new heer and could use some help...

[ksm]

We have adopted out two granddaughters, who are now 11 and 13. To understand some of the behaviors, I have to give some history. My son married a woman who had drug/alcohol problems, and who already had two children being raised by others. She was pregnant when they met and was using drugs and alcohol. She his the pregnancy for several months - but I believe she stopped using around the 5th month. About 1.5 years later, they got married. She did manage to get one child out of foster care at age 2.5 (older brother to the two we adopted) but her oldest son stayed with his dad and stepmom. Then had one more child. When the kids were 3,5,7 they were removed from the home because both parents were using drugs. They spent a year in foster care, before the courts would give us custody. Eventually the oldest went to his bio dad, and we adopted the two younger ones. Xdil has been diagnosed as bipolar. Xdil's father had "mental issues" And xdil aunt is bipolar. We have no info on our 13yo's bio dad.

OK - our difficult child has steadily had worsening behavior and academic problems at school. The therapist and teachers think she is ADD based on her teachers and us filling out a questionaire. She is now on Stratera 40mg once a day. But there are bigger issues - mainly her anger, rage, and how she reacts to her sister and us. The therapist said their might be indications of borderline personality disorder. I started reading about that - and I read about "histrionic personality disorder" and that describes her and her mom to a T.

Here is one example. Last night, I offered the girls some fruit to hold them over until supper was ready. difficult child gets all irriated and says how she can't stand bananas and apples, as they make her teeth feel disgusting. The tirade continues, and finally she was sent to her room to calm down. Afterwards, I came up to talk to her and she finally admitted that she just didn't want to eat any apple or banana, and they didn't make her teeth feel disgusting, she just didn't want to eat them. I said, why didn't you just say no thank you... and she starts crying and says I don't know why I say all that.

This is just about how every day goes. No matter how simple the things are - she makes a big dramatic production - over her everything! If she doesn't want to wear something - she goes in to a tirade about how things doesn't fit, are too tight, make her look fat. Instead of just picking something else, she rants and raves. Same with meals. Vegetables are disgusting... salad with dark leaves are disgusting... salad with too white a leaf is disgusting... she only wants medium green iceberg lettuce... and drown it with ranch dressing. She will take a fork and dissect every bite. Nothing can touch other items. All she wants is meat and starchy things and sweets.

At school she is tested above average, but does below average work. She doesn't make and keep friends easily. She is very cute, petite and attractive (has been compared to looking like Dakota Fanning at that age) but sees herself as fat and ugly. Even though she is 13 - she can still wear size 10/12 in the young girl department.

Anyway, I realize that she has been thru a lot - and I don't expect perfect behavior from a 13 yo... but I am getting worn down dealing with all of this on a daily basis. I bet there are 2 or 3 meltdowns a day. Unless, her little sister is at camp and 13yo doesn't have to get along with anyone. THis past week was awful - and we had her 15 year old brother here for a visit. I think it was because he is the oldest in his family and she is the oldest one here. She is so used to not having any one challenge her on what shows to watch, what games to play, that she just thought she would have her way all the time.

Well, there are lots more things to add - but I will close for now and see if others are dealing with similar behavior. I have asked our therapist for a consult with a psychologist (no psychiatrist for teens in our area). What ever this is - I want to get on top of it soon. Thanks. KSM

 

[crazymama30]

Wow, you are dealing with a lot. What kind of evaluations has she had? Can you create a signature so we can keep track of who is who and their logistics easier? Is she on any medications? I am sure others will pop in with more questions/support. Things can be slow here on weekends.

 

[keista]

Welcome.

I had to look up histrionic personality disorder because I had never heard of it. From what you describe, it sounds like a valid possibility. Get that referral for good evaluation. From what I read this disorder is only diagnosed after age 18 just like borderline personality disorder. I'm just guessing that this is because in childhood, the personality is still actively forming, which in my opinion means by addressing this now you have a better chance of steering her in the right direction.

