I need help

[kristen4112000]

Which Im sure you all hear a lot. Im just now admitting that we have a problem and beginning to tackle it. Im scared, and we have no resources near us. No pediatricians, no hospitals, no therapists. We have an appointment tomorrow with our NP to get started (hopefully) on figuring out what is going on with my 8 year old.

History: We have four kids, three boys, one girl. They are 10, 8, 7, and 5. I SAH with them, as a result my husband works a lot and works far from home so he is only home on the weekends. My other three kids seem to be pretty typical but my 8 year old has been difficult since he was born. Very colicky, severe skin problems, now is suffering from fairly well controlled asthma, and food allergies (specifically, peanut but his number has declined and we have another appointment the 28th to rechecki), eczema etc. He is *supposed* to be on advair, but that's it. He wont even do the advair. He lies and says he did, and he doesn't. He lies about everything, really. Recently he quit using soap in the shower, and refuses to brush his teeth.

Tip of the iceburg. Nothing is ever his fault, he's very violent towards his siblings, specifically the smaller two. A lot of tantrums, throwing around the word hate, he questions everything you tell him to do, ignores, places blame on everyone else...and if he can't place blame then he lies and didn't do whatever went wrong. He picks, is mean to my daughter specifically, calls lots of names, bad words, hits, cheats, he can't stand her being anywhere near him most of the time. If she sings it drives him totally crazy. He can't stand it. If he doesn't get the chair he wants at the table he freaks out. If I tell him no about something, he hounds you for hours begging for it (lately it was for me to set his alarm clock, long story) and then cries and cries and refuses to partake in life.

Our lives are severely disrupted by him every single day. He literally can't stop name calling and hitting. Literally. And pouting. Within 2 minutes of him being around people they are crying. The thing is, he is an angel in school. His teacher says he's very neutral to her, she said she could scream at him or tell him he won the lottery and the reaction would be the same. He gets this glazed look on his face when he's in trouble like he just isn't with you at all when you talk to him.

We do all kinds of special things with him, and in turn he just disrespects me and craps all over me. He's very touchy, is always touching someone and up in thier space. BUt if anyone dares get near him he will hit them or hurt them in some way.

He lies and hides his homework telling me he did it, then at bedtime has a massive 2 hour breakdown that I didn't remind him enough and that I didn't help him and he hasn't done it. It's always my fault.

I dont know what to do or where to turn.

 

[rlsnights]

Welcome. Sorry to hear things are so hard and you are alone to deal with it most of the time.

I'm going to offer you my thoughts and it will be a lot to take in. Others will do the same. You might want to print out our posts so you can take your time to think about the suggestions and questions you have. You can also search through other posts. Hopefully one of the moderators will respond and direct you to the book lists and forum resources like the parent report. I'm a little hazy on where you find those.

I understand you don't have any nearby resources. But, you have a kid who is going to need some in depth assessment I think. Based on my own experiences, your difficult child sounds like he may have issues with sensory integration (touching but not wanting to be touched, the soap and tooth brushing issues), perspective taking (can't figure out why you won't give him what he wants or recognize when other people are sending him clues he is out of line or respond with appropriate emotion to teacher), impulsiveness - and those could be masking an underlying psychological or development condition. That's a lot of very different behaviors and I could suggest possible reasons until I run out but that's not going to really help you.

What your difficult child needs is a neuropsychologist assessment and possibly some other assessments with Occupational Therapist (OT), Speech Pathologist - not sure but the neuropsychologist is the place to start. You need a comprehensive assessment and a neuropsychologist is most likely to give you a that. To get that assessment you are going to have to travel and you are going to need to do it without the other kids along.

And you also need to get him to a pediatrician, tell him/her about these issues and ask for a thorough work up to rule out any physical conditions like celiac that could be contributing to or causing some of these behaviors. I would not let the peds diagnoses ADHD or do any psychiatric diagnosing or medication. I do not believe that they have the training needed to prescribe and monitor mind-altering drugs to kids. That's what child psychiatrists (psychiatrists), neurologists and neuropsychologist are trained to do. Not pediatricians.

Sorry for the soap box. Pet peeve.

Anyway, on a practical level I would strongly suggest that you get your hands on The Explosive Child by Ross Greene as soon as you can. Today if possible. This will help you focus your time/efforts in a more productive way to manage his behaviors.

If he is picking on the younger children in front of you who knows what he's doing when you aren't around. You need to get your other children into a totally private space where they feel safe and ask them to talk about the way their brother treats them and what he has said/done to them. You may find nothing - or you may be shocked and scared by what you hear.

