update on my 5 yr old

[wolonfab]

Hi all

Just been to our mental health appointment..... Jay has been a nightmare on the anti- depressent,:smile: threatening me , punching me, hitting the house, took a knife to baby (told her he would slice her) the other day cause she laughed..has been up and down ...had to be pulled out of mums arms the other day cause he wouldn't come home... nightmares are really bad and gorey again.......'

anyway after an hour and a half they have booked him in to see their new doctor who is specialising with under 12s and mental illnesses.....so school is on the back burner again...was supposed to start tommorrow (3 days late) now have to put it off till friday at least ....

mental health have called doctor's as they have to report it.....and they say there is too much going in in my baby not to get him dealt with and try to stabilize right away......wish i knew what they were thinking.....why do we need a doctor to look at him?is it a special type of doctor in mental health? can someone tell me what this means? :hammer:

the new school has had staff meetings re difficult child, teacher meetings, called the paed, they are pulling out all stops to help.....and keep all the staff and kids safe....so hopefully all will be better this yr

have to go as difficult child has just bit the 2 yr old and told me a dog did it that came into out yard..... what is it with lies..... will update when i know more

 

[SRL]

I'm sure sorry that your son isn't settled down but I'm glad the doors are finally opening to get some help and that they recognize the need is urgent.

The doctors that specialize in children's mental health here are called child psychiatrists. They train as regular physicians first and then go on for specialized training in pediatric mental health. Given the medications your son has been on I'm surprised that he hasn't seen one yet because most regular pediatricians here won't prescribe those. Child psychs do both outpatient and inpatient treatments.

DOCS No doubt M. will catch this but I'm wondering if those initials (or something close to them) stand for something in the way of child protection or child welfare services. Given that difficult child could be a safety threat to your little one that is an unfortunate possibility.

 

[Marguerite]

Hi Paula, we've been waiting for your update. I remembered the Mental Health appointment was today and was hoping it helped.

Paula, that lie about "the dog did it" - I'm concerned there's more than just autism here. Unless he's VERY high-functioning plus I already know he's very bright. difficult child 3 can lie like that now, but he couldn't at 6. Then again, your difficult child is very much an individual.

DOCS - sounds like Mental Health felt that mandatory reporting was necessary. I think they're probably right, but I'm appalled, if that's the case, that the hospital didn't report - they probably should have.

DOCS = Department Of Community Services. It's the Aussie equivalent of CPS. But they do a lot more - they will assess a child with educational (and other) needs. The school's concerns over safety, plus your concerns and others' concerns for your little girl, means that having DOCS involved is not a surprise. There are many departments in DOCS and only some are related to child welfare and neglect issues. Other departments do a lot of stuff that is useful for families with various problems.

difficult child 3 was on the books with DOCS because the local day care reported his language delays. However, the sub-section of DOCS working with him said they could not continue to assess and support him because he failed to meet their criteria - he was too bright. But that connects back to the suspected reasons for his language delay. Your son's needs are different.

Gather together in one file all your records on him, all the notes you've kept on who he's seen, when, and what they said. Also list the people you've tried to get him in to see. Make it abundantly clear that you've been expressing concerns for well over a year and you've still only got this far, because of all the obstacles in your way.

You're stuck between a rock and a hard place. You love your son and want the best for him, but he needs to be safe. Your little girl also needs to be safe. Right now she is not. DOCS will want assurance (from everybody, including doctors) that you will all be as safe as anyone else. I don't see how that assurance can be given right now. You're neither Supergirl nor a team of prison guards. One big thing that DOCS can do - they can exert pressure on health professionals AND schools to ensure that everything possible is being done for your son. When you speak, the health professionals say, "yeah, yeah..." but when DOCS speaks, it's "How high, ma'am?" Here's hoping.

The psychiatrists - it's their job to work with this sort of problem. A psychologist has a degree in psychology and a licence to practice as a counsellor and assistant in diagnosing various learning problems. A psychologist's report, and similarly an occupational therapist's report and a speech therapist's report can be used BY A DOCTOR to assist in confirming any one of a number of diagnoses. But they are not doctors in their own right unless they have separately done a medical degree.

Psychiatrists are doctors first, then they've specialised further (like gynaecologists, orthopaedic surgeons and paediatricians). The extra specialisation includes further study and a lot of time spent working in a hospital setting in their field of training. They then have to pass accreditation in order to be able to hang up their "Member of Royal Australasian College of...[whatever specialisation]". They usually have their medical degree somewhere too - in a lot of cases it's MBBS, not necessarily MD. "MBBS" stands for Bachelor of Medicine, Bachelor of Surgery". It's a two-pronged degree and the piece of paper should also show you the year they graduated as well as which university.

