Trying to adopt a 7 yo with severe ADHD. Scared.

[MistyJ]

We have been in the process of adopting a little boy from the foster system; our staffing meeting is Friday. He is described as having severe ADHD, and is in a special ed classroom with a total of 10 students. Talking to his social worker, she said they seem to think it is undiagnosed bipolar.

 

Our almost 14 yo ds has bipolar; he is fairly stable now, but I have no illusions about how hard that path is. Now, though, I am no longer resistent to medications. Had we medicated earlier, we would have saved ourselves a lot of trouble.

 

So, I've been reading all the threads here about RAD, the severe violence, one deadly stabbing, the rage, institutionalization, and I'm terrified. We have been been fantasizing about adopting this boy for weeks and weeks, talking to the kids about him; we've all been very excited. Now I'm not sure.

 

What are the questions we should ask? Is there any way of knowing if he has RAD so severely that we couldn't handle him? I also have a bio 10 yo dd, and now I'm thinking of her safety. I was previously thinking of the boy in terms of bipolar; there will be hard times, medication adjustments, colossal need for patience. Reading about RAD, I have become really discouraged. Needless to say, our adoption training (4 years ago) did not prepare us very well.

[Laurie4b]

We have been in the process of adopting a little boy from the foster system; our staffing meeting is Friday. He is described as having severe ADHD, and is in a special ed classroom with a total of 10 students. Talking to his social worker, she said they seem to think it is undiagnosed bipolar.

 

Our almost 14 yo ds has bipolar; he is fairly stable now, but I have no illusions about how hard that path is. Now, though, I am no longer resistent to medications. Had we medicated earlier, we would have saved ourselves a lot of trouble.

 

So, I've been reading all the threads here about RAD, the severe violence, one deadly stabbing, the rage, institutionalization, and I'm terrified. We have been been fantasizing about adopting this boy for weeks and weeks, talking to the kids about him; we've all been very excited. Now I'm not sure.

 

What are the questions we should ask? Is there any way of knowing if he has RAD so severely that we couldn't handle him? I also have a bio 10 yo dd, and now I'm thinking of her safety. I was previously thinking of the boy in terms of bipolar; there will be hard times, medication adjustments, colossal need for patience. Reading about RAD, I have become really discouraged. Needless to say, our adoption training (4 years ago) did not prepare us very well.

 

I wouldn't do it until I had an independent evalution from someone not connected to the foster care system who specializes in RAD. Ask social services if they would allow that. If they won't allow it, I would make an appt. myself with the person to get some direction.

 

You might want to listen to your gut on this one.

[Jean in Newcastle]

I wouldn't do it until I had an independent evalution from someone not connected to the foster care system who specializes in RAD. Ask social services if they would allow that. If they won't allow it, I would make an appt. myself with the person to get some direction.

 

You might want to listen to your gut on this one.

 

:iagree: Has he ever been placed with younger children? How has he done? I would want to know if he had ever acted violently or inappropriately with someone vulnerable to him.

[Murmer]

Being in the adoption world for a while it is pretty commonly expected that any child who has been in the foster care system will have RAD. Talk talk talk to the social workers, I don't know what you should ask (I have done newborn domestic adoptions) but I would want to know how many past families he has been with (that will let you know if he has had a chance to bond with any family), if he has had to be removed and why, if there is reason to suspect sexual abuse (sadly victim can become perpretrator). Also I would prepare all safety precautions as if he was the worst case, locks on doors above where he can reach, alarms on doors. Set forth rules about not being in bedrooms, one person under a blanket ect. But with all of that if you truly feel you are his family then take the plunge, he deserves a family that is loving and can teach him how to love in return and it sounds like you are prepared to deal with his medical issues beyond RAD.

[Happy2BaMom]

With our current agency, we would not be allowed to adopt a child until they had been in our home for at least six months...is that not the case where you are at?

 

While state law probably varies state to state (we've only fostered in our current state), you should be allowed to read his *entire* case file. INSIST ON IT. If you are not allowed to read it, I would not adopt him without having him placed in my home for at least a six month period of time.

 

While I am against "test driving" a child in theory, in reality a lot of foster children have a lot of problems that *sort of* don't get mentioned. I've been told that a child does not/has not/will not ______________, only to find out that not only will said child _________, but said child has a previous history of __________ and has had ____________ done to/with/for him by multiple people multiple times.

 

Foster children can make a lot a lot of progress with a loving home. But you need to know what you are signing up for. The state is concerned with placing this child, not necessarily what you are going to have to deal with after you have him home.

 

God bless you in your efforts. best of luck to you, truly. I pray it works out for all of you, especially that boy.

[mom4him]

What are the questions we should ask? Is there any way of knowing if he has RAD so severely that we couldn't handle him? I also have a bio 10 yo dd, and now I'm thinking of her safety. I was previously thinking of the boy in terms of bipolar; there will be hard times, medication adjustments, colossal need for patience. Reading about RAD, I have become really discouraged. Needless to say, our adoption training (4 years ago) did not prepare us very well.

 

How long has he been at his present placement.

Has he truly attached to his present family.

Is there any history of him 'hurting' any animals.This is very important in my book.

 

We did not adopt older children by our son and dil presently has 4 that have been from the ages of 4 1/2 to 7 when they adopted them. For sure they have had and do have struggles but they have not looked back with regret.

 

My biggest advice would be pray, pray, pray, pray until you and your dh have a total peace one way or the other.

