New Here, Overwrought

[EB67]

Hi all. I'm here because I am overwrought and I crave the company of other parents who understand what it is to be pushed to the limits of sanity by a demanding child.

My name is Ella-- I have two wonderful kids. I say wonderful even without a hint of sarcasm because they are wonderful. Thought one of them has probably shaved a few years of off my life for the stress being his mother has caused me.

My 3 year old son Miles is as sweet as sugar. He is kind, empathetic and he is a pleaser. I never understood how people could have many children but if it were a family of kids like Miles it would be possible. He isn't without defects: he has a pragmatic language delay and no interest in the toilet. But truly, as a person, he's mild and sunny.

His brother Seb? Not so much.

Seb is 7 and finishing what has been a very tumultous year in second grade. He has combined type ADHD, sensory issues, oppositional features and a 99th percentile IQ. He is, hell on wheels. Seb is surly, argumentative and explosive. And he is smart as a whip. A master of rhetoric. In all debates, you lose. He's a force of nature.

The current family stress is due to the fact that Seb REFUSES to make his medication. He was prescribed Adderall XR some time back. At first I was able to get him to take it with much fighting. And at first the results seemed promising.

Now there are daily fights which result in Seb not taking his medication most of the time. When he does in fact take it his teacher reports that he is still up and out of his chair and unwilling to do his school work.

For a while we just thought, "Hmm, he's bored. Ah the peril of being gifted". After all, this is a child who devours the NY Times every day, who is a voracious reader and has an encyclopedic memory. But even when the school accelerated his work to his so-called level, he still did nothing. Seb is a child who despite his intelligence does absolutely nothing at school.

The daily take-your-medication fights are brutal. Today Seb shoved me at the breakfast table when I approached him with his pill. This was a first. I am afraid of the corner I have turned.

I've turned to you all because I need some community, some guidance. I've started to be Angry Mom, Shouting Mom and Mom Who Says Things That Should Not Be Said. It's hard to remain composed and effective as a parent when the person you devote your life to care for is oppositional and unwilling to follow your directives where health care is concerned.

Thanks for your time-

Ella

 

[smallworld]

Ella, welcome! I'm glad you found us.

Have you read The Explosive Child by Ross Greene? It's a book that has helped many of us here parent our extra-challenging children. It sounds as if it might help you, too.

Do you know why Seb is refusing his medications? Sometimes it's the way they taste or the way they make the child feel or something else entirely. Once we figured out why my son didn't want to take his medications, we were able to work with his doctor to come up with a solution my son could live with. Finding a way for him to "buy in" solved our problem.

One other question: What kind of doctor diagnosed Seb? With ADHD-like symptoms, sensory issues, oppositional behavior and a gifted IQ, there's a chance you may be looking at Asperger's Syndrome (I'm not diagnosing over the internet, just throwing out the possibility in the event you haven't considered it). Kids with AS frequently need specialized interventions both at home and at school to help them succeed.

Again, welcome. You will find a lot of support here.

 

[sweepymom]

what medication is he on? oh yeah welcome I have 4 wonderful children. Most of which are explosive. I have one that fights her medications. and I have to put them in food or she won't take them. Tonight she swallowed her medications. with no problem but usually she just fights. and if you want to get physical my 8 used to push and shove me to try to avoid taking his medications. but that was when he was 4 Now he just tries that when he is not getting his way.

 

[Hound dog]

Welcome to the board.

I am thinking along the lines of smw with the autism. All of his issues tend to make me think it's possible they've overlooked this possibility.

Hugs

 

[SRL]

Hi EB67, I'm glad you found us! We were are all desperate parents when we arrived here and we're well acquainted with Angry Mom, Shouting Mom and Mom Who Says Things That Should Not Be Said from our own lives. I think you'll find some good help and encouragement among us.

