Psychiatrist day

The kids see their psychiatrist every couple of months to check in on how they are doing.  He manages all the ADHD meds and the anxiety meds and I love that he is so involved in their care.  Back in our last state, meds were only checked up on every 6-12 months unless I requested a review.  While doses rarely change, I like that Dr. C spends an hour or two with all of them every few months so he's gotten to know them and he talks things over with them, even if its yet another monologue on the joys of video games ( ;) ) so when issues do arise, he can actually  help us with it because he knows our family dynamic and what types of suggestions may work with us.

We talked a lot about the Busy Little B's OCD tendencies.  I don't say that lightly--when he was younger and going through testing for autism, OCD came up a lot.  They said he was too young for a diagnosis but that it was definitely something we'd need to watch and it would not be surprising if he got the diagnosis later on.  Some of his rigidity/obsessions is starting to interfere with daily life, especially at school, but it isn't causing things to come to a full stop.  At the moment we can work around these things and Dr C says some of the medications that help with OCD have side effects that we don't want to mess with unless we have to so we keep watching, keep doing therapy, keep working with the school to find ways to get his work done without disturbing his set-in-stone points.  At home I work with him on calm ways to work with his "rules" so he can solve the problem but if they try to challenge him on them at school, its a bit of a disaster.  I think they've decided to leave the working on those to me and his therapist because last conversation we had about it, they were just working his "rules" into their day so he would continue to work on his schoolwork instead of obsessing :p

Feeling frustrated.....

For years, my busy little B has had pretty bad meltdowns, to the point where he would need to be physically restrained and his preschool classroom sometimes had to be cleared out until he calmed down.  The severity of these meltdowns and the suddenness of their ending made his pediatrician wonder if he could be having seizure activity like his sister.  She referred us to neurology and we took him to the same neurologist Iz sees.  The neurologist thought seizure activity could possible explain the meltdowns as well (not positive but possible) and B's EEG showed similar abnormal brain activity like Iz's so B started medication.  His dosage has been raised a few times and the frequency of the meltdowns has changed--they are few and far between now.  He's never had one at school this year so the kinder teacher has never seen what he used to be like.  Now, though, he is on the opposite extreme--he will completely shut down, refuse to participate or talk or move.  Honestly, though, the shut down is a million times better than the meltdown--at least with a shut down I don't have to be worried he will hurt himself or others.

The shut downs don't frustrate me.  When they happen at home, we treat them much as we would a mild meltdown--we leave him alone once we've made sure he doesn't seem to be currently having a seizure and he's okay and that gives him time to collect himself and come back to us.  However, his teacher called me and wanted me to punish him at home for having a shut down at school :-|  THAT frustrates me to no end.  She in insistent that this is all control issue and that he will just not work at school and then I'll let him play all evening and she can't have that.  A control struggle with B looks very very different.  He may refuse to do something, he may even refuse to talk to you while he is refusing to comply, but he never stops moving.  He wiggles, he spins, he wriggles around while sitting down, he looks all over the room.  The hyperactivity part of his ADHD does not stop because he is trying to exert control over a situation.  A shut down, though?  He is still.

I tried to talk to her about what his shut downs at home are like, about his OCD tendencies that can kick in and make him lose it over things that normally are just routine, about his anxieties that flare up without warning.  But she just kept insisting its a control thing and I need to punish him.  I talked it over with B's therapist and she is feeling the same frustration I am!  She has seen B's meltdowns and shutdowns as well as him trying to exert control and yeah, a shut down is not a control move.

At the moment, I'm at a loss on how to get through to this teacher.  I need to figure something out :\

Hopeful and.......not

I feel both hopeful and discouraged, all at the same time.  I finally got the final report for S back from the neuropsych and while I've been waiting on it and knowing he needs a more formal diagnosis in order to get him the therapies and services he needs, it still makes me sad to get the list.  Especially since the list is much longer than I had anticipated :\  We've had the ADHD and SPD diagnosis and an acknowledgement that he has anxiety--I kind of expected maybe one more diagnosis, formalizing the anxiety or maybe even OCD but man, there are like ten of them.  And a recommendation to re-evaluate after a year of therapy because they could not rule out OCD but couldn't definitively say he has it, either.  *sigh*  Ah, well, forward we go.

Having three weeks off really messed up our routines but the kids seem to be settling back into them for the most part.  And thank goodness they are because poor B does not do well with disruptions to the routine and no school for three weeks was hard for him :p  At least in summer there are plenty of distractions outside but freezing cold means we were mostly trapped inside :p  I am already noticing less fighting between him and Iz so *whew* glad school is back in session!

We are finally making some progress with figuring out what B has.  ASD has been ruled out--he's had autism assessments in two places and both of them show he is not on the spectrum.  I don't have the full results yet for the second eval (waiting on that appointment) but the first one came back with a diagnosis of a communication disorder and a recommendation for more testing for OCD and a full assessment through the local mental health agency to see if he qualifies for services for the communication disorder and also to screen for other possible things than can cause the symptoms that made doctors/school think he may have autism.  So the pediatrician is reading over the results so she can decide what next step she wants to take and I need to find a time to take B in alone for the full assessment (our county is walk-in only so that makes things a bit difficult).  But at least we are moving forward and the more information we get, the better it is for the school to implement a plan to better help him :)