How do you parent a child with multiple issues?

[CrossRockMama]

I'm feeling so helpless. We adopted our son from foster care. We were not his FP, just did straight adoption. We got him at 3 1/2 and he is 5 now. We were his 6th placement! We have two bio-girls (8 & 12). I teach preschool and worked in ECSE/EI for 5 years, so I knew from the start, he was not a "typical" child. We had a Neuro/Psych eval done in March and came home with quite a few diagnoses. Now I'm just confused and don't know where to start in our on-going struggle to parent him. He has RAD, possible ADHD, MERLD, Possible LD, and is DD. He pretty much tested at a 3 -4 yr level. He has come a long way in the short time we've had him, but it's been a ROUGH road. I started with knowing he had RAD, how could he not?! Suspected ADHD, but this MERLD thing is new to me, but makes perfect sense. He is a strange kid! Conversations with him leave me frustrated and him in his room throwing a tantrum over something I didn't even say! So many of these diagnoses over-lap with their behaviors, that I feel like I'm at a loss on how to parent him and help him to be successful! Plus, my husband just brushes off everything and thinks he will be fine. I feel pretty alone in this. It's frustrating. I don't know that you guys can really answer my question, maybe I just needed to vent.:0) I'm hoping to find some connections here for the MERLD as it's new to me!
Thanks!

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http://open.salon.com/blog/cheryl_ci...27/merld_world

I had absolutely no idea what most of those are. So, I googled. There is a lot of great information and stories out there.

http://www.inspire.com/groups/commun...erld-question/

[CrossRockMama]

Sorry!!
RAD= Reactive Attachment Disorder
LD= Learning Disability
DD= Developmental Delay
MERLD= Mixed Expressive/Receptive Language Disorder
I forgot to mention that they said all his delays and behaviors are consistent with Fetal Alcohol Effects too, but bio-mom states she used nothing during pg, so we can't prove it. I think the other diagnoses cover most all his issues though.

[KCMichigan]

My first thought is do you have a support system??

My DD has mild issues, so I have not dealt with more complex things- but our support has been fantastic. My family has been supportive, we have had a lot of help from EI and now the school has her on an IEP that has been wonderful.

Are there support groups around? For RAD? For adoptive parents? For DD? I know our area has all 3 and a lot of them overlap a lot.

Did the school offer you any help (IEP , speech, Spec.Ed placement?)? They have the potential to be a wonderful resource and may offer social skills training, speech, alternative communication, behavior plans, etc that you could use at home as well.

How do they suspect LD at age 5? It would be unusual, though not impossible.

Does your area has respite care? Wrap around services for adoptive families?

Does your DS have the physical features of FAS? Can you get a clinical diagnosis of FAE/FAS?

I think if you found some other people that have multiple or similar issues you may find some workable solutions- if not someone that can share your journey.

I hope you find some solutions and some support in your area soon!

[CrossRockMama]

Yes, we have help. He just graduated his ECSE preschool (it was the same one I used to work in!) and will be entering K with an IEP. Our girls attend a small private school and we had the tough decision on where to send him. Went with public so he could get the help he needs. We also get therapy services and online groups have been helpful too. Our family is very supportive, everyone loves him. We learned fast that you have to put tight boundaries on him and be very consistent, so sometimes our family thinks we are being too hard on him.

[heatherdeg]

Originally Posted by KCMichigan

My first thought is do you have a support system??

Not just your family accepting and loving him, but truly supporting your household... taking the girls for a break from the intermittent (or maybe constant?) tension, cooking a meal for you once in a while, etc...?

Originally Posted by KCMichigan

How do they suspect LD at age 5? It would be unusual, though not impossible.

Actually, my bio got an IEP for LD at 3yo when he transitioned from EI to the local districts (this is a Federal thing--that the districts pick it up at 3yo). They have to address anything that would affect learning in a classroom setting, and therefore a lot of things fall under LD... fine motor issues that could prevent appropriate hand-writing, scissor use, etc. Speech problems that would affect participating in classroom discussion or reading aloud, etc. That's in addition to any cognitive impairment or disruptive behavior issues ("disruptive" meaning that it interrupts the learning process--in addition to possibly being disruptive to the class).

Originally Posted by KCMichigan

Does your area has respite care? Wrap around services for adoptive families?

Originally Posted by KCMichigan

Does your DS have the physical features of FAS? Can you get a clinical diagnosis of FAE/FAS?

We've been down this road and getting a dx is SO. DIFFICULT. Especially if the bm denies use. In fact, our ffd actually had the physical characteristics.


So what I'll add...

Are you guys with an attachment therapist? Because that would probably help.

My bio, believe it or not, had some rather severe behaviors due to a less severe attachment problem (he didn't know I was in the room with him until he was nearly 2yo ). I've found that really, the only book I could get any relief from was the Positive Discipline series by Jane Nelson. The truly, full-blown RAD books were trying to assist with SEVERE RAD (I'm thinking of "Beyond Logic, Consequences & Control" although that was the first book to address kids with attachment problems who were not adopted and the possible other causes--which opened my eyes). The mainstream books were NOT going to help me at all. But the Positive Discipline series made it possible for me to help him understand that we had some basic rules of living to adhere to but not tear down his self-esteem or alienate him any further (making the attachment issues more severe).

So that was managing safety and some semblence of order. When that was accomplished, life in general got way easier to manage, I (and everyone else) was able to relax a little more and then we could focus on other things (which seemed so much more possible).