It is possible that she ALSO has ADHD. Those questionnaires are a start, but there are other evaluations that are more definitive like the TOVA.

Welcome again, you've found a great place for support, guidance and insights.

 

[BusynMember]

Hi there.
I just woke up so forgive me if I ramble a bit

We adopted two children who were exposed to drugs/alcohol during pregnancy. We also adopted two children (one was six and one eleven) who came to us after having chaotic early years (especially the 11 year old).

It is unlikely that you are going to be able to pinpoint one problem with your grandchildren. The facts are, both alcohol/drug use during pregnancy (even if she actually did stop at five months) AND early chaos cause serious problems in children that often last a lifetime. In the case of alcohol, use in utero can and often does cause brain damage that is not reversible. Kids on the fetal alchol spectrum often do not learn from their mistakes and really DON'T know why they behave in certain ways. medications often are ineffective in curbing their behaviors and, from what I know of children who have suffered alcohol affects, they usually grow up to not understand good choices and often drink too much themselves and have children with alcohol spectrum problems. From what I've read on the syndrome, the best treatment is constant care to help them curb their bad choices (which aren't their faults and aren't because they are "bad" kids). Whether this is your main problem or not, I don't know.

Reactive attachment disorder is also a huge problem with kids who have had lack of early nurturing. The children learn to trust one person: THEM. They have trouble, even fear, loving somebody and have various degrees of trouble attaching. Raging, antisocial behavior, setting fires, hurting animals (these are the extremes) can happen. Our 11 year old was too damaged to live in a family as he killed our animals and sexually abused (over and over again) our two youngest. He had to leave. We dissolved the adoption. He didn't care. He wasn't attached to us or to anyone. We also suspect he had fetal alcohol effects as his birthmother had indulged when she had been pregnant.

I would take t he kids to a neuropsychologist. He may not be able to pinpoint everything going on, and he may not even be able to help, BUT he might be VERY helpful. And there may be disorders going on that CAN be helped. With complicated children like yours and my two, in my opinion a psychiatrist or therapist or pediatrician isn't enough. They have been through more than the normal child even before they were born and probably have a combination of both neurological and psychiatric issues.

You may also want to join a parent group of adoptive parents. Trust me, they will understand your problems. They are common within the adoptive community...most in those groups have deliberately adopted high maintenance kids and understand their behaviors and exchange strategies.

Bless you for taking in your grandchildren. Keep us posted on your progress. We can not diagnose here...and my best guess is that a lot is going on, both neurological and psychiatric. But I could be wrong. See a neuropsychologist. I will say that our neuropsychologist told us that it's common for drug/alcohol affected kids to display autistic traits or to have autism. But that is rarely the only thing going on.

 

[ksm]

Wow, you are dealing with a lot. What kind of evaluations has she had? Can you create a signature so we can keep track of who is who and their logistics easier? Is she on any medications? I am sure others will pop in with more questions/support. Things can be slow here on weekends.

OK, I figured out how to add a signature line. Hope that helps!

She has been taking Stratera 40 mg for a couple of months. They tried to get her up to 60 mg but she couldn't tolerate that. She didn't feel that she needed medication, but once we stopped it (at 60mg) she said she noticed that she was kind of hyper and couldn't concentrate as well. She said she noticed on the medications that kids would talk to her more at school. But I think when she was off the medications, she talks a lot... and randomly... like it doesn't fit in with the conversation. She does that at home a lot, blurts out something that doesn't have any thing to do with what we are talking about.

After the rant about apples and bananas being disgusting - she had cereal this morning and sliced a banana in it! This behavior isn't new... just seems to be getting worse. One time, about 5 years ago - when she was about 7 and her sister 5. She had a day long rage because they were playing "Barbie" and her doll HAD to go to prom FIRST! Her little sister held her ground and said all the dolls get to show up at prom at the same time. But no, difficult child's doll had to make an entrance first, then all the other dolls could show up 15 minutes later. That should have been a clue what the future held. It seems like such a silly argument between two little girls. But I gave her a time out until she could calm down, then compromise and play. Well, after several hours of crying and arguing she finally explained to me: "I have tried to compromise, but she STILL won't do it my way!!!"