Edited July 3, 2010 by mom4him

[MistyJ]

With our current agency, we would not be allowed to adopt a child until they had been in our home for at least six months...is that not the case where you are at?

 

While state law probably varies state to state (we've only fostered in our current state), you should be allowed to read his *entire* case file. INSIST ON IT. If you are not allowed to read it, I would not adopt him without having him placed in my home for at least a six month period of time.

 

While I am against "test driving" a child in theory, in reality a lot of foster children have a lot of problems that *sort of* don't get mentioned. I've been told that a child does not/has not/will not ______________, only to find out that not only will said child _________, but said child has a previous history of __________ and has had ____________ done to/with/for him by multiple people multiple times.

 

Foster children can make a lot a lot of progress with a loving home. But you need to know what you are signing up for. The state is concerned with placing this child, not necessarily what you are going to have to deal with after you have him home.

 

God bless you in your efforts. best of luck to you, truly. I pray it works out for all of you, especially that boy.

 

Yes, if we are chosen Friday, we will be allowed to read his entire file. And yes, the adoption is not final until he has lived in our house for 6 months, but, maybe I'm idealistic, but I don't think it's fair to bring him into the house until we're 100% committed to keeping him.

 

All the naysayers in our circles like to tell stories about how adopted children tear up families. I didn't take those comments seriously, until I read all the posts here.

[MistyJ]

How long has he been at his present placement.

Has he truly attached to his present family.

Is there any history of him 'hurting' any animals.This is very important in my book.

.

 

He was about 8 months with a retired teacher, who finally gave him up because of tantrums. He's been about 2 months in a therapeutic foster home where he is doing well (no tantrums, academic progress.)

[justasque]

I read an interesting article about this today. It was not a happy article, but worth reading beforehand; I think it will help you to come up with some questions and to motivate you to be sure you get answers before making a commitment.

 

http://www.brainchildmag.com/essays/summer2010_friedman.asp

[Pippen]

In addition to what's already been mentioned, if there's been a need for a therapeutic foster home already by this age, you need to check out your insurance company's coverage for short and long-term residential treatment. Residential treatment is incredibly expensive and most insurance companies cover far less than what the child needs.

[FairProspects]

Being in the adoption world for a while it is pretty commonly expected that any child who has been in the foster care system will have RAD.

 

I'm sorry, but I have to strongly disagree with this statement. My dh works in the foster care system, has had hundreds of foster care clients and is a Licensed Mental Health Professional with a graduate degree in Clinical Psychology. He states that true diagnoses of RAD are rare. When they do occur, they are both tragic and dramatic, and because of this the stories linger and make RAD appear more common than is actually true. He wanted me to state this to dispel some of the fear that RAD is prevalent among foster care children.

[HS Mom in NC]

I just joined this site this morning.

 

We spent 2004 considering which route we would take adopting a child. We considered domestic private, fost adopt in AZ, international adoption in Russia, S. Korea, and Guatemala. Our considerations included reading/discussing the actual experiences of dozens people who had either adopted, tried to adopt, or were professionals treating adoptees from those situations.

 

We had 2 children (8 and 6) already, so what was best for them was the most important factor in our considerations. We also had no intention of "test driving" a child. We were 100% committed.

 

It became clear after several months and interviews with people currently and recently involved in the fost-adopt program in AZ that fost-adopt was so severely problematic in AZ at that time there was no way it was for us. These are experiences of people I have an ongoing relationship with.

 

1. Severance in AZ was so hard, one couple had requested only children available for adoption be placed with them. Of the 12 placed over a course of 3 years they applied to adopt 11 of them. None of them were actually available for adoption.

 

2. A very close friend went through the fost adopt programs while we went through our international adoption in 2005. She had 4 children already. She was told she was being given all the information they had about the boy by her social workers here in AZ. A few months before they finalized they moved to KY. KY pulled his file and gave it to them-AZ told them only a small fraction of what what was in those files. They finalized.

 

The child (then 5) was so violent he tried to actually kill one of the other children after they finalized. The other children slept with baseball bats (he commonly came into their rooms and stood over them while they slept) in case he tried to kill anyone again. They gave him to the state of KY when they were assured he would be placed in a home with no other children.

 

3. Another friend in 2000 had a 2 year old child already and had a 6 year old foster child placed with them in hopes of adopting him. The social workers did tell them he had been sexually abused in at least 3 other foster homes. A few months into his placement she walked in on him trying to molest her 2 year old. She had him removed immediately.

 

4. Two years ago another friend who already had 5 younger children was placed with a sibling set of four children. Again, what they were being told by social workers in the foster care system was only the very tip of the iceberg compared to the reality. The foster children were so violent and molested each other and should never be around other children.

 

5. We only met one couple who did successfully adopt kids through foster care. They got the children as an infant and a toddler. It took 3 years to sever the birthparents' rights even though there was no cooperation at all and the extended relatives requested the children be adopted by the foster parents.

 

6. Most of the other people we met never planned to adopt the kids.

 

We talked to our pediatrician, a developmental pediatrician at a behavioral health center with experience in tough adoption situations, and a pediatric dentist whose early training included volunteering her services for adoptees from all over. All of them said the same thing, "If you have young kids in your house, adopt a S. Korean child. Problems with them are very rare."

 

RAD is one of MANY serious emotional and developmental problems in foster kids and adoptees. Attachment therapists and pediatricians with specialized training in dealing with children in these situations are the people who know what's going on and can be objective about any particular child. Talk to them.