You don't say whether the behavior changes when husband is at home - just wondering about that. If difficult child is "perfect" as far as husband is concerned, you need to have husband stay home for several days so that effect wears off and he gets to see what's really going on. You are going to need husband's support and you will have to stand together because your difficult child will surely try to triangulate you, pitting you against each other. I hate to predict the future but I suspect you and your husband are going to have to take a hard look at your current arrangement and find a way for him (or someone) to be there with you as your difficult child grows up. Once he's bigger/stronger than you, unless things have changed a lot, you are not going to want to be alone with him and younger children at the same time.

You may want to go do some observation at school - especially on the playground/before/after school when he is relatively unsupervised. He may be having problems with peers that the teachers aren't aware of. If so you will want to take action on that, perhaps asking school for a Special Education assessment.

Hugs and glad you found us.

 

[kristen4112000]

Have already had the book sent to my kindle and am attempting to read, schools out though and he's outside so Im "on duty" till about 10 tonight. Im hoping our PCP can give us some referrals tomorrow to where we need to go.

 

[BusynMember]

Hi there.
I live in a small town and basically we have to travel to get help for our kids (beyond just the normal sniffles and flu) and we do. Sometimes it's a 3-4 hour drive, but it's worth it to have him tested. I would call your nearest university hospital and get him in to see a neuropsychologist. We found them better at diagnosing than psychiatrists because very often psychiatrists leave out neurological disorders when they diagnose...very often they just don't know much about, say, autistic spectrum and may diagnose it as something else when it is actually not a mental health issue at all.

Short of evaluating your child, you probably will sadly not see much improvement. Our kids tend to be very resistant to normal parenting methods. Also, please don't get offended that he doesn't seem to appreciate you. Most likely his brain is wired differently than your other children...and he just can't process things right.I don't believe his behavioral problems can be helped by no diagnosis and no outside help and, although it's a pain in the you-know-what to travel, it beats having a violent child in the house.

Hugs and I wish you luck, whatever you decide to do.

 

[Malika]

Kristen, a question: was your son always this way, ever since you can remember, did he change suddenly into this very difficult child at some point or was it a gradual evolution? Does he have any other sides to his character or redeeming qualities?

 

[kristen4112000]

My son does have redeeming qualities. He's very bright, he's always willing to help me do chores if I ask him to, he's always the only one of the kids that is willing to help or come play a game with me. He's the funniest kid I know too, he's got my smartass sense of humor, and he says some of the funniest stuff. He's also fairly mature for his age when he's not having a breakdown over things.

Being that I had him, had his sister when he was 18 months, and then another child when he was 3, my memory doesn't serve to be the best. But I do know that things have been difficult with him since he was very small. Started with colic, medical issues, he's the only child I have that has broken a bone, is color blind, has had to be hospitalized, have stitches, had an ultrasound etc. In utero he had cysts on his brain and I thought he was going to die. When he turned out to be "fine" I was so happy that the fact he screamed for the first 5 months of his life never even bothered me. By school aged I was afraid he wouldn't do well in school because of his behavior. So I do believe that he's been consistent in being difficult. After he began school and we received nothing but rave reviews from his teachers, I thought it was me.
I feel as though things come and go in terms of his behavior. We'll have a good few days and then it just turns awful.

 

[rlsnights]

Your son sounds a lot like mine when he was young. Sweet and rageful all in one package.

A neuropsychologist is definitely where you need to go. The prenatal stuff could be a factor here and a lot of time kids "grow" into their disabilities. That means their limits don't seem to be a problem until they reach the developmental stage where they're supposed to grow beyond them - and they don't.

It may be that is what you are seeing in the rages and other difficult behaviors.

I suggest that you start keeping a diary or chart of his behaviors. You can do a brief daily diary with a narrative. Or you can do more of a chart. Here's a list of the things I tracked with my difficult child 2:

Moods - high and low for that day - with younger kids changes in energy levels may go with changes in mood; use a consistent number scale that makes sense to you, 1 is "normal" 10 is extreme.
Irritability - does everything rub him the wrong way?
Sleep - how many hours, naps during the day, quality of sleep if that is something you notice
Aggressiveness toward others
Rages - how long they last, if there's things that seem to have triggered the rage

