My therapist think difficult child 2 needs to see a psychiatrist

[Alisonlg]

I had been putting C on the backburner while M's issues took center stage, but always knowing that I eventually wanted to get C evaluated to rule out Pervasive Developmental Disorder (PDD) and to see if we potentially had any other issues going on. Well, I had my therapist appointment today and we were discussing M and then C and therapist was alarmed by a lot of C's behaviors and feels that C should be seen, and I got the feeling she meant sooner rather than later.

The behaviors were his hurting the cat (he's been doing this for years...and when we had the dog, he did it to the dog too)...he squeezes her with the expressed intent to hurt her, strangles her, hits her, pulls her tail...this is not a kid that doesn't understand how to handle a cat...this is malicious and purposeful and all the while he either laughs or has a smile on his face. He also has escallated to hurting his brother...yesterday he grabbed his brothers mouth and dug his nails into his face and broke the skin! Poor M has wounds! He also threw things at him, hit him, etc. All unprovoked and he wasn't angry at all....he was laughing. He thinks it's funny. It drives me mad! He's outwardly defiant...but in a different way than M. But, like M, timeout has no effect on him. He has learned certain behaviors from M that M used to do during his rages (such as throw things, kick walls/doors, run away from us), so he imitates those behaviors. And, even though he hasn't seen M do those behaviors in over a month, C continues to imitate them.

He's 3 1/2 and still not potty trained. I understand that techincally this is "normal" but it's interesting to note that it appears to be a choice of C's. We know C is PHYSICALLY ready and in control of his bodily functions and aware of his bodily functions. He throws a tantrum if we talk about underware, however. Sometimes he'll start to cry simply if I ask him if he's wet because he doesn't want me to change him. Getting him into pull-ups was a big ordeal! I feel like he will NEVER be out of some form of diaper. The child never wants to be potty trained.

So, anyway, that's my little bit for the day. therapist said it sounds like I have my hands full between the two of them. Like, yeah lady...this is why I'm here! LOL Every day, one more brain cell dies and I'm one step closer to my own private padded room! But I digress. :wink:

 

[BusynMember]

If he's willfully harming animals and people, I'd agree with therapist. I'd actually have him see a neuropsychologist if it were my kid though because they test. Actually I think a psychiatrist/neuropsychologist combination is best--sounds like he may have some sensory issues plus psychiatric issues and each professional is so specialized these days (psychiatrists often miss neurological red flags and neuropsychs need psychiatrists for medication, etc). I'm not so sure your little one is mimicking the older one. He may just have his own issues--things are often inherited. It's best to have him tested and to find out.
I wouldn't worry about potty training right now. in my opinion it's the last of your concerns. He may or may NOT be able to tell when he has to go. I have five kids, and only one of them was completely trained by three and a half. They all pottied late, and only one had special problems. I never made a big deal out of it, and they learned. I hope you make an appointment. for your son and it works out well. You do have your hands full. Wish it could be easier.

 

[Steely]

I am SO sorry you are dealing with all of this right now.
Try not to panic - and take one day at a time. You have gotten the older one stabilized, now you can focus a bit more on the younger one.

Sending positive thoughts your way.

 

[guest3]

<<<HUGS>>> I feel it's all I can give and that makes me feel so helpless! I have been getting tag teamed by my 2 difficult child's all night and now they're quiet (scary quiet). Prayers and hugs to you, my padded room is going to have a disco ball and a chocolate fountain. I hope you will visit me???

 

[witzend]

Oh, my goodness, you have a lot on your plate! I'm sure it must be overwhelming. I think that perhaps a psychiatrist is a good idea.

M was potty trained early, but he kept his pacifier forever. I know he was nearly four years old. They were gross! I finally told him that he was on his last set and I wasn't buying any more. He knew how to count to three, so he knew what was going on. He lost one, then he threw one down a hold that was knocked in a wall by the doorknob. The last one he did the same thing with, but not for a few weeks. There were big tears, but he got over it.

I wonder if maybe you can try telling C that he may not be potty trained, but you are. Show him where the baby wipes are, where the diapers are, and that you are not changing his diapers anymore. He's big enough to change his own and put the dirty/wet ones in the trash. Failure to do so means a rashy bottom. Not disposing of them properly means loss of a small priviledge. (desert, a treat, etc.) He can decide that he wants to use pull ups instead, but you're done.

I am totally aware that he might not go for it. But it can't get a heck of a lot worse than what he's pulling now. And I would think that even if it didn't work initially, if you went back to willingly doing it for him, he might decide he didn't like that after all...

 

[smallworld]

Alison, sorry about all you're facing right now. I agree that C needs an evaluation, but I'm not sure I would limit it to a child psychiatrist. With a speech delay and sensory issues (is that why he's in Occupational Therapist (OT)?), I'd recommend an evaluation by a developmental pediatrician in addition to a child psychiatrist. He is only 3.5 years old, and it would be too bad to limit the diagnosis when it could be so many different possibilities at this point.

In terms of potty training, I would not look at his reluctance as a choice or as defiance. His reluctance may be tied to anxiety, sensory issues, difficulty transitioning or a need to have things remain the same (or all of the above). I will compare the situation to my own son, who resists taking showers (yeah -- pretty gross for a teenager). While it is common for young teen boys to resist showering (similar to some 3.5-year-olds not being potty trained), we have a lot more difficulty getting our son into the shower than parents of his easy child teen friends. J's psychiatrist explained to us that he always likes things to feel the same (part sensory, part anxiety, part difficulty transitioning). If he takes a shower, even though we think he will feel better (and smell better!), he actually feels worse because he feels different from how he felt before his shower. It is why he holds on to the same gross comforter he's had on his bed for years and why he has difficulty visiting grandparents even though he loves them (it feels different from home). This scenario may be playing out with C and his reluctance to potty train.

So I would not stress about potty training until you have thorough evaluations and know what you're facing with C. With these evaluations, you will obtain some understanding of the issues C's facing and then you can put some plans into place for appropriate interventions to help him on all fronts.

Good luck.

 

[Alisonlg]

Thanks everyone. C's evaluation should be interesting...he's so DIFFERENT than M. I should start my parent report NOW while I'm thinking of all of the differences...I don't want to forget any of the litte quirks or weird things he does/says. ::::

Seriously...mama **NEVER** said there'd be days like this!!!! LOL