Edited July 1, 2010 by Homeschool Mom in AZ
clarification

[MistyJ]

bump

[Lisa in Jax]

I'm sorry, but I have to strongly disagree with this statement. My dh works in the foster care system, has had hundreds of foster care clients and is a Licensed Mental Health Professional with a graduate degree in Clinical Psychology. He states that true diagnoses of RAD are rare. When they do occur, they are both tragic and dramatic, and because of this the stories linger and make RAD appear more common than is actually true. He wanted me to state this to dispel some of the fear that RAD is prevalent among foster care children.

 

True cases of RAD *are* rare, but cases of "Attachment Disorder" are NOT rare, and, frankly are more difficult to treat. (FWIW, I have a Master's degree in MH Counseling.)

 

We adopted two kids seven years ago. BOTH had attachment disorder. Neither of our adopted kids had "RAD," but they almost destroyed our family.

 

In terms of the ADHD, I doubt that he has classic ADHD. Kids with attachment issues and trauma *look* like they have ADHD, but they are often actually dealing with PTSD or other trauma issues. If that's the case, it's imperative that you treat the trauma, not the symptoms of ADHD.

 

Lisa

Edited July 2, 2010 by Lisa in Jax
Personal details removed.

[MistyJ]

In terms of the ADHD, I doubt that he has classic ADHD. Kids with attachment issues and trauma *look* like they have ADHD, but they are often actually dealing with PTSD or other trauma issues. If that's the case, it's imperative that you treat the trauma, not the symptoms of ADHD.

QUOTE]

 

 

Lisa, besides a therapist who specializes in attachment issues, how did you treat the trauma?

[Lisa in Jax]

In terms of the ADHD, I doubt that he has classic ADHD. Kids with attachment issues and trauma *look* like they have ADHD, but they are often actually dealing with PTSD or other trauma issues. If that's the case, it's imperative that you treat the trauma, not the symptoms of ADHD.

QUOTE]

 

 

Lisa, besides a therapist who specializes in attachment issues, how did you treat the trauma?

 

You work with a therapist who knows trauma AND attachment issues, and you get extensive training in how to parent him in ways that help him heal. It takes very specialized parenting to do this. These kids can't tell you that they're stressed -- they tantrum. When they're tantrumming, they CANNOT be reasoned with and they're not rational -- they're often angry or scared out of their minds, but they often cannot explain their feelings.

 

In most cases, kids with AD just aren't in touch with their emotions OR their bodies. For example, it took a full year of explanation/reminder to help my son understand that "empty pain in stomach with rumbling" equalled "hungry." "Hunger" is very concrete, and it took a year. We're STILL (seven years later) working on helping him understand and identify complex emotions like anger and guilt. His ability to make cause-effect inferences is VERY basic. It takes a lot (thousands) of repetitions to learn cause-effect stuff, where a non-traumatized child might learn it in just a couple of repetitions.

 

In terms of not treating it like ADHD, what I meant was that you DON'T medicate with stimulants, etc., as you might with typical ADHD. The reason for avoiding stimulants is this: think of being more scared and stressed than you've ever been. Now imagine the effect a stimulant would have on your already stressed-out mind/body. It's not good!

 

In addition to the emotional effects of trauma, we've had to deal with the physical effects of trauma, too. Due to his early life, my son's adrenal system and immune system were shot -- at FOUR years old. He developed several food intolerances and NEVER got sick (which is actually a bad thing!), b/c his immune system was so dysfunctional. We've had to work hard to feed healthy, whole foods and provide clean, chemical-free supplements (like essential fatty acids, zinc, B vitamins, etc.) to support his body while he began to calm.

 

I have to be honest with you: knowing what I know now, I wouldn't do it again. I love my son, and I'm glad (now) that we adopted him, but I could not have said that even after five years. It has only been in the last 18 months that I can truly say that I am glad we adopted him. It has been a LONG road.

 

So, please think long and hard about this before you agree. If your agency didn't prepare you, DON'T accept the placement. Get more training, then see if you feel ready to adopt. A child who needs therapeutic foster care at age 7 is a child who needs well-trained, dedicated, experienced adoptive parents. If you're dedicated but not well-trained or experienced, this placement may not be a good idea for you or for him.

 

Lisa

[HS Mom in NC]

I want to further address the idea of being 100% committed.

 

First, there are children who do very well adopted from the state foster care systems. They are thriving. It is a real possibility that should not be discounted.

 

If the state for what ever reason (good or bad) chose to remove a foster child from your home before finalization, are you willing to accept that? Since we were not (they are a lot of wonderful people who are) we saw that fost-adopt was categorically not for us, because we were not going to consider the possibility of a child leaving our home. We also knew that adopting older children internationally was not for us either. We chose to adopt an infant from S. Korea. That's not for everyone, but it was clear that was the best route for us.

 

Parents who have children (biological or adopted) with known risks of particular challenges should seek out information about the following things:

 

Are you prepared to provide the resources necessary to meet the child's needs if there is a serious problem? How will it affect your daily life? How many appointments with professionals per week would it require? For how many years? How close are you to those resources? What kind of parent training at home and follow up by the parents is required? How much time and money will it cost? What is a typical day with a child with these issues like for the child? What is it like for the parents? What is it like for siblings? If a worst case scenario happened (like one child being a threat to the life of a family member) what would you do? What options are available to you in that case? What if there is a serious issue yet to be diagnosed? What does 100% committed look like in the light of all these situations?

