New day, new problem with difficult child.... Punched window then used glass to cut himself.

Discussion in 'General Parenting' started by ringelberg, Feb 2, 2012.

  1. ringelberg

    ringelberg New Member

    I just don't know what to do. Over the last year (since we got custody), I have talked to and gotten advice from therapists, doctors, police, local Children's psychiatric hospital. (which he has stayed at several times), you name it. No one has helped or given any advice that has helped us. He has spent several short stays at the local psychiatric Hospital after particularly bad violence, but no long term treatment is available there. They told me that if he had medicaid, it would be no problem, but no private insurance will pay for long term treatment. His therapist says that we have made progress, but honestly I am just not seeing it. I almost wonder if she is saying it to make herself feel like she has helped. The school acts like somehow his problems and extensive absences are our fault. The guidance counselor was almost insulting in the way that she tried to give me parenting advice. During our parent teacher conference last week (which included 10 school employees including the social worker) they strongly urged us to do anything needed to keep him from being absent, because he is sooo far behind in school. Now the problem.... He became angry this afternoon...during his time out in his room he punched his bedroom window, cracked it then used a tiny piece of glass to cut long shallow cuts on his arm and hand. What now. Do I take him back to the hospital? Wont they just release him after a couple of days? Husband has no advice, no opinion. He is great if I give him a task, but he won't help make decisions.

    Been trying to find a support group for parents of CD or Reactive Attachment Disorder (RAD) children, but havent found one so far. I really don't know if I am the best person to raise him, but it looks like I am all he has.
     
  2. TerryJ2

    TerryJ2 Well-Known Member

    Welcome, Ringleberg.
    I am so sorry your little boy is having such problems. It sounds like he has serious anxiety issues, breaking a window and deliberately cutting himself. I don't see that you've got him on any medications. Have you tried any?
    I would get a referral to a children's psychiatrist (you should have gotten one upon dismissal from the local psychiatric hospital). S/he can write out prescriptions. Beware--they are not good at diagnosis-ing and will often just experiment with-one drug after another, depending upon the accompanying paperwork. I'm guessing that the psychiatric hospital discharge just said "Mood disorder, not otherwise specified."
    You may be correct in regard to Reactive Attachment Disorder (RAD). In that case, you pretty much just have to stay the course, because he has learned not to trust anyone and then acts out to prove his point, so to speak. (Oversimplification, but still ... ) Since he is also ADHD, he acts on impulse, which is clear by breaking windows, etc. Anything that you or I may think fleetingly, he will actually do. He doesn't have a filter or a Stop button, Know what I mean??
    I would not use regular discipline for him. IOW, spanking will probably just enrage him.
    Is there a history of mental illness, alcoholism, autism, or whatever in his family tree?
    What, specificially, does the therapist say is improving? Next time, have her give a very, very specific example. Like, he talks now instead of screaming; he shows up for appts; he goes to bed on time, etc. If she cannot, then just find a new therapist.
    Many of us have gone through many psychiatrists, tdocs, and pediatricians (not to mention teachers and so-called experts in behavior issues) and have learned to advocate for ourselves and our kids. Don't expect the experts to really be experts. Then you won't be angry and disappointed all the time. Just a thought.
    I need a bit more info. Can you tell us about his bio family? His birth and milestones such as talking and walking? What he was in the psychiatric hospital for and whether they put him on medications?
     
  3. ringelberg

    ringelberg New Member

    Thanks for your response. Feeling so desperate right now. He has been seeing a psychiatrist and a therapist since June. The psychiatrist put him on Adderall and Depakote. The hospital. took him off the adderall -they thought (and I think a agree) that made him fixate on issues that enraged him. Since they took him off, his episodes do not last as long. Now he is on Straterra for his ADHD. It def. does not work as well to help him concentrate at school, but he does not fixate like he did. The depakote has never worked at any level. No improvement was seen even with increased doses. He no longer takes it. Tried to get hospital. doctor and psychiatrist to try something other than depakote, but the hospital. doctor said his problems were poor parenting and the psychiatrist just kept changing the dose of the depakote. On Mon. I called every child psychiatric in the area.... all were either not accepting new patients, didn't take any insurance or just not Cigna. Not sure what is happening in the Orlando area, but wow. Left lots of messages on machines - only got one returned call. Lots of sick children in FL?

    When discharged from the hospital, they diagnosed him with, Reactive Attachment Disorder (RAD), ADHD, Bipolar, Depression and Anxiety. Yes I know, if they diagnosed him with these issues, then why say it is our fault and can not be helped with medications? He only displays the outbursts at home - although he did flip out once in the therapist office. When at school or at the hospital., he is the model of the perfect, charming child.