My first thought when I was reading through your post was to suggest looking into Asperger's Syndrome. It's frequently missed by doctors and parents at younger ages, especially so if it's borderline or atypical. I have a child who leans in the direction of AS and I could have been writing your post (sans the ADHD) when he was 5. By learning what was going on in his mind through all those explosions we've been able to help him make tremendous progress.

As smallword mentioned we don't diagnose here but we can give you some direction on where to start and this site has some basic information. If it rings a bell we can provide you with more direction.

http://www.aspergersyndrome.org/

What types of specialists gave his diagnosis's? Has he been seen by a developmental pediatrician or neuropsychologist? As a whole, we've found those two speciality areas to be most reliable in pediatric diagnoses.

The Explosive Child changed our lives, literally.

 

[Marguerite]

The book's been recommended. Good. It should help a lot, especially with a bright kid. He sounds like he uses reason and therefore should be open to reason, where it isn't affected by his impulse control problems or other issues which can override common sense.

He's only 7. You've got time on your side. But it does sound to me like he is angry and very frustrated.

Have you tried explaining to him what the medications are for? Asking him why he doesn't want to take them? I went through this with easy child 2/difficult child 2 and it turned out (after a lot of careful discussion, tantrums, explosions and "I can't put it into words" despite her IQ also being extraordinary) that there was something in how the medications made her feel. We talked it through, talked to the doctor and adjusted her medications (timing and dosage) until she felt better.

A big part of the problem was that easy child 2/difficult child 2 (and difficult child 1) simply had no idea how others perceived her, medication-less. SHE felt she was perfectly fine, but we wanted to strangle her. Off her medications she thought this was terribly funny.

In our case, we had siblings to help explain, so it wasn't just us saying, "Take your medications! Without them, you're a ditz!" But we were getting ready to videotape the kids while off medications, to show the problems we had. difficult child 1 off medications isn't a ditz, he's aggressive. He gets a look on his face and a tone to his voice that is totally at odds with how he is 99% of the time.

I STRONGLY urge you to get his diagnosis checked. And remember, the brighter the child, the harder it is to pinpoint Pervasive Developmental Disorder (PDD) because as they get older they learn to mask it. They're not being deceptive; they're being 'normal', in that they're trying to fit in to a world t hat makes t hem feel like aliens.

A suggestion - go to http://www.childbrain.com and look for their online Pervasive Developmental Disorder (PDD) test. This is NOT diagnostic, you can't use it that way, but it can give you some idea of what we mean. You can also print the test result and take it to your doctor to get a professional opinion. It's a good way to crystallise concerns and provide a summary of things in that area which are maybe worth looking at.

Percentile 99 - if that's top 1%, then that's all four of my kids too. NOT fun, but very interesting in other ways. We had to pull both our boys out of mainstream because it simply wasn't meeting their needs. difficult child 1 was failing. difficult child 3 should have been failing. They were enrolled in correspondence school (an option for us). difficult child 3 & I were there today for their Open Day and I had a talk to a couple of his senior teachers about a curriculum problem. I pointed out to them that only at home and in correspondence has difficult child 3 learned ANYTHING. He was seven years in mainstream and learnt absolutely nothing positive. He still has gaps in his knowledge that we are filling as we identify them. because he is autistic, he needs to learn in his own way, not the way the schools necessarily think is the way. I explained it to difficult child 3 as different people having different operating systems in their brains. Some people have easy child brains, other people have mac brains, but the output off the printer, if the correct software is there for each type of person, is indistinguishable. Basically, he can feel free to learn in his own way as long as he can produce what is recognised as equal (or better) to others.

