Why do you think treatment thus far hasn't worked?

slsh

member since 1999
I was asked this last week and was left speechless (call Ripley's, LOL). I've been chewing on it since Thursday and still really don't have it nailed down.

Wondering what your thoughts are about your difficult child's treatment and how you guys would answer this.
 

TerryJ2

Well-Known Member
What did you come up with?

I think our treatment could have been more successful if we had held difficult child back in Kindergarten instead of 3rd gr; put him on Adderal in 2nd gr.; and been totally consistent with-our discipline and rules. I was basically doing it by myself, and husband was in denial. It took yrs to get it straight.
Our treatment thus far HAS worked, FWIW. difficult child is maturing. He's still a difficult child but much improved.
 

BusynMember

Well-Known Member
Our sons treatment didn't work until he had the right diagnosis, which was hard to get. I think that's often the reason our kids still struggle. The wrong diagnosis. can lead to the wrong medications and the wrong medications often makes things even worse, and the core problem isn't addressed...etc.
 

smallworld

Moderator
Sue, my difficult child 1 isn't as old as yours nor have we been at this as long as your family has. But I will say that my son's recent improvement came about after having a fresh set of eyes observe him for 6 weeks in a day treatment program at a local psychiatric hospital. Those eyes belonged to a child psychiatrist, a gifted psychopharmacologist who refined the diagnosis and changed the medications in a way that now allows J to access treatment.

I should back up a bit. J has always struggled with school (since K) in spite of a high IQ. He was diagnosed with ADHD and anxiety at age 9. We made some progress with ADHD medications in 4th and 5th grades, but his mood issues intensified in 6th grade. He was prescribed Zoloft for anxiety in 7th grade and had a prolonged intense manic reaction that involved aggression toward family members. Depakote stopped the mania, but he plunged into a deep depression (which can be a side effect of Depakote). For the last two years, the psychiatrist made medication change after medication change, but J continued to be depressed, become socially isolated and fail classes at school. His psychiatrist told us many times that J just needed to mature and grow out of it. We had a hard time accepting that because we felt something was preventing him from being able to. Things completely spun out of control this fall when J became emotionally shut down to the point that his school (private) said he could not stay without further psychiatric intervention. That's when we placed him in day treatment.

The new medications have made a tremendous difference. He's no longer depressed. He's interacting with family members in a (mostly) positive way. He's cooperative and even helpful at times. He's much easier to live with. We're definitely not out of the woods yet -- we still may need to find a more suitable academic environment -- but things have improved to a point where I feel hopeful for the first time in years.

So I will ask you:
Has thank you been evaluated and treated by fresh eyes in the last year or so?
Have his medications been the same for a while?
Do you feel that everything possible has been done medically to stabilize him so that he has the ability to access therapy and other interventions?

I know apropriate medication is not THE answer, but for us, it was the step we needed to take before we could go on with further treatment.

I hope you find some answers soon. Hugs.
 

crazymama30

Active Member
I think our treatment of difficult child is working. For now. I think it was mainly a matter of finding the right medications, and eventually therapy. Cannot afford that right now. What worries me is what so many of you have been thru, the times that medications work followed by the times that they don't work. It seems like for many medications work for a while, then they do not work anymore. I hope we can avoid that, but I do not know how to.


I hope you get some answers. You seem to be in a very frustrating place.
 

timer lady

Queen of Hearts
Sue,

You - struck dumb by a question? Put to you by a team member? Or just a stranger wandering by & curious? Give us the facts, ma'am.
:stopglass:

I spent some time pondering this last night. In our case, I really believe it was a combination.

First of all husband & I could not believe these 2 beautiful young children that we were blessed to have placed in our home; these 2 children that allowed us to be parents could/would be so very ill.

After 2 years of evaluations, medications, & such - it was so difficult to accept. I believe that in a subconscious way I was out to prove all the experts wrong & that a strong loving mother could "fix" what ailed my children.