    More background on him. - Mom was in prison when he was born. We took him in as part of a Christian Foster care for infants of prison moms. After she gave birth, she did not see him for several months until I brought him to visit her. I picked him up at 2 days old. We had full custody of him for 6 months. (After giving him back to mom, we did our best to stay a part of his life. She would not allow him to visit often -only when she needed a break- so I called and visited as often as I could. They lived a very unstable life, moving from one home to another every few months - abandoning all of their possessions each time. Austin's punishments were severe, and sometimes pretty scary or very embarrassing.) Early during the pregnancy I know that she used marjuana and alchohol and she smoked throughout. Do not know what else if anything that she did. She was only 19 when I gave him back to her. She has epilepsy, does not currently drink. Both of her parents, her brother and my difficult child's biological dad all have spent time in prison. The bio dad also has long history of alchoholism.

    As a baby, he was pretty high strung. He cried alot and threw up alot. When he got older (9-18 mo) he could would get frustrated at being in his car seat and cry for 2 hours straight. He was extremely curious and would systematically go from one item to the next throughout the room manipulating each thing as he came across it. I feel quite sure that even if Austin had lived in the most serene environment, he would still have been a difficult child. I think he walked at about 11 mo., can't remember when he began talking, but it seemed normal. He never liked being confined, could get out of his crib and playpen VERY early. Started showing symptoms of behavioral issues and learning problems at age 4. Although I repeatedly urged his mother to get him help, she did not.

    We are not spankers, never have been. (If Austin had been my first child, I might have a completely different theory on it...lol.) Right now his discipline consists of time-out and a series of privledges ( going to play with neighborhood friends, going to the park, Super Mario, TV, the racing game...etc..) that he can earn or lose according to his behavior. We try to keep all discipline limited to today and tomorrow and make sure that at no time is it all lost, meaning he can always work towards something to recover. For the past several months when he progressed to the point of hitting, biting, kicking etc. we have called the police. He is too strong for me to restrain and has hurt each of us at one time or another. I hate calling the police, as I know that it probably increases his distrust (just read Raising Children who Refuse to be Raised) and in addition it causes him to have more school absences. Lately, (for the past few weeks - since the school urged us to stop the absences - we reverted to time outs in his room when there is someone here to help get him there safely. After today, I don't see how we can do that anymore.

    Oh, and along the way he has been arrested twice. They took him in, kept him til about 3 am, then had us come pick him up. He was not at all disturbed by it, after the fact, that is. The prosecutor did not pursue either instance. In the end, Austin just got to stay home from school the next day.

    Each of the psychiatric hospital admissions was after a violent episode where he injured one of us.

    Sorry that my info is kind of here or there....guess that is how my brain is... :) Thank you again.
     
  4. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Hi.

    I would have him assessed by a neuropsychologist for fetal alcohol spectrum. He probably has all of the thnigs he was diagnosed with, but, in the end, if she drank while pregnant he probably has some sort of organic brain damage from the alcohol. There is almost no way to take drugs and drink while pregnant yet have a "normal" child. It is child abuse in the womb. If he is alcohol affected this would explain why the drugs are not working well...there isn't a lot you can give that help kids on the fetal alcohol spectrum. Do you think he understands right from wrong? Unfortunately, lack of a conscience is not only a symptom of Reactive Attachment Disorder (RAD), but fetal alcohol spectrum. Fetal alcohol kids can have swiss cheese thinking in which they remember something one day and forget it the very next. Many adults with it end up in jail, but don't understand why they got there and do the same thing as soon as they get out. They require a lot of supervision their whole lives long so that they can stay out of trouble.

    I'm surprised no doctor brought up the liklihood that his birthmother's pregnancy drug use/alcohol use may be a big factor here. Fetal alcohol kids, even those who do not have the entire spectrum, tend to be extremely ADHD and emotionally liable and are very hard to raise and it is NOT parenting. Anyone who says that to you does not understand either Reactive Attachment Disorder (RAD) or drug/alcohol related issues in children.

    We adopted a child who was drug/alcohol affected. I would do the neuropsychologist evaluation.
     