It would be funny if it wasn't my life. To other people, they think she is the easy child. She relates well to adults and prefers to hang with them... or to baby sit toddlers and little kids. She is charming. Just not at home. When she has a rage - she later feels remorseful and says things like, everyone would be better off I was never born (or dead) and other times she cries I don't know why I am so mean to my family. I don't know if it is true remorse, or just more attention seeking behavior.

KSM

 

[ksm]

OK - I don't know how to put the signature line at the bottom. I went to edit profile, and did info, place, hobbies, work, etc... but it is not showing upl. KSM

 

[keista]

Edit signature is under the settings tab, about halfway down the page.

"I have tried to compromise, but she STILL won't do it my way!!!"

DD1 used to say those words ALL the time. Ppl (including me) just stopped playing with her. Now with her peers she's better feeinign the natural consequences and is learning to really compromise.

When she has a rage - she later feels remorseful and says things like, everyone would be better off I was never born (or dead) and other times she cries I don't know why I am so mean to my family.

DD1 does this as well. For her it is NOT manipulative behavior, she is truly in pain. Has your difficult child Always done that? If so I would tend to look at it more as a REAL symptom than manipulative behavior. If this is NEW it could still be a REAL symptom, but at 13 the thought process to manipulate is certainly better formed and thus manipulation becomes a much more viable possibility. Ultimately, if it is manipulation, then that in and of itself becomes a symptom.

It really sounds like you have more than just one issue going on with your difficult child. Suicidal thoughts are not listed as a symptom of histrionic personality disorder.

 

[DDD]

Having raised two grandsons I admire your goals. It is not an easy road...that's for sure! The most helpful action I ever took was getting neuro/psychological examinations. Some people on the Board have not had beneficial results but it was right on target for us and gave us much needed direction. ADHD is a diagnosis that we have lived with for over forty years. Often it does not stand alone. Very often (using the Conner which is probably what you filled in) it is identified when in fact those behaviors are triggered by some other issues. The whole process is tricky. The medications are also tricky as there are many of them and what works best for one may not work well or have side effects for another. the newest medication Vyvance (sp?) has been an improvement over the Concerta for the two grandkids who still take it daily.

Welcome aboard. It's likely to be a bumpy ride. Consider finding the best resource for neuro/psychiatric testing. It is mutliple tests given over a six or eight hour period that gives a full overview. I also suggest that in lieu of a Pediatrician that you find the best qualified Child/Adolescent Psychiatrist available for guidance and medication control.
It sounds like there are multiple issues involved and you'll need expert help to find the right path. DDD

 

[ksm]

Thanks DDD - I will look in to that - but the insurance company will probably make it difficult to see a neuro-pysch. Will see if we can pay for it out of pocket. I am not sure how far away we would have to go to even find one - and if they will see teens. When I talked to the therapist - he said that the psychatrist in our community will not see anyone until age 18. The nurse PRNA (I think those are her credentials...) works under a psychiatrist in a nearby town - and is the one who prescribed the stratera. He has a better opinion of her than the psychiatric in our town. So hard to know where to get help. KSM

 

[InsaneCdn]

First, welcome...

It would be funny if it wasn't my life. To other people, they think she is the easy child. She relates well to adults and prefers to hang with them... or to baby sit toddlers and little kids. She is charming. Just not at home. When she has a rage - she later feels remorseful and says things like, everyone would be better off I was never born (or dead) and other times she cries I don't know why I am so mean to my family. I don't know if it is true remorse, or just more attention seeking behavior.

There's some positives buried in what you write - but its easier to see them when you're not living in the situation. (been there done that)
Its positive that she can tell the difference on-medication vs. off-medication - it also gives you a good guideline on the effectiveness.

