Concerned about 4.5 year old, what to do?

[lifesajourney]

My son will be five in February, but we are finally at the point where I feel like we may benefit from seeking out a diagnosis and therapy for his behavior. Unfortunately, I am unsure how I want to proceed. My husband is in the military, we just moved here to San Antonio, but are moving again in march To Oklahoma (he is only here for training). Change and transitions are extremely hard on my son, so I felt like it was not worth starting the eval process here, knowing our stay is only temporary. However, my son has been out of control at some point everyday since we arrived two weeks ago, and the aggression is most concerning. We were under the care of a homeopath before we moved from WA, and we were seeing some benefits from the homeopathic remedies. I did get in touch with her since we've moved, and even with her 'large dose' recommendation, we only got a few 'good' days. I do prefer the natural approach, but i feel like I also kind of need to know what else is going on, as does my husband. My question is basically what to do now? We are currently on base, and if we sought out an appointment it would be with a military doctor, never my first choice. I also believe he'd be eligible for some testing through the school district (child find?). I am just not sure where to go from here, again, knowing we are leaving in a few months,and sometimes the waiting lists can be just that long. I would love and appreciate anyone's input and perspective, as the process is all new to me. Lastly, I am very interested in perusing rdi therapy, but wondering if it's ever covered by insurance? Thanks!

[Misty]

We are a military family and we live in Oklahoma. Are you going to Lawton or near Oklahoma City? I can help put you in touch with the appropriate contacts once you get here.

 

Have you tried an elimination diet with your son? Does he drink a lot of dairy and crave things like crackers and breads? If so, he might need to be dairy free and gluten free. My now 8yr old daughter was completely out of control when she was your son's age. She was completely addicted to both dairy and crackers/breads. Removing these foods was the best thing we ever did for her.. She has been through numerous therapies, but none of them even came close to what changing her diet did for her. We also had to remove soy for her. But her aggression, rage, hyperactivity, and stimming is gone now. Her severe OCD is gone now also. She is very manageable today. But if she gets the slightest bit of gluten or dairy or soy, she regresses back to the way she used to be. Sometimes even worse than ever before depending on how much she gets. Please contact me privately if you have any questions. We are in the Oklahoma City area and I know a good Naturopath who is very affordable. I also know how to squeeze every last drop out of Tricare for therapies and alternative docs. We've barely had to pay a penny for all sorts of therapies and for our DAN (Defeat Autism Now) doctor. We also got food sensitivity testing done, all paid for by Tricare. Get in touch with me and I'll guide you! :)

 

I also wanted to add... You can go to your military primary care doc and ask for a referral to a psychologist out in town to do the evaluations. Tricare will pay for it. I've had all four of my children evaluated through private psychs and Tricare paid every penny. Are you Tricare Prime or Standard? We are Prime. I would initiate the eval now and get that done while you're in San Antonio.. Wait lists here are only about 2 months for evaluations with child psychologists. So you could probably get that done where you are now and then wait till you get to OK to begin therapies, etc.

Edited November 11, 2011 by Misty

[Cindyg]

I don't have answers for you, but I wanted to tell you that I read this and I hope you get the help you need. And I'm bumping your post so that someone else will answer it.

[PeterPan]

Not to be intrusive, but have you taken him to a ped just to let them compare him to normal developmental markers? Your first thing is to find out where he stands developmentally and figure out what is causing the aggression. Do you know? What do you suspect? I mean it can be anything from speech problems frustrating him to blood sugar to food allergies to inability to self-regulate to SPD to... You've just got a wide field right now.

 

Will the military pay or help you do privately anything they can't refer you to within the military hospital? I would get proper evals and not go through the school. With the aggression you're talking about, you need thorough evals. You can't take chances that they won't evaluate thoroughly and catch everything.

