Anyone with experience teaching a child with a mood disorder?

[Innisfree]

Hi, I've been lurking for a while but finally decided it was time to join.

 

My two daughters (8 and 10) and I are finishing our first year of homeschooling. We've had a lot of difficulty, mainly because of the younger girl's issues.

 

She has a diagnosis of Mood Disorder-NOS. I think she may also have learning disabilities: she has trouble with sequences (before/after, left/right, and particularly numerical sequences and greater than/less than questions). She can handle addition and subtraction with ease, though, and has no trouble understanding multiplication and division concepts. I asked her school for an evaluation at the end of last year, citing my concerns, but they said she was within the normal range for first grade and they saw no problems.

 

The biggest problem, though, is that her mood swings wildly, and her frustration tolerance is extremely low. Hitting a tricky math problem or being asked to fix a spelling word often sends her into a meltdown. She is on risperidone, which has helped a lot but certainly does not eliminate the problem. Trying to get through a day's work is very difficult, though I've cut my expectations down to the bare essentials. She doesn't just have trouble getting her own work done, she makes it extremely difficult for her older sister to focus.

 

I'm feeling guilty for pulling them out of school, though we had plenty of good reasons for doing so. I feel like I'm not meeting their educational needs. Younger Girl never misbehaved at school, but she was at the breaking point every day when she got home because she'd been controlling herself all day. Evenings were horrendous, and the family just couldn't take another year of that. Older Girl wasn't being challenged. Well, now her schoolwork is appropriate, but I can hardly find time to work with her, and the biggest challenge is learning to cope with a mentally ill sister.

 

We are waiting for a sensory evaluation which the psychiatrist recommended. I would like to pursue testing for learning disabilities, but until her behavioral issues are better controlled I'm not sure she'll cooperate (in fact, fairly sure she won't :glare: ). I want to keep homeschooling, but I worry that I'm doing my older daughter, especially, a disservice.

 

Has anyone else dealt with these issues? Help? and thanks!

[Tiramisu]

:grouphug: I wish I could help.

 

I have one who went through a very bad stage because of a lot of sad events hitting her at once. Getting things done was a trial. Her siblings did not have patience with her and that made things worse. After trying all we could to help her at home, I decided to put her in school and it's been very good for her. She was happier and our home was peaceful again. Years have passed and I do not regret that decision at all.

 

Others may give you opposite advice, that she needs to be home where she can get your support and her needs met better. Every situation is different but sending one to school worked well for us, maybe because the kid in question really wanted to go to school and the others really wanted to stay home. That might be something to think about. Also, it's good when the tough one can behave very well outside the house and get good feedback on it from others. It can give them a much needed boost when the atmosphere at home has become negative.

[Tokyomarie]

I would encourage you to not wait on a learning disabilities evaluation. It is highly possible that one major factor in your daughter's mood issues is the presence of a learning disability. When children are aware somehow that they learn differently or that their performance doesn't meet their expectations or the expectations of the adults who work with them but they can't seem to figure out how to do better, they act out. Younger children don't have the perspective of life experience to understand or the language to express what they are experiencing, so they act out. They get stubborn and actively or passively resistant. They melt down and shut down.

 

Getting a full neuropsychological evaluation with a neuropsych who is highly experienced with children who have a variety of learning and behavioral issues can help you better understand how your daughter learns- both her strengths and her weaknesses. If significant learning weaknesses are identified, a good neuropsych can give you recommendations for local resources to help you get past those roadblocks. A good neuropsych has tools for conducting the evaluation in such a way as to get the best possible performance out of a child. The child may not always score in a way that demonstrates their highest potential, but the evaluator will usually be able to gather data from a large enough list of tests that some good conclusions can be drawn.

 

Here are a couple of names/resources for you to consider for tools in working with children who exhibit challenging behaviors:

 

Ross Greene: The Explosive Child and Lost at School

 

Greene's website: Lives in the Balance

 

Howard Glasser: Transforming the Difficult Child: The Nurtured Heart Approach

 

Glasser's website: The Nurtured Heart Approach

 

ETA: added website links

[Pen]

Sometimes one has to deal with the mood/behavior issue as a main thing-- acceptable behavior practice might need to be done, specific words to use when frustrated, things she can do to relieve feelings. . Things she can do as independent work or even "busywork" when you need to work with older sister (a baby sitter?, audiobooks or just fun for her books if she can read? art? chores?). Maybe a family therapist to help?

