In healthcare, insurance companies are the "Big Brother" of healthcare providers. If a diagnosis/label is not placed in the chart then the provider does not get paid for their service. Children struggling with challenging behaviors are often given one diagnosis which leads to additional diagnosis. For example, I have cared for children diagnosed with ADD, PTSD, and Bipolar all at the same time. Once a child is diagnosed, parents try to process each new diagnosis, the next medication, and the new psychosocial treatment. Outsiders looking in see each new diagnosis as a new label or just "bad parenting". However, what is the real root of the problem behavior? Some diagnosis have developmental, cognitive, psychosocial, environmental, metabolic, or anatomical causes. For example, a ten year old male adopted from Africa at the age of 13 months. Mom was homeless and placed him into a foster home with multiple caregivers during his first year of life. Once he arrived to the United States, he thrived socially and developmentally. Once he started school he exhibited symptoms of fine motor lags, and attention deficit disorder, with the classic difficulty with reading and math. His family diligently worked with occupational therapists, teachers, psychotherapists, and his healthcare provider to improve his focus, attention, and cognitive abilities, with some improvements. However, on the the last day of school he suffered from a three minute tonic clonic seizure. He was eventually diagnosed with epilepsy. It is possible he may been having small seizures that were not noticed while sleeping or awake. Does this mean every child with ADD or other complicated behaviors has undiagnosed epilepsy, absolutely not. However, if behaviors, developmental or cognitive delays continue despite changes in medication, diet, parenting or the environment a neurological evaluation may be something to consider.
Not sure where to start with disruptive behaviors? Start with just FIVE MINUTES
of individualized time. This is time away from other kids in the home and activities. Give this time to each child. During this time words may be expressed, but some kids are not ready for words. One way to initiate conversation is to ask the child: "Tell me something sweet about your day...tell me something sour about your day." Just listen. This time for "stillness" rather than problem solving.
What does Five Minutes look like?
TBRI ® Principals: Connecting and Empowering child and adolescent mental health