 

Be very clear on what are and are not willing to do and find the best route that matches it.

[Mom-2-7]

There have been a lot of horror stories posted here. I'm sad to see so many negative views. Adoption can be a wonderful thing!

 

Five years ago, dh and I adopted a 2 year old from the Philippines. He had been in a therapeutic orphanage all his life. We were introduced to him, he lifted his arms to me and he never looked back! Today he is the most amazing 7 year old boy I've ever met! He is completely healthy physically and emotionally.

 

A year later we became foster parents. We were blessed with a 2 year old girl and a 1 year old boy. We were their 5th home. There was abuse and neglect in their past. They currently have minor issues to to prenatal drug/alcohol exposure. The girl has minor ld's and the boy is immature for his age.

 

5 months later their newborn sister was placed with us. She has some behavioral issues due to exposure. She is hyper and moody. She is certainly our "exclamation point" child! But she's ours and we have never regretted it!

 

A year later a baby girl was placed with us. She was 4 months old and was just a shell of a baby when she came to us. She came out of an abusive and neglectful foster home. Within a week she was nearly normal. Now, at 2 1/2 she still shows signs of very very mild RAD but she is expected to grow out of it. Yes, even babies can have RAD. I know several.

 

Just 6 months ago two of her siblings were placed with us. They were 4 (now 5) and 6 years old. They both had a host of issues which was why their last placement failed. The girl was aggressive, acted out sexually, was belligerent to her caregivers and purposely wet herself. She was diagnosed with ADHD, ODD and sensory disorder.

 

The boy also was belligerent and aggressive, starting fights at school. He was diagnosed ADHD and ODD.

 

When we took placement of the kids, it was with the agreement that we would homeschool the kids. We pulled them out of every service they had, including their therapeutic daycare facility. Within 4 month, all the negative behaviors have stopped, except for lying. That will take a little longer. They are no longer considered to be anything but normal, healthy kids.

 

My dc have another sibling out there who we are not equipped to take. He sounds much like the boy you are considering. He is 7 and lives in a treatment facility (when he is not in the mental hospital). He has been diagnosed with FAS, ADHD and bipolar. Apparently the meds for ADHD make the bipolar worse and the meds for bipolar make the ADHD worse. So getting him stable has been rough. He has been on more meds than any kid should. Right now they are taking him off everything to reassess. He's been a guest in our home off and on for the last couple of years, sometimes for up to 2 weeks. When he's feeling safe and secure, he's a great kid with so much to offer!

 

I really believe that a secure loving home will help with many issues that foster kids deal with. I'm not silly enough to say that love cures all ails, but it does help a lot! Sometimes it takes kids years to feel safe and they will push you in all sorts of ways to test your commitment to them. It is very hard to stand by that commitment when they are acting out and you have not yet formed that loving bond with them. Forming that bond with older kids is difficult. They have many memories of their former lives and their personalities are, for the most part, already formed and influenced in ways you may not be thrilled with.

 

I have many friends who are or were foster parents. All these people now have beautiful, loving families to show for it. Yes, it takes a lot of work and a lot of patience but it is worth it. You do need to know what you and your family can handle. That is key.

[FairProspects]

True cases of RAD *are* rare, but cases of "Attachment Disorder" are NOT rare, and, frankly are more difficult to treat. (FWIW, I have a Master's degree in MH Counseling.)

 

We adopted two kids from India seven years ago. BOTH had attachment disorder. Our son is still in our family; he has attached, and is doing very well (though he still has issues). His sister began to have psychotic breaks and made threats to my life. She is now with another family. The five years she lived with us were difficult beyond explanation. I have a lot of guilt about the chaos her adoption created for our bio dd. Neither of our adopted kids had "RAD," but they almost destroyed our family.

 

In terms of the ADHD, I doubt that he has classic ADHD. Kids with attachment issues and trauma *look* like they have ADHD, but they are often actually dealing with PTSD or other trauma issues. If that's the case, it's imperative that you treat the trauma, not the symptoms of ADHD.

 

Lisa

mom of Kaley-17 (bio) and Daniel 11-India.

 

I'm very sorry for your situation. That must have been incomprehensible to deal with.

 

Also, I'm not as familiar with International Adoption and attachment, as dh doesn't deal with those kinds of cases very often (he has only had one that I can recall).

 

However, as I stated before, he has worked with literally hundreds of state foster care kids in his practice (he works for a Family Preservation Agency, which includes preventing disrupted or failed adoptions), most of them pre-teens or teenagers, and he would disagree that severe attachment issues are common. They are extremely problematic when they do occur, but he sees far more clients with PTSD issues or true mental health diagnoses (like bipolar). He feels that attachment issues and the fear surrounding them are often overblown in the foster care system, and that they prevent families from fostering or adopting kids who would really benefit from a stable environment (along with therapy, medications, respite, and accommodations).

[HS Mom in NC]

I think the spirit of this discussion is not so much about a specific attachment issue, but rather an awareness of the spectrum of serious emotional and mental issues related to children in the foster care system at older ages.

 

It seems to me that people working for agencies (private and state) have a set of goals that sometimes align with the goals of adoptive parents, foster kids, and adoptees, and sometimes their goals are more in line with satisfying the goals the agencies they work for. It's important to keep that in mind when looking for an independent assessment by a specialist in the field. Every child has to be viewed and assessed individually.

