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update on my 5 yr old
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<blockquote data-quote="Marguerite" data-source="post: 13858" data-attributes="member: 1991"><p>Hi Paula, we've been waiting for your update. I remembered the Mental Health appointment was today and was hoping it helped.</p><p></p><p>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.</p><p></p><p>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.</p><p></p><p>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.</p><p></p><p>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.</p><p></p><p>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. </p><p></p><p>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.</p><p></p><p>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.</p><p></p><p>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.</p><p></p><p>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.</p><p></p><p>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.</p><p></p><p>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.</p><p></p><p>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.</p><p>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.</p><p></p><p>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.</p><p></p><p>But I'm surprised they still sent him home.</p><p></p><p>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.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 13858, member: 1991"] 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 [/QUOTE]
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