Your story sounds similar to mine =
As an infant my son cried constantly, had either diarrhea or constipation all his life and was still having nighttime diarrhea when he was 22 months old. He was allergic to every disposable diaper on the market, broke out if he wore anything with metal (no snaps), only slept for 30 minutes at a time for the first 4 months or so and then only when he was in physical contact with a human body. I cried when he stopped taking 1 nap a day when he was 15 months old but he didn't sleep through the night until he was 7. He had asthma by age 2, chronic ear infections from 8 months, can't stand seams or tags or things that are even slightly scratchy and avoids many different foods because of their texture or smell. He had surgery 4 times by age 7, was moderately deaf in his right ear due to a rare congenital growth that destroyed the bones of his middle ear, had topical and inhaled allergies and at age 10 was diagnosed with Crohn's Disease. He walked at 9 months and was talking in 8 word sentences at 15 months. He also has migraines, language processing problems, and a bipolar diagnosis with mild thought disorders. At this point we think his biggest hurdle is actually his inability to take another person's perspective. I am not saying your son has these same diagnoses or will have them. Rather that you are right to take your son's problems seriously and try to figure things out now.

Truly, if I had known then what I know now, I would have done anything in my power to get my son accurately and thoroughly assessed when he was young. Interventions are always more effective with a younger child than an older one. And your son may also be scared and confused by his own behavior.

For my difficult child the two areas that no one assessed when he was young that have turned out to be really important were language processing/pragmatic language (assessed by a speech pathologist) and sensory integration (Occupational therapist with special training). A neuropsychologist may recommended these assessments also be done in addition to things he/she will be doing.

I would speak with your son's allergist about his behavior problems and ask if there's any chance his allergies or another related condition might be part of the cause. I'm specifically thinking of celiac's which can have CNS effects. I doubt this is the case but it's worth asking the question, especially when you have a kid who has lots of physical sensitivities.

It's wonderful that he is often so warm, caring and happy.

Hugs,

Patricia

 

[Malika]

Interesting this theme of crying as a baby. My son also went through a period of crying for literally hours as a small baby - at the time, I put it down to the adoption and the change. Now I wonder.
Another question, rlsnights - or anyone. At what age do neuro-psychologists evaluate in the US? After speaking to a local neuro-psychologist here (might be different in the big cities or Paris), I was told there is simply no point before the age of six or so. A child is not developed enough until then to be properly measured, she said...
So I am interested to know the position in the States.

 

[sunshinecan]

My first thoughts where Sensory Integration, my middle son was diagnosed. Each child will be different with their input and output needs but here's a couple of things that made me feel 'better' about my situation.

He too was great at school, and great when he goes to his dad's. What they told me was that he has the capacity to 'hold it together' for a time, but once he reaches the comfort levels of home, he can decompress, and OH he does! When I pick them up from their dad's it's 45 drive home, and it's not unusual for him to YELL at the top of his lungs until we get home. And heaven help me if it's a long weekend and he has spent three days there. Interestingly enough when his dad had him and his brothers for a week last summer all i heard was how poorly he behaved, I know that it's his Sensory Integration Disorder (SID), but his dad had never seen that side of him, it was a relief to know it was just me!

His assessment determined that he needs to do things like monkey bars, push pull with his hands. So I can be seen at the grocery store letting him hang of my arms, or doing wheel barrow races through our house. It's not a perfect solution but atleaast gives me something to work with. What's interesting is he's always like to hang from everything, counter tops, door knobs, whatever.

Hugs to you, I feel your frustration! we are still trying to work through his medications, but things are better then they where.

Melatonin has also proven to help, it helps him be able to go to sleep (so everyone else can get to sleep) and if he's had a good nights rest then he can function better...

 

[confuzzled]

i'll go out on a completely different limb and say maybe you need to revisit the allergies. often, where there is one, there are more...and if has chronic excema they arent under control, in my opinion.

i'd specifically look into gluten.

there can be massive behavorial fallout from uncontrolled allergies, and i personally feel EVERY medical diagnosis needs to be ruled out before it becomes "only" a behavioral or psychiatric issue. if he indeed still has allergy issues it makes sense to treat them, and focus on whats left after.

just my .02

 

[kristen4112000]

I will definately be bringing it up at his allergist/immunologist appointment on the 28th. I feel like our allergist is quick to dismiss and ignore my concerns at one visit, then happy to oblige at the next. When he had a full panel done at age 2 they said they thought everything was probably false except for peanut and trees, mold, grasses etc. Now after 2 prick tests in which he responded to even the control on one, and then responded to nothing on the other, they are leaning towards him just having sensitive skin for the first test. We were getting ready to launch into allergy shots. YEARS of allergy shots because his asthma and allergies were so bad. Then, after me pushing for YEARS they switched him to advair and redid the panel and low and behold his asthma is mostly managed and he had no allergies on the prick test. The kid is throwing me for a big loop. I never know what is going on.