[Momto5]

It seems to me that people working for agencies (private and state) have a set of goals that sometimes align with the goals of adoptive parents, foster kids, and adoptees, and sometimes their goals are more in line with satisfying the goals the agencies they work for. It's important to keep that in mind when looking for an independent assessment by a specialist in the field. Every child has to be viewed and assessed individually.

:iagree: I agree with Homeschool Mom's statement whole heartedly. Each child is so very different. We were foster parents for about 10 years and have adopted 3 of our foster children. Not only are individual children different but social workers also differ in their approach to placement and disclosure. Some workers were very honest with us about our children's life experiences prior to placement and some were not as forthcoming. I highly encourage you to have an independent evaluation done for this child.

 

Good luck to you.

[TravelingChris]

I agree about getting an independent evaluation and also, a very specific history. I doubt that he only has severe adhd. Severe adhd is not a reason for a therapeutic placement. I am the mother of a severely adhd child and while she does goofy things and can be annoying, the condition is treatable with medication and being very inattentive or hyperactive by itself is no reason for hospitalization or therapeutic placement. Something else is a problem. Can it be bipolar- certainly. But even if you are experienced with a bipolar, there is a huge difference in a mentally ill person for whom medication works and one for whom it doesn't. Again, I would question why a bipolar child for whom medication works would be in a facility. If they are in a facility, it is likely that it is because medication doesn't work or there are problems there that medication won't address.

 

We had a foster daughter before we had kids. At first, everything seemed fine. Then we found her lying and lying and lying. There was no support. We took her to a psychologist and he diagnosed her with a precursor to anti social personality disorder. She was well on her way to becoming a conwoman. I think that being in a very bad situation for the first nine years of her life was probably more than she could overcome. It was extremely sad. SHe also had been neglected by the first foster family. Unfortunately, some of the others in foster training just kept asking about money. During the time we had her, we spent more money on her than we received. Not the previous foster parent who sent her on her way with clothing for a fat adult instead of a skinny nine year old.

[MistyJ]

Okay, they picked out homestudy at today's meeting. We go to the offices Tuesday to read his whole file.

[Ottakee]

We have adopted 3 special needs kids---including one with bipolar and a 7 year old boy (not the same child though).

 

I would check into the post adoption support services he will qualify for. There should be an adoption subsidy---a monthly check about equal to what his foster parents are getting for him right now. This comes monthly until the child is 18. It stops earlier if they leave home and can be extended for a year if they are still in school. At bare minimum, he should have a "difficulty of care" rate that is higher than the typical rate for a child his age. Make SURE he will qualify for this. I know you aren't adopting for the money but once you get into this you will soon realize that the money will come in very handy for extra transportation, higher priced babysitters/respite, co-pays, special activities, etc.

 

Next, make SURE SURE SURE that he qualifies for a medical subisdy---medicaid along with state payment for any future counseling, therapeutic homes, in patient care at a mental hospital, etc. Medicaid doesn't always pay for mental health services so you need to make sure that both are covered.

 

Right now you might have great health insurance but if dh has a change in his insurance, etc. you may find yourself with no good coverage for his needs.

 

This all sounds like it is about money but in reality, adopting a child with mental health concerns can ruin a family financially as some of the treatments are thousands of dollars a month--often not covered even my good insurance.

 

I would make sure to read the entire file, talk with the doctors, therapists, etc.

 

Someone is here so I have to go but this is a start on my thoughts.

[MistyJ]

We have adopted 3 special needs kids---including one with bipolar and a 7 year old boy (not the same child though).

 

I would check into the post adoption support services he will qualify for. There should be an adoption subsidy---a monthly check about equal to what his foster parents are getting for him right now. This comes monthly until the child is 18. It stops earlier if they leave home and can be extended for a year if they are still in school. At bare minimum, he should have a "difficulty of care" rate that is higher than the typical rate for a child his age. Make SURE he will qualify for this. I know you aren't adopting for the money but once you get into this you will soon realize that the money will come in very handy for extra transportation, higher priced babysitters/respite, co-pays, special activities, etc.

 

Next, make SURE SURE SURE that he qualifies for a medical subisdy---medicaid along with state payment for any future counseling, therapeutic homes, in patient care at a mental hospital, etc. Medicaid doesn't always pay for mental health services so you need to make sure that both are covered.

 

Right now you might have great health insurance but if dh has a change in his insurance, etc. you may find yourself with no good coverage for his needs.

 

This all sounds like it is about money but in reality, adopting a child with mental health concerns can ruin a family financially as some of the treatments are thousands of dollars a month--often not covered even my good insurance.

 

I would make sure to read the entire file, talk with the doctors, therapists, etc.

 

Someone is here so I have to go but this is a start on my thoughts.

 

No, I get it, trust me. His social worker told me about the monthly subsidy, and I just kept saying, "Co-pay, co-pay,' since I know how those can add up with special needs, between med checks and prescriptions.

 

I'll ask about medical subsidy. Thanks so much for that.

[MistyJ]

deleted...double post.

[Ottakee]

Also, as to the RAD/Attachment issues, what we found in our RAD support group was that about 80% or more of the kids that were diagnosed with RAD/severe attachment issues, also had bipolar or other mental health issue behind their attachment issues. Once those were accurately addressed (meds and therapy) the attachment issues could be worked on.

 

My daughter with bipolar is doing very well with her moods, etc. on the correct meds.