It sounds like difficult child has been assigned to a paediatric psychiatrist. This means this doctor has done the MBBS and specialised in both paediatrics and psychiatry. You can probably still keep his paediatrician; not sure about that. I don't see why not, though. Ask your GP about that. The paediatrician will t ell you if it's inappropriate for him to continue to be involved. This isn't a factor of our health care system, it's more a matter of professional ethics between the two specialists.

SRL, in Australia most ADHD kids are treated by a paediatrician. Some specialists are also psychiatrists (difficult child 1 saw one for a while) but both can prescribe the restricted medications used for ADHD and other related problems. To prescribe restricted medications the doctor first has to get authorisation from Medicare to prescribe that drug to that child. paperwork goes in. Then, for each prescription, the specialist has to telephone medicare and notify them. They give the doctor a prescription number and an authority number. It all gets registered centrally and also written both on the child's medical file and on the prescription itself. Then after the medication has been dispensed all the paperwork goes back in to Medicare and gets centrally processed. Numbers are matched up again. We can't shop around - only one doctor can get an prescribe the medications for each child. Because the child's Medicare number is used to verify identity, you'd have to have multiple Medicare numbers which is not only very difficult, it can also cause a lot of problems if they find out. Everything is cross-checked with Medicare numbers (like Social Security numbers, but linked right in to our health care system) and Tax File Numbers (provided to every citizen over 15 years old). We have entire buildings full or people whose entire job is to search through all this data and find anomalies. It's fairly watertight when it comes to medications.

We simply don't have the degree of paediatric specialisation in psychiatry here that you have in the US. For whatever reason - some paediatricians tend to unofficially specialise in ADHD and autism; others simply see babies at their 6-week check-up or deal mostly with general paed issues. Our family paediatrician is one who has a well-known reputation for treating ADHD and autism.

The other weird thing - we don't have many doctors that an adult with ADHD or autism can see as a specialist. Our psychiatrists seem to be too busy working on other health matters so kids continue to see the paediatrician well into adulthood and beyond. Basically, the shrinks often refer back to the expert paeds. The exceptions are people diagnosed as adults. I have a friend diagnosed at age 35, with Asperger's. However, she sees a psychiatrist who is also treating her for schizoaffective disorder. That's the main thing he's working on, not the Asperger's which he sees as an irrelevant side issue.
So today, difficult child 1 and easy child 2/difficult child 2, who are both adults, saw the paediatrician along with difficult child 3. There simply isn't anyone better to refer the older ones on to.

So Paula, that could by why the idea of seeing a psychiatrist is confusing. But in this case they should have the capability to assess existing diagnosis as well as consider and hopefully treat any other possibilities.

But I'm surprised they still sent him home.

I really hope that these people can help you get to the bottom of this and find a way to treat him. Your family just can't go on like this.

Marg

 

[SRL]

If you have any crisis situations it sounds like putting in a call to mental health would be the thing to do. Keep them informed.

Do not leave your little one alone at any time!!!! If you have to go to another part of the house, take her with you. If you have friends or family that she could stay with until this crisis is over that would be the best solution. If you have a family that she would be secure with it would be far better for her to be away from home and difficult child for a little while and be safe.

 

[SearchingForRainbows]

I'm glad you updated us. I'm also glad that things are finally starting to happen as far as services for difficult child are concerned. I'm really concerned though. I'm afraid for the baby's safety. Please keep your eyes on her at all times!!!

Thinking of you and sending many, many cyber hugs. WFEN

 

[timer lady]

Appreciate the update - continued good thoughts heading your way for difficult children stabilization/safety.

Take a deep breath - this is the start of the journey. :warrior:

 

[wolonfab]

Hi all

we have been to the appoint with the pediatric psychiatrist.... she was ok...she wanted me to describe a recent event where he was violent very in depth....lots of description etc..... did i see it coming, did he look angry, what precipitated it..... blah blah blah..... we talked about what i have tried and she told me my son is in control of my house and life...she said we have to come up with a new strategy for home...... (i think she thinks i am letting him away with murder and that this is all my fault... :smile: maybe it is ..I am strict but when it comes to having a full blown rage i would rather not keep pushing him..... don't look like they see anything else there )she then talked about summarizing findings for next appoint .....

mum said while i was in the appoint and she had him he hit his head against the wall (not autistic rocking type but hurt self type)and tried to get sister to do it too...he was yelling, and racing around and everyone was looking at him... she said he was a nightmare to deal with /ubbthreads/images/graemlins/919Mad.gif

psychiatrist took the time to talk to difficult child alone as i told her i think my son hates me and would be happy if i died...she said he has high anxiety.....he drew some pics for her on the board of his family when asked (they say for being autistic he is very engaging and quite willing to talk while alone with them) and afterwards she and the phsycologist went off to confer about what to do next.....she decided that she needs to spend some time with him in play, observing, talking etc.... she has booked a min of 3x 1 hour appointments with her.......Not sure why and what this means? if it was nothing would she bother? is she checking for something or is because its just methat cant deal with my son and she wants proof?


psychiatrist is ringing our paed to discuss medications again as difficult child is still on tofranil..Mum says he is fine on ritalin (but not in my eyes cause he tried to hurt himself...He was calmer but not less aggressive).....we went back to mums and jay became a little monster, hitting me, being rude, getting his sister to do things that he isn't allowed to do .....he screamed bloody murder when i touched him cause he was naughty.... I decided that if its my fault that he is this way then i have to get even tougher and so i smacked him back.... He was exhausted though and feel asleep on way home from mums.....