 

The neuropsychs around here run a few months out (1-3) and the OT's are usually that or a little less (2 or less). But you know sometimes you can be surprised and get in sooner. In your shoes *I* would want some answers now, not 4-6 months from now. If the wait is long to get in locally, then worst case it to make those appointments in OK and do it when you get there. But personally, I would make some moves now. And actually, if you can just pick what you want, I think an OT eval might be amenable to you. It's not invasive or meds or anything like that, and it's directly focused on getting SOLUTIONS, natural solutions. You want an OT who does lots of SPD and kids with autism, not just any old OT from the base handling other types of scenarios. The OT can look at issues of sensory, self-regulation, stim level, and get you lots of practical answers that would make a functional difference right away. Yes, unfortunately you'd have a change there. But he's going to have changes anyway. And I'm saying the difference an OT can make could make it worth it, giving you ways to help him with the move, etc. That's just one way to go about this.

 

Meanwhile, if you haven't done this, get some developmental charts for his age and see where he's hitting stuff and where he's not. The lists are readily available online and pretty specific. That way you know if you're wanting a developmental ped (instead of a regular one) or what.

[lifesajourney]

Thank you so much for your responses. Misty I will absolutely be emailing you!!! We will be in Enid, I can't remember if it's an hour or more from OKC.

 

While in WA he was also seen by a reg ped, and I actually brought up some of the issues At his four year (shutting down, aggression, avoidance, etc) and she did refer him for a speech and neuro eval, but other than that he is pretty much on target developmentally. Unfortunately the Neuro eval was a six month wait list, and the first three appts required both parents present, no children. At the time my husband was deployed, and I have two other little ones. We were also planning to move over the summer (we ended up moving this fall, a few weeks ago.). I did have the speech eval done only because I mistakenly thought it was ot also. But now we can confirm there are no speech issues.

 

The (not so funny) part of it is before kids I was a special education teacher. Never did I think I would be so baffled by my four year old. I just don't know what's going on, and I guess bottom line, we need to find out. Diet is definitely another areA to consider. We were 100% dairy free for over a year, but I can't say for sure how much it helped. In his little life hes had a major stressor at least every six months (move, new baby, daddy deployed, repeat). So somehow yogurt (and now cheese unfortunately) has crept back into our diet. He does seem to crave cheese, and chocolate, and I often wonder if that's increasing his aggression.

 

I apologize for the type os, this thing has a mind of its own!

[PeterPan]

Hate to say this, but craving is often a sign of allergy/poor digestion. That's how you know the first things to cut, when you look at what they're craving. :(

[2squared]

We were stationed at Lackland for four years, and I had fabulous care through Wilford Hall. The care there was better than the care I have received since we left the military. I would at least see what the docs at Wilford Hall can do for you. I think Lackland has more resources available than the average base b/c it is a training base.

[Alessandra]

You have got such good advice! I'm not military or in your area, but I have sometimes been able to get quick appointments. First I make a regular appointment -- in our area developmental peds have 6 month waits. Then I find out from the office when appointments are confirmed for the week -- it's usually a Monday or Friday. I explain that I am ready to come in at a moment's notice if there is a cancellation and ask when is the best time to call. I then call every week at the appropriate time and ask about cancellations. Most practices have them, and I have often got to a doctor in a few weeks rather than months.

[lifesajourney]

Thank you guys, I truly mean it, for all the great advice. We completed a CAST questionnaire last night, and it became glaringly obvious. I had been trying for days to make an appointment through the online system, to no avail. I tried again this morning and Miraclously there was an appointment for tomorrow morning. It is just our starting point at the regular ped, I'm going to ask for a referral off base for a private assessment (thanks for the advice!). I think I'm just finally moving past denial. Thanks again, wish us luck tomorrow, I have to bring all three, it's always an adventure! I'm still not sure what to even say, maybe I'll print a copy of the CAST we filled out?

[Misty]

Write down a list of all his symptoms to have with you.. You could even give it to the doctor to avoid talking about your son right in front of him.

 

Don't take no for an answer as far as getting that referral goes.. You will regret it later. Don't leave until you have convinced the doctor that you need the referral. Just an FYI, in case you don't know.. If you are Tricare Standard, then you don't need a referral. Tricare Prime people need referrals. And it may depend on the base.. But if you have a Naval hospital or an Army hospital where you are, then you will get sent there instead of out in town. Not a bad starting point, but be prepared to argue your case because some doctors (both military and civilian) just don't see what you see at first glance. I was fortunate.. Mine did. But I've heard so many times that the parents were not taken seriously and the situations were blown off, only to find later that there were significant issues that would have benefited from an early diagnosis.