[FaithManor]

And make sure that you check the fine print of your own private insurance.

 

I hate to say this, but sometimes adopting a special placement means that mom and dad or the sibs will occasionally need counseling in order to help them deal with any feelings that arise from the new addition. But, your private insurance may not cover this or at least, not enough. I have a friend who is a foster parent and she is just exhausted by one of the littles that she adopted. Her private insurance will only pay for 24 hours of mental health treatment per year which comes out to two bi-weekly appointments per month with her counselor and the co-pay is $45.00 for each of those visits so she isn't going as often as she'd like.

 

You also need to find out what the restrictions are in your state on mental health services. In many Michigan counties -I suspect that other states may be in this boat as well - there are very, very few and sometimes nooooo pediatric psychologists or therapists so when you find one close to home, that is naturally where you want to go. However, that doesn't mean they are on "the plan" for your state. We have friends that just ripped up their foster care license before they even got their first placement because they live in a rural area and the agency told them that the closest pediatric psychologist or counselor that the state insurance was willing to pay for was over two hours away from their home. That's a four hour commute and the children that FIA wanted to place with them were currently seeing their counselor three times per week! That's twelve hours of driving per week plus the three hours of counseling (each child had individual appointments). They already had two children of their own that they were homeschooling and this would have been impossible to manage. Not to mention that they would not be getting mileage paid for this and the children, though significantly emotional disturbed, were only regular subsidy. They won't be fostering. Sad.

 

Faith

[MistyJ]

I wouldn't do it until I had an independent evalution from someone not connected to the foster care system who specializes in RAD. Ask social services if they would allow that. If they won't allow it, I would make an appt. myself with the person to get some direction.

 

You might want to listen to your gut on this one.

 

What sort of professional does "independent evaluations"?

 

Our red file was today. It went well, and we were quite excited, then I read the whole file on my own tonight, after dh went to sleep. Before his therapeutic foster placement, he was tantruming violently almost every day. Don't know what to do next.

[Starr]

Wow that sounds tough. :grouphug: I don't think I'd be up to it with another child at home.

[Jean in Newcastle]

What sort of professional does "independent evaluations"?

 

Our red file was today. It went well, and we were quite excited, then I read the whole file on my own tonight, after dh went to sleep. Before his therapeutic foster placement, he was tantruming violently almost every day. Don't know what to do next.

 

I would want to know exactly what "tantruming violently" meant. (You might already know the details but if not specified I would want to know.) One person might say that crying until he throws up is tantruming violently. For someone else, it might be flying into a rage and hitting and kicking at everyone within reach. If the violence put only the adults in danger I might consider it as long as I got specific help in learning how to deal with it. But if it put the kids in danger then it would be a dealbreaker for me - as sad as that would be.

[MistyJ]

I would want to know exactly what "tantruming violently" meant. (You might already know the details but if not specified I would want to know.) One person might say that crying until he throws up is tantruming violently. For someone else, it might be flying into a rage and hitting and kicking at everyone within reach. If the violence put only the adults in danger I might consider it as long as I got specific help in learning how to deal with it. But if it put the kids in danger then it would be a dealbreaker for me - as sad as that would be.

 

Hitting, kicking, biting, breaking things. We are familiar with these, save the biting, having raised a bipolar child. The incident report/journal which contains these things are from a placement where there were no other children. I am going to ask about what has happened when there are other children in the home.

[Ottakee]

What sort of professional does "independent evaluations"?

 

Our red file was today. It went well, and we were quite excited, then I read the whole file on my own tonight, after dh went to sleep. Before his therapeutic foster placement, he was tantruming violently almost every day. Don't know what to do next.

 

 

Can you find out WHAT changed so that he is not acting like that now---different parenting, therapy, meds, or ????

 

I would want to talk to both the first foster family as well as the current placement to find out EXACTLY what is going on. How long was he in each placement?

 

Ask is you can go along to the doctors/psychiatrist or talk to them as well.

 

Are you close enough that you could do "respite" for a few weekends, then a week or so, etc. before deciding?

 

Did you ask about the medical subsidy and coverage for counseling, inpatient help, etc. after adoption? That would be KEY for me.

[Denisemomof4]

Is there any way of knowing if he has RAD so severely that we couldn't handle him? I also have a bio 10 yo dd, and now I'm thinking of her safety.

 

As a mother of a child with RAD, the second sentence above made me want to :svengo: I've been on this long, difficult journey for 6 years now. Dd was 14 months old when she came to us. Because of what you say and because of my experience, I can never encourage you with this adoption. Are you truly prepared for the dangerous behaviors of a severe ADHD/bipolar child? Honestly, read about RAD. Then ask if you want to risk your children. My RAD child is my youngest, and still, the affects she's had on my other children are all negative.

 

I belong to several online adoption support groups. Severe ADHD and perhaps undiagnosed bipolar in a 7 year old? I would almost put money on it that this child has a severe case of RAD or attachment disorder - AGAIN because of my experience. There are families in crisis all over those groups who were lied to about a child, told they had ADHD when they knew the child had RAD.

 

Can you foster them first? Go way beyond the honeymoon stage to see what their true behaviors are. The charm will wear off. It always does. Do you know the child's history? You do understand that the social workers are never completely honest, don't you? As what support you'll get after adoption. In our state? NONE. If you foster them, you'll get support. If you adopt them, they are YOUR issue, YOUR problem, the state is done with you.