And he does. He still needs things explained in a fairy concrete way although he's capable of some amazing abstractions. Despite his autism label, he is highly sociable and enjoys being around other people. A thought for you - difficult child 3's autism means he is often socially inappropriate in a way I suspect your son might be too - he does not distinguish between adult or child, in his interactions. difficult child 3 would chastise a teacher in the same tone a teacher might use on him. So if a teacher chastised him for dropping a paper on the ground they would need to be very sure they never did the same thing, or they would hear across the playground: "Oy, you there! Mr Anderson! Pick that up NOW!" in exactly the tone of voice they used to him. Because in talking to him like that, they modelled appropriate behaviour for him, in his mind.
He also will talk to a baby as if that baby can understand a great deal more than they really can. For example, we were in a hospital waiting room and difficult child 3 was reading a book to a 3 month old baby (my suggestion). He held up a coupe of books to the baby and asked the baby to choose which one to read. When the baby waved a vague hand (as babies do) difficult child 3 took that as t he baby making a choice, and began to read. Through the story he would stop, show the book to the baby (which autistic kids are not supposed to be able to do) and ask the baby a question, such as "Can you see the duck? What is it doing?" In this he was patterning the way we used to read to him to extend his language.
difficult child 3 was an early reader. We now know this is called hyperlexia, especially where their understanding is not as good as their reading ability. And especially when coupled with autism-like traits. difficult child 3 was typing the alphabet (upper and lower case) and numbers, when he turned 2. He was reading sheet music. He was playing piano. And he was non-verbal. He sure can talk now! And very clearly and fluently, too.

So keep an open mind, be aware that your child is going to break a lot of rules and descriptions, and be prepared to treat him as the extreme individual he is. The recommended book will help you plug into him more effectively (and positively) which will bring the fringe benefit of you being able to recognise and therefore meet his needs socially, academically and therapeutically. Be creative, be adventurous and you will really begin to enjoy your unique child. That book really helps you deal positively with the oppositionality. It's not a cure, but it makes a big difference.

And welcome.

Marg

 

[BusynMember]

Hi, Ella. How are you doing? I have a suggestion. I would take both kids to NeuroPsychs. Both could be on the autism spectrum, and NeuroPsychs are the best way to rule that in or out. Aspergers kids are often brilliant, but socially clueless, with precocious vocabularies and some have staggering abilities, but they still need help, which is why they act out and get so frustrated. They may "get" the NY Times, but they don't "get" people and need special interventions for life to get better (I speak from first hand experience. My son is on the spectrum, but wasn't diagnosed until elevin--yes ADHD was his first diagnosis, actually ADHD/ODD). The little guy, with is pragmatic speech delay, is also at risk to be on the spectrum. Not all Autism Spectrum Disorders (ASD) kids act out. My son, after horrific toddler years, is the sweetest fourteen year old on earth, making great progress. I strongly recommend a neuropsychologist for the older child and a Developmental Pediatrician for the younger one. Is the youngest in early education, at least getting speech? In the case of these boys, I would not go to a Psychiatrist or therapist first--they need to see if there are neurological problems beyond ADHD (although NeuroPsychs are great at spotting just ADHD too). THey run intensive tests--my son had twelve hours of testing. I also would not put this type of behavior in the hands of a pediatrician. They don't have the extra training to spot these things (been there/done that myself!) I would start with the neuropsychologist because the more you understand what is going on with your child, the easier it is to deal with them, relate to them, and get them help. NIce to "meet" you.

 

[Marguerite]

Ella, MWM is generally fairly close to the mark with things like this. I endorse what she said. Ignore me when I talk about my kids' pediatrician - it's how it's done here in Australia, our pediatrician also specialises in ADHD and autism. But he is rare. He also is continuing to see our older kids even though they're adults, because we have no other speciality here which CAN deal with adult ADHD/Pervasive Developmental Disorder (PDD) as well as he does.

The delay in toileting with your younger one could also fit this picture.

And remember from my description - this is not the bad news people might think it to be. The world needs kids like ours! Think - Bill Gates, Einstein, René Rivkin, Steve Irwin (possibly) - highly intelligent people with a passion for knowledge and experience in a very narrow area of interest. Steve's daughter Bindi is a prodigy, her brains had to come from somewhere.

