New here... ADHD/FASD/ODD concerns for 3 year old

[amandaf]

I'm so glad to have found this board & I'm hopeful to find others in my shoes to get info from....

My son will be 3 in just a couple months... He was adopted at birth by us.

He has always been a difficult raise... Colicy baby... always wanted to be held or bounced. I can remember sitting at adoption meetings & all the other babies would either lay on their blankets on the floor & play or sleep in their carseats... Our little guy would cry unless he was being bounced & walked around the room the whole time. He's been a pretty good sleeper for the most part.... Started sleeping through the night at 3 months & still naps well too. He was late to roll over and crawl, but not so much that I was ever super concerned. He walked the day he turned 1, so I didn't feel like we had any signifigant physical delays.

He has no motor skill problems whatsoever... Works great with his hands & is very very active... Always running, jumping, etc... He rarely walks anywhere.

Our biggest issues is tantrums. He can NOT hear "no"... If you tell him no for anything, you're guarenteed to have a tantrum break out. He has a tantrum before bed and naptime EVERY SINGLE DAY and has for as long as I can remember. We are very VERY "strict" so to speak.... meaning, we don't give in. I could understand tantrums if he thought it could get him somewhere, but we never give in, which makes me concerned about why he continues to do this. Also, his tantrums involve lots of kicking, hitting, biting, screaming, crying, etc... Throwing himself on the floor or doing the "loose fish" thing so you can't get ahold of him are typical behaviors for him. Once a meltdown starts, there's no stopping it until he's in the corner for a few minutes.

I've pretty much given up on taking him into public. If I do take him somewhere, he has to be strapped into something... cart, stroller, etc... because otherwise he will get into everything & then throw himself on the ground into a huge tantrum when he gets told "no" for that. He gets kicked out of the nursery at church because he just cries the whole time, however, he acts like an angel when he's with either of our parents (his grandparents).

His speach is delayed as well, though I'm not sure how much. Our pediatrician told me about 6 months ago that I shouldnt worry about getting EI for that until he's 3, though I did have him evaluated anyways and he tested okay for everything except speach.

He doesn't use words like "I" "our" "yours" etc... and I don't know that he understand things like "love" "I'm sorry" etc... (things that aren't tangible). I've also never seen him show remorse when he's injured someone.

His attention span is pretty much nil. He'll start a movie and within 10 minutes wants to watch a different one. Start playing with one toy and 5 minutes later switches to another.

He still "mouths" toys/hands (sometimes more than others). Destroys everything he can get his hands on (DEMOLISHED the entire thing of mini-blinds in his bedroom... ripped them into a million pieces and shoved them into the baseboard of the room.... I was not happy.)... rips all his books/stickers/etc...

I'm sure I'm forgetting some things but that's the basics.

He is a sweet kid as well (when he's not making me a crazy person) and I love him to peices. He did not test positive for drugs or alcohol at birth, but my husband saw several empty hard liquor bottles in the back of the birthmoms car at the hospital, so I'm being realistic that it's a possibility that she drank during her pregnancy at some point.

Thank you for any and all input! We're going to take him to the pediatrician this week hopefully to talk about our concerns.... My husband has been very worried about him for a long time, but I have just recently come to terms with the fact that there could be something really wrong. Finally seeing that is scary, but I've carried alot of guilt that I'm just a horrible mother, so I hope to be able to work through that now that I'm realizing that something isn't right.

 

[Marguerite]

There are a number of possibilities and it will at this stage require the involvement of a number of health professionals. As a priority, get him assessed by a Speech Pathologist Whatever is assessed NOW is going to be locked away in time forever as valuable data. How he presents NOW is vitally important, even if he overcomes all his language delays and performs perfectly normally - the HISTORY is what is needed.

Next - what you're already doing, getting him seen by the pediatrician. In australia that is the direction we need to take. But in the US, a neuropsychologist is where you will get the best information.

In the meantime, how do you cope?

