What to do if you feel your child has a mental disorder....

Brenda - posted on 11/17/2010 ( 16 moms have responded )

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Well I got to thinking about this, and in case someone needs this advice, I'll pass it on. Many of you know, I'm training to be a school counselor (high school or middle school) and my recent studies have been in diagnosis and treatment methods of childhood mental disorders. So I came up with a list of things I would tell any parent who is or might be dealing with this.

1. Our first instinct is to ask our pediatrician about things, and sometimes that's okay, unless you are afraid of a mental disorder of some sort (Asperger's, Autism spectrum, ADHD, learning disorders, anything really). This is really not a good idea because they have a turn on a psych ward during their residency, and it may not have been a children's psych ward even. So who to ask? Seek the help of a licensed counselor, psychologist or a psychiatrist. A counselor is least expensive and can tell you if you have something to worry about. A psycholgist is trained only in mental health and should have a Ph.d. or Psy.d. A psychiatrist is a medical doctor who has been trainined in mental health (and is the only one who can write a prescription).

2. Most the time, it is not recommended to diagnose a child before the age of 6. Some things can be evaluated, but only a few things can be diagnosed before 6 (stuff like Autism and childhood schizophrenia can be diagnosed) but there is a vast amount of 2-3 year olds diagnosed with ADHD when it is recommended to wait until six or older. Children change at fast rates, so it is possible that symptoms will disappear as they mature. Also, personality disorders are not diagnosed before 18-20 years of age.

3. If you are in public school system, (in the US) you have certain rights. You as a parent have the right to request an evaluation of your child for free for special services. I have to explain though, just because a child has a doctor's diagnosis does not mean they automatically get special services. (If a child is ADHD, for example, and it is completely controlled with medication, there is no need for an IEP - Individual Education Plan). And what the schools consider a diagnosis and what doctors consider a diagnosis are based on two seperate criteria. Schools base things on IDEA (Individuals with disabilities Education Act) whle doctors use the DSM IV TR (Diagnositic and Statistical Manual, 4 text revision).

4. Medication can be beneficial, and is sometimes necessary, however it is MORE effective when combined with therapy. ADHD sometimes goes untreated because parents say it "changes" their child. The child is the same, they are only not seeking intense stimulation at such a rapid rate, so they may seem more calm and reserved, but this will allow them to concentrate and focus where before they could not. However, a parent should never go into medication without less than full information on what it does and why they need it. When in doubt, seek a second opinion.

5. And always remember, everyone shows symptoms of many disorders, but it does not mean they have that disorder. You can look down the list of Autism symptoms, and find several you might have, I know I can. It is a combination of multiple symptoms that last a certain amount of time that makes someone (child or adult) be diagnosed with something.

I'm going to give this link, just keep in mind number five, and NEVER self diagnose. Seek a professional if you think sometime may apply to you, but please don't walk in and say I think I have this. Just give your symptoms and let them do the work.

http://psychcentral.com/disorders/

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Geralyn - posted on 11/23/2010

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Brenda, its so hard to condense what needs to be said in 5 bulleted items. You have a lot of great information there. School districts are not always responsive and have "cookie cutter" one size fits all programs and services that are not necessarily appropriate for all children with special needs. You may want to share with them a link to: http://www.wrightslaw.com/ It has books and articles about all kinds of issues. Not only do the parents have to become "experts" in their child's disability but they must also become experts in laws concerning special education. They cannot just go along with what school districts say or offer, but they must question things. Much of my work was advocating for appropriate school placements or services from providers outside of the school districts to be funded by the school districts. Its all about informed consent...

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Brenda - posted on 11/24/2010

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My five year old can't ride a bike, yet, lol. :) He never did learn to ride a trike either...

Nicole - posted on 11/24/2010

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Actually, Logan is now 8 years old and still can't ride a bike. He has just never shown enough interest to learn... or so I thought... Maybe it's because he doesn't want to fail.

Brenda - posted on 11/23/2010

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Well, this is the basics off the top of my head that I KNOW people don't know. But the best person to advocate for the child is the parent. It is unfortunate so few parents do this, and rely solely on what the school says. Special ed is expensive, and some schools don't want to approve children. But IDEA has a different definition than what you will get from a psychiatrist too.

