Thursday, March 1, 2012

Testing, Treatment & Medications

Neuro-psych test
I know some of my fellow trauma mamas fight long and hard with physicians and psychiatrists (even some neuro-psychiatrists) to have their children treated with medication.  Some of them even have to fight just to get them tested to see what’s going on.  (But at least they fight.)  It is amazing to me how people do not want to “label” children.  What they do not realize is while they’re taking all that time not labeling them, they are perpetuating the neglect they’ve already suffered.  Yes, I wrote that.

Now, please understand, I am NOT saying every adopted child needs to be on medication.  I am not saying every adopted child needs on-going therapy.  In fact, Youngest Son will likely "graduate" from therapy this summer if all continues to go well.  However, if a child had diabetes, or asthma, or cystic fibrosis, or a heart murmur – if a parent or a clinician saw any sign of a possibility of any of these conditions, or hundreds more, and they did not test them – did not treat them, the parent would be charged with child neglect and the clinician would lose their license.  So why do we wait with hurt children?

My kids were home more than a year before they were ever tested.  We didn’t live near one of the big cities.  I didn’t have the money to go see Dr. Boris Gindis or Dr. Jane Aronson.  I knew it would be BEST to have my kids tested in their first language (Russian) as soon as possible after getting home, but that was a logistic impossibility here.  By the time anything could be arranged, the kids were already in what Gindis calls “language limbo,” and they could not be tested in Russian.  What I did not know at the time, however, was there are other tests – non-verbal tests – my kids could have taken before they had a good handle on English.  We could have gotten started on therapy and medical treatment a lot sooner than we did.  Because of my ignorance, they were neglected.

At 1.5 years home, both The Princess and Youngest Son went through a battery of tests at our local mental health facility.  This was after our school district gave them a test at grade level (not age level) and said they were “normal.”  I would have LOVED to have our special education director live with them for a month or two and then tell me they were “normal.”

Testing included having me fill out forms and complete some tests myself.  I completed these tests for both kids:

*PCRI – Parent/Child Relationship Inventory (Parental style)
*PSI – Parenting Stress Index

Both kids had the following tests at different times:
 *ADHDT – Attention-Deficit/Hyperactivity Disorder Test (Behavior Rating Scale or BRS)
*BASC – Behavior Assessment System for Children (BRS)
*CVLT – California Verbal Learning Test for Children (you don’t have to live in CA to use this test – for Neuro: Memory/Learning or NM/L)
*CAS – Cognitive Abilities Scale II (Neuro: Educational or NE)
*MACI – Million Adolescent Clinical Inventory (Personality)
*SCAN-3C – Test for Auditory Processing Disorders in Children (NE)
*TSC – Trauma Symptom Checklist for Children (this is listed as a “Personality” test, but it’s more of an experience inventory)
*WISC-IV – Wechsler Intell Scale for Children (IQ-Multitask – probably the most involved and comprehensive test ever)

Youngest Son also had this test: 
*Suicidal Ideation Questionnaire (Symptom Rating Scale)

What going through all the testing boils down to is that both kids continue in psycho-therapy and take medicine to manage their symptoms.

Medications either currently taken, or taken by my kids in the past that have had beneficial effects included:

*Tenex (or guanfacine) and Intuniv (a slow-release form of guanfacine) for attention-deficit disorder or ADD.  Youngest Son is diagnosed with attention deficit, but without the hyperactivity.

*Focalin XR and dexmethylphenida (same as Focalin but not slow release) for ADHD, emphasis on the “H.”  The Princess is very active and attention deficit.  This is combined with a keen sense of hyper-vigilance.  She rarely feels completely safe unless she is with me, and even then finds it difficult at times.

*Wellbutrin – for depression

*Abilify – for depression

*Seroquel XR (both 50 mg. and 150 mg.) – for depression and to treat strong, inappropriate emotions and acting out behaviors (such as trying to tear your mother’s arm out of its socket).

Meds that caused problems for my kids:

Concerta (Methylin ER and Methylphenidate) – for ADHD.  The Princess became aggressive on this medicine and set fires.  She’d never done that before and has not done it since going off the medicine.

Celexa – for depression and anxiety.  Made my kids too sleepy and “out of it.”

Cymbalta – for depression.  Gave Youngest Son massive headaches.

Strattera - for ADHD.  Gave The Princess massive, daily afternoon headaches.

Natural herbs used at times (with psychiatrist’s consent):

Gaba – for anxiety

Valerian Root – for calming effect

Bottom line, in my opinion, is this:  Don’t be afraid of tests.  Don’t be afraid of well-tested and time-tried medicines. They just may be one of the best tools you have in your tool box to help your child heal.

THE ABOVE POST is shared as my personal experience only and is not to be substituted for the care and instruction of your family's own personal physician/psychiatrist.



Courtney said...

I'm interested in the gaba and valerian root. Did you just get those at a supplement store? We don't have anyone who needs meds at this point (never know how things may pan out in the future!) but I would love to try a supplement to help Alex calm at times. We have actually used caffeine with good success on him. A cup of coffee in the morning really helps him settle down.

Trauma Mama T said...

Hi Courtney - if you have a health food store around that also sells supplements and essential oils, you should be able to find them there. I bought valerian root at Walgreens. It smells like rotten milk and The Princess calls them her "stinky pills." She takes them quickly. If I take two or three of them, I'm out like a light. If she takes three when she's particularly animated, it just slows her down a little bit. Gaba is good for calming and anxiety. I've also taken that myself.

I learned about both from Diana ( I talked with our doc and therapist about them. Therapist hadn't heard of valerian root. It's basically nature's Xanax.

Diana said...

Great post. Love what you said about testing. I see so many people whose kids (bio and adopted) clearly have issues that they won't test, treat, or even allow the school to address...all in the name of not wanting to "label" them or make them "different". Hello! the differences are obvious!!

Meds we've used and continue to use here:

Zoloft: Made my kid suicidal

Concerta: The only thing that's ever really worked for one of my kids for ADHD. VERY expensive, but the fall back we go to when everything else fails.

Prozac: Increased aggression with one, short lived effectiveness with the other.

Ripserdal: aggression

Ritalin/Focaline: Didn't work nearly as well as other preparations

Adderal: One son has been on it for several years now. Only thing even close to effective for his intense ADHD. Not so effective for the other one. Not effective at all on it's own. Must be combined with guanfacine.

Guanfacine: not effective on it's own, but helps tons when combined with adderal. For us, the generic stuff worked WAY better than Intuniv.

Vyvanse: currently trying it as an alternative to Concerta.

Nicain: OTC. Has a calming effect. I use it as well. There is research out there suggesting that for some, high doses can replace Rx meds. Do your research though. It can also be toxic in high doses.

Still use GABA and Valerian and Melatonin as needed.

The moral of the with all things, there isn't one right answer. Use this info to talk with your doctor. I took in a list of meds I'd heard others having success with and talked about each one with the doc. Expect caution to be used. There should be. I'm more than a little frustrated that it took so long to convince them that my child needed more than they were getting. Things changed almost immediately after he started it and our family was pretty much needlessly dragged through hell for a good year until I put my foot down and said "HELP or it's RTC!"

Trauma Mama T said...

Diana, Thanks for sharing your list as well. As you said, it's clear that there is no one solution. Each child is different. I'm glad your little man is getting the additional meds and pray they'll continue to help him feel better - you, too. ;o)