 

Siiiiiiiigh. I know so many here probably think I'm terrible for repeating this over and over and over and over but unless you've lived the hell that I do, YOU WILL NEVER UNDERSTAND.

 

Are you prepared to have the child within eye sight and ear shot every single waking moment, closing them into their room at night with an alarm on their door to know the animals, house, and people are safe? This is my life. I go to the bathroom, she's there. I take a shower, she's there. I can't even let her play outside unattended anymore after finding out what she was doing with the animals. We have a farm - I can't keep ducks and dogs and cats all sheltered from her. I have to keep her in my eyesight all the time. Do you have any idea how exhausting that is?

[Denisemomof4]

Yes, if we are chosen Friday, we will be allowed to read his entire file. And yes, the adoption is not final until he has lived in our house for 6 months, but, maybe I'm idealistic, but I don't think it's fair to bring him into the house until we're 100% committed to keeping him.

 

All the naysayers in our circles like to tell stories about how adopted children tear up families. I didn't take those comments seriously, until I read all the posts here.

 

take the stories seriously. Have you read the statistics of divorce after adopting a troubled child? Have you read what happens to those families? Are you prepared? READ, READ, READ. Not wanting the truth so you can have this adoption will set you up for severe stress and heartache later. The adoption community is LOADED with moms with health issues brought on by tremendous stress by their RAD child. The MOMS get PTSD just from taking care of them. There's no way to know for certain if he has RAD and what the outcome will come, but in the VERY FEW cases where it was stated that a child had severe behavioral problems, the kid had SEVERE problems which jeopardized the safety of the other children, the parents, the animals, the house. I can't believe that this keeps on happening. Many lives destroyed because of one, and the state usually knows fully well the issues the kids have when they adopt them out. This is just what I read, my dd came from an orphanage.

[Denisemomof4]

He was about 8 months with a retired teacher, who finally gave him up because of tantrums. He's been about 2 months in a therapeutic foster home where he is doing well (no tantrums, academic progress.)

 

2 months - honeymoon stage.

[Denisemomof4]

I'm sorry, but I have to strongly disagree with this statement. My dh works in the foster care system, has had hundreds of foster care clients and is a Licensed Mental Health Professional with a graduate degree in Clinical Psychology. He states that true diagnoses of RAD are rare. When they do occur, they are both tragic and dramatic, and because of this the stories linger and make RAD appear more common than is actually true. He wanted me to state this to dispel some of the fear that RAD is prevalent among foster care children.

 

and then there are those of us IN the RAD circle who have professionals tell us that RAD is far more common than anyone realizes, but that finding people trained in the diagnosing and treatment of it is extremely difficult.

 

In my adoption circles, RAD and attachment issues are UNDER diagnosed until you see someone who specializes in it. This is why it took me so long to get MY answers, and why so many people we saw stood there scratching their heads and had no answers.

 

It truly takes special training to understand RAD. It's widely known that you need to see someone who SPECIALIZES in RAD/attachment disorder or the therapist can actually make them worse. The therapist can be a tremendously skilled one, very, very good, but without specialized training, they can't help these kids.

[Denisemomof4]

In terms of the ADHD, I doubt that he has classic ADHD. Kids with attachment issues and trauma *look* like they have ADHD, but they are often actually dealing with PTSD or other trauma issues. If that's the case, it's imperative that you treat the trauma, not the symptoms of ADHD.

 

Lisa

 

and again, I'm certain that someone who KNOWS his full story also knows he's not truly ADHD/undiagnosed bipolar. Professionals not trained with severe attachment disorder diagnose these two conditions erroneously All The Time.

[Denisemomof4]

I really believe that a secure loving home will help with many issues that foster kids deal with. I'm not silly enough to say that love cures all ails, but it does help a lot!

 

If a secure, loving home, with EXTRA commitment and love, were enough, I would have a healed daughter. My dd was only 14 months old when we got her. I never imagined love truly couldn't be enough, but I now live it every day.

[Pippen]

What sort of professional does "independent evaluations"?

 

Our red file was today. It went well, and we were quite excited, then I read the whole file on my own tonight, after dh went to sleep. Before his therapeutic foster placement, he was tantruming violently almost every day. Don't know what to do next.

 

In this situation I would want a full work up by a pediatric neuropsychologist (not a regular child and adolescent psych). A neuropsychologist typically would spend 10-15 hours assessing the child as opposed to the short intake you typically would find by a child psychiatrist. I'd also want someone in the community (that specialty area would vary) in the region who parents have found reputable in assessing for attachment issues. Also if he's been diagnosed with severe ADHD, an OT assessment if it hasn't already been done, I'd want that too as sometimes kids who appear to be ADHD are sensory seekers due to undiagnosed sensory processing issues.

 

I agree with the others who have said proceed with caution, especially if you already have a child with BP. Kids with BP who are stable don't necessarily stay that way and having two kids with issues under the same roof doesn't double the stress on the family--it often increases it exponentially.

 

I also agree that if you decide to go forward you need to make sure that all the resources you could need are available to you--medical subsidy (get details in writing), insurance that would cover residential placements if ever needed, mental health professionals nearby (counselor plus child psychiastrist as most pediatricians won't mess with meds beyond ADHD), a parent available to drive to appointments, and a parent or other trusted adult available to supervise at all times so children are never alone.

[MistyJ]

Can you find out WHAT changed so that he is not acting like that now---different parenting, therapy, meds, or ????

