Tuesday, October 12, 2004

60 days on medication and Now everyone thinks RAD is not the issue?

Well--it has been only 60-days since medication has really been in full use and both the therapists and the psychiatrist have backed off the RAD Diagnosis.

We have been in intensive Attachment Therapy since June and been seeing the psychiatrist since August and as of this week both have informed me that they do NOT feel we are dealing with Reactive Attachment Disorder as the big problem at all.......

Makala is severely ADHD and suffers from strong Anxiety with clear reason to suspect bi-polar. However they also agree that Makala has been exhibiting attachment with most of it appearing to be rather healthy. Personally, I don't think this is ADHD at all!

The FACT is that since Risperdal (more information about Risperdal )has been used we have not had a single RAGE lasting more then a few minutes and her overall mood has been consistant and stable. The school is NOT reporting any abnormal behaviors and feel my concern is over-reactive and that 99% of her behavior at school falls within normal expectations.

She is NOT having problems sitting in her seat during class since we have added Ridlin.... and she is not having problems on the bus.

The psychiatrist feels that in most ways the stealing is still within age and experience history and that she did NOT appear to completely understand that stealing is WRONG. In therapy she talked about this being what birth mom did in order to get food and milk....and that Makala got candy when she helped steal food at the store. Makala also talked about the fact that birthmom did pan handling with a cardboard sign and people would give her money.... And that birthmom was very happy when they did.

The assumption is leading to everyone to believe that her behaviors are somewhat conditioned and that RAD is less of an issue....

They are still concerned about the sexualized behaviors and we have not actually figured out where these behaviors come from?

Jeremiah has been attending a few appointments for observation with both doctors and both agree that he is showing some very strong ADHD signs as well--however as everyone knows they will not Diagnosis for him until he is at least 5 or 6.

Makala seems to need to dominate the conversations as a 'control' issue seen often with RAD--but, we have seen dramatic changes in this behavior after the psychiatrist suggested several exercises to help Makala learn to wait to talk--and give me some time here and there for a break....

A star chart and rewards for delaying her intrusive behavior has worked very well and she has learned to say, Excuse me before talking and has learned to wait for her turn. Which star charts and that kind of stuff is usually not effective with RAD.

The plan now is to continue with both Attachment Therapy and the psychiatrist weekly until after the winter holiday and then in January start to eleminate the Risperdal to see if the old behaviors return....should they it will be assumed that she is Bi-polar and not suffering from RAD.

There are still impulsive behaviors however when observing Jeremiah both doctors can see that if Makala was even half as determined and ADHD as he appears and if her birth mother GAVE in to the determination that he exhibits then she has been conditioned to get what she wants when she wants it.... Jeremiah has become a little terror the past few months and is having tantrums and shows signs of NEVER giving up until he has exactly what he wants.... Very stubborn personality and very persistent for a little boy who is not even 3 yet.

so who knows?

Jeremiah started a new speech class this week where I am not to stay with him. He goes for three hours on Monday mornings and Yesterday they said he did wonderful and didn't appear to have a single problem after I left the classroom...he participated just exactly as they expected and he showed very few sings of anxiety during the whole time.... When he left the class he found me in the crowed of moms...and walked right to me with a smile on his face and was excited to show me his art work.

The psychiatrist sees that Makala is showing great signs as well and feels that she has a good sense of family and a normal desire for approval from me..... and that she is gaining new skills every week and doing wonderful.

I don't really know what to think at this point.... I can say that we have been thrilled with some of the changes since the medications were started and that overall our home is 100% more peaceful then it was only 60-days ago.

Clonidine was removed from the program and a second ADHD med was added.... Lately Makala has shown that she is able to concentrate and color and play games for much longer periods of time....and that she is focusing on her learning and starting to understand some things she didn't every day. At night she has been so tired she just goes to bed without even an argument.

We have been using the STAR reward system for the past few weeks and she is appearing to understand and respond very well to this. She has also had some small chores added to her day and is eager to do these to earn a star and the praise that comes with it.... She is working toward allowance and seems excited about her role in doing things around the house.

so I will just wait and see.... I suppose it is possible that the RAD was real and that my education and efforts have made a big difference? We have always been acutely aware of attachment and we started right off with the techniques we learned and have adjusted them as needed--maybe this all has made a difference? January will be the two year mark from the time the children were placed and perhaps this summer was the DARK before the dawn?

It will thrill us if she is taken off Risperdal and continues to have the control not to fly off into the RAGES....

I had thought that maybe my BIO children were just sedate and clam kids and that I was spoiled by their passive natures--and I had not realized just how busy these little ones really are? I thought maybe my older age made me more sensitive to the behaviors.... But both doctors tell me these children are very active and very busy and that I have my hands full! So I am relieved to know I am not crazy when I don't remember things being this hard 15 and 20 years ago..... my oldest son and Tori are clam and sedate people and always have been.... so who knows?

Anyway---that's the stat today.

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