child away from me. The other 2 were nothing but doctors being doctors no biggy but the never once took her away. I admitted to the last one as I did hit her hard enough to bruise her face. NOT ok in any setting and I hated myself for it but they did their investigation found no evidence that I was "abusive" enough to take her in to custody and found that she was a difficult child but that I was in therapy to help me deal with her. SOO don't sweat CPS if they get called tell them the truth stick with it and they will do an investigation and find that you are not abusing her. As for the therapist I would personally go talk to them and find out what was really said. As stated earlier they are mandadated by LAW to report suspected abuse. IF the T did say this find out what made them think that. If you don't have a dialog with T it is time to get a new one. I see difficult child's every week and have a very open dialog. She knows everything going on at home and KNOWS my difficult child lies about things. Take some steps to find out where this is coming from and if you find something you don't like find another therapist. I understand the NUMB thing too. It is just the I cant take anymore of this feeling not the I am horrible and have no feelings thing. Sending lots of hugs for your mommy heart.

 

[Ehlena]

That's rough, DaisyFace. Don't worry about CPS. Our difficult child has made abuse allegations more than once, and they have yet to take him away. Your difficult child has a history of behaving this way, and you have people who can vouch for you and difficult child's instability. Please don't worry about it. I know I drove myself silly worrying about the consequences of our difficult child claiming abuse only for it to turn into nothing.

 

[DaisyFace]

Another quick update:

Spoke with psychiatrist at psychiatric hospital--child-abuse and neglect has been discussed and as far as he is concerned, difficult child's allegations are completely unfounded.

So that is a relief!

on the other hand--psychiatrist is considering a new diagnosis....this time Conduct Disorder...but he wants a few more days of analysis before making that diagnosis "official"...and he is considering changing/adding medications.

So....it turns out that, indeed, I was worried about CPS for nothing.

OK...deep breaths....one day at a time.....I can do this.

Thank you all! Truly, you are the best friends one can have at a time like this!!!

--DaisyFace

 

[smallworld]

DaisyFace,

Conduct Disorder is reserved for the over-18 crowd. It's similar to ODD, a very unhelpful diagnosis that describes a set of behaviors with an underlying cause. When the underlying cause is identified and treated, the CD behaviors typically improve. Furthemore, there are no medications that specifically treat CD, but there are medications that treat the underlying conditions that contribute to CD. So . . . it's my strong recommendation to go back to the psychiatrist and ask for psychological testing to help figure out what the underlying condtion or conditions are.

 

[DaisyFace]

DaisyFace,

Conduct Disorder is reserved for the over-18 crowd. It's similar to ODD, a very unhelpful diagnosis that describes a set of behaviors with an underlying cause. When the underlying cause is identified and treated, the CD behaviors typically improve. Furthemore, there are no medications that specifically treat CD, but there are medications that treat the underlying conditions that contribute to CD. So . . . it's my strong recommendation to go back to the psychiatrist and ask for psychological testing to help figure out what the underlying condtion or conditions are.

Smallworld--

That had been my understanding, as well...

So I did a little online research and it seems to me that perhaps that's been changed, because I'm finding three terms:

Early-Onset Conduct Disorder

Late-Onset Conduct Disorder

And once they turn 18

Anti-Social Personality Disorder.

So I think those definitions have been revised somewhat from what they used to be.

I have begged everyone I know to beg for phsychological testing...the county mental health doctors, two different crisis stabilization centers, the university hospital--I even called the State Dept of Mental Health AND Child and Family Services.

The five mental health doctors and multiple therapists that have evaluated her in the last two years all seem to be of the opinion that no further in-depth testing is warranted.

There is no one left to ask...

 

[smallworld]

What is the source for the terms you found?

 

[flutterby]

It actually talks about early onset Conduct Disorder (don't know if it's called early onset, but it talks about different ages of manifestation) in the DSM IV. I'd have to pull mine out, but I specifically remember the age of 10 being used - maybe as a guideline, i.e., manifested before age 10 or after age 10.

 

[emotionallybankrupt]

I'm getting in later in the game. I'd never heard the term "conduct disorder" for anybody OVER 18. I just checked Wikipedia as well as American Academy of Child and Adolescent Psychiatry. Seems to back it up as an "under 18" diagnosis, although COULD be over 18 if criteria are not met for antisocial personality disorder.