Lately it's been the stomach aches, he has HORRIBLE breath. To the point you can't stand to be near him when he talks. Dentist says everything is ok in there. I have no idea how they can say that given the smell coming from his mouth. Those things lead me to believe he might actually HAVE some hidden allergies. We already avoid red dye. Allergist says it's not an allergy if he can eat it. I think she's missing what Im saying. I HAVE brought this up before and she wouldn't let me even finish my sentence and said no. If he's eating it, then it's fine. She's concentrated on anaphylaxis.

I wanted to share a picture of what my baby looked like from birth on. In fact, he still looks much this way. I think we're definately dealing with some food issues but moreso I think there is more going on than just that.
http://img.photobucket.com/albums/v84/kristen4112000/Ethanandcarter/carterjoseph.jpg

I just hope we can find someone that will take us seriously and help. I keep hearing "If he can be good in school then he's CHOOSING to be bad at home" and I want to just slap someone silly.

 

[kristen4112000]

Your story sounds similar to mine =
As an infant my son cried constantly, had either diarrhea or constipation all his life and was still having nighttime diarrhea when he was 22 months old. He was allergic to every disposable diaper on the market, broke out if he wore anything with metal (no snaps), only slept for 30 minutes at a time for the first 4 months or so and then only when he was in physical contact with a human body. I cried when he stopped taking 1 nap a day when he was 15 months old but he didn't sleep through the night until he was 7. He had asthma by age 2, chronic ear infections from 8 months, can't stand seams or tags or things that are even slightly scratchy and avoids many different foods because of their texture or smell. He had surgery 4 times by age 7, was moderately deaf in his right ear due to a rare congenital growth that destroyed the bones of his middle ear, had topical and inhaled allergies and at age 10 was diagnosed with Crohn's Disease. He walked at 9 months and was talking in 8 word sentences at 15 months. He also has migraines, language processing problems, and a bipolar diagnosis with mild thought disorders. At this point we think his biggest hurdle is actually his inability to take another person's perspective. I am not saying your son has these same diagnoses or will have them. Rather that you are right to take your son's problems seriously and try to figure things out now.

My guy was walking at 10 months and at his 18 month check up the doctor walked in just as he said "I poke you in da eye" and he certainly did. Jabbed his index finger right in my eyeball. The dr said well, no issues with speech, I take it. We battled asthma, eczema, food reactions, and getting anyone to listen. At 6 weeks our pediatrician told me I was setting him up for a life of failure because he had grown so much. Said I was over feeding and he would for sure be diabetic. Which, you know. Truth be told I probably WAS overfeeding him, because it's hard to tell what you've done and not done when your baby hasn't slept in 6 weeks and hasn't stopped crying yet. Anyways. They said the fact he laid as a newborn and dug his head until it bled was probably ringworm. Which it wasn't. they tested and it wasn't. Hello. It was eczema, which I was screaming at them and they wouldn't listen.

By 2 we were hospitalized with asthma. It seemed like everything just kept getting worse. If it wasn't medical it was behavioral. It's been a lot to deal with, I hate that Im just now addressing the issue. But now his medical issues are mostly under control so. This is where I am.

The thing is. He's a daredevil. Nothing bothers him. He can wear 50 layers and they can be all bunched up and he doesn't care at all. He will try anything twice. Honestly that scares me about him. He doesn't seem to have the thought process of what is dangerous and what isn't. Having him in my life is sort of like being stuck with an 18 month old in a china shop. You just can't ever let him out of your site or out of reach. Or something is going to go horribly wrong, and fast.

He's never slept much either. I think I was finally getting him to nap around a year old, then he gave that up. There were nights, he never even went to sleep. I make him go to bed here, rumor has it he'll still be up at 3 am if grandma allows it.

 

[BusynMember]

Hey...they can't diagnose a child for sure unless the child is very obvious at a young age, but they can find out the problems and deficits and implement interventions.

When we adopted my son, he was two years old and had symptoms of autism, so we were prepared for an uncertain journey. A neuropsychologist is great at pointing out where the child needs help and therefore you can GET the help, whereas, at least in the US, you can't get interventions or help before a diagnosis is given. The community programs and school districts are stretched thin on funding and they only let in kids that yjru are sure need the help. And that requires a diagnosis. even if it is tentative and may change.

