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[Preemie Mommie]

I am new here but by no means new to messageboards.

I am at my wits end up my daughter(difficult child#3). Currently she is upstairs screaming that I am mean and she hates me. As much as it hurts me, I am able to just turn my back and walk away which sometimes stops the screaming.

She was a preemie born at 26 weeks and had a brain bleed while in the NICU along with a whole slew of other medical issues. She has always been a difficult, high energy child. Easily frustrated and easily angered.

difficult child's behaviours are numerous and include: Disrespectful talk to both husband and myself, aggressive with peers and adults, gets along with kids as long as they do what she wants, argues, will not do as she is asked, hits, bites and kicks us, lies, does something wrong and blames others, can't sit still, can't pay attention, talks non stop, destructive, spiteful, and quite honestly a nightmare to be with. She will be 6 in November and is going into grade 1 and is still wearing a pullup and peeing and pooping her pants. Her destructiveness is starting to run me broke!!! She has threatened to kill me and has told both of us to get out of HER house. She doesn't sleep much and has been up until 3 in the morning wide awake more than a few times and going to bed at night is always a battle nowadays.

We took her to a dev. pediatrician a couple years ago who in turn referred us to a behaviour pediatrician that only works with kids that have mental conditions.He is able to prescribe medications but refers out for things like psychotherapy and B Mod etc. He diagnosis her with ADHD and ODD but was reluctant to trial any medications due to her age at the time(3 going on 4).She last saw this doctor in 2005 when we decided we would take a wait and see approach because we had trialed Ritalin and Dexedrine(at our insistence due to desperation) and both were of no help and actually had made things worse as far as rages, crashing and insomnia. We saw a child psychiatric in early 2006 who ruled out ADHD and ODD at that time.

We have been referred back to this doctor to help make sense of what is going on. Our appointment is May 14th and it seems like years away. We are hoping to get an official diagnosis of ADHD and ODD and even more hopeful that the medications may work on her now that she is older. I wonder if a mood stabilizer might help her as well. I know of the side effects and the weight gain doesn't bother me too much since she is only at the 10th %ile on the growth chart for weight anyway.

I am at my wits end and feel a little better getting it off of my chest. This is just an issue that my preemie message board can't fully answer.

 

[BusynMember]

Hi, there. First of all, are you in the US? Secondly, do her early health problems maybe affect the way she is now? A mood stabilizer is not for ADHD that I know of. It is for early onset bipolar. Sometimes, however, ODD kids do well on them, which in my opinion indicates ODD is often bipolar, misdiagnosed. What do the doctors say about her early medical problems and her behavioral problems? Welcome to the board :smile:

 

[Preemie Mommie]

We have had her to a neuro who proclaimed that she is perfectly fine for a former 26 weeker but I'm not convinced. I suspect it could be some of the reason behind her current issues but can't say with certainty. The brain bleed is still considered head trauma and can cause damage that no one knows about until later. We did request an MRI but were turned down flat.

I am an american(from Ohio)but I am living in Canada. I met my husband online almost 7 years ago and he is Canadian.

I have heard stabilizers can be used for aggresiveness with the added side effect of helping them sleep. Both of which are big issues for her.

I often question her early history and how much it has to do with things because when I look at my older kids(#3's half bros)and all of the issues they have and my family, which is riddled with depression(I do not know of a single family member that isn't taking antidepressant medications), plus husband's mental history and my mother in law has Bipolar. Was the poor kid doomed from the start? She truly got a triple whammy.

To give a little more insight:

My oldest difficult child was expelled from school last school year for hitting a teacher. This was after he was put in a class for kids with emotional problems. Things continued to escalate an my mom finally had to get the police involved and put him in a Residential Treatment Facility (RTF). His issues were manageable until he hit puberty and then it went bad in a hurry.

Mr difficult child#2 is gifted and talented and as long as he stays on his medications does fairly well and functions almost like a easy child. He tried to kill himself at age 6 and got the bipolar diagnosis after that. He was diagnosis ADHD/ODD at age 3.

I gave custody of the boys to my mom because I simply could not handle them and my mom could. I hate everyday that it came to that but it ended up being the best for the boys and for myself. I could never imagine 3 difficult child's under one roof. I have the utmost respect for those of you that are dealing with more than one difficult child on a daily basis. Both boys are on SSI and have been for a long long time. Chances of my oldest ever living independently is doubtful.

Thanks for the welcome.

 

[Hound dog]

Is there any way you can get her another evaluation from a different neuro and request an MRI? (not sure how things work up there)

I would say you stand a good chance that alot of her behaviors stem from that brain bleed. But even if they don't, damage from that bleed should be looked into. Depending on amt of damage, where it's located, when it effects behavior it can mimick a mental disorder. You can have major impulse, mood issues, social issues ect. And you could be missing learning problems that have yet to be picked up on.

Welcome to the board.

Hugs

 

[Marguerite]

Having 3 difficult children under one roof - it can be done, but it does depend on what you're dealing with as well as how you're handling it. I don't know if I could deal with any other difficult children, other than my own.

Whether what you're dealing with here is related to the premature birth, the brain bleed or what, I don't think much matters. You can't do anything about those things. An understanding can help a bit, but when it all boils down, you still have to manage day to day.

So, no matter what the case (and the causes can be wide-ranging) there is help. Get a copy of "The Explosive Child" by Ross Greene. Grab a library copy if you can, and see if it strikes a chord. It has made a huge difference to a lot of us.

