New to Forum/difficult child home from inpatient tonight

[tJoy&sRose]

Hello! I am new to the forum. I stumbled onto the site while doing a google search while I'm at home waiting for my SO to get home with our difficult child (7, adhd, odd,cd, possible cobd). Over the last couple of months we had been seeing an escalation in difficult child's oppositional and aggressive tendencies which culminated into two days of him acting out violently towards another child and my SO and myself. He was admitted inpatient on friday night and is coming home tonight. They changed/increased medications, now he will be taking stratterra, risperidone, and clonidine. We had a family meeting with the doctor today which was hard to swallow. The doctors prognosis included such phrases: will be hard to comply to societal rules, will require behavior modified classroom, in home care, residential treatment, genetics is playing a dominant factor (father of difficult child is incarcerated, ADHD, Bipolar), and is/will not be easy to parent throughout development. I guess I'm just looking for other sources of ideas and support to continue in the battle we've already been diligently fighting day in and day out (my SO MUCH longer than I have as she is mother). Ironically this is the first time in my life I've been entirely grateful of my own mental illness (bipolar, adhd, childhood Reactive Attachment Disorder (RAD)) as I hope that my life experience and knowledge is something I'll be able to answers in and be an example for our difficult child.

So, I look forward to sharing with you all and hope to gain as well as give through this forum.

 

[Andy]

Welcome!

It does sound like you have a long road to follow that will have lots of ups and downs and twists and turns.

My 1st advise is STRUCTURE. Find out what the bedtime routine was at the hospital and implement that tonight. When my difficult child came home from a two week hospital stay, he had just turned 11 years old and confided in me that he was "a little homesick of the hospital". The strict bedtime routine gave him a sense of security. We did not keep it as strict as the hospital has it, but for a quite a few nights that tight schedule made transitioning to home easier. It will loosen up naturally.

Then, set a Structured morning routine. Your difficult child can help make a picture poster board of each thing. Help him find pictures in catalogs and write up your morning - get up, bathroom, brush teeth, get dressed, breakfast - in whatever order is best for your home. Give him daily rewards in following the routine without refusal.

In this day and age, a daytime routine seems so hard to adhere to but if you can find one I think you will that it will also help. It is the hardest for me to do because I hate structure - I hate doing the same thing over and over and knowing that each day will be the same. However, many kids thrive on it - it keeps them from getting too overwhelmed with life - they have a hard time with surprises, new things, transitions, ect.

Be as positive as possible with instructions. Kids pick up negativity even when it is not intended. Instead of saying, "Please get dressed" try "We have to leave in a few minutes, do you have enough time to get ready?" or "Put your toys away" try "Once your toys are picked up, you can watch that movie."

Anytime your child senses something negative, he will try to push it into a power struggle. Keep your focus on the situation and not how it is making YOU feel. Do not acknowledge your frustration or anger to your child. That is something you can bring and vent to us - we so much understand!

Let your child know how much you love it when he is doing a good job at anything - no matter how small it is. Let him know when something he did has helped. "This morning went so well. You are very good at getting dressed by yourself" "I loved having you help me with breakfast. You made a great choice of having pancakes."

For rewards - Tend to stay away from food unless it is a choice of a snack or meal (you provide the appropriate two things to choose from). Time with you is the very best - when bedtime goes well, an extra book read. If the morning goes well, a walk on nice days, a quick game when you have to be inside. Make the walks an adventure - have a theme for each time like, "Today we are going to count the mailboxes."

 

[tJoy&sRose]

Thanks Andy for the supportive words and advice. We do try to keep many aspects of the day as structured as possible. One of the biggest struggles with our difficult child is something the doctor talked to us about today which is an apparent total uncomprehension of cause/effect whether thats good behavior = positive reinforcement or the bad behavior = negative result. Its a struggle when any trivial trigger can create "the meltdown". Wondering if anyone has advice in regards to handling the situation where anything that doesn't happen exactly to difficult child's ideas, specifications, or desires causes outbursts. I totally understand "picking your battles" and we do this as much as is reasonable.... guess i'm feeling stuck without a solution.

 

[timer lady]

Hi & welcome.

Andy's suggestion of a routine is good. Many of our difficult children struggle with the concept of cause & effect.

With the tweedles we had a routine & a lot of if...then lessons. We work on it in therapy, in ADLs, in school, etc. Life is full of cause & effect & it's an important concept for our little wonders to grasp.

Saying that, with maturity it becomes a bit easier. In the meantime, all the diagnosis's will change many times over - take my word on this. difficult child is too young to be considered conduct disordered & far too young to be giving out a prognosis so negative. There's a lot of childhood left for difficult child to learn, to grow.

 

[Andy]

How about trying to point out the obvious in even the things we take for granted.

Some examples:

When you give him a hat to wear, say, "There, now your head will be warm."

When he brushes his teeth, say, "Now your teeth feel clean."

When he picks up a toy, say, "Now the floor looks nice."

After awhile, he may catch on that when he does something, something else will happen even if it is very natural.

Play board games - make a point at the beginning to make an "adventure" out of who may end up with the loosing end. For example, when playing Candy Land, say, "Who do you think will get the piece that sends us back to the beginning? What should we do when we get it?" Have something fun planned like the person who draws the card gets to have an extra book read at bed time. That way if he finds himself loosing, it is still a positive experience - when things don't go well, we change our plans - we learn from what happens.