Only when I came to acceptance of the level of severity the tweedles suffered did the true therapies & treatments start. Did that delay hinder or make matters worse? I'm sure to some extent it did.

However, we are dealing with some pretty significant trauma suffered before 3 years of age; brain wrinkles, my friends.

For kt, we are seeing some of the treatment working. She is grasping on to some of the life skills, learning empathy (to a degree) & beginning to be able to "stop & think". This is huge. She's 13 & still needs round the clock supervision - however there are days that she can spend in her room & she comes to check in with me. You can time it by the shows she watches; more the tv she has on for the noise - every half hour.

wm, on the other hand, seems determined not to learn the from the many interventions in place. psychiatrist believes there is some organic brain damage somewhere though it's yet to be proved by MRI. And having said that, he can do what's asked of him - an adult needs to be standing over his shoulder. He, again, needs 24/7 supervision.

Medications for the tweedles are as good as it gets. It's the traumas that have to be addressed. And it's the traumas that are pretty much guided by kt & wm. What they will address or not. Some of it's very ugly - I wouldn't want to "remember" or suffer through it again. kt & wm have shared with me either through talk or their actions what they have endured. Nope, I wouldn't want to willingly relive that type of thing again. And that is what will hold them back.

I believe kt is doing well because wm isn't living here. I believe wm is sinking his own ship because he believes he should live here; he's the "poor orphan" of the family & is playing that role to the hilt. The rest of us are invested in the "family of different addresses" - even the SWs, tdocs & psychiatrist. It's taken a lot to get all these people to believe in this concept.

It will take more to get wm to believe it. I could be out to group home every day & it wouldn't be enough. He has to be home. That has proven to be very unhealthy to the entire family.

Just a few thoughts. We still have some time - I'm hoping that treatment can work for the tweedles. I'm praying that they will use every intervention I have found & put in place for them to their highest level - not throw it away.

I've thrown away the guilt myself. This "family of different addresses" is something I came up with - sometimes in my mind it's a load of cr@p. We all belong under one roof - that's how family is supposed to be. It's how I was raised - we all stick together no matter what. However, I wasn't raised in that level of chaos & physical aggression.

And it isn't the reality with the tweedles. So we go on as we are doing.
 

trinityroyal

Well-Known Member
What an interesting question, Sue. This is a bit of a brain-breaker.

In my difficult child's case, his treatment is working to an extent because he has 24/7 sueprvision and support, and someone standing over him all day every day while he does the things he's supposed to do.

However, his staff report continuing defiance, lying, stealing etc. If "let off his leash" for even a minute, difficult child reverts to all of his old behaviour as though he hasn't received any interventions at all. He's definitely a tough nut.

difficult child's attitude seems to be that someone will always be there to pick him up when he falls, so as a result he makes no effort to catch himself. I know he can do it. I've witnessed him controlling impulses, choosing not to be defiant and following the rules by his own free will and choice many times. Enough times to know that he can do it if he wants to. The trouble is, he doesn't want to.

Unless or until he wants to, none of the interventions and programs and medications and therapy that we have put in place for him will make any difference. I am beyond frustrated by difficult child's lack of willingness to participate in his own care.

It's hard.
 

Indianamomof4

New Member
Wow, what a good question. For us, we are still not even sure of the diagnosis as he has so many symptoms of so many diagnosis's... I think it's Tourette's, so does dex, but with that comes his sensory dysfunction, attention problems, tics, noise making, learning disability, etc. No one has really nailed it down to SOMETHING that we can grasp and treat as a whole. We've been treating his symtoms for years, notably treating ADHD and it never worked. Now he's in therapy for sensory stuff, having sensory therapy in school, has an IEP for the Learning Disability (LD), and we're working on the tics and some testing to get more in-depth to see if there are any brain abnormalities, neurological dysfunction, etc. It's like putting together a very intricate puzzle with no picture to use as a guide.
 

Star*

call 911........call 911
Because Dude wasn't ready to be any more grown up than his brain would allow him to be. I don't know about most, but my son has always seemed to be behind emotionally from age 6 - now.

