Monday, January 30, 2012

Early Intervention - It's Great in Theory

Since we last spoke, our pediatrician referred us to a psychiatrist here in town.  The psychiatrist told someone in the pediatrician's office that he needs us to go to a counselor first and get referred from there, and even told us which counseling office to go to.  So we did.  This counseling appointment was a frustrating experience because once again, Little Man had to just sit there and play while we talked about him with him in the room.  And after all that the counselor suggested a book called 1-2-3 Magic.  Which I'm sure is a lovely book on discipline, but we've been working for over 2 years to ensure that Little Man understands the expectations for his behavior and that we have immediate, logical consequences for him.  I'm willing to read and try the techniques in this book, but his violence & outbursts aren't going to be solved by counting to 3.  I did schedule a follow-up for us with this counselor.  She's quite young and the book thing frustrates me, but I do feel that she's sincerely trying to figure out what will work for Little Man.

She, like the pediatrician, suggested high-functioning Aspergers.  It's funny that people who have interacted with him (psychologist briefly, and a family member who is a child psychiatrist, plus Daddio and me) don't see Aspergers, but people who have spent little time with him and are making assessments primarily on what has been written about him (pediatrician, counselor) say Aspergers.  We're willing to get assessed for it and I've contacted the VT Autism Clinic, but I was told immediately that the waiting list is up to a year long.  At that point we might as well take him to a city that has more resources to get him assessed.  But since Daddio and I are both still skeptical of this path, I'm not sure how many hoops we're willing to jump through.  The Autism Clinic gave me the name of a psychiatrist/ physician duo in Roanoke who may be able to help.

The counselor also said it seemed funny to her that a psychiatrist is requiring us to see a counselor when we've already been referred to psychiatry by our pediatrician.  So I went ahead and called the counseling group that this psychiatrist is with.  And they don't see kids under 10.  You have got to be kidding me!  So I called the pediatrician's office back.  They seemed a bit confused.  One message they gave me was that they knew that this office doesn't see under 10.  But then they kept referring back to a note that said that this psychiatrist will manage medication for kids of any age.  I updated the person working on the referrals on what we've done so far and where we're at in regards to his assessment/ treatment, and she's trying to find something that will work for us.

In the meantime, we sent everything we have to a family member who is in child psychiatry.  He said that any psychiatrist we see will suspect bipolar disorder due to family history and Little Man's unpredictability.  But it's just too early to tell on that.  Plus, mood stabilizing drugs are difficult to manage, especially in little people.  He felt that ADHD is a decent theory to explain Little Man's "poor frustration tolerance" and violent outbursts.  We are just about convinced to try an old-school stimulant-based med.  These work quickly and metabolize out quickly.  So if there are negative side effects, they'll be gone by the end of the day.  There was one that he specifically recommended against due to the possibility of a developing mood disorder in Little Man.  However, as I mentioned in my prior post, our pediatrician isn't willing to medicate.  Which is part of the reason we need a psychiatrist.  Alternately, we could switch his primary care physician to someone willing to medicate.  I don't think we're there yet, though.

And hence, the name of this post.  Early Intervention - It's Great in Theory.  We are really trying to intervene on behalf of our son to get him ready for Kindergarten.  And ultimately, our goal is to find techniques that we and his teachers can use to cope now, but also that he can use to cope throughout his life.  And we've all heard that early intervention is key.  But it's darn hard to get early intervention.

Up Next: I experienced a violent outburst personally and lived to tell about it.

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