The sooner you have some idea what you're dealing with, the sooner you can get the extra help and make changes needed to give your kids the kick-start they need but aren't getting (the school isn't extending your older son properly, or he would be embracing it).

Also - high IQ tends to gallop in families. Siblings rarely vary more than 10 IQ points from each other. And intelligence can show up in different ways. difficult child 3 was the earliest reader, but in many ways easy child 2/difficult child 2 seemed incredibly bright, early on. easy child was also amazing but considered to be within normal range by most people. She needed the least help from us, and thankfully was able to find her niche.

Look back through your families, you and their father. Can you recognise any odd, gifted or simply 'different' members of the family? Think about their stories, what worked for them and what didn't.

Marg

 

[Kjs]

Hello ella. Your story is familiar. Only my difficult child is Occupational Therapist (OT) adhd, definately ODD/ bipolar not otherwise specified. However the same issues. We started about the same age as your son. Most of the kids here are gifted as well. And as you will soon learn, these wonderful bright children are quite the challenge.
School also thought difficult child was bored. Not doing anything, class clown, getting in trouble. After our first conference the counselor (now a dear friend) asked for permission to test him. We were so proud to think of how gifted he was. not knowing what a challenge we were in for. They transfered him to a more "challenging" first grade. Same issues. Good teacher. Then second grade. Issues became more frequent and more disruptive. Even though the school has early childhood programs, programs for the remedial kids, there was nothing for the advanced kids. so, the decision, along with many counselors, School District and teachers, was made to advance him a grade. keep him challenged. Same issues, good teacher.
He entered Middle School at age 10. Friends have always been hard to come by because of his outbursts, so he wanted to be popular in this big school. Chose friends that were same grade, 2 years older. Was caught with drugs..AGE 10. By semester we were given the option of special education or expulsion. We transferred him to Spec. Ed. and he finished the year much better than he started. He seemed to mature over that summer, gave up those friends and went to the more preppy, cheerleading group. (by the way..drug tests were weekly. All, including first one came back clean)Honor roll second qtr 7th grade. Now, refusing work, refusing to go to class, student/teacher conflicts, peer troubles. Has a reputation. I have spent 6 years fighting for him. His father is blind to the fact he has any problem at all. I have gotten upto as many as 5 calls from school a day. I quit. I recently just gave up. I cannot take the disrespect he shows me. the yelling, the name calling. Not violent thank god.
I am babbling, but the point I want to stress, is if the option of advancing a grade is mentioned please think deeply about it. We would never have done it if we would of known how hard it is for him with peers who are so much more emotionally and physically mature. They simply won't put up with him. Breaks my heart, but true. If he settles down, and applies himself, or atleast does the work, he will enter his senior year of High school at age 16. it is very hard on us, and it is extremely hard on him socially.

 

[Sheila]

Wanted to say hello and welcome.

 

[timer lady]

Just popped in to say "hi" & welcome.

 

[Big Bad Kitty]

Hugs and welcome, you found a very safe place. Lots of experience and empathy here.

 

[DDD]

Welcome aboard. DDD

 

[Crazy-Steph]

Welcome! There is lots of good support and advice here!

 

[EB67]

I am SO overwhelmed (in a GOOOD way) by the support! I'll stat to reply to the questions...

>>Have you read The Explosive Child by Ross Greene?

I'll have to add it to my library- I have The Angry Child and The Difficult Child, but not that one. I will read it.

>>Do you know why Seb is refusing his medications? Sometimes it's the way they taste or the way they make the child feel or something else entirely.

I think there are a few things at play. First and foremost, he is averse to the idea of having ADHD. He just plain does not want to have it and taking medication means owning the diagnosis.

The other issue is sensory. He can't swallow a pill and I have tried every possible delivery method with his input. We have placed it in his favorite things and still he acts as though he is being tortured. You should see the very carefully carved pickle filled with Adderall or the Adderall Marshmallow sandwiches I've made. Then there was Adderall ice cream, Adderall pudding... All rejects. All promted hysteria.