Red up on what you can from this site. We have a wealth of information. Go to the archives, especially the Early Childhood archives (and forum) and read. On Early Childhood we have a sticky dealing with how to adapt one of the site's favourite books, "The Explosive Child" by Ross Greene, to younger children.

Whatever the diagnosis, there are things you can do.

What worked for us (and difficult child 3 presented very similarly) was to let him have his head, so to speak, wherever it really didn't make any difference to us. So if we were going for a walk and he wanted to go down A Street when I had planned to go down B Street - well, if it really didn't make much difference we would go down B Street. However, if he insisted always on going down B Street I would do a deal ahead of time - "Today I want to go down A Street a little way. Then we will come back and go down B Street if you want."
You need to be wary of setting up repetitive patterns that risk locking him in to the security of sameness.

Where you can, prepare him. "We are going to do X. It will happen in Y minutes/hours." If you need to put this in writing, do so. Brightly-coloured Post-It notes are a good way of doing this. You write a time on the note with what he has to do (it needn't be a word, it can be a picture) and stick it next to whatever he is doing. Keep gently letting him know how much time he has left. Use a timer if you need to.

But use a timer that he can see counting down. difficult child 3 learned to count backwards at age 2 because I used the microwave oven timer so much!

One of the most important principles in "Explosive Child" that really works for us, is to head off the tantrums where possible. If you can predict he is going to scream, "No!" then try to figure out why, to help you find a different way to get cooperation.

An example that I've used - you have a kid rushing out to play in the snow. You don't want him running out there without his jacket, so you block the doorway and don't let him past until he's wearing his jacket. With a kid like yours and mine, that would set off a screaming rage.
Alternative - ask him, "Do you want your blue jacket or your red jacket?"
You have given him choice, rather than ultimatum. He has control, but you win because whichever colour, he's choosing a jacket.

Alternative 2 - let him go. if you let him go without a fight, he has no vested interest in being stubborn. He will feel cold, he will be back. And he will have learnt that to not wear a jacket means he will feel cold.

There are many different ways to get what you want.

But don't think of it as winning, because then you are seeing him as an adversary. That is unhealthy. Instead, you and he both need to see your relationship as one where you are his support, his help. Instead of it being him raging against you, he needs to see that you are helping him stay calm. The book can help.

Welcome on board.

Marg

 

[BusynMember]

I'm an adoptive mom and I will give you my input and experience. I adopted four kids. by the way, welcome to the board, although sorry you have to be here .

Adopted children are quite a bit harder to diagnose than biological children because of the unknown genetic history and also the unknowns of how the birthmother took care of herself during pregnancy. If she drank and you have an Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE) diagnosis...you have a lot of problems and they are not necessarily resolvable. However, if you are just guessing, ask yourself if your boy can remember things, like the ABCs, day to day. Can he memorize things? Does he have "swiss-cheese" thinking as in he knows something one day,but forgets it the next. That's the reality of Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE). My son did not have that "I remember one day" "I forget the next day" and he dodged a bullet...he is not on the fetal alcohol spectrum. It does sound as if birthmom didn't take very good care of him while shes carried him.

You son also sounds like he could be on the autism spectrum. If he is, count your blessings. That's workable and not so bad. The child we adopted from foster care was exposed to lots of substances in utero, however he just has high functioning autism as a casualty and with interventions is doing great. I disagree with your pediatrician to start these interventions at age three.

I'd take him to a neuropsychologist to see if he comes up deficient in any neurological or psychiatric areas (or both). A neuropsychologist is NOT a neurologist. They are psychologists with extra training in the brain, and do fantastic, intensive evaluations (which our complicated adopted kids really need).

Usually we can guess what may be wrong with a child, however, due to his history, none of us really can. These are complicated kids. Do you have any history on the biological parents other than she obviously drank while pregnant?

 

[tictoc]

Hi,
Just wanted to add that you and your husband definitely should follow your instincts. My 'gut' told me something was different about our son when he was 7 months old. My experience at my mom and baby group was very similar to yours. I never got to sit down.

