Problem Child Out Of Control - Please Help!!!

Hey friends,

Quick run down about my 10yr old step-son (I have 2 step sons) and 1 young daughter (2yrs old)..

1. Diagnosed a couple years back with ADD/ADHD, Impulsivity, and some EDs ...

2. Lives with us 95% of the time, goes to fathers every other weekend with other brother who has sensory issues (no rules there, no structure etc).

3. Has been suspended from schools 4x in last 3 yrs, has been in now 3 different schools, currently accepted to a therapeutic school in which he just started 3 days ago -

4. Shuts down when he doesn't want to do anything, looks for negative attention all the time to get a rise out of people -

5. Looks for inappropriate ways to be during anything he does - (once told a girl he wanted to have se.. with her until she dies!!)

6. When not getting the attention he wants or is asked to do something (like reading with a group) and he doesn't want to do it he has started banging his head on the wall, and rubbing face into carpet) - yes this is in his new school 3 days in -

7. Is on a slew of medication which since the addition of a stimulant has made his behavior worse than ever !

8. The last straw was last night when he tried to swing on me, and screamed like a lunatic to my wife when we tried to talk to him about his behaviors

Long story short there are many many more examples i can make of his inappropriate, scratch your head no common sense things he does on a daily basis but i think you get the idea - when you speak to him he doesn't listen whatsoever its like you look right through him - he has a problem with food at night (medication issues most likely) where we find stuff everywhere - of course it doesn't phase him, he could sleep in the mess and he acts like it never happened etc. And just like the article on the front page suggestions by the time he comes home the meds already wore off and apparently more meds for afternoon/night is not an option right now -

The father does jack for him, most likely treats him like a baby (sons mental status is already way below his age) when he is there, lets them stay up etc all hours playing on ipads or watching movies (many conversations have been had) currently he does not go there but his brother does) - we in our house have everything monitored right down to the ratings on the TV - he literally needs to be watched with every moves he makes -

If you meet him for the first time you would never know anything was wrong, its when he is asked to do things, challenged, in a school setting, told not to do something, or asked to stop a behavior he loses his mind literally - we are at our wits end, just buying a new house we have yet to enjoy it and i constantly am worried about my daughter with all the issues we are seeing-

He is medicated by a psychiatrist and seen weekly at this point, sees a therapist monthly - was told recently we have to change medications or toggle down current ones - and hospitalization is not an option - don't know what else to do we have tried everything and all we want to do is enjoy life in our house (sounds selfish but we are exhausted)

I have many suggestions for you but am at work and will reply later today.

Is he in counseling for emotions - not just seeing a doc who puts him on meds? Can you even through a mediator or inviting his father to speak with his teachers and counselors so that he understands what kind of reinforcement needs to happen in his home?

In what world is once a month therapy remotely acceptable for a child with these conditions? Hopefully the new school will prove beneficial not only in their accommodations but perhaps their recommendations and referrals as well. It sounds like this child has been failed on multiple levels pretty much his whole life. How long have you been the step father?

(many conversations have been had)

maybe its time for a mediator to step in and explain the child's needs to him and what is required to keep him on even keel.

BTW, sugar and red food dye are a big trigger sometimes for kids with different needs. If that is what he eats at dad's or gets treats in school, it could be contributing. I would also get him tested for allergies like dairy, gluten, wheat, soy, etc - food allergies can cause brain fog at best but can mimic schizophrenia at worst

Your wife and/or his father need to take him to the best pediatric neurologist they can find for a second opinion and complete workup. Your wife and his father need a better co-parenting plan and both need to attend some sessions with the child's therapist at least until that is achieved...and then for follow up.

he has started banging his head on the wall, and rubbing face into carpet. sons mental status is already way below his age. He is medicated by a psychiatrist and seen weekly at this point, sees a therapist monthly

In what world is once a month therapy remotely acceptable for a child with these conditions? Hopefully the new school will prove beneficial not only in their accommodations but perhaps their recommendations and referrals as well. It sounds like this child has been failed on multiple levels pretty much his whole life. How long have you been the step father?