At 6 - he was like a 3
At 8 - he was like a 5
At 10 he was like a 7
At 11 he was like an 8
At 12 he was like a 9
at 13 he went back to 8
At 14 he was like an 11
At 17 he's like a 13 -
so as far as I can tell emotionally he's always been about 3 years behind. What I see now at 17 COULD be anyone elses' unusually mature 12 year old, but still 12.
 

Sheila

Moderator
I think there are some things with our difficult child that just can't be fixed -- executive function type items come to mind immediately. His ADHD medication helps, but it by no means is a perfect answer. I always feel fortunate that his medication helped to the extent that it allows him to access learning of a lot of other skills.

He's had all types of other treatments for motor skill delays, auditory processing disorder, language therapy, social skills training, counseling, IEP, and probably some others that slip my mind at the moment.

Because of the abuse he experienced from birth until 5 yrs old, I'm not sure his trust and attachment issues won't adversely impact his adult relationships. Then there's the possibility of adoption issues. [After he was dismissed from therapy, his counselor almost guarantee us that these issues would pop up in his teen or early adult years.] So treatment? Yes, he's had it. But time will tell if it has a lasting effect.

Until he was probably 10 or 11, on paper he look like a walking disaster. But again we were fortunate enough that the therapies helped. If he were to be evaluated today, without the evaluator having extensive background info on difficult child, he wouldn't come close to being considered a child with Pervasive Developmental Disorder (PDD). But I know it is still there and always will be.

Then there are the days when I think absolutely nothing we've done has worked, but thankfully, those days are few and far between. (I remember well the reverse; the occasional "good day" we would have between +/-5 to 7 yrs old.)

And I dread his episodes, e.g., about every 18 - 24 months something will trigger his anxiety and I'll be darn if every symptom he's every had with-every disorder doesn't come roaring back.

I think we would have had even better luck with-the therapies if we had concentrated on motor skills and sensory issues first. (I have nothing to back that statement up with -- it's just my opinion.)

difficult child still has "holes" in his learning and definately is a work in progress. But I know the seeds have been planted and I can hope that someday at least some of them will bare fruit in the future. (Shoot difficult child still attends after-school care. Primary reason? Further development of social skills.)

Age-appropriate maturity is also a problem for us. It can't be "fixed." I've come to believe that difficult children' develop in their own time.

I do believe that no effective treatment can be found for some kids.

I think it's just as hard to answer the question of, "How would things be if we'd never tried intervention or treatment?"
 

susiestar

Roll With It
I think that for many years my son was so depressed and angry that NOTHING would work. He refused to work WITH a therapist, to put in the effort to work with his medications, and that sensory issues blocked any and all progress. He and his dad were so very different, and each so intolerant of each other, that it really blocked any progress. Getting my husband on the same parenting strategy helped. with-o that there would be no progress, no "working".

Right now, things ARE working. He is developing a relationship with his dad, and his grandpa works him through the rages (very very few now).

I think he finally matured enough to have empathy for people (not just animals) and to see how his behavior changed other people's behavior. Watching his grandma go through some pretty major stuff made him want to help her. They struck a pact to both avoid a dangerous behavior, and have both stuck to it.

His best friend is also a factor - she just doesn't have any respect for dangerous behavior, idiots, or people who flunk on purpose. Peer pressure in this case is a wonderful thing.

So right now it is working. I think it will continue to work, but there will be setbacks.

Learning that I could be DONE with the day to day stuff and living with him, while NEVER being done loving him also made a huge difference.

I know that some of the medications blocked progress, but with-o medications he just can't function. And HE sees this. (sign of maturity???) I KNOW some of the medications made things worse. I KNOW some of my/husband's parenting made things worse.

But we never woke up and asked how we could mess him up today, and he finally understands this a little bit. (Though for YEARS he had the idea that grownups stayed up all night on New Years Eve to think of new ways to make children's lives miserable, LOL!!!)

I think it is different for every single one of our kids.
 
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