Possible New Diagnosis...

[DaisyFace]

As you may remember, we brought difficult child to a new psychiatrist for "psychometric testing"...and one of the first things the doctor recommended was to try a behavior chart.

We soon discovered that the "psychiatrist' is not actually a psychiatrist. Rather, she has spent a career as a Social Worker working with troubled kids in RTCs and Foster Homes, and now works at the University training therapists and counselors to work effectively with difficult children and their families. Wasn't sure what to make of that...

I was quite disappointed to have to use a "Behavior Chart"...and you may remember that the chart I devised was at a very elementary school level. Well, it's been almost six weeks and difficult child is STILL unable to complete even half of the goals on the chart. Her success rate varies between 35% and 45% on very basic tasks.

However, based upon difficult child's difficulty with the chart AND her negative interactions with the family AND her behavioral history--the doctor feels that what we are dealing with is an Attachment Disorder. She further explained that it seems as if difficult child's development has been arrested somewhere, and that's why in many ways, difficult child's behaviors, reactions and responses are still at almost a toddler level.

This is so different from what other psychiatrists and tdocs have been telling us over the years.

I wonder if we are finally on the road to "figuring out" our daughter....?

I am beginning to feel a bit hopeful...



--DaisyFace

 

[klmno]

I don't know DF. How much faith do you have in this SW if she appeared to be a psychiatrist when she wasn't? (I'm hoping she wasn't rx'ing medications.) Was there anything that happened in the past that could have caused an attachment disorder in your daughter? Maybe she is right- I don't know. These kids are so hard to figure out and find ways to deal with. My son never deal well on a behavior contract- as a matter of fact, it always made him much worse whether at home or school. He did do well when expectations/coonsequences were kept completely separate from ways to earn rewards, more privileges or allowance. But as you know, what works for one difficult child doesn't work for all.

 

[smallworld]

First, I would ask the same question as klmno: What would have caused an attachment disorder in your daughter? Attachment disorders don't occur when a child is brought up in a stable home.

Second, has this social worker done any neuropscyhological testing to come up with her "diagnosis"?

Third, many of the kids written about on this board don't respond positively to behavior charts, including all three of mine, and that doesn't mean they have attachment disorders. It means they have disorders that don't respond positively to behavior charts, like anxiety, depression, bipolar disorder, Autism Spectrum Disorders (ASD), etc.

 

[DaisyFace]

K--

She IS a doctor. She has a PhD in Counselor Education, is a professor at the University and runs the Neuropsychiatry Clinic at the University. So when she was introduced to us as "Doctor", the head of the Neuropsychiatry Clinic...I assumed she was a psychiatrist. We were referred to the clinic for thorough testing. No, she is not prescribing any medications.

And no...there is nothing in the history that would indicate abuse, or neglect, or abandonment....she wasn't adopted, she was never in a foster home. There is no event or occurrence that could be considered a 'smoking gun'.

However, this doctor does seem to have an insight into how difficult child functions--or rather, does not function.

For a long time, I have been trying to tell docs and therapists what I have been seeing and feeling and dealing with from difficult child--and for a long time I have been told that I was wrong. This doctor "sees" the same things that I see...and she says that it looks like an attachment disorder of some kind. I asked whether she meant Reactive Attachment Disorder (RAD)...and she said no--not quite like that. At that time, she did not get any more specific...other than to reassure me that it was not my fault.

But, "attachment disorder" is definitely new....and a possibility that no one else has considered.

So I guess we'll see how it goes...?

 

[DaisyFace]

First, I would ask the same question as klmno: What would have caused an attachment disorder in your daughter? Attachment disorders don't occur when a child is brought up in a stable home.

Second, has this social worker done any neuropscyhological testing to come up with her "diagnosis"?

Some of this diagnosis has been based upon her observation that difficult child considers me, her Mom, to be her competition, her arch-enemy. The doctor observed that difficult child seems to have a lot of anger and venom for me--without any sort of reason. difficult child has been talking and writing and drawing about killing me for many years now. Most docs have explained that this just means that difficult child needs more of my attention and that I must not be giving her enough "quality time".