>>One other question: What kind of doctor diagnosed Seb?

Seb was diagnosed by a pediatric behavioral neurologist whose practice is limited to ADHD, Aspergers, ODD, Tourettes. He is a big proponet of The Syndrome mix and just published a book on the subject. I was about to say WE like him-- I am not sure how Seb feels about him. Last time we saw him Seb told me he thought that "the guy has issues". Which he does. The doctor himself has ADHD as do his sons. He's brilliant and an expert in his field but nutty as the day is long.

In fact, we are off to the doctor in an hour! Hopefully for some new medication as well as some ideas on how to get Seb to cooperate with taking his medications.


>>With ADHD-like symptoms, sensory issues, oppositional behavior and a gifted IQ, there's a chance you may be looking at Asperger's Syndrome (I'm not diagnosing over the internet, just throwing out the possibility in the event you haven't considered it).

I appreciate your thoughts there and I will ask the doctor what he thinks. Something tells me that Seb doesn't fit the model but I am probably generalizing and unable to say so. He just seems very socially adroit even though he fails to see the difference between himself and adults (and therefore has trouble respecting authority).

My fear, my niggling litttle fear is that there may be some bi-polar. My mother is bi-polar. I see depressive qualities in Seb. I'm terrified of bi-polar.

>>Kids with AS frequently need specialized interventions both at home and at school to help them succeed.

Oh yes, Seb has a-plenty of interventions. He's been receiving services for Occupational Therapist (OT) and classrooom accommodations (things like a sit-upon, a dynaband on his chair to kick, a seat by the teacher). He's also been getting diferentiated work. And our 504 meeting is at the end of the month.

MANY thanks!!

Ella (who sees that she needs a signature. To follow)

 

[EB67]

As smallword mentioned we don't diagnose here but we can give you some direction on where to start and this site has some basic information. If it rings a bell we can provide you with more direction.

http://www.aspergersyndrome.org/

Rings more than a few bells I tell you.
The only piece that doesn't fully fit is the social one as he is very outgoing. Though he does miss social cues at times and has almost no threshold for frustration. He does avoid eye contact. He does appear to be "a little professor".

I could furnish examples that would make you laugh or cry or at least roll your eyes... Suffice it to say whatever you know he knows more (according to him). In spite of my advanced education he views me as a complete idiot (and has told me that he's amazed that I have advanced degress as I know nothing). Yesterday he wrote a poem in class called "Antidissestablishmentarianism". Need I say more?

>>What types of specialists gave his diagnosis's? Has he been seen by a developmental pediatrician or neuropsychologist? As a whole, we've found those two speciality areas to be most reliable in pediatric diagnoses.

Interesting. He is seen by a pediatric behavioral neurologist (SHOOOT I literally have to run to get him and take him there NOW). Do you think a different doctor would be preferable??

Ella

The Explosive Child changed our lives, literally.

 

[SRL]

My difficult child has Autistic traits but falls short of the clinical diagnosis of any of the Autistic Spectrum Disorders. He started reading when he was 2, had a memory that astonished us, had sensory issues that ebbed and flowed, and was much more social and verbal than the typical Autism Spectrum Disorders (ASD) kid. Oh, and did I mention oppositional? Once in all seriousness he informed me that he was the ruler of our house.

Those of us who have been around here for any length of time definitely understand the overlap of symptoms for the various syndromes we typically see through here. But we have also seen some trends that tend to emerge within the various groups. For instance, undiagnosed Autism Spectrum Disorders (ASD) kids frequently look bipolar and often their social differences become more pronounced as they get older. There also often is a grey area between profoundly gifted and Asperger's. Even if you don't think he fits the full clinical description, you might be able to find some good help from the AS camp as I did.

