Therapeutic boarding school

[isis]

Hello,
I am new to this forum. We have 3 kids, the younger two literally ideal children (the type that if you have two like this you don't have any clue how difficult parenting can be). The oldest, 13 1/2 year old boy, with severe dyslexia (but smart!), depression, anxiety, adhd, who knows what else sometimes it seems like they make it up (ODD certainly but that seems more a behavior/symtpom diagnosis than an underlying diagnosis - sort of like saying you have a stomach ache). W
e have poured resources toward him: individual tutoring, therapy, medications (citalopram, abilify, vyvanse), private school with small class size and close relationships with lots of adults there; we have tried and continue to try so many behavioral modification tools recommended by various psychiatric people. He is intermittenly so capable, but often (lately always) making his own rules, refusing to follow ours, abusive to me (hitting, kicking), verbally abusive to everyone, bullying to his younger siblings.
As many of you all also experience daily, there is no 'normal' life at home. I tried to help my younger son clean his room yesterday while my difficult child pointed a nerf gun and fired at my face repeatedly. Another (small, trivial) project abandoned. He took all of his medications and threw them in the garden. Serious money lost. I retrieved some of them and he took them today, so hasn't missed any. He frequently says he's not going to school, but so far always does (missed once last year, went in 2 hours late once this year). I have told him school and medications are non negotiable, and though I had to talk him into school today I have told him I'm not doing that anymore, he's just going (not going means loss of all privelages, most of which he has lost anywat). Nevertheless I know that is next, i.e. him having the courage to challenge us and just stay home from school. Once he does it once, he will do it more.
We severely limit his screens as there is no question they make him much worse - when he turns off, if we can get him off, he is way more irritable and likely to bully, etc.
Despite all of this, he is strangely naive and, probably because of Obsessive Compulsive Disorder (OCD) tendencies, is constantly cleaning, doing laundry etc in our home. Im sure many would love that. But at the same time he steals my wallet, my ipad, our modem so that we cannot carry on with anything - work from home, driving (without a drivers license in my wallet), etc. Its just a bizarre dichotomy.
My husband and I are considering a therapeutic boarding school (i.e. designed for kids with adhd, emotional problems, etc). Many kids there have substance abuse issues. He is very high risk for them, but at 13 has been in such a protected environment, he has been introduced to nothing. (Really, hard to believe but true. Its one reason we have him at the private school - super protected and small combined elementary middle school). He is also extremely anxious and a home body. So I am worried about making the wrong decision in which 'sending him away' causes his anxiety to spin out of control, and also worry that he will be likely be bullied - despite staff best efforts - and introduced to the idea of substance abuse.
On the other hand, I want to protect the two youngest, and the rest of the family needs to be able to live and work and carry on with daily tasks without being abused and harrassed.
I'm rambling, its such a long post, I would love any any thoughts as I try to work this out in my brain. In particular I would love to know if anyone has had success with a therapeutic boarding school (not a military school!).
Thanks!!!

 

[InsaneCdn]

Well...
No experience with Residential Treatment Center (RTC), lots of experience with an out-of-control pre/early-teen.

Loved your definition of ODD, by the way... really matches how lots of us feel around here.

What kinds of evaluations has your difficult child had? Who gave the current dxes? Who prescribes the medications?

You see, even ADHD is a tricky diagnosis.
MOST kids who get that label are either...
1) ADHD plus a whole list of other stuff, OR
2) something else entirely (not uncommon to end up with Aspie diagnosis, or other things, instead of ADHD)

And none of that should be a surprise, because ADHD traits are part of the definition for Aspie, as are many of these other dxes that can go along with ADHD. Having a whole string of dxes, though, doesn't make one an Aspie. (confusing, I know.)

Some examples of things that often go with ADHD (and/or are part of Aspie), and often get missed:
1) Developmental Coordination Disorder (DCD) - developmental coordination disorder
2) Sensory Integration Disorder (SID)/sensory processing disorder (SPD) - sensory integration disorder sometimes called sensory processing disorder
3) Auditory Processing Disorders (APD) - auditory processing disorders
4) NonVerbal Learning Disorder (NVLD) - non-verbal learning disorders
5) other LDs - you listed dyslexia, there's also dysgraphia, dyscalcula, and others.

On top of those... secondary MH issues come into play, especially depression and/or anxiety... from NOT getting the right dxes, and/or not getting the right accommodations, interventions and/or medications.

If he's got these kinds of issues? Residential Treatment Center (RTC) is probably a bad idea. Not that there are any easy solutions, though.