But this doctor is saying--wait a minute. What if this hatred of the mother is not a symptom of Depression--but rather, is the problem in the first place??? (sort of a 'we're trying so hard to see that forest, but we can't because of all of these darn trees?' situation)

And that's what gives me hope...

That someone is looking at this situation in a new way.

 

[DaisyFace]

One more thing....

It was explained to me that there CAN be a genetic, chemical-imbalance or other "natural" cause for a child to have an attachment disorder. Although most times it is caused by abuse or neglect--that is not always the case.

 

[klmno]

Well, I can understand everything you are saying, but in my layman's opinion only I don't see how she concluded attachment disorder from that. Adjustment disorder, maybe, and there are several other things. I'm glad she can see what you see as far as the effect on difficult child and you, though.

 

[Wiped Out]

DF,
Glad therapist is seeing what you are seeing and that you are hopeful you are on the right road. Hugs.

 

[flutterby]

DF -

I'm glad this therapist is seeing what you're seeing and is willing to accept an alternative to the same old garbage you've been given before. However, the treatment for attachment disorders is very specific - from what I remember reading - and I would proceed with caution before getting too involved in that process. Some treatment, if it isn't right for the patient, can do more harm than good. I would really delve into the why's of the diagnosis, give therapist a chance to get a good feel, do some research, etc.

I'm really glad you have hope. It's something we're all looking for at one time or another through this process. And it can be very easy to grab onto something because it gives one hope. I'm just urging you to use caution.

I'm not singling you out. I'm using caution with all the various things I'm hearing from therapist, as well. With kids like ours, and as our therapist admitted, sometimes they're grasping at straws trying to get a true picture and trying to help our kids.

I hope therapist is onto something and this is the beginning of healing. But, remember to trust your mommy gut.

(((hugs)))

 

[Shari]

In the case of my Wee, his early development was drastically out of the ordinary. He had cognitivie thinking skills at 2 that shoudln't be present til at least 4. He had gross motors skills and strenght of a child over twice his age.

He, too, has been diagnosed with disordered attachement. There was a very brief period of time when he was 4-6 months old that its likely DEX didn't care for him while I was at work. We're talkling a minute window, but a window, nonetheless. However, they explained to me that with Wee's haphazard development, he didn't go thru the attachment process at the same time or manner as a "typical". He was too busy on his own agenda to care about me.

Not sure Im relaying it accurately, but that's how they explained it to me, and it made sense then...

 

[DammitJanet]

I was just talking to my therapist recently about attachment disorder the other day and we were pondering what it became when the attachment disordered child became an adult. I/we are of the minds that they become some form of personality disorder...probably borderline or a mix of histrionic and narcissistic and borderline combined. I think that is more females. Males may go on to ASPD or if not as severe, keep the label of CD.

I do think there are different forms of attachment disorder.

Obviously this therapist is getting a good look at your dtr. I think those make the best diagnosticians. They see them for more than just a few hours over a day or two.

 

[DaisyFace]

I'm really glad you have hope. It's something we're all looking for at one time or another through this process. And it can be very easy to grab onto something because it gives one hope. I'm just urging you to use caution.

(((hugs)))

Thank you, Heather!

Yes, I admit that I am grasping at straws a bit too much. And right now, I may be too excited and hopeful over what may turn out to be nothing. But, that's exactly why I wanted to turn to my board Friends and "discuss it" with everyone.

 

[DaisyFace]

Shari--

What you say makes a lot of sense. I wonder if difficult child had a similarly unusual development that affected attachment?

Janet--

How very interesting! A connection between attachment difficulties and personality disorders? So it may be along the same continuum...

Sharon, KLMNO, Smallworld--

Thanks so much!

 

[DammitJanet]

DF...doesnt it make a bit of sense?

Remember back when they said kids couldnt have certain things like bipolar? I always questioned that because...how does bipolar know a birthdate. Does it hang around waiting for a certain day and go...oh...I will ride in with the birthday gifts all wrapped up in a nice package and bow and say "Now that you have had your 18th birthday, here I am, you are bipolar!" Of course not!

A diagnosis doesnt know your birthday. One day isnt any different from another.

But....ODD is a diagnosis of childhood. So what are you when you are an adult? You cant be defiant against yourself anymore...lol. Sure you could go into CD...maybe. Or you might go into a personality disorder.