How does he do with these questions on play behaviors if you answer from birth to present?
2) Does/did the child
a. Favor objects for play that aren’t typically used as toys by their peers (such as wheels, sticks,
magnet letters, etc.)?
b. Seem fascinated or obsessed by objects/topics that aren’t typical for kids of their age (such as
numbers, the alphabet, words, math, geography, mechanical things such as air conditioners or vacuum cleaners, things with motors, etc)?
c. Play “differently” with toys or household objects (such as spin them, line them up in straight
lines, set them up in formations, etc.)?
d. Exhibit weak or unusual pretend play skills such as:
-act out memorized scenes from books/films/TV/DVD instead of
creating situations and dialogue
-move toy trains around but not pretend to be the engineer/go places/pick up passengers
-arrange pretend people or action figures but not create imaginary situations with them or have them interact with each other, etc?
e. Display behaviors and/or routines that seem unusual or quirky?

Again, we aren't professionals, but in my opinion it would be worth taking a further look because there is something to pinpointing down a diagnosis or nearest diagnosis that can help you beyond interventions. Because I know my child struggles with executive function, sensory, anxiety, rigidity, and egocentric thinking stemming from in the neighborhood of Autism I am better able to stop and think "How is this going to impact difficult child" or "How is he thinking" before speaking, acting or planning. It's made a huge difference in my ability to find strategies for him that work.

It wouldn't be uncommon for an oppositional child to not want to own a diagnosis, especially if they have a rigid thinking patterns and/or egocentric nature. You might want to keep this in mind as you deal with further issues. I've never specifically identified any of my son's diagnoses with him for this reason but treated each issue just as I would with any other child's issue in our house.

Check the drug company websites: most medications come in liquid forms. I opted not to tell my difficult child about the medications because I knew every single day would be a battle. Rotated the foods I hid them in and that did the trick. Some pills can be crushed--check with the pharmacist on that--and swallowed more easily.

 

[SRL]

The average age for a diagnosis of Autism in the US these days is something like age 7, older for atypical kids.

Pediatric behavioral neurologists isn't a common specialty so I'm guessing you live near a large metropolitan area. If that AS site rung bells all over the place, I'd be a little suspect if the doctor never even brought it up as a possibility.

If you are already working with a doctor with expertise in this area I would request that s/he assess specifically for Asperger's Syndrome, including using one of the more reliable diagnostic tools such as ASDS. If he won't do it, I'd probably go with a pediatric neuropsychologist for a second opinion since you've covered the medical bases. In the end it may not change interventions but then again you never know. For instance, I know of AS kids who are brilliant but because of executive function and/or attention problems need a 1:1 aide to function in school.

 

[CCRidr2]

Ella,

Welcome! I am fairly new here but not new to being Mom to a difficult child. Our difficult child was on Adderall XR for a while but we took him off of it and switched to Focalin XR.

The problem with Adderall for our difficult child was it made him feel "kind of fuzzy". I imagined that meant kind of the same feeling you get when you take cold medicine. He never refused to take it because in our house that is NOT an option. Dad would come home from work ready to rumble if he ever pushed me.

We have found the Focalin does not give him the same "fuzzy" feeling or the headaches that he seemed to get on the Adderall. My suggestion is to sit down with him in a calm setting (not easy, I know), maybe a car ride to the store, and ask him in a very nonchalant way if he feels ok when he takes the Adderall. Whatever his answer is, good or bad, reassure him that you didn't know what was bothering him and you'll call the doctor and see what you can do to fix it.

You may find it just makes him feel "not himself", like Ritalin did for ours, and that may be all there is to it. I always make sure teachers and others in contact with our difficult child when we switch medications so that if they notice something that we miss we can know right away. Just make him comfortable in his own skin and reassure him if he feels "weird" or anything out of the ordinary he can come to you to fix it.

Hope this helps! Again, Welcome! I have found this to be a very soft landing spot for the weak and weary.

Cyndi

 

[SearchingForRainbows]

Ella,

The others have already given you excellent advice. I just want to add my welcome and let you know I'm glad you found us. WFEN