Progress, blessed progress

Wow, who knew we'd get so much accomplished in a few hours yesterday. Earlier in Jan, I was sort of just desperately throwing darts at a board to get him in for help, calling every doctor on the school psychologist's referral list, and snapping up any appointment offered. You see, I've been wanting to approach his issues on multiple fronts, from psychologists to neuropathologists. I want every possible answer out there as to what's going on with kiddo, and how to best help him. I consider his issues to be multilayered, and they need a multilayered approach. While I was positive one diagnosis would be ADHD, there was definitely more to the story. We can't just put a big stamp across the whole thing, because his symptoms have been so all over the board.

Severe development delays
Severe cognitive delays
Receptive language disorder (indeterminant cause, presumed related to above)
recent:
complete lack of impulse control
Lack of focus ability
Manic states
increased behavioral meltdowns, fits, violence
unawareness of what occured during above
diminished capacity for attention
very recent:
downturn in negative behavior
increase in clinginess
desperate requests for reassurance

I had made an appointment with a Psychologist (Dr. A), and an ARNP (Dr. B) in my dart board approach. Little did I know how fortuitous it was to make those to in conjunction, apparently they work together on a frequent basis. I filled out multiple behavior analysis questionairres, and sent some off to the teachers to fill out as well. Once the courts made their little stamp, I was able to get the plane off the ground and move forward with the appointments. I had hoped through one of them I could snag a consult with a neuropathologist.

Dr. A and I spent several hours together yesterday, as well as her with kiddo. She had one of the more detailed questionairres regarding Anthony's behavior, as well as I had provided her with every scrap of paper ever given to me by the district (IEPs, FBAs, etc). After taking in everything, including our family histories, she gave the initial evaluation of ADHD with an underlying anxiety disorder. Both were exacerbating eachother, causing the lines to blur, but also cause the downward spiral in his behavior. The ADHD gave him the inability to focus, which was exhausting and frustrating to him. The anxiety disorder would of course flare under these circumstances, resulting in the subsequent meltdowns. Our course of action is to medicate him for the ADHD, relieving some of his stress, then counter the anxiety with multiple levels of therapy. Once those are wrestled into control, we can take a much closer look at the over development, receptive language, and cognitive delays. She recommended a particular doctor who is reknowned for ful neuropsych evaluations, although warned me it could take months to get in. But if I was managing the immediate needs, I could wait a little longer to get the big picture on the delays. My primary concern is to help him with what he needs help with right NOW, which is the meltdowns at school.

She agreed completely that a placement change would be the worse possible thing for him. Not only would it rip him away from his support structure (hello, anxiety!), but it would put him in a place where he'd be seeing a model of much worse behavioral issues. As he tends to pick up on these things, it would become increasingly difficult to determine which were learned and which were inherent when trying to decipher the delay issues.

When I asked about the most recent behaviors, she said that was the anxiety disorder showing it's face in light of the turmoil at home. More than likely kiddo was picking up on Scott's beginning to pull out of the relationship in earnest, whereas I was putting blinders up. The unresolved stress from that, my feelings of lack of support, all of that was being swept under the table, but "piling up under the rug", so to speak. Regardless of the trauma of the inevitable abandonment that occured later, all of the unacknowledged tension was stressing out a child who cannot contain their feelings of anxiety. Thus, the surge in tantrums at school. The recent few weeks he's actually shown a lack of those freakouts, and it was at the exact time Scott had walked out. While the beginnings of his fears of abandonment are now apparent via the clinginess and constant need for reassurance of other's presence in his life, the huge ball of tension is now over, therefor his anxiety is ultimately reduced.

I took him up to the med specialist today, thinking it would be abother 3 hour appointment of me needing to explain just what's up, but Anthony surprised me with showing her exactly his problems. No sooner had we walked in than he began escalating into a full meltdown. I shouldn't have been surprised. It was his second day of not going to school, an unfamiliar place and person, a big scary office with no toys or distractions. The chaos the situation provided essentially primed him for his plummet. It began with a manic state of scrambling around flipping switches and ignoring my pleas to sit, then escalated quickly to him shoving furniture across the floor, kicking walls, and screaming. He rammed me, tried to shove the doctor, and actually managed to shove a two seat bench clear across the room. The climax was when I had to restrain him, and he began screaming uncontrollably and kicking wildly, and punching. Yea, mama's got a few more bruises now, he landed two to my head and several to the ribcage.
She looked at me and said she was pleased she could witness first hand what was happening, rather than have to piece it together from all the reports. It was very clear my child was quickly losing control, and in desperate need of help. We decided on Aderoll as an immediate med, with multiple followups to tweak it. This will be a long road as well, of trial and error, but at least we're on a road.

The part that surprised me about all of this was during the psych appointment yesterday, her request of myself. During the discussion of family history (including my own), and of course home life and recent events, apparently she put together a much more alarming picture of me than I had previously thought. She's asking me to seek professional help regarding issues of abandonment, aggressive rejection fears, and lastly, unchecked eating disorder. I was loath to admit the last part, and still feel a lot of shame admitting it now. I don't really want to talk about that until I am actually in help for it, tho, so don't mind if I gloss the subject. Suffice to say all three have been around for ages, and perhaps the doc is right, it's time I actually get help for them. Her concern is that my unchecked anorexia manifests itself in front of my child as a need for perfection in the home, which could cause him more anxiety. The other two obviously were present during the last few months of not knowing the lack of stability in my relationship, and were causing my child stress, in addition to sparking the anorexia to rear its ugly head again.

The irony to this is that I hadn't sought professional help earlier because, well, I like to think I'm strong enough to handle anything on my own. But apparently that's my downfall. If I simply allow myself to "get over it" but hardening up, remaining angry, resentful, and fearful, I am really only setting my child up to see a poor example. What I see as strength becomes a weakness in the eyes of a child who needs to grow up thinking that the world is an ok place, and not something to constantly be afraid of. I don't want to cry on someone's couch, and I feel like a stupid little girl whining about how a boy rejected me. But ultimately, these issues are pretty severe, and I need to buck up and get help for the sake of my child. *sigh*