Help with 4 year old

karif

crazymomof4
I have posted here many times before. I just wanted to give an update on what has been going on since last post. We have been to several doctors, behavioral pediatrician at UCI, and UCLA. We have been going to a new therapist that has been so great for my son. All the doctors say he has autisitc like behaviors but they really think he is bipolar. After reading the book "The biplar child" I would tend to agree. The first 4 pages was describing my difficult child perfectly. He is still violent, anxious, tempermental and has many Obsessive Compulsive Disorder (OCD) traits. However, he is finally learning. YEAH!! He can now sing his ABC's and can count to 11. He is finally getting Occupational Therapist (OT) at school after a year of fighting for it. Now grant you it is only 10 minutes a week but it is something. He is mostly potty trained. He still wears a diaper at night and still sucks a bottle at night but I am chosing my battles with this guy and that is not one I want to fight right now. If anyone has any suggestions I would love to here it. He is adnormally attached to his bottle. This makes taking away my 2 year olds bottle impossible. Well that is my post for now. Oh year we also increase his Respridol to .3 in the morning and .35 at night. This has helped and he is still on Depakote 2ml at night. Blessings all from my crazy house to yours.:tongue:
 

SRL

Active Member
Hi Karif, I'm glad you've been able to get some professionals to take a look, and glad that they agree. What I suggest that you do at this age is to consider this a working diagnosis, that is a sort of tentative diagnosis that you try on for a few years and see if it fits. See how he responds to treatment and how he develops over the next few years.

A few thoughts: since he's exhibiting some characteristics of both Autism Spectrum Disorders (ASD) and BiPolar (BP), so your homework in both areas and put together a treatment plan from both camps. Bipolar usually means medications but there are some areas medications probably won't help him, but that the Autism camp will have worked extensively with. You also are more apt to have a better outcome if you don't rely only on medications for issues like anxiety, problems with transitions, etc.

Attachments to bottles, lovies, and pacifiers pretty much all boil down to the same few categories of solutions:
1) Let it go for awhile in hopes the child will ditch it themselves or be older and better able to rationalize with.
2) The Bribe
3) The Gradually Reduce or Substitute Approach
4) Cold Turkey

There's a zillion variations that desperate parents have utilized but they all pretty much boil down to these. I had one that was extremely attached to his pacifier at bedtime and at age 4 when nothing else worked I took it away cold turkey. I planned it for a time when my husband would be home to help (when child was well and we had no major things on our calendar), cut up his pacifiers, and went for it. The first week was really bad, the second still a little rough, but then it was over forever. :)

Potty training was equally bad--he didn't respond to the usual little bribes so I had to go with big ones (Magic School Bus Computer games). Got the job done, though.

Glad to hear the learning is kicking into gear! That's always so exciting--I could watch it over and over and over again.
 

karif

crazymomof4
I was just thinking today having a child with special needs, is like going to an amusement park everyday all day long. You never know what's around the corner. We could ride the wild ride and have fun or be sick and frustrated all day. You just never know. My little difficult child is amazing somedays. He act so "normal" I put normal in '' '' because no one is normal. Other days he acts like well a special needs child that he is. I don't get frustrated anymore well at least not as much as I used to. I look at him with empathy and love and think if only his mom had not done meth and crack. He could have been so differant. However, this is the hand God had dealt him and us. We will learn day by day how to handle it. I want to encourage anyone who might be going throught he same thing, hang in there. There is hope and love and hang on to the good moments. You might only see one or to a week but hang on to them and remember them when the bad dark days come.;)
 

DammitJanet

Well-Known Member
Glad you are seeing some improvements.

On the bottle front. Does he use the bottle all the time or only at bedtime? If it is all the time, would he go for picking out one of the fancy smancy cool sippy cups with the soft spouts first? Then as time goes by, you could change to the harder spouts, then to the regular lids, then to no lid. Then you get him to sleep with no cup at all. Yes it will take time but that is what we did with my granddaughter.

Of course, my granddaughter is "normal" and didnt have an attachment to her bottles. She went on the cup at 8 months. Thankfully!
 

Marguerite

Active Member
Compromise is often the way to go with weaning off. The big problem is if he won't drink out of a cup at all, even during the day. Maybe you could compromise that the only way he can have a bottle is like babies do, while being held in your arms. When he gets down off your lap, the bottle goes away. But in the meantime - he can always have a sippy cup.
Or perhaps a "no bottle in public" rule.

We weaned our kids off dummies by putting the dummy under the child's pillow and say, "It's only for bedtime. If you feel you need it then you may come into your room, sit on your bed and use it. But when you are ready to go back outside, the dummy goes back under your pillow so you can find it at bedtime."

Some comfort props - they can hang around permanently. easy child 2/difficult child 2 is 23 and married; still sleeps with the same teddy bear she had as a baby. It's been cute - sometimes if her husband is sleeping in, he will be cuddling the bear!

