parenting question

[houseofcards]

I have an 8 yo difficult child who I believe is bipolar or in the developmental stages. His first p-doctor diagnosed BiPolar (BP) when he was 5 and unmedicated. The next 2 p-docs want to see adhd and to focus on that. They add mood disorder not otherwise specified but they try to ignore it when it comes to medication( he is still on a low dose of Zyprexa, but they always want to add stims). Has anyone successfully changed the mind of a p-doctor that doesn’t get it?, how?
I have experience with adhd and believe that it responses to tough parenting, i.e. when a teacher once told me the kids get 3 chances in her class I started laughing and told her just punish the behavior, no chances. My son was smart and bored and loved to see if he could get 4 chances or tick her off before he was given 3...it just made for trouble, also I learned to not explain myself because he had an argument for everything.
I don’t do that with my difficult child that I believe is BiPolar (BP). It isn’t effective. I need to put up with more minor stuff and I need to reassure and comfort a great deal more. He can’t handle the frustration and perceived rejection it would create. It also just wouldn’t change his behavior I already tried that. I see anxiety at the root of a lot of his trouble and have been trying to get him to see it and learn to calm himself with very little success. Still when he messes up big he is punished, but he gets away with a lot of little things. My second question is about when do you hold your child accountable, as the world will? Am I off base to think it has to do with whether he is trying to learn better behavior? Or should I keep trying to get the standards the same for him as the other kids just shy of the point that he starts to fall apart? I thought I was waiting for the magic pill that would make everything alright but I am beginning to doubt it exists and if it does, it doesn’t seem to be going to be available for my son for some time so I am done waiting on it.

 

[Sunlight]

I do not know if you can change the mind of a p-doctor but you can certainly inform them of your experiences. they are always learning too.

as for when do you hold your child accountable, as the world will???
it really depends on the child. school has one set of standards that the child must adapt to. I think at home, the family adapts somewhat to the child's needs.

 

[OTE]

In my experience with a LOT of psychiatrists because of all the places my difficult child has been...there are only a few who will re-think their position. Sometimes they won't even give you 2 minutes to explain your position. But every once in a while you get one who is willing to listen and think. Personally I find it best to make my case for something short and to the point. Their attention span is VERY short. First time I would present my position. If they close down then I just play a waiting game. Every time we see him/her I use an example of something that happened since the last time we were there to make my point. Something that could NOT be from their diagnosis, but could be from mine. Enough time goes by, you reimind them of all the cumulative evidence after a period of time and hopefully they'll at least consider it. Making a mental health diagnosis on an 8 yr old is smoke and mirrors anyway. They know that.

When to make the child accountable in my humble opinion... from toddlers. With several kids I don't find it possible to have rules for one and different rules for another... no matter what the disability. Sure, comfort, don't do something that's going to cause a meltdown, make the consequences different for each kid as much as you can, but don't ignore the rules because of a disability. One of my Pervasive Developmental Disorder (PDD) kids' school aides recently saw us coming from the grocery store. She was stunned that I had him hauling groceries around like his bros. in my humble opinion, if he's physically capable he does what all the others do or has consequences (typically not getting a treat).

Have you considered Pervasive Developmental Disorder (PDD) for this child? Lack of attention, low frustration, perceived rejection all requiring unusual level of comforting from adult, anxieties, seeming inability to change "wrong" behaviors... all could be interpreted as Pervasive Developmental Disorder (PDD). Pervasive Developmental Disorder (PDD) is often co-morbid with BiPolar (BP). In other words, you can't get him to change the behaviors now because you don't understand why they exist.

 

[Lothlorien]

When you find the right doctor, let me know who he/she is.

I'm in a similar situ. I think you need to make adjustments for what works for each child. At this point, you should hold him accountable for what's necessary in your household. If he can't handle certain things, then drop it and bring it up again in a few months. Bring up the standards as he gets older and matures more.

 

[timer lady]

I've learned to wait the psychiatrist out. Seriously, each appointment I would go in & mention the possibility of adding a MS & dropping the stimulant. It took about 6 months with some additional articles for him to read.

Having said that, our difficult children are a work in progress. I expect the tweedles will have several diagnosis's over the course of their years - they simply started out as ADHD. Now that's been dropped & others have been diagnosis'd.

In the meantime, I'd allow for "some" of your difficult children deficits. If he cannot sit still through dinner let him stand at the table. As your difficult child matures you will be able to add in the world's expectations, keeping in mind that your difficult child may never be able to meet those expectations.

