Keep appointment?

[sickofbeingtired]

Hi-
New to site (and all of this, for that matter) but feeling blessed that I found this right now. Earlier this week, I contacted the mental health provider in our area that specializes in child psychology (and is the only one referred by my health ins.) I've had my hands full with my 6 yr old son for a long time, but has been much more pronounced over the past month or two. I've chalked it up to transition: he started 1st grade recently and I married my long-time boyfriend this summer.

That said, this week alone 1) teacher called because he "hates school," as he announced to her one morning and only does well when he has her direct attention, 2) had several instances of hurting his 3 yr-old brother, and 3) told me he wants to be dead and he is always miserable, even when he looks happy. While discussing the need for me and other adults to keep him safe, he went off on how he would kill anyone who tried to make him go somewhere, and he would "get me fired" if I ever tried to stop him from doing what he wants. Little bugger even had a plan how to do it.

I am VERY concerned about the hateful threats (not the first but getting worse) and the fact that a 6-yr old talks about wanting to die. I called the agency mentioned above, who said a therapist can meet with us (set up for next week) but a child psychiatrist would be several months. My mom sent me a link last night to info on the criteria for ODD and I cried. He doesn't exhibit some of these behaviors; he exhibits all and frequently. I have honestly been thinking I should consider placing him with someone else because I am doing such a lousy job parenting him (although little brother doesn't seem to have any behaviors outside of what I see with other of his peers). The possibility this actually is a disorder, and not just spoiling him, etc (as my dad will suggest) was oddly liberating.

Question: I've been reading thru many posts (thank you!) and see alot about getting evaluations. I'm generaly a bit leary of licensed therapists (in our state, MSW's who have had little or no clinical education can be licensed), but it may be best to keep the appointment. Or should I skip and do an evaluation first? I worry that if he has ODD (and my guess would be ADHD), a therapist may try to suggest behavior mod that's appropriate for a "normal" 6 yr-old, which would just be frustrating for my difficult child. Trust me, we've had tons of reward & punishment methods thru the years, not very effective...

Thanks for any input you can provide!

 

[smallworld]

Is the only way to get into a child psychiatrist through the agency that you have the appointment with next week? Can you find a child psychiatrist through a children's hospital or university teaching hospital? Or through friends or work colleagues who have special needs children? Or even by going through the Yellow Pages?

For what it's worth, I'm not a doctor, just a mom with a lot of experience with children who have anxiety, depression and a lot of assorted mood dysregulation issues, and I don't think your son has ODD or ADHD. I think he's suffering from some sort of mood issue that needs immediate evaluation by a child psychiatrist. I would not waste my time with a social worker, psychologist or any professional who tries to do behavior modification. Your child is crying out for help with his words and his actions. And he needs immediate attention.

To that end, I would not leave him alone at any time for his own safety. And I would certainly not leave him unsupervised with his little brother. I'm not trying to scare you, but the situation is serious. As you well know, it is not normal for a 6-year-old to talk about wanting to be dead.

By the way, many of us around here believe that ODD merely describes a set of behaviors for which there is an underlying cause. When the underlying cause is diagnosed and treated, the oppositional behavior typically subsides. I don't see any ADHD behavior (inattention, hyperactivity, impulsivity) in what you describe about your son.

In the meantime, you might want to pick up a copy of The Explosive Child by Ross Greene. It has helped many of us on this board parent our extra-challenging children.

And if your son does anything harmful to himself or others, I would not hesitate to take him to the Emergency Room for an evaluation. That will definitely set the wheels in motion for help.

 

[smallworld]

One other thought: You might want to call your local chapter of the National Alliance on Mental Illness to locate child psychiatrists in your area. Check www.nami.org to locate your state and local NAMI chapters.

The American Academy of Child and Adolescent Psychiatrists also maintains a "doctor finder" database on its website at www.aacap.org.

Good luck.

 

[BusynMember]

Suicide threats are more in line with early onset mood disorders than ADHD. I agree with smallmom.

Take care, whatever you decide to do.

 

[sickofbeingtired]

Thanks for your replies. I'll need to check into mood disorders...not really sure what that refers to specifically but I'm interested in finding out as much as I can.

 

[smallworld]

Mood disorders are a catch-all phrase that can include anxiety, depression and early onset bipolar disorder. Some kids don't fit neatly into a specific category (like my middle daughter) and can have a diagnosis of Mood Disorder-not otherwise specified (Not Otherwise Specified).

 

[BusynMember]

He could also have high functioning autism, especially if he is clueless about social skills, obsessive, plays inappropriately with toys, can't make eye contact, and is just plain quirky. I"d see a neuropsychologist not the other professionals. Autism Spectrum Disorders (ASD) kids also get so frustrated that they tend to say they want to kill themselves. Mood disorders and Autism Spectrum Disorders (ASD) are often confused by professionals.

Good luck, whatever you decide!