Tuesday, June 28, 2011

Diagnosis . . .

When Dustin came to us, he had a veritable alphabet behind his name. He had every possible diagnosis I could think of, except schizophrenia which oddly enough is one of only two now. Those letters dropped off as we changed psychiatrists (several times until we got our golden p-doc) and others dropped off with therapists, and if the wind blew just right they would change then too.

Did he remarkably get "healed" from Early On-Set BiPolar or did he suddenly stop having Sensory Integration Disorder? No, it just seemed that everyone had different opinions on "what was driving his bus".

When we first started seeing our wonderful p-doc he wiped everything clean. The only thing he labeled Dustin was Fetal Alcohol Syndrome. Did this change any of his behaviors? No. Dr. R simply said (in his wonderful Pakistani accent) "It does not matter what we call it. We still have to deal with it just the same." I held to that. I liked that perspective.

Those letters behind his name did nothing to help me deal with the behavior. Those letters did nothing to change the behavior. Now, don't get me wrong, I think labeling a child's issues can be important in helping others understand what they are dealing with. They can help us find resources and they can help us tell others find information. But the child is the same regardless of the diagnosis and we have to deal with what is presenting itself.

I wrote this several years ago:

I have always struggled with diagnosing kids with psychiatric disorders. It has nothing to do with labeling. I know some people freak out about slapping a label on their kids, but who the heck cares. Who has to know? It's not like they are required to wear a Tshirt that says, "I have been diagnosed BiPolar" to the local community pool. The only reason it should be brought up is in school and then only if their are issues or if services are needed. Then, it's obvious there's a need for that label. You don't have to place an ad in the newspaper to make the town aware of a diagnosis.

The reason I struggle is "how do we really know"? I mean, okay, when Dustin came to us in foster care he had every label imaginable. A few I can name off the top of my head are: Sensory Integration Disorder, Fetal Alcohol Syndrome, Shaken Baby Syndrome, Post Traumatic Stress Disorder, Attention Deficit Hyperactivity Disorder, Early On-set Bi-Polar Disorder, Aspergers Syndrome, blah blah blah. Basically the only label we never had was Reactive Attachment Disorder, even though this was mentioned more than once and I think it is absolutely ACCURATE. Now we simply have a Fetal Alcohol Disorder and a BiPolar label ONLY, with a Moderately Mentally Handicapped status thrown in for good measure. That's what's "driving the bus" in Dustin's brain and everything else is "sitting in the back seats along for the ride". Basically my child is psychotic due to prenatal alcohol exposure. Period.

Do those labels help me deal with him better. Nope. What they do is help others see his weaknesses and celebrate his differences. They don't give excuses for his behaviors but they do give reasons. Our psychiatrist once said to me, I don't really care what you call it, we still have to learn to deal with it whatever it is. Amen brother! Sometimes it helps to tell people he has traits of Aspergers Syndrome because that is what they are familiar with and it gives them something to work with. Does he have Aspergers? Who knows, he definitely exhibits some form of Pervasive Developmental Disorder, and it is definitely sitting in one of those back seats on Dustin's Brain Bus.

Okay, here's where it gets tricky for me. . . hold on to your panties. How dare people who don't know me or haven't seen my kid or spent time with them say he couldn't possibly have that. It does seem that there is a trend toward a specific diagnosis in the child's psychiatric community from time to time. A few years ago, everyone was ADD, then it seemed to be Autism, and now it seems to the leaning toward RAD. Now it may be one thing to say that a particular diagnosis is overused, it is quite another thing to say it doesn't exist. Excuse me? Are you a doctor? Just because you have adopted successfully and haven't had to deal with it doesn't mean other's don't. I am pleased that you are so wonderful that your child seems to love you at first sight, but seriously you don't know every child. And perhaps you don't know everything. *gasp*

My whole problem with sayng RAD isn't real, is that these children are damaged. Just as my child's brain is "broken" due to prenatal alcohol exposure these children are "broken" due to abuse, neglect, multiple placements etc. Who am I to say that doesn't happen? Who am I to say that can't happen? I guess my take on it is that we as a country and as a people are moving toward a mentality that says "me me me" all the time. "Screw my kids, screw their needs I need a drink, a fix, a night out. Who cares how it affects them!" It's obvious that these kids who have been taken from their homes are damaged by this trauma and "broken". How can they trust another adult just because you say you are safe? Especially when some of the trauma came from supposed "safe" foster families. Maybe as the trend continues children are becoming more and more traumatized and now we are seeing more and more and more RAD. Whether a child gets FAS depends on the strength of the baby, how much the mother drinks and how often as well as the time frame in which she drank during pregnancy. Couldn't this be a similar situation for RAD, some kids are simply tougher than others. You, missy, got lucky, and so did your kids! Saying that because you haven't dealt with it so it doesn't exist is like saying I've never had a broken arm so I don't believe bones can break. Ignorant.

I guess my entire frustration with this is that we are all in this together. Does your child mad pee? Let's talk about options and what you've tried. Does your child bang their head on walls? Hey, what works for you to get them to stop? That's why I blog. 

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