 

[isis]

He had extensive neuropsychologist testing when he was 8 which showed his severe language based learning disability (he was also very disabled in math, but this is thought to be due to large extent to his poor visual memory which is part of what I call dyslexia because its easier. They did not respond at all to our extensive concerns about his behavior because they were so darned focused on his learning disability. She though he 'might' have ADHD (guess what, thats a learning disability, it helps to treat when you are this learning disabled!). A pscyhologist we had seen when he was 7 ws totally unhelpful, a pscyhologist we were seeing at the time who specialized in cognitive behavioral therapy but wasn't convinced he was 'anxious' which the neuropsychologist person thought he might be.
Finally when he was 10 we saw a psychologist whose eyes popped out of her head and jaw dropped open when she found out that no one had diagnosied him with adhd, which she thought he obviously had, severe, manifest primarily though not entirely by impulsivity. She also was quite convinced he was depressed and anxious. We started seeing a psychiatrist for the medications, who eventually recommended psychotherapy which he is getting. She continues to believe that he has anxiety with Obsessive Compulsive Disorder (OCD) manifestations, depression, adhd. She also notes that kids like him: highly irritable and emotionally dysregulated. are a hot topic in psychiatry right now, that lots of research is going on (functional MRI stuff), lots of discussion and that there is acutually going to be a new DSM diagnosis that he will likely fit into. She notes that lots of them get bipolar diagnosis when that is probably not exactly what they have.
As soon as he went on citalopram, he was immediately noticably better and more jovial (this was a couple of years ago now). He has since marched up on the dose of that and abilify has been added. The medications seem to just stop working after awhile. Though he has also entered adolescence of course.
I think these diagnosis are the best they can do right now. I think he needs the medications. He does cycle in mood, I believe he has a mood disorder for sure.
He is very coordinated, he has always been above average verbally, his auditory memory is outstanding and I think his processing is too. But his visual processing is for sure seriously abnormal and he has been getting lots and lots of tutoring for that. He CAN be very empathetic, though has no insight into his own impact on others and if anything is hypervigilant about picking up others' emotional responses to things (unless he caused them, then Im not sure if he gets it), so I dont think he has aspergers, though he has some eccentricities that some would likely call aspergers like.
I'm hoping a therapeutic boarding school would a) help him with his depression and anxiety in a more intensive way b) help him learn moe appropriate behaviors in response to how he is feeling. He doesn't learn anything from us anymore, as far as I can tell.
Thanks

 

[JJJ]

Has he ever done a PHP or IOP program?

 

[isis]

I don't now what either of those abbreviations mean...

 

[JJJ]

PHP...Partial Hospitalization Program, generally 9am-3pm spent at the hospital getting therapy and medication management.

IOP...Intensive Outpatient Program, generally 3pm-7pm spent at the hospital getting therapy and medication management (the child attends their regular school during the day)

These are usually offered through the psychiatric hospital. Some kids go for a week, others for much longer.

 

[isis]

His psychiatrist has not mentioned these as options, I will definitely ask. I have also read about MST online, but there are apparently no groups in Seattle that offer that. Thanks for the suggestion.
I guess I am surprised that there aren't more in the community who have tried therapeutic boarding schools. Are they just too few or are they not what one would hope they would be? What do other people do to keep younger siblings 'safe'?

 

[JJJ]

My oldest has spent 5 years in a Residential Treatment Center (RTC)/therapuetic boarding school. There are some kids on this board, and others I've met in real life, who have benefitted from Residential Treatment Center (RTC)/TBS. For Kanga, while she made a small amount of progress, the primary good was the protection of the other children.

The cost of these places will bring you to your knees. Kanga's were $250+/day. Do you have a funding source lined up?

 

[isis]

whoa

 

[JJJ]

How is he at school? If he is bad enough at school, there are rare cases where the school pays for the placement. There are a few sliding scale places as well.

 

[JJJ]

I would suggest lining up summer programming for him. If you start now, you may be able to get a lot of the summer covered. YMCA camps, Salvation Army camps, Scout camps, and various religious camps can often offer our families a break. If he normally behaves when away from you, this could be a great source of respite for all of you.

 

[isis]

He's actually OK at school. In fact, as he has been getting worse these last few months at home, we've had more than one report that he is better at school with better impulse control. His school work is not the best due to learning disabilities and lack of real interest (he doesn't have any real interests, except for cleaning right now). I always assume that he is working so hard to keep it all in at school that he lets the valve open at home, but maybe I'm cutting him too much of a break.
He refuses to do summer camps. Even though he 'hates us' he doesn't actually want to be away from home. I wish there was a sort of 'day program' in the summer where he was getting help too.

 

[InsaneCdn]

I always assume that he is working so hard to keep it all in at school that he lets the valve open at home, but maybe I'm cutting him too much of a break.


Read more: http://www.conductdisorders.com/forum/f12/therapeutic-boarding-school-51353/#ixzz2DgcT0iQZ​

Trust your Mommy gut. LOTS of us have kids exactly like that.
When difficult child was at his absolute worst... was when his needs and what his world was actually providing collided head on. As we got on top of his situation and got better dxes, interventions, accommodations, medications... the behavior improved first at school, and then at home.