Nicole: this is just a quick blurb from psych central on the clumbsiness:

Asperger’s: Physical Clumsiness
Delayed motor development — that is, the ability to move one’s physical body with ease and grace — is an associated feature, although it’s not a required criterion for diagnosis of Asperger’s Disorder. Individuals with AS may have a history of delayed motor skills such as riding a bike, catching a ball or opening jars. They are often awkward, with a rigid walk, odd posture and problems with visual-motor coordination.

Although this differs from motor development in autistic children, whose motor skills often are a relative strength, it is somewhat similar to patterns seen in older autistic individuals. The similarity might stem from different underlying factors, however, such as psychomotor deficits in AS and poor body image and sense of self in autism. This highlights the importance of describing this symptom in developmental terms.
http://psychcentral.com/lib/2010/asperge...

Pretty good info page though.

Nicole - posted on 11/23/2010

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Thank you. That's why his "clumsiness" never came to mind before. Everything that I have seen with "symptoms" about Aspergers, never went into much detail, if at all, about anything with motor disability. I just thought it was part of his personality and being so spontaneous. Not to mention that this would all explain his clumsiness and puts things in perspective. I never got angry with him for that and somehow always knew he couldn't help it.

Geralyn - posted on 11/23/2010

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Children with Asperger's tend to be "clumsy" and not perform well in gross motor activities. Motor planning, performance are affected and it is related to Asperger's, which is a neurological disability. Each part of the brain controls more than one area, and so I believe that is why the gross motor difficulties are usually present. Its usually an indicator. There are checklists on line I bet that would sort of prompt you to consider areas that may be related. For example, people would not necessarily associate gross motor deficits with Asperger's. If asked by an assessor, they may respond no because they are thinking no physical disability. But some of the indicators are more subtle. I'll see what I can find.... Let me see if I can get some names of books together for you to take a look at....

Nicole - posted on 11/23/2010

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Geralyn, no. He doesn't have any serious motor deficits. He is clumsy (he knocks over his baby brother all the time and doesn't seem to "look out for him") and he is not very good at sports (actually pretty bad at them). I always thought he just wasn't paying attention and because he hated sports (as part of his personality). He's very spontaneous and his little brother (or sports) don't fit into his plans. ;o) Unless, he is building something. He is amazing with Legos!!!! You should see some of the things he creates!!! He can make sculptures or cities and so on, to the amazement of anyone that sees them and spend many concentrated hours on them, but when he is walking throughout the house, he can't be bothered to take less than a second to avoid knocking down his 13 month old brother. I thought he was just clumsy or going too fast. Does this all go hand-in-hand???

Geralyn - posted on 11/23/2010

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Nicole, there is a genetic component. And in your dad's generation, it was not recognized as a diagnosis. You are absolutely correct to pursue an evaluation by an expert to identify or rule out Asperger's or a related issue. If it is not addressed, it can lead to emotional difficulties in the future, including depression, etc., and it can certainly lead to bullying, which in this day and time has become an epidemic. Logan can be given tools to help him.

Does he have any gross motor deficits?

Geralyn - posted on 11/23/2010

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April, that is insulting for people to minimize or dismiss what you have had to overcome. Even a mild hearing loss can impact learning and education significantly let alone being deaf. Your success really is based upon your determination and hard work.

Nicole - posted on 11/23/2010

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Thank you all! April, I would hate to lean towards Aspergers and push for it as a diagnosis IF my son doesn't truly have it, but I can't help but lean that way. When I started to research all different disorders I noticed that my dad, too, seems to have many traits of Aspergers. I seem to be the only one of my family who understands my dad. He is a bit eccentric and I guess many don't understand him, but I have always been very close to my dad. Maybe that helped me prepare to be patient and understanding of my son. I am grateful for that. Anyway, looking at my son and at my dad has made me wonder... Could they both have Aspergers? Could someone be predisposed for something like that by genetics? hmm..... But then... My dad has never been diagnosed with anything either...

April - posted on 11/23/2010

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i agree with you Nicole...I think you are right on the money with his diagnosis. A mother knows! I hope the right person can give a proper diagnosis and your son can get the services he needs, not the services he doesn't need! Good luck with the IEP...I know how hard it can be to work with the schools! I am deaf and I had an IEP all of my academic life, except college. I speak coherently and normally...it makes people think I am not deaf. it has lead them to believe that i didn't need the services i was requesting. I can totally relate to your son and his story!