While the world won't take into account our children's illnesses, I'm already working on transition care into adult hood. Looking into group homes and such. And praying that level of service won't be needed.

Don't lose hope - there's a lot of time between 8 & 18 years of age. There's a lot of time for changes, improvements or the status quo.

Plan for the worst, expect the best. :warrior:

 

[Allan-Matlem]

Hi,
Restitution or fixing damage etc is best at the end of the problem solving process, once the kid has a vision for the future. Accountability is the respnsibility to put things right and to try and come up with a better plan , not paying a price or receiving punishment

Elie Newberger - The method of withdrawing privileges is essentially negative: I can't communicate with you, and so I'll hurt you if you don't mind me. The positive counterpoint is: We all make mistakes, and you can trust me to help you do better in the future.

Allan

 

[BusynMember]

On the psychiatrist question, if you don't trust his judgement, I'd switch to somebody better. You want want to get a neuropsychologist exam. They do intensive testing and often get to the root of the problem where others just seem to take guesses. I personally give a doctor six months for improvement, and then move on. I won't give my son medications that don't help, even if they're prescribed. I tossed many bottles in the garbage. Not recommending it, but they said my son had ADHD and the stims made him worse, so why give him stims? I didn't. Good luck.

 

[transformtriumph]

[ QUOTE ]

I thought I was waiting for the magic pill that would make everything alright but I am beginning to doubt it exists and if it does, it doesn’t seem to be going to be available for my son for some time so I am done waiting on it.

[/ QUOTE ]
It would be terrific to find a magic pill but there isn't one. Our children are complicated and require comprehensive plans to help them learn to manage their behaviors and moods. The plans have to include teaching them skills that they will need for their whole lives.

 

[amy4129]

Has anyone successfully changed the mind of a p-doctor that doesn’t get it?, how? I have experience with adhd and believe that it responses to tough parenting,

[/ QUOTE ]

As far as changing a psychiatrists mind I would suggest you have a neuro psychiatric evaluation and gain more insight into your son's diagnosis. Whatever it turns out to be, ADHD, bipolar.
As far as the ADHD and your experience goes- I'm really not sure how on one hand you want the best for your child and lump all adhd children as a parenting issue. in my humble opinion I found your comment thoughtless to those of us who fight tooth and nail to do the best for our children regardless of the diagnosis and how ordinary it is.
Amy

 

[Janna]

Well, here's my .02 coming from a parent with a child that has ADHD AND another child that is Bipolar.

I treat all of my children exactly the same and give them all the same expectations. Chores. Homework. Rules. Consequences. Rewards. All equally.

I started a rigorous behavior modification about 4 years ago. This was before we knew Dylan was Bipolar. Before we knew easy child was ADHD. I just knew my kids were out of control and they were taking advantage of me big time.

Once I learned to say what I mean, mean what I say, and keep to a pretty strict regime of rules/rewards and consequences, it got better. It took a LONG time to get to where we are today. In all honesty, Dylan, my Bipolar child, did okay 50% of the time. Unstable on medications, it was very hard for him, but we always kept the same rules for him that we did for all the others.

For me, I am not going to allow my child to grow up saying or thinking "oh well, I'm Bipolar, I don't have to....." or "oh, well, I'm Bipolar, they can make a special exception for me", or any other sort. I'm trying to keep him as normal as normal can be. And you know something? Now stable on the right medications, I have absolutely no issues with him. The "ODD" - gone. He gets up in the A.M., no issues, is the first one ready for school. Comes home, lays out the book bag, does homework, gets his shower, does his chores, the whole nine. I don't even have to ask twice. If he doesn't do something, he knows the consequence.

I'm not a big advocate on going easy on children because they have "issues". I agree they need some interventions, therapies and help along the way, but that shouldn't be forever.

And if you're not comfortable with the psychiatrist, I'd find another. I've had enough idiots give us an ADHD/ODD diagnosis. Don't need them.

Janna

 

[houseofcards]