Ive been in his life for about 5-6 yrs and i don't remember it being this severe but than again we handled it differently when he was younger because well he was younger and it wasn't as noticeable or inappropriate (granted as he got older prior to this year in the past he has had other things sporadically like sleep walking and bathroom issues) that came and went ... and when he was younger he has had a normal life, however his behaviors dictate what we can and cant do with him and that has been the theme - he may watch something semi inappropriate somehow and than it will surface in his behavior at any point thereafter -

As far as the Psychologist unfortunately the system is pretty bad and we as parents can sit with him and talk and ask the same questions as much as any of these Drs do ...he pretty much takes advantage of the session by playing with legos and telling the person what they want to hear its quite amazing to think he is as smart as that but cant handle life like a normal child can - and unfortunately because of this he has no friends, and cant be trusted with other kids alone -

Your wife and/or his father need to take him to the best pediatric neurologist they can find for a second opinion and complete workup. Your wife and his father need a better co-parenting plan and both need to attend some sessions with the child's therapist at least until that is achieved...and then for follow up.

I will def bring that up, so thank you for that - he has had blood workups in the past and nothing has come up - but I'm afraid as he is getting older things are changing for the worst mentally because he acts as if none of this effects him in anyway - and 2 mins after a breakdown he acts as if it never happened and all is well in the world! The psychologist has told us he doesn't have a fully functional part in his brain that says right from wrong, hence the impulsiveness

Is he in counseling for emotions - not just seeing a doc who puts him on meds? Can you even through a mediator or inviting his father to speak with his teachers and counselors so that he understands what kind of reinforcement needs to happen in his home?

Has been done many times over and everyone in the school settings basically has given up on him because of the way the world is nothing can be done to a child who doesn't want to listen but call the parents and pick him up! He sees two DRs and its kinda a joke honestly - i really cant believe so far nothing has worked for him through counseling, DRs, special schools, programs i mean the works!!

Has this kid always gotten whatever he wanted from a young age without any disciplinary action for his mess-ups? It seems like most young boys who have a little extra energy these days are placed on adhd meds...

I work in a related field and work with teens who are on the spectrum or have ED. I also got ADHD and have a long history working with kids similar to your step son. Unfortunately I got a long doctor's appointment today, so I will get to you in a bit.

Has this kid always gotten whatever he wanted from a young age without any disciplinary action for his mess-ups? It seems like most young boys who have a little extra energy these days are placed on adhd meds...

Not at all, everytime he did something there was consequences ... and while i agree there is extra energy pent up thats not the force we are dealing with ... now as for the other environment he is in every other weekend i can almost attest to the fact that has something to do with the behaviors even if its minor ...that is why we have changed the way things have worked as of lately but again it never has been this bad ...

So any parent in this scenerio what do you do ?

1. Strict routine bedtime, TV, ipad ...etc..

2. Positive reinforcement

3. Rewards for good behavior

4. Dietary changes

5. Counseling / Pediatric Drs visits

6. Medication and Psychiatrict intervention

7. Special programs/Schools

8. ?

9. ??

And when all those fail, what do you do than?!? Thats where we are at unfortunately and stress is the norm which is not healthy for everyone else in the household ...

blood work ups won't necessarily tell you about a neurological problem.

blood work ups won't necessarily tell you about a neurological problem.

Will def look into that!! Well we contacted DRs and made decision to pull him from the stimulants and he has leveled off thus far (no crazy ball of energy looking to act out so impulsively) - obviously we still have to work on the whole picture so we have more Dr appts later today to sort through the remaining concerns -

The stimulant he was on was the devil ... we know others that tried similar things and that made them zombies the opposite bf what we experienced (so it really depends on the person and diagnosis how they will react)

Will def look into that!! Well we contacted DRs and made decision to pull him from the stimulants and he has leveled off thus far (no crazy ball of energy looking to act out so impulsively) - obviously we still have to work on the whole picture so we have more Dr appts later today to sort through the remaining concerns -

 

The stimulant he was on was the devil ... we know others that tried similar things and that made them zombies the opposite bf what we experienced (so it really depends on the person and diagnosis how they will react)

You might want to consider that this child is completely over medicated and get a second, third and even fourth opinion on his drug cocktail and dosage as well. Unfortunately, in the US it's all too common for doctors to throw handfuls of pills at problems and very difficult to find doctors with a better approach. These kinds of drugs can have rather ironic side effects - namely exacerbating the problem or even creating additional psychological problems. You've got to be careful with them.

Also, have you tried putting him into sports? A distant cousin of mine had severe adhd as a child and sports were a life saver - not only energy wise, but helping the brain focus and get out of the fog. Physical exercise produces positive chemicals in the brain. You might want to try some different sports and see what he likes and what sticks so to speak.