:bravo: the new school are going for more funding for him... this time risk and transition funding...the old school told them he was a great kid and no trouble.... (Huh?) he was introduced this morning to his teacher and the heads etc.... he was very quiet and very nervous.. wonder how he will be when he gets home :hammer:

 

[Marguerite]

Paula, you said, "I am strict but when it comes to having a full blown rage i would rather not keep pushing him". In my book, that's what I would do in your shoes. It's what I HAVE done, with far less meltdown than you're having to deal with.

At this stage it's likely that you will be feeling 'got at'. I sure did. But I persevered, which told them I was prepared to stick it out. That told them that I wasn't going to walk away easily, I was desperate.

Right now it seems to me that they have some ideas they want to explore, but they're not sure enough of them, or there are too many ideas, to scare you with details right now. They will not mention any of these ideas until they've either confirmed them or ruled them out - it's probably a precautionary thing, so you won't hear a label that terrifies you and will have you heading for the hills. For example, by the time anyone mentioned "autism" to me with difficult child 3, he had been in therapy and assessment for six months. I KNOW, when I look back, that they must have suspected autism from within five minutes of meeting him, but they couldn't officially discuss the label until it had been independently confirmed by others on the team, who took their time seeing him and then more time writing their reports.
In your case, they're are really hurrying up, which is good.

Being quite engaging and willing to talk to total strangers - it can happen in autism (and other conditions) - difficult child 3 is like that.

The three x 1 hour appointments - you've expressed strong concerns about him. The paed is now awake. So is the GP. If this shrink thinks it's nothing, she's got to be darned sure, up against three of you. But chances are, it's not nothing and she knows it. She needs those three appointments to get a handle on him and a feel for how he is. As long as he's pretty much himself at these appointments she should be able to work it out.

The school - I can't believe the old school telling the new one that; unless they were afraid that the new school would refuse to take him (if they could) if the truth came out.
If that were ini an employment situation, the old school could be sued, or charged under the Trade practices or similar. No longer can an employer give an employee a false good reference just to get rid of them, or as some sort of bargaining settlement package. I'm fairly sure it would be easy for the new school to have the old one on toast for that deception. If they wanted to (and they probably just want to get on with their job).

But I'm sure they'll remember, and not trust the old school's statements for quite a while.

The bad behaviour - is there a pattern between totally appalling, out of control behaviour and when he goes to sleep? Sometimes they're fighting tiredness so hard they fight everything else, too. I still find that evenings of hectic days are the absolute worst, behaviour-wise. If there's any way you can get him to sleep when he begins to misbehave - I'm not sure what cues you could put in place, he really is so very out of control right now... Ask the shrink when you see her next?

Write down any observations, anything that is interesting or worries you, make notes of incidents and take the notes to the next appointment. I often hand a copy (duplicate, for them to keep) over to the psychiatrist at the beginning of the appointment, and they then can use it (or not) in their interview with my child. It can scare the child a bit, when the psychiatrist has information that logically couldn't have! But it can also set off the problems you want the psychiatrist to observe. A very useful thing.

If, after the already booked sessions, there still isn't some level of stability, she should refer you to someone who can help. If she thinks it parenting, she can't just leave you hanging but should give you some support and guidelines, as well as refer you to a parenting course. That's worst case scenario. If she thinks he has real issues needing treatment, she will either take him on for more therapy or refer him to someone else, with her notes as an introduction.

You've got the paed and the GP both pushing, plus the school using all this info to get the funding in place. Something's got to improve from here.

Have you had a Learning Team Meeting at the school yet?

And how the H*** are you managing about your job? That's been worrying me, too.

Also, have you got the application in for Child Disability Support (or Carer's Payment/Allowance/whatever they're calling it this week). It's got to help at least a bit, financially. Now might be an interesting time to lobby your local Federal AND State MPs, with elections coming up. If you need the extra lobbying, that is. If the wheels fall off anything, right now both MPs are going to be wanting to be seen to be helpful. Federal will be more helpful, because I think state-wise, they'll be fairly complacent (weak opposition, in my opinion). Still, you never know.

Keep us posted. Fingers crossed for you. Lots of people here are worrying about you all, and barracking for you (I'm being careful here to avoid using the common US term, which has potentially offensive double meaning in Australia!).

Marg