I definitely needed 10 minutes to myself each day. If your dh truly sees nothing wrong, well, that's not helpful to you--but then he also shouldn't mind having a father-son date at least once/month, too. And then you can spend some quality time with your girls, too. It would be ideal if you could have some time to yourself, too... but I realize that may be pushing it. When #2 came along and had issues, I really only got a bedtime story and a snuggle from #1 each day to reconnect. I think it was really worth it. And dh started learning how to give baths (as I sat downstairs listening to all of them figure out how to manage it... cringing every moment )

It's definitely gotten better. At some point, you'll just start addressing the specific issues vs. finding solutions specific to a dx. You're right: there's a lot of overlap. At the end of the day, the dx is way less relevant when trying to figure out how to actual help your child (and possibly family) cope with the actual symptom that pops up from that condition. Does that make sense? The labels are often great for obtaining assistance and certainly give you keywords to use to seek advice, ideas, guidance, help and occasionally services. But focus on what's causing issues either for you, for your child or for the family and tackle those one at a time until you are all somewhat at ease enough to really enjoy one another and pass the time without feeling like you're treading water.

It will get better. Hugs to you, mama.

[KCMichigan]

Originally Posted by heatherdeg

Actually, my bio got an IEP for LD at 3yo when he transitioned from EI to the local districts (this is a Federal thing--that the districts pick it up at 3yo). They have to address anything that would affect learning in a classroom setting, and therefore a lot of things fall under LD... fine motor issues that could prevent appropriate hand-writing, scissor use, etc. Speech problems that would affect participating in classroom discussion or reading aloud, etc. That's in addition to any cognitive impairment or disruptive behavior issues ("disruptive" meaning that it interrupts the learning process--in addition to possibly being disruptive to the class).

I am surprised only because I worked for the school systems and usually children ages 3 to 6/7 were given a PPI (preprimary impaired) or ECDD (elementary developmentally delayed) if they had delays that were not cognitive or severely physical. Or a simple speech IEP or an OHI diagnosis (which is what my DD has for gross motor/social delays). She gets PT/OT as well with this dx. It is a more 'catch all' than a true LD. LD is usually a difference in cognitive ability and achievement. School system are mostly using an RTI model to determine an LD dx (or rather lack of response to interventions). Since cognitive and achievement levels can swing so greatly (most cognitive tests are not considered truly stable until age 7+) at young ages.


I would try to find a RAD / adoptive parent group for support and resources, they can provide a lot of insights and resources that may help your family.

I would also try to get involved with a behavioral therapist, speech language teacher, or social worker that can help your family work with son on communication--they may have some ideas you have not explored (augmented communication??).

[CrossRockMama]

Thanks guys! It's nice to talk to people who understand. We have been getting attachment therapy (Theraplay) and it's helped a lot. My husband has been great with him and I didn't mean he thinks there is nothing wrong with him, just that he doesn't want him "labeled" and so I feel like he tunes out when I bring stuff up. He spends a lot of time with him and believe me; I get out of the house whenever I can. A friend and I go to the movies in the evening a lot! We both need to get out and it's nice to be able to do that. I work at the private school our girls go to, so I get to spend a lot of time with them there and we do make sure to give them extra time at home too. Yes, he gets Speech services too. He has an inconsistent stutter that varies from non-existent to so severe he makes faces trying to get the sound out. It's taken us a while to figure this guy out, but like I said, we've come a long way and we do see improvements all the time. I am very curious how he will do in a typical classroom next year as he enters Kindergarten. He'll go in on an IEP and hopefully they will be patient with him.

[CrossRockMama]

Oh, and the LD diagnoses, wasn't a diagnoses, they said they thought there would be a possibility of it and so to keep an eye on it. It's hard to say. He is great with concrete facts. He knows all his colors, shapes, numbers, letters, and sounds of the letters. You can give him a word and he can tell you what letter it starts with, but you ask him a "why", "when" or "how" question and he has no idea how to answer it. Or his answer doesn't quite fit the question.

[heatherdeg]

Originally Posted by KCMichigan

I am surprised only because I worked for the school systems and usually children ages 3 to 6/7 were given a PPI (preprimary impaired) or ECDD (elementary developmentally delayed) if they had delays that were not cognitive or severely physical. Or a simple speech IEP or an OHI diagnosis (which is what my DD has for gross motor/social delays). She gets PT/OT as well with this dx. It is a more 'catch all' than a true LD. LD is usually a difference in cognitive ability and achievement. School system are mostly using an RTI model to determine an LD dx (or rather lack of response to interventions). Since cognitive and achievement levels can swing so greatly (most cognitive tests are not considered truly stable until age 7+) at young ages.

Guessing that different districts must do it differently, and maybe part of this has to do with whether the children are coming to them from EI or not...? Not sure. And he was deemed "multiply disabled" and then stepped down to LD before being declassified.

Originally Posted by CrossRockMama

He is great with concrete facts. He knows all his colors, shapes, numbers, letters, and sounds of the letters. You can give him a word and he can tell you what letter it starts with, but you ask him a "why", "when" or "how" question and he has no idea how to answer it. Or his answer doesn't quite fit the question.

Wow... that was totally my kid. It scared the life out of me. In fact, he COULD tell you why, when or how about things--but only if he initiated that information vs. being asked about it... which was very frustrating.