You might want to consider that this child is completely over medicated and get a second, third and even fourth opinion on his drug cocktail and dosage as well. Unfortunately, in the US it's all too common for doctors to throw handfuls of pills at problems and very difficult to find doctors with a better approach. These kinds of drugs can have rather ironic side effects - namely exacerbating the problem or even creating additional psychological problems. You've got to be careful with them.

 

Also, have you tried putting him into sports? A distant cousin of mine had severe adhd as a child and sports were a life saver - not only energy wise, but helping the brain focus and get out of the fog. Physical exercise produces positive chemicals in the brain. You might want to try some different sports and see what he likes and what sticks so to speak.

We tried programs a year ago with mixed results anything to challenging like karate was a nightmare for him, to structured and sports he did flag football and had a hard time staying with the rules and organization of the groups : playing as a team etc usually went off on his own on the side .. he did do well from what we know in camp for a few hours during the summer months but the school he is in now is like a year round camp anyway ...yes the meds are not a one size fits all and I guess we haven’t found the right combo of All things yet

Will def look into that!! Well we contacted DRs and made decision to pull him from the stimulants and he has leveled off thus far (no crazy ball of energy looking to act out so impulsively) - obviously we still have to work on the whole picture so we have more Dr appts later today to sort through the remaining concerns -

 

The stimulant he was on was the devil ... we know others that tried similar things and that made them zombies the opposite bf what we experienced (so it really depends on the person and diagnosis how they will react)

I would definitely see a neurologist and mention the head banging. A doctor of psychiatry knows a lot, but if there is something actually short circuiting in the brain, or there was a situation where he was deprived of oxygen in the womb, etc, a neurologist can dig deeper. The psychiatrist can deal with moods but if something is going on that's physical with the brain -- the neuro is who you need to see just to rule things out or see what else he can be helped with or get a better understanding.

We tried programs a year ago with mixed results anything to challenging like karate was a nightmare for him, to structured and sports he did flag football and had a hard time staying with the rules and organization of the groups : playing as a team etc usually went off on his own on the side .. he did do well from what we know in camp for a few hours during the summer months but the school he is in now is like a year round camp anyway ...yes the meds are not a one size fits all and I guess we haven’t found the right combo of All things yet

You know he can't handle the structure -- kids who can't understand structure sometimes respond to unstructured time outside -- make it up as you go along type of games, etc, just exploring and looking for different leafs and bugs in the woods (with of course supervision).

True. Only a qualified pediatric neurologist can do all the appropriate exams, studies, labs, etc including brain imaging, genetic testing, etc. Throwing random stimulants like m&ms at a child like this is going to make matters much worse. Particularly without a specific, accurate diagnosis and more evidence based and targeted, rather than trendy, treatment.

blood work ups won't necessarily tell you about a neurological problem.

You might want to consider that this child is completely over medicated and get a second, third and even fourth opinion on his drug cocktail and dosage as well. Unfortunately, in the US it's all too common for doctors to throw handfuls of pills at problems and very difficult to find doctors with a better approach.

It depends on state regulations for neurological narcotics. Some are more strict than others. When I was living in Pennsylvania it was a requirement for me to attend sessions with a behavioral specialist AND the psychiatrist before they could prescribe any refills for Concerta (ADHD meds). I moved to another state a couple years.... hey cool, I can get the same prescription from a family doctor without any referrals from a therapist. However I had to have former evaluations dating back to my childhood proving my diagnosis, but nothing current.

It depends on state regulations for neurological narcotics. Some are more strict than others. When I was living in Pennsylvania it was a requirement for me to attend sessions with a behavioral specialist AND the psychiatrist before they could prescribe any refills for Concerta (ADHD meds). I moved to another state a couple years.... hey cool, I can get the same prescription from a family doctor without any referrals from a therapist. However I had to have former evaluations dating back to my childhood proving my diagnosis, but nothing current.

Update he is doing better but that is subjective as the medication he is on causes strange behaviors at night (food binging and complete messes, and total forgetfulness doing things 4-5x after repeatedly asked and asked to repeat instructions ) the food thing is the worst in which he tries to hide some, but leaves it for every one to find - the strange thing of all is even with consequences he has no idea its even happening and continues to demonstrate it night after night ...