If he is interested, find ways that he can help in meal preparation. That teaches time management and has lots of cause and effects opportunities. If the toast burns, we don't get upset, we just start over and lower the setting of the toaster - no big deal. If he can see how you manage these setbacks, he will learn that getting upset isn't necessary. So, when something doesn't go your way, go ahead and let him know what happened and how you handled it. "difficult child, on my way home from work today, a train went through blocking traffic. I was a little upset because I needed to get you on time. So, I found a way around that train - I was able to turn around and go to the street that goes under the train. No train is going to keep me from getting you." Hope that makes sense?

 

[Red Chief]

Hi, and welcome from another new member.

I wish I had some advice to give you. We are going thru much the same thing with my difficult child. There is a lot of good advise going around this board. I will definitely be monitoring this thread for ideas too!

I can give a little advice though. This may be something you already know, or it might not pertain. Sometimes after a kid gets out of a hospital stay, they may express a desire to go back, especially after getting in trouble or having a break down. My daughter did that just yesterday; she's going to a daytime outpatient program and she intentionally had a temper tantrum trying to get admitted into the hospital. Normally, they would have admitted her, as they had to hold her down & sedate her. But her doctor didn't buy it. Her doctor explained that it is a common thing for kids to do because they find it easier to stay out of trouble in the controlled environment. So watch out for that. I'm not saying that you shouldn't take him back if he or you really feels it necessary, just beware if you seem to get a lot of requests to go back.

Good luck!

 

[gcvmom]

Another welcome here!

If you get a chance, take a look at the book "The Explosive Child" by Ross Greene -- should be in your local library. It has some very helpful ideas for managing kids with hair-trigger tempers, regardless of the cause.

While I know it feels very gloom-and-doom hearing those words for the first time from a psychiatrist, and indeed, it IS a very hard job, it is not an impossible job. The best you can do is to educate yourself on all the aspects of having a child like this, from the types of supports for the school environment, to medications, to behavior modification techniques, and so on.

If you've never taken a NAMI Basics class (which are generally offered free of charge) I highly recommend that for both you and your SO. Even with your own personal experience with mental illness, the class helps you deal with the emotions of having a family member with a mental illness, introduces you to other families grappling with the same issues, and provides you with resource information for your area. NAMI has their own website that you can visit to locate a chapter near you.

 

[Wiped Out]

Just adding in my welcome. Glad you found your way here but sorry you needed to.

 

[tJoy&sRose]

Thanks for all the welcomes and wise words. It's been great to be able to read and share with people in like situations already. Because of my own mental illnesses and my insatiable thirst for information and more and more and more information I can out talk a lot of doctors on many disorders and psychopharmacology, etc. LOL But now that its not myself I've found myself in this whole new realm of unconditional love mixed with overwhelming concern, stress, and frustration and for the first time am so appreciative of a place just to "vent" and exchange ideas and real life experience. I know there are big reasons the universe brought me into my SO and difficult child's life and I can only hope I fullfill them to the best of my ability so I'm gonna need all the help I can get

 

[BusynMember]

Hi there. I'm sorry you are having such a hard time.

I've had over thirty years in the mental health system and I can tell you right now that psychiatrists can be wrong about adults, let alone seven year old kids. It took me over ten years to get the right sort of mood disorder diagnosis and didn't get my most pressing diagnoses (borderline personalty disorder) until I was 56...lol. Not ONE professional figured it out. I had to do it and now everyone listens to my explanation of my old behaviors and says, "Oh, yes, it was obvious!" Lots and lots of therapy and two great medications had changed my life already, but not one doctor had ever figured out what the raging and freaking out had been about. They helped the symptoms, but never figured out the core disorder. I'm not even sure it's that important as long as you are getting adequate help for the symptoms.

Your psychiatrist is assuming that because your boy's father is incarcerated that he has a higher chance of becoming antisocial. While that's true, it also isn't the bottom line. I have four adopted kids. Two of the kids have parents who are incarcerated. These two kids are the best, sweetest kids on the face of the earth. Biology CAN factor in (kids can inherit the personality characteristics that tend to cause criminal behavior) however it is not written in stone. Whoever pretty much said that your child is a hopeless case already may think it's true, but that doesn't make him right.

I strongly suggest that you take your little guy to a neuropsychologist to see if he has any underlying deficits or disorders that are causing his behavior. A lot of things look like ODD/CDish behaviors. At that age almost all disorders mimic one another. Another thing I caution you on is that Straterra is famous for making violent kiddos even more violent. It can take a month or two before the violence kicks in (it takes a while for the drug to build up in the system), but I'd never put my kids on Straterra...nor any violent kid of any stimulant either. He sounds more severe than ADHD. If he needs interventions in school for concentration in my opinion that's better than having his moodswings and violence.

Besides the neuropsychologist evaluation, which many of us feel is the best diagnostic tool there is (6-10 hours of intense testing), I'd find a new psychiatrist. I had one psychiatrist tell me about my adopted son, "There is no help for THESE kids." He was sure the boy had fetal alcohol problems and he said it right in front of my kid as if he weren't a person.

My son dodoged the fetal alcohol bullet and although had some late development problems and is on the high end of the autism spectrum, he is the sweetest, kindest teenager I know. He is also on the honor roll and the psychiatrist was 100% wrong about him.

Every diagnosis is just one opinion. This opinion wasn't very helpful. I'd get a fresh perspective from other professionals who don't know this man. I wouldn't tell them what was already diagnosed either. I'd let them draw their own conclusions. We did this many times with my son. The older he got, the easier it was for them to see the Asperger-like behaviors and they stopped saying he was defiant because he isn't anymore. He had a lot of school interventions and that helped TONS.

I hope you give someone else a chance with your son and hope things improve for your family. And sorry for the tough times...I know how it is, trust me.