Haven't posted in awhile-need advice/help

[loves_rainy_days]

Hi, I haven't posted in a long while, things have been to crazy to get online. So here's a re introduction:

I am J, mom/stepmom/adoptive mom or whatever you want to call me, to Dillpickle (The Pickle), 11yr old with the only diagnosis as Severe ADHD. Autism and Reactive Detachment Disorder has been ruled out since I last posted.

Brief history on the Pickle.
Birth to 9mths, severely abused & neglected by birth mom who was a meth addict.
9mths to 18mths lived with a foster mom and from what I have heard was a wonderful lady that loved Dillpickle and wanted to adopt him.
At 18mths old his dad, my fiancee, The Gentle Giant, finally got custody of him.
Problems were there through the years before I came along. I have been in their lives for 3yrs now. He calls me Mom and tells everyone I am his mom, his one and only mom.
These are our problems:
The Pickle is very verbally abusive. Uses a lot of I hate you, you're an idiot and lately I want you dead.
Also says that he is going to kill himself or that he wants to die.
Will not bring his homework home or do it. Will not do assignments at school.
Pees and poops in his pants. Wets the bed. Pees all over the bathroom if we do not make him sit down and supervise him
Refuses to bathe or wipe his butt after going to the bathroom.
Refuses to brush his teeth. Gets abscesses all the time. We ran out of dentists, they all refuses to see him because of the way he acts.
Hits or throws things at other students at school. Threatens other students at school. Threatened to blow up the school yesterday.
Chokes, hits, kicks and throws the cats. He is no longer allowed to be near the cats or touch them. Safety precautions are in place to keep everyone safe.
Does not do anything he is told to do and when we tell him to do something, he becomes verbally abusive and screams at the top of his lungs.
Destroys anything in the house he can get his hands on. Has to be constantly supervised.
Will touch other kids inappropriately if they make him mad or annoy him.
Has been caught masturbating several times. First time he was caught he said he was trying to kill himself. That was at 10yrs old
Tried to choke himself at school because a teacher told him he need to sit down and do his school work.
Says the only thing he cares about his food and water.
Lies constantly and makes up stories to get people in trouble.
Writes on the walls, furniture and his clothing. Has even picked at his skin until it bled and wrote on the walls in blood.
Cuts up his clothing and shoes. This is mostly done at school because he no longer has access to scissors at home.
Very manipulative.
Has a High IQ
Has had a neuropsychologist testing, an MRI.
For the last 2yrs has had in home therapy twice a week. That ended last week because there has been absolutely no improvement and so the insurance company will not pay for it anymore. His therapist were ready for it to end, they were exhausted.
Inpatient hospitalizations have not worked, he thinks they are fun.
Outpatient group therapy has not worked.
We have been evicted because of what he has done to neighborhood kids and for his screaming. We live above a bar now with no neighbors and he is no longer allowed outside.
We do everything in our power to keep people and animals safe.
We have tried everything and now with in home therapy ending, we have no idea what our next option is or what else we can do.
Any advice Please!

~J~ Struggling to help The Pickle and missing his smile and his bright eyes that now seem to be forever dark
~The Gentle Giant~ Pickles dad, who has given up everything to help The Pickle
~TAG~ 21yr old son of J diagnosis Good kid with a big heart and a mouthy lil bugger
~Dillpickle aka The Pickle~ 11yrs old diagnosis severe ADHD, ruled out Autism & Reactive Attachment Disorder. diagnosis he gave himself: Fake autism, dementia, alzheimer's,
~Mr Excuse~ 14yr old son of J. diagnosis Epilepsy, Hemianopsia, Hemiparesis, 12yr brain tumor survivor. Has some learning disabilities and an excuse for everything.
~The Fur Children~ Diesel aka Pretty Boy, Zoey aka Trouble Maker, Felix aka The Naughty Boy and can not forget Twelvy the Turtle diagnosis Napoleon Complex

 

[BusynMember]

Hi there. Wow! What a mess. Feel for you.

Who diagnosed him as only having severe ADHD? His symptoms do seem like they could be attachment issues or a mental health disorder. That is certainly not typical behavior...and was he exposed to drugs and alcohol in utero? That could be a big factor as well. I am just a layperson, but I did do foster care/adoption and this kid is probably a lot more than just ADHD...and his early years were very disruptive. Do you monitor him all the time when he is around other children? I want to add, that it is normal to masturbate, however, it is a bit odd to do it in front of people once the child is old enough to know better. Does he exhibit other sexual behaviors? Frankly, I think he sounds classicaly attachment disordered along with maybe some mood disorders, but, hey, I'm not the one who can diagnose. I do highly recommend getting another opinion by a highly credentialed professional. A neuropsychologist is very good usually, but they are not that "on top" of attachment disorder. Really, every professional is so specialized these days, it is mindboggling to get our kids into the right categories so that they can get help. Most likely, this child has many different issues going on at once. Does he play with fire?

Has he been dangerous to your other kids? That would determine for me, at least, what to do next.

Really, really sorry you had to come back. You and your hub need to have serious "us" time away from him so you can recoup. Do you use respite services? You really need to enjoy yourselves in spite of having a very difficult child. Also, I would try hard, if possible, to make sure the other kids get a lot of attention too. This child sounds all-consuming, which isn't anyone's fault, but...you know. Kids are kids. They all need to feel special. I assume they are afraid of or resentful of this child.

 

[InsaneCdn]

I'd ignore the fact that other dxes have been "ruled out".
You need a second - or third - or whatever number you are on - opinion.

This is WAY more than ADHD.
They may not know what it is... but it isn't what they have given you.

Perhaps, try to seek out a professional with extensive experience with attachment-disordered kids, as one source of a second opinion. Usually, don't like the "specialist" approach because they often tend to see what they specialize in, but... with attachment disorders, the other evaluators usually don't know enough about it.

 

[loves_rainy_days]

I have lost count on how many opinions we have gotten. The Neuro-psychiatric was the one that diagnosis him as being severe ADHD. The worst case she had even seen, she said.
We monitor him when he is around other children, school, however doesn't. They don't see the need despite there being many incidents that indicate otherwise.
We have been to everyone in town and have drive 2hrs away to try and get help and so far no one is able to help. He is a master manipulator.
Anymore I feel like we are going to be those parents on the news whose child did something horrible.