He also continues to test his new school, trying to get out of activity he doesn't want to do (put a rock in his mouth, and tried to eat a flower) to get negative attention and get out of work - things he would never try at home .... he also has a habit of taking things he knows hes not suppose to touch knowing he will get in trouble

While we know some is kid behavior the other 90 % is just frustrating - and our emergency appt. with the psychiatrist was once again a joke - "so we stopped the stimulant and he is doing better?" Ok lets see where he is at 2 weeks from now ... I asked about a pediatric neuro and he said "There is no magic answer in mental health your free to bring him there but i am not sure what your goal is " Yes i went off on him - this is the world of I don't care or they don't pay me enough to deal with this, we live in -

I can't fathom how frustrating this is for you guys... Have you tried talking to the kid? (stupid question, but I had to ask) Just a normal, no pressure convo. I still wonder if you can trace his behavior change to a specific event that had happened?

Sorry this is happening. Definitely just take him to a pediatric neurologist, your wife doesn't need this shrinks approval to do so. Many things in this age group can be neurological, genetic, metabolic, etc. and not just mental health, even though the manifestations are of course behavioral. It's important to note that throwing drugs around empirically, particularly in the pediatric population, can cause more harm than good, create permanent damage in a developing brain and does not get to the root causes so does not address this child's issues and needs. The good of any treatment must outweigh the bad, remember...first do no harm, right?

I asked about a pediatric neuro and he said "There is no magic answer in mental health your free to bring him there but i am not sure what your goal is "

I understand there is no magic answer, but if your kid is banging his head against the floor or wall it could be also neurological. I would list as many physical behaviors as well as willful/thought out behaviors as you can.

Well if he has no rules when he is with his dad, i think its high time for a mediator to sit everyone down and update everyone for dad's benefit on what the child needs according to doctors. Maybe he should not have free reign at dad's house or require supervised visits if dad is eroding things by just having a free for all. Have you considered locking the refrigerator?

Well if he has no rules when he is with his dad, i think its high time for a mediator to sit everyone down and update everyone for dad's benefit on what the child needs according to doctors. Maybe he should not have free reign at dad's house or require supervised visits if dad is eroding things by just having a free for all. Have you considered locking the refrigerator?

Well the Dad issue has been dealt with so far the last couple of weekends he hasn't went, he honestly could care less and has been included in alot of reports from schools and Drs but has no real input or rational for it ....and as far as locking the refrigerator believe me i have wanted to do that for the longest but since we have other kids in house it doesn't seem right to do so ....

the problem is he does things for positive and negative attention, and he smart enough to know what he can do or say to trigger getting out of something ... but on the flip side i don't think mentally he understands what he exactly is doing (right from wrong, inappropriate etc) .. I have a two yr old with my wife and at that age she is running circles around him how smart she is and it amazes me how genetics and environment can play a huge role in a childs learning etc.

Excellent observation. Especially since your wife is adopted, this is all the more reason to consult a pediatric neurologist. She really doesn't know if genetic issues run in her family.

It would be a tragedy to treat biological issues as a custody/behavior issue. That would be like the dark ages when medical science didn't exist and people were thought to be possessed or punished and caged for things like mental retardation, chromosomal aberrations, inborn errors of metabolism, etc.

Once an appropriate assessment is made, then treatment including therapy for the families and child to cope are indicated.

I have a two yr old with my wife and at that age she is running circles around him how smart she is and it amazes me how genetics and environment can play a huge role in a childs learning etc.

Well most were right, we gave them an opportunity to go the fathers this past weekend only to pick them up (both boys) and to have the 11yr old crazy tired (couldn't keep his eyes open in the car, yet alone slept almost all day ) because of being up all night playing "games" with no supervision or adult intervention, and our 10yr old (*the one i started the thread on) looking like he lost 5 lbs (secondary to medication issues) but also because there is no intervention to allow him to eat more (he eats there, so there no question of that just the fact that he isn't being monitored with activity (they have a pool) so calories out vs calories in to offset medication loss of appetite -

So the question is to look into supervised visitation or not allow them to go there period - the father claims the 11 yr old waited until everyone went to sleep to play games so he was lying how he wasn't up all night, and the 10 yr old he had no comments on just that he was "good"

So around and around we go, my wife seems to think i should call him and express concern (ive done this before with no luck or even an ounce of smart responses ) bc her stress levels with all this is very high ...