Jumping in here, hoping for some advice

Discussion in 'General Parenting' started by RyanS, Oct 11, 2011.

  1. RyanS

    RyanS New Member

    Hi All,

    I only recently found this board and I think it's going to be a godsend for me, so thank you for being here! I would love some advice on how to proceed from here with my 7yo daughter. Sorry I don't have a signature yet, I will work on that!

    So let's see. Besides being a sort of cranky baby (but not too bad) my daughter was totally normal and happy until about 3-4 when she began to hate going to preschool because she was feeling excluded by some girls she liked. When she hit kindergarten we sent her to a tiny private school and she literally cried and clung to me every day at drop off for pretty much the whole year. We started CBT that year in the winter but it didn't really help at all. Her behavior at school was pretty much okay, besides the separation stuff we had few concerns. When she hit 1st grade, same school and same multi-age classroom, she started to become oppositional with her teachers and downright mean to her classmates. She had difficulty making/keeping friends and "didn't care" how she was hurting other people. We re-started CBT with a new therapist and my daughter went for several months and we ended up stopping because it wasn't working (therapist agreed).

    Besides school, my daughter is extremely mean to her 5 yo sister. She CAN be sweet, but when she wants to be mean she can be quite hurtful, physically and emotionally. She has been this way with her sister since day one. She is quite oppositional with my husband (her dad) and I, as well. Screaming, throwing huge fits, trying to hurt us, sometimes destroying things. She also has anxiety.

    I decided to pull her out of school right before the end of 1st grade because I thought her behavior was so out of hand and decided to homeschool her for 2nd grade. We thought she would do well in a tiny homeschool program with a few other kids for a few hours a week but her behavior was so out of control (I think it was mostly fueled by her anxiety about the program) she was kicked out after eight classes. She is becoming impossible to homeschool at home, she screams and refuses to do anything and yesterday was throwing things at me. I don't *want* to homeschool her, but I am not sure where else to send her. Her little sister is in public school and when/if they have room for my 7 yo I want to try and get her in to the same school, but I fear it will be an absolute nightmare for her, us and the school. The one good thing is my daughter is smart and at or above grade level on all subjects.

    We have had a psychiatrist tell us to put her on medications, and we are getting close to being okay with that. We have another appointment next week to talk more seriously about it.

    So what am I hoping to get advice on? What are your thoughts/experiences on medicating a 7 yo? Anything else we can try? We have done therapists, parenting classes (and therefor a whole host of parenting changes that didn't help), seen an MD and an ND, done food allergy testing. Any thoughts on the right kind of schooling situation?

    Thank you thank you thank you in advance. I really appreciate it.
     
  2. InsaneCdn

    InsaneCdn Well-Known Member

    Ever had a comprehensive evaluation done? like, neuropsychologist, or child development team, or such?

    You have a problem. But the biggest problem is that you don't know what the source of the problem is, and until you do - there isn't much chance of finding the "right" solution...
     
  3. buddy

    buddy New Member

    Hi there! Yeah, I second this. Really, kids who have more subtle issues (I know it doesn't feel subtle right now, but by that I mean no huge cognitive delays or obvious unusual behaviors that anyone would spot in a grocery store, etc) , sometimes are not easy to figure out until the gap grows, they are stretched beyond their limits and they just can't handle what they otherwise could have when less demands were on them (language wise, social wise, structure wise, etc.) If it was me, I would be looking for a neuropsychologist evaluation along with a sp/lang and Occupational Therapist (OT) evaluation to get a big picture on any possible issues she may have that are triggering these behaviors. I would certainly do that before medications. Unless there is a safety emergency of course. Just MHO.
    Following that, I would have a complete school evaluation because even though her academics are up to par, she needs behavioral support in order to manage the classroom. It might be help with organization, sensory stuff, social issues, whatever....could be lots of things... She deserves that kind of consideration in school.
    Keep posting and checking in, happy to have you!

    PS as I re read this, I mean to say if you can get a directon before you start medications...not instead of medications if that is needed. medications are the reason my kid is able to live in a home environment and attend school. Very important. Just meaning to help guide where to start...adhd medications versus bi-polar medications versus depression or anxiety medications etc....
     
    Last edited: Oct 11, 2011
  4. keista

    keista New Member

    Yes, she needs to have a good (several) evaluation done to determine what the source of her issues is.