Thank you all for your replies. I am at a frustrating time and alot of other things such as my mothers health are piling on. I will continue to mention the behaviors as I see them but I don't thing the p-doctor values my insight. I will also try to get others like his teachers to give their insight.
As far as behavior that I ignore where I wouldn't with the other kids, when he is upset he will run upstairs, slam doors, and kick toys. Punishing it does nothing so I don't unless he actually destroys something...instead I am trying to teach him other ways to get the same release without appearing so out of control I believe dreamer gave an article that speaks of this that I found very helpful. I also don't handle the lying/stealing that seems to occur in cycles as I would with the other kids, in part because there just isn't any shock about it anymore. I do make him give restitution/ and he loses my trust for awhile until I believe he is back to the kid that knows it is wrong and is trustworthy. For instance he has been finding money alot lately(small change), even from school. Now I asked him his exact amount that he has and I keep track..any other money goes into the family money jar unless I know who it goes to. If my other kids were to steal I would be shocked and they would understand how badly they messed (at least in part) up by my shock.
I also think I need a neuro psy evaluation for him, I will put it on my list.
Amy, I misspoke if I implied I understand all adhd, I think I understand my now adult son with adhd. This child just doesn't seem to be like him in some very intense ways. I didn't mean to imply that adhd was easily dealt with, My husband had to become a Cub Scout leader when my son was younger because I didn't want to dump his behavior on anyone else and in an unstructured group he was a challenge.
Again thanks for the replies, I love this place and the insight it gives me as well as the comfort of just not being alone in this.

 

[kris]

<font color="blue">i'm thinking a new psychiatrist is in order. i know...no one likes to change psychiatrists, but sometimes there is nothing else to do. i'd look for someone who is first, more suited to listneing to your input & second, more open to childhood onset bipolar. i think once a doctor, any kind of doctor, makes up their minds it's hard to change them. an aweful lot of psychiatrists seem to have a *favorite* diagnosis.

i agree that kids must be held accountable for their behaviors.....even kids with-multiple dxs. by the time they hit 15/16 society will not look kindly on them no matter what their issues are.

personally i would not take on all the issues at once. if you haven't read The Explosive Child do so now. if you have read it....read it again. this is where greene's basket plan comes into play. pick two issues ~~~ one basket A & one basket B ~~~ & work on those....then as he becomes more responsive & compliant you move a basket C to B & the B to A.

it's a process....not a quick process nor an easy one. it's a good food takes time mentality.

just my two cents.

kris :smile: </font>

 

[Hound dog]

Sounds to me like you've got a pretty good grasp on your child and his behaviors. There is no magic pill. Although medications can make a difficult child stable, which makes a world of difference. Sometimes finding the right medication at the right doses can be a challange all it's own.

There are alot of psychiatrists out there who won't diagnosis bipolar before a certain age even if it is cut or dry. If it were me, I'd write down my concerns and really discuss it with psychiatrist. If that doesn't work, I agree with Kris, it's time for a new one. If psychiatrist isn't addressing difficult child's problems he's not doing either of you any good anyway.

It stinks to have to find another psychiatrist. But it's better than having difficult child not treated.

Hugs

 

[Sunlight]

aw allan...this is such a loving and wonderful statement:
"We all make mistakes, and you can trust me to help you do better in the future."

My philosophy with ant but I would add:
We all make mistakes, and you can trust me to help you do better in the future-IF YOU WILL ALSO HELP YOURSELF.

 

[Allan-Matlem]

Hi,
Kids have to see themselves as part of the solution and have a vision for the future.
Rewards, punishments and consequences gets in the way. Instead of reflecting on one's actions and the consequences they have on others and one's future , reinforcements just teach the kid to ask the question , what's in it for me , what will I get or what will be done to me , instead of reflecting about what type of person do I want to become , what kind of school, classroom , family or community do I want these social units to be. Sometimes , serving a consequence is taken by the child as I have paid a price , I don't need to change. Maybe I will start a thread on parenting philosophies. I have always been an advocate of ' working with ' , problem solving approaches like Collaborative problem solving - Explosive child , Myrna Shure series etc as opposed to ' doing to' a kid. The author Alfie Kohn - Unconditional parenting has rounded my parenting approach by talking about education and character building. He also wrote a book on schools whose principle applies in the home as well - from Compliance to community - as the title implies if kids are educated to expereince intrinsic reward and fulfillment from being cooperative , caring and kind , take the perspectives and feelings of others into consideration, understand the value of a community , you can move away from control and compliance.
http://alfiekohn.org check the articles
http://empathic-discipline.com/talk/YaBB.pl - forum that focuses on ' working with' approaches like UP - unconditional parenting , NVC - non violent communication , the Explosive child , Playful parenting. Although not specifically for difficult children , I think parenting philosophies do influence our approach to kids and even more so when we are passed the been there done that stage and see parenting as something more than just becoming functional and putting out fires.
Education is a long process, we don't want to change behavior , we want to change the person

Allan

 

[houseofcards]