Its also postitive that she is better with others than at home. Usually, this means two things... first, that they have some control over their behavior, and second, that they feel safe at home. As a result, they put in the effort in public to hold things together (and are at least partially successful), but then are burned out from the effort, and so "home" gets the brunt of it. (been there done that)

The feelings that are coming out, are also positive - she's not likely "detached". And she's responsible enough to baby-sit?! WOW! That's another positive.

But there's definitely issues... and you are wise to be seeking help.

We don't have access to neuropsychologist here either... but have had success in a couple of different scenarios... one was a BSN(P) (= Degree psychiatric nurse with pediatric training) who worked out of a mixed-resource clinic - the nurses were the only full-time staff, but they had access to a string of specialists that they could bring in. These can be good at screening - and then figuring out what resources are appropriate given the needs being presented. This seems to be what you've been offered, and the source of the ADD/ADHD diagnosis (and rx)... There is nothing wrong with pursuing this further, especially if they can get you in quickly. We've also had good success with Doctoral Psychologists (PhD-level) - these are not as good at therapy, but really good at research - so, really good at thorough testing and detailed recommendations. Just a couple of ideas...

Keep in mind that many of these kids are complex. There won't necessarily be "one" diagnosis that explains what is going on. More likely, there will be multiple layers, and you won't find all of them on the first pass because the next set of symptoms may not show up until you start dealing with the more surface issues, or the symptoms may be from more than one cause, and dealing with one cause won't solve all of it...

Hang in there!

 

[BusynMember]

The big difference in these kids and others are that they were probably exposed to alcohol before birth and had very chaotic early years. Those are HUGE. A neuropsychologist or specialist who understands complicated adopted kids (because this is just like a foster care adoption as far as issues go) would probably be better than somebody with no experience with drug exposed/early deprived children at all. Sadly, many professionals don't understand the harm of alcohol in utero or neglect in the early years and many of us spin our wheels forever trying to get the right kind of help.

In a way, those adopted out of foster care have an edge because their new parents expect them to have issues, they often already have some services in place, and foster/adoptive parents don't have to think "How did somebody in my family do this to this child?"

If respite is available, I certainly recommend it. I'd call social services to see what is available. We all need time to just relax.


It's not easy. Keep us posted.

 

[ksm]

If respite is available, I certainly recommend it. I'd call social services to see what is available. We all need time to just relax.


It's not easy. Keep us posted.


Even though the kids had been in the system for 2+ years (1 year foster family, 1+years with us) the courts pulled a fast one at the parents termination hearing. The judge asked the parents if they would sign a form naming us as the adoptive family, and they did. Then that afternoon, we were informed that this constituted a private adoption and that the state would not pay for the adoption costs, continue the health care on the girls til 18, provide respite care or pay a monthly subsidy to offset the costs of raising two children. But, if they were adopted by strangers, the state would have given the adoptive family all those incentives.

Basically, I think the court did that to protect themselves and SRS because our grandchildren are tribal members and all the time they were in SRS custody, they didn't follow ICWA (Indian Child Welfare Act). So by getting the parents to sign the form, the court did not have to prove the parents unfit, and then protected themselves for not following ICWA, which is a federal law. Long story, we got the kids, that is the main thing. It would have been nice to be able to provide some of the extras for them that would have been easier if it was a state adoption.

If they were not tribal members, SRS would have had these girls on the fast road to adoption. The CASA and family support worker warned us that they were highly adoptable children.

Today, has been so-so. difficult child is highly irritated with her sister. If her sister sings a song, she yells at her to stop... but if she whistles contantly and is asked to stop, then it is "I CAN'T HELP IT!!!" She also makes this irritating squeaky noise, that I believe is made by pulling air in thru the small gap between her teeth. Not sure how she does it, but if you are sitting next to her you can go bonkers after a while. I usually just try to go to a different room. She says she doesn't know why the squeak happens - she said their is a hole in the roof of her mouth and it just makes the noise. Yea right. She has an excuse for every thing.

She wants everyone to tolerate her quirks... but doesn't want to do the same for any one else. KSM