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.

Stepping Back Into the Light

Yes, it was therapy day for The Princess and I this morning.  If you’ve read this blog for a while, you know therapy has not been a very productive or fun time these last couple of months.  Today was different.  The Princess was engaged, made appropriate eye contact, paid attention as much as her ADHD would allow her to do, and she PARTICIPATED!  She was even pleasant.  I believe our happy, sweet girl is on her way back.

We have eased out of using Seroquel XR 50 mg/day over the last month, and have slowly added Abilify.  The Princess has another med check on Friday, but I believe this is working for us.  She is also on Focalin XR before school and a generic (not slow release) Focalin after school.  Abilify is usually added to an anti-depressant.  She is not on one of those now, but the Abilify seems to be helping anyway.  (Maybe tomorrow, I should do a post on medications?  I could list those I know and what they’re used for and let you know how effective they’ve been when we’ve used them.  The thing is, there are on-going adjustments that are made as the kids’ systems get used to the medications and they become less effective over time.)

I’m proud of my girl.  She’s working.  It’s hard.  She’s not always conscious of what she’s doing or how she’s behaving, but she wants to be.  She responds well when she’s approached in a manner that displays teaching rather than irritation or condemnation.  She just wants the freedom to be who she is, but she needs to learn the tools to help her mature and navigate the world.  Today, she was willing to start working on that again.

I feel like we’re stepping back into the light.