 

[flutterby]

Yeah, it typically is for the under 18 crowd.

 

[susiestar]

This was changed very recently. I think it was changed in the DSM that just came out or will be changed in DSM if it hasn't been released yet.

I found it confusing and hopeless as a diagnosis. With Aspergers or Bipolar or even Schizophrenia you have some avenues of therapy. with CD you don't have those.

It is sad that more docs are using this.

 

[rlsnights]

Sorry to hear about all the drama. Unfortunately it also sounds familiar from difficult child 1's time with us. Wish I could promise you that it's going to get better soon.

I'm assuming you live somewhere other than the US since you talk about being unable to get psychiatric testing done. Here, unless you've been down this road already, you can ask for (and often get) some testing done by the schools.

I agree with others who have talked about poor reality testing playing a part making it hard to be sure what she does or doesn't believe to be true. Asking the psychiatrist specifically about this may be helpful.

I'm late to the game and don't have time to go back too far in your posts. So forgive me if I'm going over old ground but has a Borderline Personality Disorder diagnosis been considered and tossed out? If not, perhaps thats an avenue for discussion with the psychiatrists.

One thing with Borderline (BPD) is that repeated hospitalization is actually considered a way of feeding into the illness so hospitalizations in response to dramatic threats is discouraged. There is a fair amount of controversy about whether Borderline (BPD) might be on the bipolar spectrum but mood stabilizers can be effective at times.

And Borderline (BPD) has been shown to be somewhat responsive to a specific style of therapy - Dialectical Behavioral Therapy or DBT - in actual clinical trials.

Even if she doesn't have a Borderline (BPD) diagnosis, doing DBT might be helpful to her if she is having a lot of mood swings.

Finally, I want to tell you as others have done, YOU are not THE problem. While there may be ways you and husband are feeding into her behavior, most likely out of a lack of guidance from a well-qualified professional, the "professionals" in her life may be doing an even better job of that than you are and then blaming you when their approach fails.

I second the suggestion that you look for a really good therapist who is seasoned - like as in 20 years seasoned - and has extensive experience with disturbed adolescents. It may be someone who specializes in treating these children - that's what you want. Someone who knows the games and the strategies parents can use to counter the drama, accusations and poor quality care she may be getting from "professionals".

Have you alerted her therapist to the current drama especially the child abuse accusations? If not, I would do so and ask for a meeting with the therapist.

 

[DaisyFace]

I do live in the States...

after a little more online research (and yes, I'm finding this information on sites like Wikipedia and WebMD) it seems like it must be a matter of changing terms....it
used to be Conduct Disorder was reserved for older kids, but now is a diagnosis for teens and pre-teens

and "Anti-Social Personality Disorder"--now diagnosed in adults instead of Conduct Disorder--is the new term for "Sociopath".

I think I know why I'm getting the runaround for more testing....

I've been thinking (hoping??) all this time that my daughter's social difficulties, and the angry outbursts, and the trouble in school, and the lying, cheating and stealing are all attributed to some form of Pervasive Developmental Disorder (PDD)...

So as we meet each new doctor and the doctor screens difficult child...

After meeting with her the docs dismiss my request for further testing. They use terms to desribe her like "Deliberate", "Controlled", "Lacks Empathy", "Cunning", "Manipulative" and "Abusive"....and they have each said there's absolutely no evidence of underlying issues.

Is it possible that they feel that difficult child is developing into a Sociopath?

That's what I'm beginning to think at this point.

Some serious mental illnesses run in the family....

I know we can't and don't diagnose here....I'm really just "Thinking out loud"...

comments and opinions welcome

maybe we can "think out loud" together?

--DaisyFace

 

[smallworld]

Daisy, if she has a form of Pervasive Developmental Disorder (PDD), it's not deliberate. It's neurological wiring that truly means she's socially clueless. And yes, she does need testing to see if she has it.

by the way, I would not trust Wikipedia or WebMD as my go-to medication references. I would trust true clinical journals.

 

[DaisyFace]

Daisy, if she has a form of Pervasive Developmental Disorder (PDD), it's not deliberate. It's neurological wiring that truly means she's socially clueless. And yes, she does need testing to see if she has it.