It's not a cure - all it does is help us understand what our kids are seeing and feeling, day to day, minute by minute. Armed with this, it's easier to find ways to work with the children, not against them. Because kids like this quickly get into the habit of emotional tug of war. They pull away in a dangerous direction; we pull back to keep them safe. This makes them pull harder. It escalates. The trouble is, these kids can be stronger at pulling than we are, and if they win... then the damage can be severe. They learn to enjoy winning and the parent is no longer in the driving seat.

By learning how to not pull against them, you deflect the tug of war and learn to guide them back in different ways.

I know this sounds waffly, but the book explains it in practical ways. There is a newer edition of the book, about 18 months old, but the older book is also helpful.

Welcome - sorry you need us, but glad to have you on board. We can help.

Marg

 

[Preemie Mommie]

Thank you for the welcomes. I am going to go look for that book.It sounds like it would be helpful for husband and I.

What makes it so hard is no one around us understands what we are going through. I try very hard not to tell family too much of anything anymore because they just do not get it and our parenting is constantly being judged to boot.

She's being lazy, she's controlling you guys, you guys spoil her too much, she doesn't act like that at my house and on and on it goes. I'm sure you guys have heard all of that and more too.

Just makes me want to scream sometimes!!!

 

[SRL]

Welcome, I'm glad you found us.

One of the most difficult situations we occasionally see here is that a child with a complex medical history will have a neurological disorder lurking that goes unrecognized because the symptoms can be explained away by the medical condition. ie a child who has had many hospitalizations is extremely anxious but anxiety disorder isn't recognized because it's expected that numerous hospitalizations could be stress enough.

This may not wind up being your situation but I thought I'd toss it out there since you are looking for answers. I've put a link for Nonverbal Learning Disability as that can be a result of oxygen deprivation at birth as well as Autism which can have overlapping symptoms (such as speech delays and sensory issues) with premature birth. Doctors frequently miss these in young children, especially if there are medical complications.

http://www.childbrain.com/pddq6.shtml

 

[Just keep swimming]

Hi and welcome! I was going to post something similar to SRL about possible Autism. Also, hate to throw this out there, but have the docs or therapists looked into attachment disorder? Due to her obvious long stay in the NICU and possible other hospitalizations, this came to my mind. My difficult child was adopted from birth, not preemie, and I was present from birth on. When her therapist threw in the diagnosis of attachment challenged, I was shocked! I mean, we were there from the beginning! How in the world could she have an attachment disorder. doctor explained that ANY significant stress at or around birth and even during pregnancy can cause an attachment disordered child.

Just something to maybe discuss with docs, might help with her therapy.

Hugs of welcome,
Vickie

 

[Steely]

Welcome....

Just my 2 cents, having a child who acted similarly to yours at that age, I would really try and stay away from stimulant medication until you rule out any type of mood disorder. When my son, who is now dxs with bi-polar and NonVerbal Learning Disorder (NVLD), took Rhitalin at age 6, he became suicidal, rageful, and had to be hospitalized. It is my experience that doctors., and maybe society, try to push this type of medication first, but pushed on the wrong little kiddo, it can have horrible repercussions.

Mood stablilizers are hard when kids are that age too....because they are such a strong medication...however, with the right Dr they can be really helpful. I would get her a good neuro psyche evaluation, and go from there. I do not think that it really matters where or how she got the mood instabilization, at this point you can only go forward. A small dose of a mood stabilizer may completely change her life.

The hard thing about these kids is that they are smart, and manipulative, and know exactly how to push our buttons to the point of our own rageful explosions. However, we also have to remember that they are in significant pain too, and that their rages are their cry for help.

Definitely read The Explosive Child, and definitely, definitely, ignore family and friends judgemental comments. They just cannot possibly begin to understand what you - or me - or anyone on this board - go through everyday!!!! It's impossible.......

 

[slsh]

Welcome!

I have to agree with- Lisa that with- the brain bleed, I would be extremely suspicious of a neurodevelopmental issue. My oldest kiddo was a 30-weeker in the days before Surfactant - no bleed but severe hypoxia. I used to stay on top of preemie studies, but at this point... it's kind of old news in our house. :wink:

There was/is an ongoing Canadian study on the effects of prematurity. The last time I read about it was probably 9 years ago, and it had been going on for a decade or more at that point. I seem to recall that they were finding there were more long-term issues with LBW preemies (under that magic 1500 grams), along the lines of ADHD types of behaviors, learning disabilities, etc., as they hit older ages, even if they didn't have the more obvious developmental issues they were at risk for. I can't find the silly study, being apparently google impaired this afternoon, but I *think* it's one of the first and most involved studies regarding growth and development of LBW kiddos as they move into school age and beyond. It has to be in its second decade now - I'm 99% sure it's still going on.

OK, still google impaired, but after searching again I finally found Helen Harrison's name and a good listing on her site about relatively recent research on "normal" preemies (I'm assuming those without CP or other obvious developmental disabilities) and behavioral/learning issues as they hit school age. http://www.comeunity.com/premature/research/helen-packets-comments.html

Not saying that the gene pool :wink: hasn't muddied the waters but, given my bias re: prematurity and its effects, I'd probably head more in the direction of a neurodevelopmental pediatrician first. Can you get copies of MRIs/CTs done while she was in NICU? Might help clarify things or maybe get someone to consider repeating an MRI.

Anyway... welcome and glad you found us!! :smile: :laugh: