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New and could really use some advice (long)
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<blockquote data-quote="slsh" data-source="post: 373472" data-attributes="member: 8"><p>Hi zba and welcome! Wow.... you have a lot of valid concerns. I'm not even sure where to jump in. <img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite2" alt=";)" title="Wink ;)" loading="lazy" data-shortname=";)" /> I haven't read other responses so forgive me if I repeat. None of us have *the* answer, but you'll surely get a wide variety of opinions based on our individual experiences - take what you can use and ditch the rest. </p><p></p><p>The therapist's advice about behavior charts and rewards is pretty SOP. That works pretty well with- pcs. difficult children? Not so much. My difficult child actually had a very strong negative reaction to positive reinforcement. He craved negative reinforcement from a very early age (2 years), and those time outs? He loved them, especially since he would never stay in his room and therefore a 10 minute time out would turn into an hour long ordeal with me barring his bedroom doorway. Massive negative reinforcement - cha-ching, big payoff for him. I think you do have to go thru the motions and make a genuine effort with- the charts and rewards, documented well, just so that the therapist will (hopefully) grasp that it's not going to be a successful strategy and you don't waste a whole lot of time on them.</p><p></p><p>As far as unemotional parenting - BRAVO!! That's actually a strategy that I learned here on this board. We'd already been thru 4 years of therapy by the time I got here, and not 1 therapist had addressed this. My emotional reaction to my kid's behaviors was like throwing gasoline on a fire. He just ate it up. It actually gave him control of the situation, because I'd be screaming like a banshee and he'd just sit there smirking, then very calmly and intentionally repeat the behavior. Every kid I'd ever been around wanted approval and rewards - it just completely boggled my mind that thank you was the *exact* opposite. By taking the (negative) emotion out of my parenting, I was able to retain control of situation. Of course, he ramped up his behaviors to try to push my buttons, and I still occasionally failed, but I'm also very competitive and when I got into the mindset that there was no way I was going to allow my 6 (7,8,9) y/o kid send me over the edge, I was able to hang on pretty well.</p><p></p><p>I think your house in lock down is a necessary accommodation until the behaviors are more manageable. It's absolutely a lousy way to live but... it has to be done. From age 6 until about a year ago (when he was definitely never going to live here again), nothing came into this house without it's weapon factor being weighed. No heavy lamps, nothing on walls, no sharp edges, pointy things, glass objects. None of my little decorative touches on shelves or coffee tables. No vases. When he launched my coffee pot at me, I bought a metal one - yes, metal will hurt more if it makes contact, but at least it won't shatter. Knives, forks, tools, and all medications all locked up in a tool box with a keyed lock. No matchbox cars (those really sting when launched) - he got a lot of stuffed animals, nerf toys, art supplies, and legos. I know of at least one family who had to replace windows in their difficult child's room with- some kind of plexiglass thing because their difficult child kept breaking out the glass. By doing this you're not only keeping everyone safer, but you're also removing the opportunity for difficult child to impulsively destroy whatever is in proximity.</p><p></p><p>It's been years since we've played pharmacological roulette. It's very frustrating that there's no one-medication-fits-all scenario. I'm not a dr. and this is just my lay opinion, but if there is a mood disorder going on I really believe that the first line of treatment should be a mood stabilizer. Lithium is going to be out with- your son's thyroid issues. We started out with- Depakote when thank you was 6. Now, I was/am pretty much anti-medication - we did 4 years of therapy before I considered it, but things were steadily getting worse and worse. Depakote (and Tegretol, another common mood stabilizer) has an extensive database of use in children because they're also antiseizure medications. Within 6 weeks of starting, thank you's rages were spacing out from a gazillion a day (only slight exaggeration, LOL) to daily to weekly to what eventually became his best pattern of about 10 weeks of *relative* stability and then 2 weeks of revving up to a major blow out and hospitalization. Lather rinse repeat. We later added Risperdal which did a really fabulous job of further bringing down the intensity, duration, and frequency of the rages.</p><p></p><p>Again - there's no magic combination of medications because our kids all react differently. Your son's negative reaction to Prozac raises a big red flag to me - antidepressants and stimulant can provoke manic behaviors in kids. It seems like some doctors are using Risperdal to even out moods, but just based on my experience, I would want a more traditional mood stabilizer on board first.</p><p></p><p>And a note about moods in young kids that I figured out after the fact, LOL. Hindsight being 20/20, my son's depressive and manic episodes were very similar looking. I wasn't quite as tuned in to the pressured speech and racing thoughts aspect, or lack thereof, probably because I was too busy trying to just contain the kid. To me, raging = manic. But in looking back, and talking with- thank you as he got older, I think a lot of his raging episodes were born out of depression. </p><p></p><p>You are absolutely right - no medication is going to "fix" the problem. It absolutely has to be a global approach including behavior plans, as well as parenting adjustments (not disparaging your parenting, just recognizing that *no* one is prepared right off the bat to raise a kid with- such challenges). BUT - if you look at medications as a tool, especially when they are having the desired effect, then it may be easier to reconcile the use of medications. *If* the Risperdal (or whatever) is decreasing intensity/frequency/duration of rages, then it gives you that much more opportunity to teach him tools to use when he's angry/frustrated/feeling impulsive. It's a trade off.</p><p></p><p>As far as the Residential Treatment Center (RTC).... I am a big believer in following your gut. At the same time, placement in Residential Treatment Center (RTC) goes against every grain of my (selfish) maternal being (please note, my son's first hospitalization was at age 6, and we did that on average every 3 months until he was placed in Residential Treatment Center (RTC) at age 9, came home at 12, left for Residential Treatment Center (RTC) #2 at 12, came home at 13, left for Residential Treatment Center (RTC) #3 at 13, and has not lived at home since, so I'm obviously not anti-Residential Treatment Center (RTC), just know that it' a horrible decision to have to make). I think when you have misgivings, you have to very carefully and thoughtfully weigh them to ensure they're not based on your own desire to have your kid with you. Is your son safe? Are his immediate needs being met? My inclination would be to wait until his therapist is back and gets a chance to meet with- your son, see what his take is. You are absolutely right - bringing him home without a more definitive behavior management plan is a recipe for disaster. Since it is a comparatively short stay in the Residential Treatment Center (RTC), I would start now on discharge planning, even before Residential Treatment Center (RTC) therapist is back. *You* know your son best. Talk to his community therapist about behavior plans, get input from Residential Treatment Center (RTC) staff, talk to psychiatrist. What resources are available in your community (respite, crisis team, therapeutic recreation)? </p><p></p><p>Sorry - this got pretty long. You do strike me as an amazingly insightful mom, especially with so young a child (took me years to get insightful, if I'm even there yet, LOL). I think you are absolutely asking the right questions; the hard part is getting answers. There is no crystal ball (trust me on that one, LOL, I've searched for 2 decades now). I'm generally a pessimist and my parenting (and life) strategy is to plan for the worst, hope for the best. That way, if the worst happens, I've got it under control because it's not unexpected and I know what to do, and if something better happens, I feel like I've won the lottery. <img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite8" alt=":D" title="Big Grin :D" loading="lazy" data-shortname=":D" /> I think your son is very lucky to have you as his mom - feeling uncomfortable as a parent of a challenging kid is good, I think, because it will keep you on your toes so you can make the very best possible choices for him. </p><p></p><p>Last, and most importantly, make sure that you take time for yourself. Parenting in general is a marathon, and having a challenging child just makes it more stressful. It is absolutely vital that you make sure to take care of yourself both physically and emotionally.</p><p></p><p>Again - welcome and I'm so glad you found us!!</p></blockquote><p></p>
[QUOTE="slsh, post: 373472, member: 8"] Hi zba and welcome! Wow.... you have a lot of valid concerns. I'm not even sure where to jump in. :winking: I haven't read other responses so forgive me if I repeat. None of us have *the* answer, but you'll surely get a wide variety of opinions based on our individual experiences - take what you can use and ditch the rest. The therapist's advice about behavior charts and rewards is pretty SOP. That works pretty well with- pcs. difficult children? Not so much. My difficult child actually had a very strong negative reaction to positive reinforcement. He craved negative reinforcement from a very early age (2 years), and those time outs? He loved them, especially since he would never stay in his room and therefore a 10 minute time out would turn into an hour long ordeal with me barring his bedroom doorway. Massive negative reinforcement - cha-ching, big payoff for him. I think you do have to go thru the motions and make a genuine effort with- the charts and rewards, documented well, just so that the therapist will (hopefully) grasp that it's not going to be a successful strategy and you don't waste a whole lot of time on them. As far as unemotional parenting - BRAVO!! That's actually a strategy that I learned here on this board. We'd already been thru 4 years of therapy by the time I got here, and not 1 therapist had addressed this. My emotional reaction to my kid's behaviors was like throwing gasoline on a fire. He just ate it up. It actually gave him control of the situation, because I'd be screaming like a banshee and he'd just sit there smirking, then very calmly and intentionally repeat the behavior. Every kid I'd ever been around wanted approval and rewards - it just completely boggled my mind that thank you was the *exact* opposite. By taking the (negative) emotion out of my parenting, I was able to retain control of situation. Of course, he ramped up his behaviors to try to push my buttons, and I still occasionally failed, but I'm also very competitive and when I got into the mindset that there was no way I was going to allow my 6 (7,8,9) y/o kid send me over the edge, I was able to hang on pretty well. I think your house in lock down is a necessary accommodation until the behaviors are more manageable. It's absolutely a lousy way to live but... it has to be done. From age 6 until about a year ago (when he was definitely never going to live here again), nothing came into this house without it's weapon factor being weighed. No heavy lamps, nothing on walls, no sharp edges, pointy things, glass objects. None of my little decorative touches on shelves or coffee tables. No vases. When he launched my coffee pot at me, I bought a metal one - yes, metal will hurt more if it makes contact, but at least