    Regarding medications. My DD1 was just one year older when I started medicating her. We tried some bad medications and some that worked very well. She even was on a medication that worked WONDERFULLY but after about six months started causing new symptoms. Despite the roller coaster ride, I do not regret any of it. The reason is this: Through her medication trials, she did experience many periods of "normal". During these times, she was able to practice and use coping skills she learned from tdocs, teachers and me. She also began to identify when things started to go bad for her (something she either doesn't like to do or doesn't like to verbalize or both). She is now two years older and medication free temporarily until we get a better picture of what's going on with her. Fortunately things have been "good" but I suspect that this is part of her natural rhythm. She always was much calmer in the fall.

    The decision to medicate is a very tricky one, but I am a firm believer in medication. I know for a fact that therapy alone will not fix every problem. And when a child (adult even) is filled with so much internal chaos, therapy alone can't even hope to fix things. medications are necessary in many situations. No different than for physical illnesses. Diabetes for example. Diet can go a long way in managing juvenile diabetes, but insulin will still be necessary. the same goes for mental/behavioral illnesses.

    Welcome to the board! :notalone:
     
  5. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    You need to see a neuropsychologist.
     
  6. Liahona

    Liahona Guest

    Hi, to get things started at school I'd go talk to the principal of the local public school. Take a behavior log of your daughters behaviors. Tell him/her you need to registrar her for school. Say you would like to make sure your daughter gets into the appropriate placement because you don't want her "disrupting the other kids learning." Those are key words. She would qualify for an IEP if her behavior would disrupt her or others kids learning. Say you would be willing to sign any forms they require for sp ed testing and would be willing to bring her in for the testing. They might want to put her in a gen ed class first while they do this testing. Point out that would be very bad for them, the other kids, and difficult child.

    I just yesterday enrolled difficult child 2 and difficult child 3 into school from homeschooling. Now I have 3 kids in 3 different schools. It is taking them a few days to get everything set up in the other class rooms and transportation set up. I expect them to be in school by Monday of next week. With your daughter not having an IEP already it might take them longer. And they might need to have the school district help them know what to do. This isn't a situation most principal's encounter every day. You don't have to wait until they have the room or resources. If they don't know about your daughter they won't ever have the room or resources.

    If talking to the principal doesn't work go talk to the sp ed director of the school district. If that doesn't work mail a certified letter to the sp ed director.

    I second the idea for an evaluation.
     
  7. buddy

    buddy New Member

    That's a great idea. In fact it reminded me that when we moved, instead of just showin up and enrolling him in the neighborhood school I first went to district Special Education and told them of the issues. Yes, he already had an IEP but they had the same Autism Spectrum Disorders (ASD)/CIP program in several elementary schools and by my going there he was put in the one that they felt had the most experience with his kinds of issues, and the most staff that could help. Still a gen. ed school with sp. ed rooms inside, but it wasn't our home school, just the one down the street a ways. Our Speech Language Pathologist (SLP) there was a brain injury rehab specialist and that is not always found. She advocated for him for the whole time we were there and that made a huge difference for him.
     
  8. DDD

    DDD Well-Known Member

    I have to make this short as I have an appointment. but I strongly suggest that you get a complete Neuro/psychiatric evaluation so you will know what steps to take next. Medications have greatly improved the lives of my difficult child's but if you don't know exactly what diagnosis's you are dealing with, then it's impossible to know which medications may or may not help. Usually there is no instant "cure" ... it's a process that takes time trying to find the right medication.

    If you are not doing so already, try to keep a little daily journal of behaviors. Not only does that sometimes show patterns that don't seem apparent by observations but it is invaluable when you are seeking the right diagnosis. Welcome. Hugs. DDD
     
  9. RyanS

    RyanS New Member

    Thank you everyone! You have no idea how much I appreciate it. Some great info for me to work with.

    So here's a sort of "duh" question: how do I get her evaluated? Neither therapist ever gave her an evaluation and when we took her to the psychiatrist, at the end of the appointment he didn't have a diagnosis but did say she needed to be on medications.
     
  10. InsaneCdn

    InsaneCdn Well-Known Member

    Assuming you're in the States (if not, let us know... and there will be other ideas!) the best bets are usually neuropsychologist, OR a child developmental/behavioral clinic, often found at children's hospitals or connected with medical universities.
     
  11. Liahona

    Liahona Guest

    Call your insurance and see which neuropsychologist is covered and if they need a pre-authorization.
     