  5. TerryJ2

    TerryJ2 Well-Known Member

    MWM has some excellent points. Your son's dxes have definitely fallen through the cracks. I see each psychiatric hospital visit as an individual episode, and his early yrs as isolated, when in fact, someone should be connecting all the dots.
    Poor kid, to be bounced around like that!
    One of the reasons I asked about alcoholism is that many of these issues are genetic, and drinking is a way of self medicating, so people in the family tree could have something that could be passed on genetically. Add that to his bio mom's lousy parenting (not yours) and traumatic issues, and you've got a serious problem.
    I would do as much research online and in books as possible, all the while, continuing to look for another dr. I think a neuropsychologist would be a good way to go. Getting in can take weeks, by the way.
    They tend to have them at children's hospitals. It's just my opinion, but for diagnosis purposes, do not use a regular psychiatrist. They look for "regular" psychiatric issues, as a rule, and do not think outside the box when it comes to neurological issues.
    Have you checked to see how much it costs for a neuropsyc test (about 8 hrs or two days, incl psychoeducational testing?) You may just want to pay cash. It may be worth it. (We actually took all of our son's savings and put them into our daughter's 529 and started something else for him, operating on the premise that if he makes it to college, it will be a miracle, and the money is needed now.)
    I wouldn't give up hope yet. He is only 8 so it's still possible to see improvements.
     
  6. ringelberg

    ringelberg New Member

    Thanks again to both of you! It is such a relief to talk to someone who understands what we are going through.


    I read the Fetal Alcohol Syndrome (FAS) sight....wow. It really never occurred to me that it could be that, so I never read up on it. He is right on the money with everything except the social loner part. He is VERY social. This is the only diagnosis that includes his extreme difficulty with math and numbers and his problems reading (which are quite bad, but we are making progress). Oh, and his memory issues. Swiss cheese, that is a good way to describe it because the importance (to him or I) does not have any affect on whether or not he remembers. My husband agreed completely.

    Did a little research today and found out that she didn't know that she was pregnant for almost half of her pregnancy. She found out when she was arrested and jailed (at about 19 1/2 weeks). She had always told me that she found out within the first month or so, which is another reason I didn't see this as a possibility.

    I have just read Raising Children who Refuse to be Raised and am now reading The Explosive Child. Any other good books to recommend? I am desperate for good info. Thanks.
     
  7. buddy

    buddy New Member

    I swear I responded to this but it is not here....sometimes I hit "reply to thread" instead of submit reply or post quick reply... UGG i hate when I do that.

    The others said what I was thinking anyway. I would be highly suspicious of chemical brain damage too... and I know a guy who has Fetal Alcohol Syndrome (FAS) and Reactive Attachment Disorder (RAD) who is the most (inappropriately) social kid ever. He will go up to a group of kids his age or older hanging out at the beach... and just be too close in the group (he doesn't know them, doesh't ask, just walks up and tries to join, will laugh when they laugh etc.... )

    Sounds like a neuropsychologist would be a great thing to add to your list of "to do's"

    HUGS.... Dee
     
  8. AnnieO

    AnnieO Shooting from the Hip

    My stepson has been diagnosis'd as Fetal Alcohol Syndrome (FAS). I don't think it's accurate, but many of the signs are there - in fact, they're also there with Onyxx.

    As for her "not knowing"... Meh. I can see not knowing till about 10 weeks... But halfway? Given all the other issues here, I think it would be safe to say she might have been deliberately ignoring the possibility, Know what I mean??

    I would definitely have him evaluated. If he is injuring people, this is NOT GOOD. It's possible he is bipolar, but I would lean more towards Fetal Alcohol Effects (FAE) and Reactive Attachment Disorder (RAD)...

    :hugs:
     
  9. HaoZi

    HaoZi Guest

    Also find someone who has experience with cutters, since he's self-harming. This behavior will likely get worse before it gets better (I speak from personal experience, and was also adopted).
     
  10. TerryJ2

    TerryJ2 Well-Known Member

    Oh, dear, bmom "didn't know" she was pregnant ... and how much was she drinking?
    So sorry.
    Still, I think there's a loving kid in there somewhere and you're doing the best you can do.
    Many hugs.
     
  11. pajamas

    pajamas Member

    Your story has so many parallels to ours that it hurts. We were non-relative foster parents who intervened for custody and got it, but it came with court-ordered overnight visitation with bios much like yours. The visits only ended 4-5 years ago, and we and the kids are paying the emotional price. One difference is that we never finalized an adoption in order to keep the kids' medicaid eligibility in case we ever needed it. I'm in the process of getting it reinstated now. Our kids have very similar diagnoses - except Tink, who was removed earlier and hugged to death (also a possibility of a few different genes in that pool, but we won't go there :) ).

    Going off in a little bit different direction from others ...

    We also have Cigna and I can tell you for a fact that they WILL pay for residential treatment, so long as they believe it is likely to cost them less in the long run. They approved CeCe's admission to Residential Treatment Center (RTC) last week, and in some ways her problems seem less severe that your son's. Our psychiatrist advised that in order to get Residential Treatment Center (RTC) approved we needed to make the psychiatric hospital a revolving door - get her admitted every time she acted out violently, every time she threatened suicide or homicide (even though we all knew it was just threats), get her transported by EMS if we had to and tell the psychiatric hospital that she or we were in imminent danger. It took 3 admissions in 3 months (total of about 15 days inpatient). psychiatrist said the admissions needed to be right on top of each other - the previous 2 admissions a year apart didn't really count in insurance pea-brains. We might even have been able to do it faster if husband hadn't been soft-hearted about keeping her home for the holidays despite major provocation. We all knew that the psychiatric hospital stays weren't doing any good, we just had to play the game until the insurance got tired of paying $1000 a day for psychiatric hospital and felt Residential Treatment Center (RTC) would be cheaper in the long run.