it won't shatter. Knives, forks, tools, and all medications all locked up in a tool box with a keyed lock. No matchbox cars (those really sting when launched) - he got a lot of stuffed animals, nerf toys, art supplies, and legos. I know of at least one family who had to replace windows in their difficult child's room with- some kind of plexiglass thing because their difficult child kept breaking out the glass. By doing this you're not only keeping everyone safer, but you're also removing the opportunity for difficult child to impulsively destroy whatever is in proximity. It's been years since we've played pharmacological roulette. It's very frustrating that there's no one-medication-fits-all scenario. I'm not a dr. and this is just my lay opinion, but if there is a mood disorder going on I really believe that the first line of treatment should be a mood stabilizer. Lithium is going to be out with- your son's thyroid issues. We started out with- Depakote when thank you was 6. Now, I was/am pretty much anti-medication - we did 4 years of therapy before I considered it, but things were steadily getting worse and worse. Depakote (and Tegretol, another common mood stabilizer) has an extensive database of use in children because they're also antiseizure medications. Within 6 weeks of starting, thank you's rages were spacing out from a gazillion a day (only slight exaggeration, LOL) to daily to weekly to what eventually became his best pattern of about 10 weeks of *relative* stability and then 2 weeks of revving up to a major blow out and hospitalization. Lather rinse repeat. We later added Risperdal which did a really fabulous job of further bringing down the intensity, duration, and frequency of the rages. Again - there's no magic combination of medications because our kids all react differently. Your son's negative reaction to Prozac raises a big red flag to me - antidepressants and stimulant can provoke manic behaviors in kids. It seems like some doctors are using Risperdal to even out moods, but just based on my experience, I would want a more traditional mood stabilizer on board first. And a note about moods in young kids that I figured out after the fact, LOL. Hindsight being 20/20, my son's depressive and manic episodes were very similar looking. I wasn't quite as tuned in to the pressured speech and racing thoughts aspect, or lack thereof, probably because I was too busy trying to just contain the kid. To me, raging = manic. But in looking back, and talking with- thank you as he got older, I think a lot of his raging episodes were born out of depression. You are absolutely right - no medication is going to "fix" the problem. It absolutely has to be a global approach including behavior plans, as well as parenting adjustments (not disparaging your parenting, just recognizing that *no* one is prepared right off the bat to raise a kid with- such challenges). BUT - if you look at medications as a tool, especially when they are having the desired effect, then it may be easier to reconcile the use of medications. *If* the Risperdal (or whatever) is decreasing intensity/frequency/duration of rages, then it gives you that much more opportunity to teach him tools to use when he's angry/frustrated/feeling impulsive. It's a trade off. As far as the Residential Treatment Center (RTC).... I am a big believer in following your gut. At the same time, placement in Residential Treatment Center (RTC) goes against every grain of my (selfish) maternal being (please note, my son's first hospitalization was at age 6, and we did that on average every 3 months until he was placed in Residential Treatment Center (RTC) at age 9, came home at 12, left for Residential Treatment Center (RTC) #2 at 12, came home at 13, left for Residential Treatment Center (RTC) #3 at 13, and has not lived at home since, so I'm obviously not anti-Residential Treatment Center (RTC), just know that it' a horrible decision to have to make). I think when you have misgivings, you have to very carefully and thoughtfully weigh them to ensure they're not based on your own desire to have your kid with you. Is your son safe? Are his immediate needs being met? My inclination would be to wait until his therapist is back and gets a chance to meet with- your son, see what his take is. You are absolutely right - bringing him home without a more definitive behavior management plan is a recipe for disaster. Since it is a comparatively short stay in the Residential Treatment Center (RTC), I would start now on discharge planning, even before Residential Treatment Center (RTC) therapist is back. *You* know your son best. Talk to his community therapist about behavior plans, get input from Residential Treatment Center (RTC) staff, talk to psychiatrist. What resources are available in your community (respite, crisis team, therapeutic recreation)? Sorry - this got pretty long. You do strike me as an amazingly insightful mom, especially with so young a child (took me years to get insightful, if I'm even there yet, LOL). I think you are absolutely asking the right questions; the hard part is getting answers. There is no crystal ball (trust me on that one, LOL, I've searched for 2 decades now). I'm generally a pessimist and my parenting (and life) strategy is to plan for the worst, hope for the best. That way, if the worst happens, I've got it under control because it's not unexpected and I know what to do, and if something better happens, I feel like I've won the lottery. :happy: I think your son is very lucky to have you as his mom - feeling uncomfortable as a parent of a challenging kid is good, I think, because it will keep you on your toes so you can make the very best possible choices for him. Last, and most importantly, make sure that you take time for yourself. Parenting in general is a marathon, and having a challenging child just makes it more stressful. It is absolutely vital that you make sure to take care of yourself both physically and emotionally. Again - welcome and I'm so glad you found us!! [/QUOTE]
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