  12. DDD

    DDD Well-Known Member

    A neuro/psychiatric examination is most often a team evaluation that last six hours or so. There is nothing physical about it (so nothing for her to fear) and the report is a collobrative summary of the results of multiple tests. The results most often identify behaviors by classification which gives you a starting point for understanding what issues she is dealing with. They do not recommend medication which is what a psychiatrist is for but once you see the results you can explore the possible diagnosis/s and then figure out what your next step should be in getting the help needed. DDD
     
  13. RyanS

    RyanS New Member

    Thank you all so much! I did some research and I think we'll be headed in a good direction.
     
  14. RyanS

    RyanS New Member

    Okay, I wanted to give an update to see if I could gather any more feedback. Saw the psychiatrist today. He said he has diagnosed my 7 yo as just "unspecified anxiety" because he didn't want to give her a diagnosis yet since he doesn't know her that well (his theory was that it is easier to wait to give a diagnosis than to undo the wrong one). He put her on 10 mg citalopram. We don't have a therapist yet, he was sort of wishy-washy on the need for it at this point, but I am feeling like I shouldn't drug her with-o therapy. Is that common? We are on a waiting list for one place that is supposed to be "the best".
    Also I asked about the neuropsychologist testing, which he said we could do, but didn't seem to care one way or the other. He did say it might be helpful, but would be expensive (I still need to look in to insurance). If/when we get that, should we do it before the medications?
    I don't know, is this the kind of info I should have gotten? I feel barely any more informed than I did before I went to the appointment. We have the names of people who can help us figure out what to do about school and a possible social skills group, but as far as how to treat my daughter and getting her a diagnosis, we just have an rx and that's about it. We go back for a medications check in 2 weeks, but we haven't filled the rx yet.
     
  15. DaisyFace

    DaisyFace Love me...Love me not

    Ryan--

    Citalopram is an anti-depressant. Brand-name "Celexa".

    YOU are the parent and the best advocate for your child. If YOU do not feel right giving a child an anti-depressant....DON'T!

    Some doctors try medications first, and then come up with a diagnosis based upon which medication worked. Personally, I do not care for docs using my kid as a guinea pig. I like a rational reason for giving medications - NOT "Well, let's give it a shot..." But that's me.
     
  16. keista

    keista New Member

    Ditto Daisy. You get the final say of what goes into your child.

    Having said that, there is no requirement that therapy must coincide with medications. That is the best way to do things, but not the only way. I started son on medications before I got him into therapy because he was in such crisis, and I wasn't waiting another day to get him help, if I could help it. on the other hand I got DD1 into therapy first, and when that alone wasn't working (I only gave it one month, but she was absolutely NOT cooperative) I then started her on medications. As I mentioned before, it was a matter of trial and error, but I researched each medication and decided if it was a logical course of action.
     
  17. buddy

    buddy New Member

    You pretty much answered your own question. The level of behaviors you are seeing...I doubt it is just anxiety. I would totally get that he would see anxiety as part of whatever else is going on. But what kind of evaluation did he do to make that diagnosis? In the ed. world we still have a few of those "we dont want to diagnose and label her too early" folks. But here is the problem....It is researched, proven over and over, that early intervention gives a child the best chance of reaching their potential. The longer one waits, the more that inappropriate behaviors and ineffective treatments continue. It is really much harder to undo a behavior than to stop it early or even prevent new behaviors from happening. Her anxiety and frustration can be reduced by finding the appropriate diagnosis/label and using therapeutic methods and interventions that are best geared for that kind of challenge. And to medicate what you dont know about? Yeah, I think your gut is saying what you feel about that.

    This guy seems very casual about a little girls LIFE. I will tell you that after being in the special needs/difficult child world, your view of severe becomes skewed. He may see such severe issues that she just doesn't cross his radar as being too needy. But you KNOW your daughter and that she is struggling. What did he mean by it is expensive....welllllll....I really believe it is pay now or pay later. I promise you if I had not had neuropsychologist along with school evaluations done I would not have near the appropriate services that we have for my difficult child.

    Trust yourself. You are saying in your post what you feel. Dont let one person who may be nice enough but clearly does not have the same level of concern you have make the decisions.... If you find out it is anxiety alone, great, you found out....but you never want to look back and say what if I had known earlier and didn't even try to find out. I have made that mistake and it feels terrible. Just my opinion.
     
  18. InsaneCdn

    InsaneCdn Well-Known Member

    This is true even if the questions you are asking do not have answers yet. We knew there were issues in grade 1... that we didn't get answers for until high school. Had we gotten lucky, we would have shaved a whole two years off that, but only two years... the tests we needed didn't exist back then.

    Keep pushing until you have the complete set of answers. It won't even happen with a neuropsychologist at this age - but it should give you "more".
     
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