Allen, I would like to get to what you are describing but my question would be how do I get a child involved in the solution when he doesn't believe there is one. In other words, when my son loses his self control he doesn't believe there is anything except waiting it out that works. I have tried to talk softly and supportivly encouraging him to do his deep breathing or practice kind "self talk" but he will just screams it doesn't work and starts in on how he hates everyone and nobody loves him. The more I reassure at that time the more things increase in volume and nastiness. He can go on and on with terrible negative self talk which he seems to believe at the time. Twenty minutes later it is another story, I can reach him and we do talk about a better way to handle it, I tell him that his mind is trying to trick him at those times and he shouldn't let himself be tricked, I ask him what would you say to a friend that is going through the same thing and he can come up with much kinder thoughts, I start to think I have helped him see a better way and then the whole process repeats the next time he is a little frustrated.
As far as raising kids that care about their place in the world, he is a generous, thoughtful kid. A teacher told me the story of a time when he was tossing all the books out of his desk in frustration and he accidentally knocked a book off another students desk. He immediately stopped his fit and picked up her book, placed it back on her desk, apologized and then continued on with his outburst. Another time he was just being a little boy and batted at an object hung in the school hallway, it fell down. He said he wasn't trying to do that and dug in his pocket and gave the teacher a dime to make up for it. ( We both thought it was very sweet but we also had to wonder where he took the dime from LOL) There are just times when he really doesn't seem to be able to regulate his emotions and I haven't been successful at finding a way to help him.

 

[Martie]

Thanks, Allen.

Alfie Kohn is speaking in Winnetka (very small place I live) on January 31 on why Homework doesn't help. I am going to go hear what he has to say.

Given his stance on competition and rewards, I wonder why SD 36 is sponsoring him. The competition is more than crazy on the North Shore--and I see it as fostered by both the schools and the parents. A change of heart, maybe?

Thanks for the information.

Martie

 

[dreamer]

Kathie- I saw you did read my post about stress, anxiety, panic etc.....

and you replied to it.
(thank you )

I just wanted to say- for your 8 yo? You can read those to him (her?) but....at 8 it might not make much sense.....(I suppose it depends on your 8 yr old)
and DURING a rage or meltdown or anxiety attack, you very likely might not "reach" thru the anxiety level to try to work on relaxation to teach it at that time, or reach thru to even explain the hows and whys of deep breathing etc.

What was done with my dtr from very early on was to simply teach the concept at a chosen time...NOT during a problem time? Maybe explain at that time it is something that can maybe help feel betetr just in general. Maybe you can integrate some little cue, one word or one specific touch, or a sound? (sometimes during panic, a touch might make a panic attack or rage worse due to hypersensitivity) But at first just practice and link the word or whatever while you teach HOW to deep breathe or relax. and then practice it during smaller stress times, first. It can take practice before it works, and trying to use it once a rage or meltdown has begun migt not work at first.....it is a skill that can take practice to master.
Truth is during major anxiety, rage, panic, etc.....very often peson cannot be reached once the wheels are already set in motion.....and words etc can escalate things, even if you ARE trying to get them to calm down. and things get going with a momentum all their own by then.
Optimally eventually it can be mastered to a level that it PREVENTS an attack, rage, meltdown etc.

Good luck!

 

[Allan-Matlem]

Hi,
When in the moment the empathy , reflective listening and reassurance that you are not in basket A is not working , usually this helps the kid deal with his emotions , I think it is best to distract the kid with some ' thinking ' , not quite related to the problem just to move him out of the subcortex back into the frontal lobe. Out of the moment , problem solve , not only his issues but more important non-emotive issues , ficticious stories, TV , newspaper stories, your experiences . We should try to come up with several alternative solutions and check these solutions for possible stumbling blocks and how to deal with them. If a kid can come up with several solutions he is less likely to become frustrated . This means , non stop dialog and problem solving during the day , becoming a thinker. One could try to help him identify his body reactions and maybe give him something sensory to have in his pocket to touch which could divert his thinking and as mentioned above a cue word. check maybe George Lynn

It is not easy , education is a long process, we need a wider and longer time frame , but every time we involve a kid in thinking , problem solving , dialog questioning , working with , we are building and promoting skills.

Allan

 

[houseofcards]

Dreamer, Thanks, I did read it to him last night and I did have to rephase more then I thought once I got going with him but he did "get" it at the time. I am glad you posted it.

Allen, Thanks for the sites and the advice, I value it. I have been to The Explosive Child site and read the book(my son's school has my last copy now) I admit I am much better at A and C baskets then the B baskets(where the learning really takes place) but I am trying. That book was the first book I read that really "got" my son and I am glad it was written. I still wish that I had more support from the p-docs but I am ready to do what I can to help my kid.