Now how do we help him?
I am not one to make excuses for my difficult child. In fact, I am probably harder on him than anyone else but I also realize how much he wants to do the right thisng but just can't control his anger.
We have a sweet, good hearted kid who is friendly and wants to do well UNTIL he becomes upset. He then goes into a violent rage. He is currently at psychiatric hospital (EP'd by the police for an episode at school) , fourth psychiatric hospital visit this year. If fact he had only been out of psychiatric hospital for 5 days when this episode occured ((new psychiatric hospital this time). Has been on practically every mood stabalizer and atypical antipsychotic medication available. Does not tolerate any stimulants or antidepreessent medication. His behaviors fit a bipolar diagnosis but he also has many sign of Pervasive Developmental Disorder (PDD) or high functioning autism. He had a neuropsychologist done at a Children's Hospital two years ago that did not place him on the spectrum and while it was a thorough evaluation of several hours over several days, it did not have a component in which difficult child was observed with other children and this is where he tends to fall apart socially. All of his psychiatric hospital visits resulted in a queston of Pervasive Developmental Disorder (PDD)-not otherwise specified or other form of autism in addition to BiPolar (BP). I am trying to get him on the neuropsychological unit of his current psychiatric hospital and they say he is too high functioning. His total IQ is in the low average range, 83, but he has high and low subtests, verbal comprehension 102, working memory 70, processing speed 73. Significant speech language needs, Occupational Therapist (OT) needs, and learning disabilities. He is already in a specialized theraputic school setting in the public school and receives intensive behavioral support services through a local agency. Seeking another neuropsychologist on my own, I'm given a wait time of over a year. His psychiatrist does not feel that seeking more nero info or actually getting a diagnosis on the autism spectrum will help with his situation. She says it his unregualted moods that cause him the problems YET we can not get a medication combo that works. This is a kid who feels badly for how he behaves. He know what to do and can tell you when he is calm. He's had a great deal of therapy and behavioral support and in my mom-who-lives-with-him-everyday opinion, he is not having these outbursts on purpose and he wants to do well. Everytime he says, "I'll never do that again", he believes himself and it breaks my heart because he is also resigned to the consequences when he has had an episode and takes personal responsibility but truly feels that he has no control over his anger. Residential Treatment Center (RTC) has been mentioned and I know it might come to that someday if things don't improve but I am not willing to go down that road yet. I can't seem to find a facility that will keep him long enough to do a thorough inpatient evaluation, everything is short term crisis management.
Where do I go from here? Do I seek out a pediatric neurologist? Who do I contact to rule out a seizure disorder or other organic problem. What am I asking for when I call? Little is known about his birth parents history. He was removed due to neglect and no history of drug or alcohol abuse was noted. I do know tht he as premature and that his birth mom smoked during pregency. It was suspected that she had a mental illness though refuse treatment and her records stated that she was mildly metally retarded. Not much know about the birth dad.
Thank you for reading this and any advice you may have.
Christy
I am not one to make excuses for my difficult child. In fact, I am probably harder on him than anyone else but I also realize how much he wants to do the right thisng but just can't control his anger.
We have a sweet, good hearted kid who is friendly and wants to do well UNTIL he becomes upset. He then goes into a violent rage. He is currently at psychiatric hospital (EP'd by the police for an episode at school) , fourth psychiatric hospital visit this year. If fact he had only been out of psychiatric hospital for 5 days when this episode occured ((new psychiatric hospital this time). Has been on practically every mood stabalizer and atypical antipsychotic medication available. Does not tolerate any stimulants or antidepreessent medication. His behaviors fit a bipolar diagnosis but he also has many sign of Pervasive Developmental Disorder (PDD) or high functioning autism. He had a neuropsychologist done at a Children's Hospital two years ago that did not place him on the spectrum and while it was a thorough evaluation of several hours over several days, it did not have a component in which difficult child was observed with other children and this is where he tends to fall apart socially. All of his psychiatric hospital visits resulted in a queston of Pervasive Developmental Disorder (PDD)-not otherwise specified or other form of autism in addition to BiPolar (BP). I am trying to get him on the neuropsychological unit of his current psychiatric hospital and they say he is too high functioning. His total IQ is in the low average range, 83, but he has high and low subtests, verbal comprehension 102, working memory 70, processing speed 73. Significant speech language needs, Occupational Therapist (OT) needs, and learning disabilities. He is already in a specialized theraputic school setting in the public school and receives intensive behavioral support services through a local agency. Seeking another neuropsychologist on my own, I'm given a wait time of over a year. His psychiatrist does not feel that seeking more nero info or actually getting a diagnosis on the autism spectrum will help with his situation. She says it his unregualted moods that cause him the problems YET we can not get a medication combo that works. This is a kid who feels badly for how he behaves. He know what to do and can tell you when he is calm. He's had a great deal of therapy and behavioral support and in my mom-who-lives-with-him-everyday opinion, he is not having these outbursts on purpose and he wants to do well. Everytime he says, "I'll never do that again", he believes himself and it breaks my heart because he is also resigned to the consequences when he has had an episode and takes personal responsibility but truly feels that he has no control over his anger. Residential Treatment Center (RTC) has been mentioned and I know it might come to that someday if things don't improve but I am not willing to go down that road yet. I can't seem to find a facility that will keep him long enough to do a thorough inpatient evaluation, everything is short term crisis management.
Where do I go from here? Do I seek out a pediatric neurologist? Who do I contact to rule out a seizure disorder or other organic problem. What am I asking for when I call? Little is known about his birth parents history. He was removed due to neglect and no history of drug or alcohol abuse was noted. I do know tht he as premature and that his birth mom smoked during pregency. It was suspected that she had a mental illness though refuse treatment and her records stated that she was mildly metally retarded. Not much know about the birth dad.
Thank you for reading this and any advice you may have.
Christy