Brenda - posted on 11/21/2010

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Temple is amazing. You should sit and watch the movie with your son. But there are things you can do to help him with the social aspects. Find yourself a specialist that deals with kids like him, and you won't have the problem with them not understand himand they can help by leaps and bounds to help him socially. Support groups, even with kids with other disabilities can be incredibly useful. It will give him the confidence to be insulated against those kids that don't like him cuz he's different. I'd get involved with the Autism Speaks stuff, and just remember that no matter what anyone says, your child is amazing, unique and more special than anyone can imagine. I love Temple's quote that more autistic people need to be where they should be. She found her niche and by her self revolutionized the cattle industry in the US. Incredibly brilliant mind, and when she was diagnosed they wanted to institutionalize her for life. :) Autisic kids can be a trial for moms and dads, but they are so amazing to be around. You have amazing minds its like they turned off some part of their brain and tuned in extreme intelligence in another part (which is where you get the savants - commonly and wrongfully often referred to as idiot savants, nothing about these kids and folks is "idiot" at all). I love your attitude, though! He's so lucky to have an awesome mom like you. :)

Nicole - posted on 11/21/2010

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Thank you! I hadn't heard of her! It is wonderful to see things like that!

Thank you for understanding. You are correct about how some feel about Autism. Because of his intelligence (which is quite high-we don't know where he got it from!), they easily dismiss him because he is not "delayed". But, I see his awkwardness, I hear him tell me that other kids "don't like" him because they can tell that he is "different". And I worry about him because he so socially awkward that he can be quite annoying to others and I know that this will always make it hard for him to make friends and I have no training to help him control the most annoying habits. For the record: I don't find him annoying, I love him, but I can see how others would think him to be. Again, thank you!

Brenda - posted on 11/21/2010

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Unfortunatley, many people do not understand the Autism spectrum disorders. They thing if a child is obviously smart, they should excell at everything. And with milder forms, like it sounds like you are dealing with (or what they term High functioning Autism), it is even harder because they can be absolutely brilliant in some areas. There is a common belief by many that all autistic children are mentally retarded as well, and while most are, not all are. They are instead somewhat "socially retarded" (my own description, nothing clinical about it), and have those boundry issues and don't know what is appropriate in social situations. Have you ever heard of a woman named Temple Grandin? High functional autistic that has made a great success.

http://www.templegrandin.com/
http://www.ted.com/talks/temple_grandin_...

Amazing woman.

Nicole - posted on 11/20/2010

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We have had such a time getting Logan a diagnosis because he has pretty much ALL of the signs of Aspergers except that he had a speech delay until he was about 2 years old but received some therapy and has since communicated and talked like one with Aspergers. In the beginning (around 3), due to his speech delay, he was given an IEP by the school system of Autism with no specifics of what type or how severe. I pulled him out of public school because I didn't want him to have an IEP of non-specific Autism because that was qualifying him for specialized treatment that he didn't need and disqualifying him from those he needed. We put him back in public school this year since it meant he would need a new IEP. I do not believe he has general Autism because none of the health professionals we have seen believe it to be (we are waiting for an appointment with the child psychiatrist that his pediatrician referred us to and it's like a year long waiting list) and because he does not have problems with eye contact, speaks like a professor rather than an 8 year old to ANYONE that would listen, he has NO problem approaching complete strangers and having inappropriate conversations with them about his favorite things and he is overly social (he has no concept of personal space or when it's not appropriate to talk about certain things or with whom) and has an above average intelligence level (he was reading on a 2nd-3rd grade level in kindergarten).



I am just frustrated because he is so intelligent that the expectations of him at school, in social circles, etc. are higher than he can obtain and they usually feel he is a behavior problem (because of his incessant talking/parroting) or rude (for the same reasons plus the fact that he says inappropriate things) and because I want him to have licensed therapy to maybe help him overcome his social awkwardness and immaturity. Anyway... I think I am going to have just come out of pocket and take him to see a psychiatrist that is not on our health insurance! UGHHH! But, I am hoping for good news with his IEP (which they are currently working on), since school will be one of his biggest challenges for now.



Thank you for the info, although it made me wonder, again, if my child has Aspergers or Autism. I think it's Aspergers, but I'm no professional. LOL

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