 

BTW.. I sent you an e-mail yesterday.. Did you get it?

 

Good luck and let us know how it goes!!

[JessicaLady]

You may be able to get in w/ a PedNeuro before you move. We live in Austin and we got a second opinion from a Neuro in SA. He didn't have an extremely long wait list at the time. I can look up his name if you'd like.

 

Also, Dev. Ped. are VERY hard to find in our area. I was on a.....13 month wait list w/ one in Temple (the next closest was Houston) and when I called to follow up 6mos into my wait, they had NO record of our being on the list. So, we scratched that plan.

 

I would LOVE to visit w/ this specialty and if they're available where you're moving to, you may want to go ahead and get on the list before you move.

[lifesajourney]

Well we survived the gen ped apt, and there was no doubt as to why we were there as ds refused anything and everything and resorted solely to grunts and actually screamed nonsense when I answered her questions (I know he hates me talking about him, and I tried to explain that and hand her a sheet with the symptoms and she wouldn't even take it! She said she was perfectly fine to ignore the screaming.). Anyways, she did make the referral to the army hospital here (to a dev ped i believe, was hard to hear here over the screaming) and it sounds like wilford hall like I believe a previous post mentioned, although she was not sure of the their wait. I have to wait for them to contact us. She also sent me to a psychiatrist, whom I met with tonight, but I'm not sure how much help he'd be honestly (I have a background in spec Ed/behavioral therapy and we are not interested in medication.). Maybe I'm just turned off that he was quick to mention bipolar, in a four year old child he's never met... But, anyways, I have you guys to thank honestly for carrying me through this week. I feel like we have at least gotten over a hump (even if this may have only been a small pebble on a very rocky road). At this point we are going to peruse homeopathy and possibly RDI therapy (meeting with someone this Fri) and none of those are covered by my insurance, so I'll also be praying we win the lottery ;)

[lifesajourney]

Jessicalady I would love the name of the person you saw. The rdi consultant we contacted partners with a dev ped in San Antonio, but their next apt is April and we move in march. She wouldn't even put me on the wait list for cancellations as they save those for u der twos apparently.

 

Misty, I didn't get you're email, and it sounds like you didn't get mine, I wasn't sure as my computer crashed as I was sending. I'll try again right now!

[Misty]

So glad to hear you got the referral. A developmental ped at the Army hospital should be fine. I wouldn't bother with the psychiatrist if you are not interested in meds.

 

Some supplements you could start him on...

 

Fish oil - we use Nordic Naturals Cod Liver oil - strawberry-flavored balls. My kids swallow them whole, but you could squeeze out the oil into some juice, or he could chew them. Fish oil helps to fatten up the brain, allowing for more connections to be made.. Little boys are especially in need of this.

 

Probiotics - Recent research has made the connection between gut health and mental health. In fact, this is the reason why the gluten-free, casein-free (GFCF) diet is so beneficial for some kids who have gut issues and behavioral issues. If nothing else, this is a good preventative measure.

 

B12 - A good brain vitamin

 

Calcium/Magnesium - Sometimes these kids also need some Cal/Mag. If you have been dairy free for the past year, I would especially consider starting this if you haven't already.

 

If he has trouble falling asleep at night, you could start him on melatonin, 1mg sublinguals at bedtime. We use the GNC brand because it is soy free and my daughter has a soy allergy. It tastes really good so there won't be any complaints from your son on this one. My anti-sleep daughter is asleep within 30 minutes of taking this.

 

Does he have any anxiety or OCD tendencies?

 

It is very possible to handle these kids without meds.. I had the most out of control daughter with severe OCD, severe ADHD, very aggressive, very moody, never slept, constant stimming, screaming, behavior issues out the wazoo.. We did have to use medications for a while until I was able to formulate a med-free plan (it was either meds or I die because I couldn't live another day with her OCD rituals and constant stimming, hyperactivity, defiance, etc.).. But today (age 8) she is med free and very stable in every area. The ADHD is probably our most problematic issue right now, but it's not near as severe as it used to be. Her Asperger's is ever present too, but since she is homeschooled, it's not a huge problem area for us. Please don't hesitate to contact me!

Edited November 17, 2011 by Misty