Sorry I've not be around much - trying to orchestrate hospital discharge, medication changes, medication followup, tracking down lab results, and desperately to get thank you into Residential Treatment Center (RTC) and our options are running out. I've been a faxing fool and an emotional puddle, LOL. On a positive note, I finally got Residential Treatment Center (RTC) #3 and it's affiliated hospital to acknowledge that their "HIPAA requirements" of thank you's signature before releasing info is in fact a violation of state law, and therefore a violation of HIPAA. Small victories. Having obtained records from Residential Treatment Center (RTC) #3, I was a bit shocked to read psychiatric evaluation from 4/2007. Mad at myself for not requesting it then, reading it then. In no way, shape, or form is current placement appropriate and that is evident from reading report. But about the forest - I guess I had kind of forgotten that my son is *severely* disabled. I mean, he's got some very serious problems in terms of coping skills and thought processes. Those trees - the daily grind with him. husband and I have gotten so caught up in the day to day stuff - hygiene, school, AWOLs, etc - that I think we really lost sight of how these relatively little issues really are not a matter of simple defiance. They are part of the big picture and are totally tied into his underlying illness. That's not to give him a pass on it at all. He still needs to do these things. But we have to help him learn to do it in the framework of his thought processes, which is tricky. The most amazing (and I think right on) section stated essentially that thank you's outward appearance of being able to cope with normal daily stresses is a facade. He needs more time and energy to understand information in his environment but even with that, his effort will be too inefficient to process everything so he focuses on 1 or 2 bits of information. Anything involving emotions completely flips him out. And all this is on a purely emotional basis because cognitively, while scores are scattered, he is at worst "average" with some spikes into very advanced skills. Just wanted to share my contemplative thoughts this morning. I don't know why I'm surprised at these reports. These have been issues forever. He speaks so well and presents so well, that you would expect him to get from point A to point B without a problem. But the basic problem is that he cannot do it and it's not purely volitional. It's just so doggone hard to remember that when you're talking about brushing teeth, you know?