Your pediatrician is a good starting point, but don't be put off if you don't make progress with him. In my experience, pediatricians often don't take tantrums very seriously in the under 3 set. If you pediatrician doesn't see the problem, get a second opinion. Or, insist on a referral to a neuropsychologist.

But, make your best case to the pediatrician. To that end, between now and your appointment, read everything you can about ADHD, Fetal Alcohol Syndrome (FAS), and autism. Even if you think autism (or ADHD, etc) doesn't apply to your son, read about it so you know why you think that. Also, keep a log of behaviors--at least a whole day of behaviors, more if possible--to discuss with the pediatrician. And, make sure the pediatrician knows that you feel like you can't leave the house with your son and that he is getting kicked out of the church nursery.

The earlier you get help the better. I also disagree with your pediatrician about speech therapy. If he needs it, do it now.

It's bedtime at my house and I'm drawing a blank on books to recommend, but I'll think about it after everyone is asleep.

 

[susiestar]

I am sorry your pediatrician does not think interventions before age 3 are in order. We have a friend who's child was in speech therapy before his first birthday. He created his own language and was almost unable to grasp the language everyone else spoke. The very early therapy has made a HUGE difference in his life.

He may truly not understand what you are saying when you speak about love or sorry or other intangibles. He is learning to think now, as he learns language, so the more help you can get for him NOW the better.

 

[pepperidge]

Hi

I adopted an fASD child at birth. When he was not even babbling at age 1 year, we had him evaluated by speech pathologist, then early intervention at suggestion of pediatrician. He started speech therapy and continued to about 3. His speech is perfectly normal now, but he has definite executive function issues (ADHD) and many behavioral challenges and learning issues, though he pretty normal IQ wise. Emotional regulation is probably the biggest.

We have seen many profesisonals over the course of the past decade regarding both of my children. I have not found them by and large to be well versed in FASD issues.

One thing to consider is that while you have to be probably a more consistent parent than many (as it sounds like you are) consistency alone will not resolve the problems. In many respects FASD children have large developmental lags in certain areas (mine had no motor skill lags), many in the behavioral realm. All the good parenting in the world isn't going to give these kids the capacity to regulate themselves on the same timetable as other children. That will come over time. You aren't doing anything wrong, you just have a very challenging child and you will no doubt have to adapt to the child--not expect that that the child can adapt to social norms of what is appropriate behavior at a given age. It is really hard because it has all sorts of implications for how you lead your life as you have already found out.

I found a phamplet by Diane Malbin on FASD children very useful in getting me to rethink my approach to my fASD child. I got it through the library.

I have found that while logical consequences and limited choices are great tools, given my child's capacity to learn from consequences and moderate his impulisve behavior that they don't yield the kind of results that they would with less challenged children. FASD kids are great at knowing what they should do but still not being able to do it. Accepting that has been a very hard struggle for me as a parent. They will go out in the cold 100 or more times without a jacket even if they know they should wear one because the impulse of the moment to go outside trumps any knowledge that they will be cold, if that makes any sense. All that to say, one possibility is that it will take your son an abnormally long time to learn something--it will require a huge huge number of trials.

I think getting him evaluated by your county's early intervention team is a great idea. Services I think are free, and it puts you in contact with professionals who will be able to diagnose a range of issues. I would really urge you to do that as soon as possible, and it will be a help when you get to the school years if you need some interventions at the school level.


There is the organic brain damage related to FASD but there may be other issues as well--sometimes birthmothers drink to deal with untreated mental illness etc. so there may be some inherited tendencies towards mental illness or learning issues as well.

Hang in there. Take time for you, it will be a long hard road and you will need strength!

P.

 

[amandaf]

Thank you all so much for your input!! We have an appointment today to see the pediatrician & talk to him about our concerns... and hopefully get a referal to go elsewhere for further investigation.