Marg
 

karif

crazymomof4
My difficult child was originally:peaceful: diagnosis with autism spectrum disorder. Now his new therapist, who is wonderful, thinks he is bipolar. When reading the book the bipolar child it fits much better than autism. He still has good days and bad days but he is making progress. He only has a bottle at night. He is potty trained and he is learning in school. It is very slow progress in school but he is learning. He came home last week and said all the days of the week. Well all except Sunday. He refuses to recognize that day. That alright with me. Baby steps right?
 

maxeygirls

New Member
karif- regarding the bottle, Ive been there. My difficult child is 3.5 years old and diagnosis bipolar. Her inability to self soothe easily makes it challenging for her to handle change. Luckily she was using a sippy and not a bottle but still attached ti it more than her own skin at bedtime and the worst is whats inside... chocolate milk. husband started it when she was just over a year old and I was working 60-70 hour weeks and only recently was difficult child stable enough to even think about taking it away.
I started by reducing temperature slowly until difficult child hit her lowest allowable temp then began watering it down until she hit the point where she wouldnt take it. From there I switched back to a bottle(yes from a sippy) with a stage 1 nipple. I slowly kept watering it down/tapering chocolate until it was a splash of milk and a lot of water.
For a solid week difficult child stuck with this but didn't get much from the bottle itself. A stage 1 nipple is a lot of work! At this point she is still taking it to bed, full of water and sucks on it for 1-5 minutes before sleep or just snuggles up to it. She also no longer freaks out when she wakes up and it isnt there which is huge.
I also explained to her and showed herthat we were out of milk and so far that keeps any melt downs under 5 minutes. Oh and we aren't out of milk... Mommy relocated it to a washed out opaque Tropicana jug since difficult child doesn't like orange juice.
I have NO idea if this will help or not but its working for us.
 

karif

crazymomof4
Thanks for the tips about the bottle I might be working on that soon. I have a new problem though. Any suggestions would be much appreciated. My difficult child has had severe anxiety lately. It all started a few weeks ago and has progressively gotten worse. It hit its peak I hope this past week. He was painting at school, usually a very loved thing to do, the paint stained his hands and that really upset him. He worked himself up to such a state that by Thursday he was completley freaked out. When I took him to school he cried himself to sleep in anticipation of painting. On Sunday we had friends come over from out of town. HE went between crieing, screaming and being very violent. We went to church he had a panic attack and peed himself. I am not sure what has brought this all on. Now keep in mind he has an ear infectiona and is on anitbotics. He also does have general anxiety problems along with his bipolar. Any suggestions on what brought this all on?:whiteflag:
 

Marguerite

Active Member
Can he tell you what upsets him about this? If it's getting paint on his hands that won't come off, then work with him to find something easy that he can use to clean his hands. I would also make it clear to his teacher that this upsets him and he needs to be given some assurance tat he won't be forced to do something that upsets him. However, he needs to be 'desensitised' as well.

I remember absolutely hating finger-painting, because I didn't like the squishy feel and I didn't like the risk of getting paint on my clothes and in places not on the paper. Teachers would insist we finger-paint because we needed to learn the sensory aspects of creativity. I insisted I hated to touch it and that it was not a skill I would need later in life; give me a paint brush. I must have really been a headache for my teacher when I was 5.

There are various ways to reassure him about paint being OK to have on your hands. Being able to clean up easily should help.

Another suggestion that YOU can do with him - dress him in "safe" clothes, ones which won't matter if they get dirty. Dress yourself similarly. Then go outside and make mud pies together. have a bucket of warm water handy so you can quickly and easily rinse off - mud rinses off fast. While making mud pies, encourage him to feel the way the mud squishes between the fingers and can be made into different shapes. I used to line pie plates with mud of different colours to make layered mud pies with a sort of sandy brown 'crust' and top, and a white clay 'filling'. Or he might have different ideas. The aim is to relax and have fun playing in the mud. When you're finished, take off the muddy clothes, put them in a pile and get him to watch you take them to the laundry. Let him see the process and keep saying how easy it all is, mud is easy.

The paint colour may have been a very glaring bright colour, which might have made him concerned that the colour would stain things (including his skin). Introducing him to paler colours, smaller quantities or more controlled painting (such as careful miniature brushwork while he's wearing a smock) could help. Or getting a pack of very small surgical gloves perhaps.

We were able to buy very small gardening gloves for children. They may be an option for him.

He needs to be able to play with paint or modelling clay that won't stain and can be easily cleaned up. He needs this experience to help de-sensitise him.

Marg
 

karif

crazymomof4
Has anyone else had problems getting their chlld some help that has been diagnosed with bipolar disorder? My son that is almost 5 has been diagnosed with bipolar disorder and is on the autism spectrum and I am finding it very difficult to find help for him.
 

karif

crazymomof4
We have been to a behavioral pediatrician that dropped us as a patent because she disagreed with diagnosis of bipolar. however UCI, the regional center and pshcologist all said he is bipolar. We have used up all our mental health benefits for the year on our regular insurance. He has medical because he was adopted so now we are trying to get a psychiatrist that will see him but it is difficult finding one that will see patients under 6 years old.
 
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