So what can I do if FIVE docs have now turned us down for testing? Our most recent experience was our pedicatrician's referral to the university hospital specifically for neuropsychologist testing....and after meeting with us the doctor at the univeristy hospital decided that testing was un-necessary. She has no problem prescribing anti-depressants and anti-histamines, however--just won't do neuro-psychiatric testing.

by the way, I would not trust Wikipedia or WebMD as my go-to medication references. I would trust true clinical journals.

I agree....but I had no clinical journals handy....and I didn't know that much about "Conduct Disorder" as a diagnosis. So I feel like I found some useful information, but as with anything online--grain of salt!

 

[smallworld]

Has she ever had any cognitive or psychological testing in her life?

 

[DaisyFace]

Has she ever had any cognitive or psychological testing in her life?

Yes, at age 7/8 she received testing from a child psychologist that took about six hours. The diagnosis was ADD, ODD, Anxiety, & Depression.

She was also seen by an audiologist in conjunction with that testing who discovered a Central Auditory Processing Disorder and determined that there was a signifincant difference in her ability to understand verbal vs written information (she had a great deal of difficulty with the verbal). So the diagnosis from the audiologist was Central Auditory Processing Disorder (CAPD) & NonVerbal Learning Disorder (NVLD).

Then a few years ago, we moved from the north to the south. The docs here will not recognize the reports from the out-of-state psychologist and they tell me the results are meaningless.

We are insured with Medicaid and money is definitely an issue--so we cannot afford to take her somewhere out of our region for testing.

 

[rlsnights]

So she has not had any testing done through the school district as part of an assessment for special education?

 

[susiestar]

If you send a letter to the schools asking for a full and complete evaluation then, by federal law, they must test her. Go over to the sp. ed for um and ask what the letter should say.

They will tell you to send it certified mail return receipt requested. This is CRUCIAL. with-o proof that they received it they will duck out of responsibility because you must PROVE that they received the letter.

More about that is over in the Sp Ed forum.

Sending hugs. This is all so hard to cope with.

 

[DaisyFace]

So she has not had any testing done through the school district as part of an assessment for special education?

Yes--the school district had their people do an evaluation in kindergarten (maybe first grade?) and found nothing. They viewed my daughter's problems strictly as a "behaviorial issue" and suggested all kinds of reward charts that I should try to get her to comply with homework and other issues.

I began searching for professional help outside the SD and eventually received a referral to the child psychologist, who is the first and only professional who ever did any sort of in-depth testing....at the time, I thought that it was very thorough.

As a result of that testing (end of second grade), difficult child was prescribed Ritalin and the school implemented a 504 Plan which required the teacher to give her preferential seating and provide written support for all verbal lessons.

Bullying, stealing and other social problems were handled on a case-by-case basis with the school's guidance dept. The counselors usually tried to mediate the situation whenever possible. Sometimes, difficult child was simply excused from certain activities altogether (such as participating in work groups).

The 504 Plan was used in third and fourth grade and then dropped, as the SD felt that difficult child had "matured".

We moved after sixth grade and difficult child started seventh in the new school district.

difficult child was hospitalized for the first time at the beginning of eigth grade.

She is now in her first year of high school.

 

[rlsnights]

I assume that she is struggling to a greater or lesser extent academically. If she is unable to participate in normal classroom activities like work groups or do lab partnerships then I think you definitely have a case to get Special Education assessment regardless of her academic standing.

It is NOT automatic that they will do an assessment. You need to write them a letter requesting the assessment and telling briefly why you believe your child has a disability that is making it hard for her at school. Since I don't know a lot of details about her issues at school I can't suggest what you should say. Figuring out whether she is clearly a child with a disability may be kind of complex from what I've read about her situation. You should go to the Special Education forum to discuss that question in detail.

Once you write the letter, deliver and send it (see Special Education forum) the school has 60 days to respond. They have two choices:

1) agree to assess her which would take the form of asking for your agreement to let them assess her and giving you a written assessment plan for your approval OR
2) refuse to assess by giving you prior written notice (IEP speak for telling you in writing) why they believe your child is NOT a child with a disability and therefore does not need assessment.

For further discussion you should post over in Special Education. You might want to go back and read some of the archives and recent posts because we have addressed these issues at length within the past couple of months over in Special Education forum.