The dx is....

[friendlyfarmer]

DD2 (7yo) has been through a lengthy eval process with a psych and therapist and we have some initial dx's! So far the confirmed are: ADHD, GAD, Pica, and intermittent explosive disorder. The psych is continuing to monitor for ODD (she's pretty sure but wants to be 100%) and schizophrenia (she's too young for the actual DX but there are signs).

The psych wanted to start DD2 off with 18mg of Concerta but insurance wouldn't approve it without us trying a lower dosage first so she's been on 5mg of generic methylphenidate for a week. So far we haven't seen any improvement, her behavior is worse if anything. DW will meet with the psych next week for an update and they will probably bump her dosage up.

Auntie, thank you for always listening and giving great advice, you have been invaluable in my struggle with this little girl.

[marissa]

D day sucks but now you know how to help her.

[friendlyfarmer]

marissa- D day was a blessing for me, a confirmation of all I had been struggling with for almost 4 years.

Now my question is how do I know whether her behavior is intentional or part of her dx and how do I deal with it?

[macchiatto]

I'm glad you got answers at last. I hope her therapists are able to give you good guidance in figuring out how to deal with her behaviors.

[Captain Serious]

I'm sorry. I know it's never easy to hear and wrap your brain around at first, even when you are so relieved that you now know what it is and can form a plan to move forward. I wish you the best as you develop an effective plan for your daughter.

[auntie]

Nov 22, 2014 12:55:46 GMT -5 friendlyfarmer said:

marissa- D day was a blessing for me, a confirmation of all I had been struggling with for almost 4 years.

Now my question is how do I know whether her behavior is intentional or part of her dx and how do I deal with it?

I'm kind of with marissa on this. D-day was hard- maybe because I wasn't expecting the two I got. I was a little in denial about the one and hadn't heard of the other. But there was that validation- I wasn't imagining it. DS was a harder kid than other kids. Prior to dx I just thought I sucked at parenthood.

Do you have some sort of behavior therapist? It can be devilishly hard to sort out what's developmentally appropriate challenging kid behavior and what's a manifestation of the disability. Either way, dysfunctional, distruptive and dangerous behavior has to be addressed and improved. You may have to set your expectations differently than you would for a NT child, but the eventual goal remains the same. You may need different strategies to teach the behavior which is why a therapist with a behavior background who understands what you and DD are up against is key. This person can help you put a comprehensive plan in place around her at home, in school and in the community.

I really like the Explosive Child for parenting and discipline. Even though DS was the sort of kid who shut down rather than exploded, I learned a lot from it. For kids who struggle to behave in the expected ways, it's important to always think about discipline in the context of "teaching"- from the original root of the word. Remember Christ had disciples- not enforcers.

I'm sorry you aren't seeing a benefit at 5mg. Stimulants can be tricky with anxious kids. Some would say they shouldn't be used for a child with anxiety because they can make it worse- that could be what you are seeing. DS has GAD and takes a stimulant, but he also takes something for the anxiety. Or it could be she's not at a theraputic dose yet and would better on 10 or 15 mg. Meds can be very helpful when they work, but getting there can be a journey.

[marissa]

I guess what I meant is it still stings even if you knew it was coming. I knew 2 of the ASD dx were coming. I knew the ODD dx was coming. That didn't make it feel any better to have received them.

[auntie]

Nov 25, 2014 16:57:02 GMT -5 marissa said:

I guess what I meant is it still stings even if you knew it was coming. I knew 2 of the ASD dx were coming. I knew the ODD dx was coming. That didn't make it feel any better to have received them.

I still go back and forth.

Validation to angst to denial. Rinse. Repeat.

[friendlyfarmer]

Agreed, it does sting. We got an official ODD dx from the psych yesterday. Then the therapist told my DW that she is seeing something bipolar/schizophrenia related in DD2 that concerns her and she wants to move forward with psychometric testing, we signed off on it and are waiting for a call to schedule. The psych bumped her dosage up to 10mg, were hoping that helps.