I think attachment disorders are personality disorders clearly in the makings. But then, I am just a layman. I just read a lot.

 

[DaisyFace]

Janet--

It makes a TON of sense!!!

Have you ever been to two different medical doctors for the same symptom--and they treat it differently? Like one doctor might take a look at your skin rash and prescribe an ointment to soothe the rash and think the problem is solved. Another doctor might look at the same rash and instead of just treating the symptoms, they will try to find the underlying cause.

For many years, I have been BEGGING professionals to please try and find an underlying cause. What? Why? Why is this child acting this way? What is causing my child to do these things?

And I feel as though docs have looked only at the surface symptoms. They have assumed superficial answers to serious questions. The child has been chronically angry--but they treat each therapy session as though the anger is acute--like something must have happened just that day to explain the child's anger. The child threatends suicide--they react as though this was an unforeseeable event. O gee--what happened this week to make this child so depressed? The child lies about EVERYTHING, constantly--and yet they want to tell me that each lie is an isolated incident, with no relavence to anything else.

So this doctor started with questionaires, and one-on-one interviews.

And then there was the behavior chart (I was not thrilled, but I went along with it) and I put all kinds of basic stuff on the chart. And now there it is, in black and white--a clear record of the stuff that difficult child cannot seem to handle, over a period of six weeks.

AND this doctor got to see first-hand some of difficult child's anger toward her family.

This doctor--unlike previous professionals--seems to be trying to fit the whole picture together.

Like you said--disorders just don't appear overnight...or on a certain birthdate or milestone. They are cumulative and quantitative.

So I am hopeful. Right now, what this doctor is telling me makes a lot of sense. I hope we get some real answers from all of this...

Thanks for listening!

--Daisyface

 

[timer lady]

DF, I had been hesitant to bring up attachment issues but as I've read your threads I would keep thinking that's kt or that's wm.

This disorder is still highly controversial & is mostly seen in children from abusive bio homes &/or have been bumped from one foster home to the next. Saying that, the professional are seeing more & more kids who's bio mom used drugs during pregnancy with attachment disordered like behaviors. That research is in it's infancy & needs a great deal more study.

I'm glad that you're seeing some light at the end of the tunnel. by the way, attachment disorders are generally caught by those in the field before it's brought before an MD. Some MDs even though the DSM states that this disorder is out there, don't "believe" it exists.

I don't trust psychiatrist's to diagnosis every little thing ~ many aren't out in the trenches. Many don't take the time to acknowledge emotional disorders unless they can be medicated - Reactive Attachment Disorder (RAD) cannot be medicated. Just my 2cents on the MD/psychiatrist issue that keeps coming up here.

 

[DaisyFace]

DF, I had been hesitant to bring up attachment issues but as I've read your threads I would keep thinking that's kt or that's wm.

This disorder is still highly controversial & is mostly seen in children from abusive bio homes &/or have been bumped from one foster home to the next. Saying that, the professional are seeing more & more kids who's bio mom used drugs during pregnancy with attachment disordered like behaviors. That research is in it's infancy & needs a great deal more study.

It is interesting to me that you had thought about attachment issues because of similarities with kt and wm. It had never occurred to me as a possibility.

I never used alcohol or drugs during pregnancy (well, other than over-the-counter cold medicine)...and ours was not an abusive home. But is does make me wonder about all the other caregivers there have been--relatives who used to babysit, day-care, etc. I wonder if something happened? Something way, way back...maybe even before difficult child could talk? And if there was something--how, at this point, would I ever know?

It's a lot to think about...

 

[TerryJ2]

DF, there are a variety of different attachment disorders. easy child is taking several psychology courses and the things she has in her books go way beyond what I've found online.
Having said that, I would agree that between the Learning Disability (LD) or anxiety (IOW, not being able to complete certain tasks) that there is a cognitive issue there that could interfere with-emotional issues and could have spiraled out of the norm.
Some arrested development can be due to psychiatric medications ... IOW, say you're a teenager and your boyfriend kills himself, and your dr gives you Prozac, but no counseling. You're going to be stuck in that mode until you actually process the information. The medications got you through the day or the event, but then what?
Sorry, just thought I'd throw that out there ... like you don't have enough to think about.