 

Need to ask if his meds changed with current foster family. Current foster family is "therapeutically trained." Asking if we can get the same training. Met the foster dad, and he radiated patience and sainthood. I don't radiate patience and sainthood.

 

I would want to talk to both the first foster family as well as the current placement to find out EXACTLY what is going on. How long was he in each placement?

 

He was in the previous placement 10 months.

 

Ask is you can go along to the doctors/psychiatrist or talk to them as well.

 

Going to ask about this.

 

Are you close enough that you could do "respite" for a few weekends, then a week or so, etc. before deciding?

 

The transition is gradual, up to a year. The foster family is in our same town.

 

Did you ask about the medical subsidy and coverage for counseling, inpatient help, etc. after adoption? That would be KEY for me.

 

I know we get a monthly stipend...will ask today about medical subsidy.

[MistyJ]

Red file yesterday. Thanks to all of you for helping us form more questions. Here's what I just sent:

 

1. Can we have an independent evaluation of _____'s needs.

 

2. Is _____ violent towards his current foster brother? Was he violent towards the little boys (brothers) when he was in foster care with the pastor?

 

3. Can we talk to his psychiatrist? Is bipolar being considered? (Dexadrine would be very activating if _____ has bipolar.)

 

4. Can we speak at length with Doc?

 

5. Can we speak with the previous two foster families?

 

6. Can we get the same therapeutic training Doc received? Where? At Aask?

 

7. What kind of respite care would _____ qualify for? Free or subsidized?

 

8. Would _____ qualify for a medical subsidy with us, after he's adopted? Please explain.

 

9. Has Doc changed _____ diet?

 

10. Did ______'s meds change when he moved to Doc's?

 

11. We would like to see the birth records.

 

12. Before adoption is finalized, could we do public school part-time, to use services? Homeschooling part-time, to reduce _____'s stress?

[Starr]

It doesn't sound like they are advising you on all the resources you will need for the rest of your lives.

[Pippen]

7. What kind of respite care would _____ qualify for? Free or subsidized?

 

8. Would _____ qualify for a medical subsidy with us, after he's adopted? Please explain.

 

If you decide to go ahead with it, be sure and get everything in writing.

[Ottakee]

Very good list of questions.

 

Now, my daughter with bipolar IS on Dexdrine and doing well with it BUT she is on 2 mood stabilizers and an anti-psychotic as well.

 

If they balk on this stuff, then I would be very very careful. You esp. want a written contract regarding future mental health stuff. He should get medicaid as well BUT you can't always find a medicaid provider for mental health needs so you need them to pay for other providers, inpatient, etc. as needed.

 

He might come to you, get on the right meds, and do very very well. On the other hand, bipolar is not a static thing as you well know and the teen years esp. can be hairy.

 

Then on the flip side, these kids really need a home and a family of their own. But you can't put your own children at risk for this either.

 

My now 14dd was expected not to be able to maintain an in home placement past preschool age due to her special needs but she is doing very very well at home with proper meds. In some things she has done WAY better than ever expected but other things are worse than what we first thought when we adopted her (her IQ has dropped over 30 points in the past few years).

[EthiopianFood]

In light of the honeymoon concept, you might want to ask the previous placement how long it took before he started exibiting those symptoms.

[Harriet Vane]

This thread has been on my mind and heart since you posted.

 

I will preface my comments by saying that I have experience with foster care and am totally supportive of both fostering and adopting in general.

 

I have dear, dear friends who considered a similar scenario. They took in an older child with intent to adopt. These friends had already successfully adopted a bipolar child (adopted as a troubled 4yo--my friends were considering their second adoption when their first adopted child was 9yo). These friends are well used to dealing with severe behaviors in their first adopted child--he is a great kid and a real joy, in addition to being closely bonded to his adopted parents, but he is bipolar and the day to day difficulties with him can be significant.

 

These friends were soooo careful--they asked all the right questions, as you are, and considered things with painstaking prayer. They did frequent visits with this girl that grew progressively longer (like their first visit was an hour, and their last official visits were entire weekends). When this girl finally transitioned into their home they thought they really did know what they were dealing with.

 

However.

 

Over months of living with this foster child her behavior changed. After a few months of a honeymoon period life with the new child in the house became a living hell. All the considerable skill and love my friends had to offer (and the loving support of their friends) was absolutely not enough. Not only did this girl's behavior deteriorate badly, but the instability in the home also caused my friend's first adopted child to break down badly. Eventually over the course of a year my friends had to draw a line. They transitioned this girl to another foster placement--she blew through several placements over the next two years. The only setting this child has ever succeeded in has been institutional. (My friends have made enormous efforts to keep in touch with this girl and try to act as family of sorts for her.)

 

At this stage, in your situation, I would consider this child unadoptable, and find it wholly inappropriate that he is being presented to you as an adoption. You may very well eventually choose to adopt this child, and it may even prove to be a successful match, but right now I don't think any of you has the information or experience with this particular child necessary for a good decision. I would say you should not even talk about adoption until you have fostered this child for a year.

Edited July 8, 2010 by strider
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[MistyJ]

Thanks everyone. You have given me great insights, great practical advice. I need to stop hearing all the horror stories now.

 

We meet the child today....if we do choose to continue, the transition is slow, and we can wait up to a year to finalize.

 

Peace & JOY!

[Starr]

:grouphug:

[Teachin'Mine]

Keeping your family and this little boy in my prayers. :)