In the US, an ADHD diagnosis. is not severe enough (unless there are other issues) to get into early education. However, the earlier interventions start, the better the prognosis. The later they start, the worse. My son was non-verbal, banged his head back, and threw horrible tantrums at two. Although he will still need help as an adult, he is very verbally astute, capable to making friends (if they take the initiative first) and capable of living a happy life. He is now a very contented person who NEVER has moodswings. This would never have happened if he had not been given early interventions. Not only would he have needed help as an adult, but he would have been miserable as well. in my opinion it's better to be safe than sorry. To me, happiness of t he child is absolutely the most important thing. My son is happier than many people who don't have any disabilities at all. I thank all his workers and Special Education teachers for his wonderful, calm disposition. I could never have accomplished this alone.

To the poster, are there any psychiatric problems or substance abuse issues in your precious child's family tree on EITHER side? Any forms of autism (as you know there are many levels--Aspergers/Pervasive Developmental Disorder (PDD)-not otherwise specified etc). These behavioral issues tend to be hereditary, unfortunately. Adopted parents are always shocked if/when the child they adopted meets his/her birthparents. In general, the child is more like they are (although he/she never lived with the birthparents) than like themselves (the people who raised them). Many even find they have similiar mannerisms to the birthparents they never knew...it's weird and scary! But it speaks a lot to biology's role in who we are.

I really hope you can get help and work it out. It is amazing what can be done for many children these days. They did not have this back when I was growing up. I have serious Learning Disability (LD)'s and even deficits and there was nobody to help me learn how to compensate for them....and I got married very young because I knew I would not be able to be independent as an adult. It was NOT a good marriage. A little support would have been very helpful...

 

[AnnieO]

Hi - and welcome.

I can't offer much beyond what has already been said, but something stuck out at me. You said he can wear layers and layers, all bunched up... This is my 12-y/o. He does not notice when he leaves his coat on (the rest of us are sweating), but won't go get it because he's "not cold". Heavy clothes and long sleeves in the summer, shorts and no shirt in the winter. I have to say that, though I do believe we have some Sensory Integration Disorder (SID) as well, he's just not wired the same as the rest of us.

You're not alone. {{{{{HUGS}}}}}

 

[rlsnights]

Oh Kristen, I sooooo feel for you. And to have so many young ones all at once - major hugs. My difficult child 2 has a twin sister. If you haven't had twins it's hard to appreciate the level of work and the challenges that come with twins even when they're "easy" babies. Both my twins were difficult babies - in different ways. Every effort we made to get them on a schedule (any schedule, singly or together) failed miserably until they were around 3 and even then my son would go to sleep at midnight and wake up at 5 am to go bang on the pots in the kitchen. I hardly remember most of the first 2 years of their lives because I was so sleep deprived. It wasn't unusual for me to sleep no more than 2 or 3 hours at one time with maybe 1 short nap during the day.

And I totally get that the physical health issues were first to get addressed. I sometimes feel I will go crazy trying to figure out when to call the doctor (and which doctor to call) when he's sick or some new thing comes up. AT this point it's crazy-making for both of us because my son is 15. When something new comes up the first question we ask? Is there a physical illness/problem that explains the signs and symptoms. So my son is walking around trying to cope with symptoms while thinking maybe he is sick or has developed a new disease/problem. Then, if we go through a bunch of medical testing/assessment and they can't find anything wrong (our current situation re: fatigue and disordered sleeping), he is told "you're not sick" and is supposed to instantly switch his thinking around and lose any anxiety he may have had when he thought he was sick and "stop" the problem behaviors that have now been persisting for weeks or months.

I hope your PCP is receptive and supportive. Do not blame yourself for anything. You have huge challenges and are doing great. You have not abandoned him and you are seeking help now that you have the breathing space to recognize the size and nature of the problems.

I hope you have had time to read Explosive Child - at least to skim it for the ideas of baskets and safety.

I encourage you to ask your husband to take time off to give you some respite or to ask a friend or extended family to help you right now while all the kids are home. Can you send him to his grandparents for a week?

If the behaviors you are describing truly wax and wane, then I think it is really important for you to keep some kind of diary or chart of behaviors. If there's a change like school is out, note that in your diary. If you can keep that for at least a month it will be *very* helpful to you and to his doctors.

Patricia