    One of the big things we have in our favor is an excellent psychiatrist who is also on staff at the psychiatric hospital. We met him at CeCe's first psychiatric hospital admission (2008) and followed him into private practice, and followed him again when he changed hospital affiliations. With him on our side and guiding us through the process, we never had to worry that she wouldn't be admitted so long as they had beds (we or he called ahead). The one time we tried the psychiatric hospital closer to us, she got turned down. She also knows how to play the game and was sweet as pie at the hospital - we were the crazy ones! She usually topped it off with abuse charges that they were mandated to investigate (while she practically danced through the halls in her satisfaction about getting us in trouble). Point: You need to find a psychiatrist and therapist 1) whom you can trust, and 2) who understand attachment disorders.

    You might consider finding someone who treats adolescents with borderline personality disorder as well. Cutting is a key symptom. No one will diagnose it in someone as young as yours (or so we were told about CeCe), but at least they'll be looking out for manifestations and considering DBT or other appropriate treatments depending on your difficult child.

    Your description of the school meeting doesn't sound like he's on an IEP - are you working on one? In the meantime, you might consider a 504 Plan (ADA) - it's not enough, but it will at least trigger them to think about his diagnoses as the cause for his absences (and could keep you out of trouble for his "truancy" as opposed to his "medical condition"). You can initiate either with a parent request - is there one sympathetic teacher among the 10 that can tell you where to start in your school? (God, spare us from 'well-meaning' guidance counselors!)

    Have you considered going back to the original placement agency for suggestions? If I'm reading your story correctly, it looks like you technically have a private adoption in the final analysis (i.e., the BPs relinquished custody and agreed to the adoption)? If the state was involved, you may have more options like special needs adoption services (even retroactively). Regardless, you might consider reaching out the the county representative of the state Office of Adoptions for recommendations. You should tell them you are trying to avoid a disrupted placement. I know you probably don't want to consider that option - and I'm not suggesting that you should - but it will get their attention. The Office of Adoptions will know of resources for parents of Reactive Attachment Disorder (RAD) kids. Given your situation, you will inevitably come to the attention of CPS, if it hasn't happened already, and it's way better to have taken the initiative to demonstrate you are doing your best in a difficult situation.

    Others have also suggested involving your county mental health agency early - especially given that the police have already been involved. If the "system" first sees him as a child with mental health needs, you may be able to avoid getting juvenile justice involved. For other support group options, try your local NAMI chapter (national www.nami.org - Orlando www.namigo.org).

    OK - that's a lot - hopefully gives you some ideas. This is a long and lonely path without folks that understand. This site is a good place to start. Welcome,

    PJ
     
  12. pajamas

    pajamas Member

    P.S. ALWAYS ask about experience with Reactive Attachment Disorder (RAD) kids. We've encountered highly regarded tdocs who thought it was so rare they'd never seen it (he did acknowledge the possibility after hearing CeCe's history of early abuse, but was clueless on treatment), inexperienced psychiatric hospital case managers who bought into CeCe's every story and were clearly hostile to us in "family counseling", and an excellent, experienced children's therapist who eventually said CeCe's case was beyond her. I personally avoid anyone who has never raised a child themselves, too - book learning only goes so far!
     
  13. InsaneCdn

    InsaneCdn Well-Known Member

    It also helps if you can deal with people who have raised non-NT/non-easy child kids, too... if all they have dealt with is PCs, some aren't much better than the childless.
     
  14. pajamas

    pajamas Member

    Very true!

    A light went on when I had a easy child in the car for the first time for the 90-minute drive to the zoo for a 2nd grade field trip. The teacher assigned me 3 difficult children because she thought I was the only parent who could handle it! (Or maybe it was getting even for mine.) I thought - wow, this is how the other half lives??? Raising PCs is a piece of cake. Fast forward, and I finally got one of my own (not bio, we should note for the record) and, despite Tink's cognitive delays, it's still true - raising PCs is a piece of cake! :)

    I did have a different teacher come up to me recently and express thanks for the experience of teaching Holden in middle school. She said it really prepared her for what to look for and expect when her own difficult child was born (he's 5 now). She's now leading the fight to get better services for Huck. But she was always one of the good 'uns.
     
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