[Innisfree]

Thank you to everyone who has responded.

 

I'm going to look into neuropsych testing. Frustration based on learning disabilities certainly makes sense, though it's evident in other situations also. Marie, your description of her active and passive resistance is spot-on.

 

We've had her and, frequently, the rest of the family seeing a therapist since she was five. Unfortunately it hasn't helped much. The therapist says therapy probably won't help much until she's on the right medication.

 

Trying to pursue that, we've seen three psychiatrists now. The first said (after less than one hour with dd, who was refusing to speak to him) that we had a discipline issue, not a medical one. The second was better, but dd also refused to speak with him through two appointments, or to allow her weight or blood pressure to be measured. The third and current psychiatrist is much better, dd was talking and laughing with her, but this one's having a baby and leaving practice in two months!

 

I asked the therapist about neuropsych testing months ago, and she said it wasn't indicated for our situation. She also doesn't approve of homeschooling, and both girls perceive her as someone who chastises them. We're looking for a new therapist, but there aren't many in our area. Sorry, I'm venting here.

 

I'm trying to find ways to engage her while I work with her sister, and will continue that.

 

I really do appreciate your ideas, and hope others will chime in. Thanks!

[Ravin]

We are in much the position you are, but with no big sister and DD is a bit older. She also doesn't have an official diagnosis, though she is on risperidone along with generic zoloft. DD is very good, however, at trying to make sure I cannot get MY work done (I'm a student). She's also similar in that she's good at controlling her mood/behavior for other people and saves the meltdowns for me. She's in an enrichment program 2 days a week. She's never been to a regular public school.

 

The key, I think, is to have some separate, focused attention for your older DD, and make it part of the daily routine. Is there some privilege or activity that your younger really enjoys and will engage in alone for a while? Save it for just that time of day.

 

Another possibility, could you tag-team your younger DD with your DH? Have him ride herd on her for part of the day while you and older DD focus on her schoolwork.

 

Yet another possibility, a part-time/enrichment program such as my DD is in. You could put them in on different days so that you have focused time with older DD on the day sister is there.

 

Finally, there is also the option of putting your younger DD back in school and continuing to homeschool the older. Younger would keep learning, you'd have the time to focus on her the older one needs, and you can focus on behavior/support with the younger when she gets home.

[Tokyomarie]

Have the therapists given any indication of what they think is driving the behavior? Until you get at what's driving the behavior, you can't budge it much. You can blame the kid, "He's just a discipline problem" and try to punish it away. You can try to medicate it away, and end up trying multiple medications as you grasp at straws to see which med works when you don't know what's behind the behavior. You need professionals who don't jump to conclusions quickly, but work to get to know the child to see what really makes him tick. You don't have to answer publicly that first question unless you're looking for some feedback on their hypotheses. It's more to make you think as you try to figure out where to go from here. In our case, I tried the "punish it away" approach- with no intentions of being harsh in my punishment, but sometimes because of the level of resistance it ended up being harsher than I wished. I can't tell you how many different "punishment that still respects the kid" approaches I tried that all failed. We never tried the medication route, in part because we never tried the "working with a professional" route for dealing with ds's behavior and learning issues until he was in high school. Sometimes meds are absolutely necessary before progress can be made with changing behavior, but I believe they should only be given after there has been careful analysis of what is likely driving the behavior.

 

Here are some other random thoughts:

 

Do, do, do read both Ross Greene's work and Howard Glasser's work. They both have long experience working with kids who exhibit exceedingly challenging behaviors. From years of reading message boards dedicated to special needs kids, especially bright special needs kids and homeschooling special needs kids, Ross Greene's name pops up over and over. One of his mantras is "Kids Do Well If They Can." When they are not doing well, we need to do some careful analysis as to why. I have read his Lost at School book and found it quite helpful. The Nurtured Heart Approach is what really helped me learn how to break through the passive resistance. I was even looking for therapists using the Nurtured Heart Approach and never had to follow through on it because applying what I learned in the book so dramatically changed my interaction with my son.

 

You might even decide to read both books before seeking another therapist, even if that means going a short time without therapy. It will change your perspective on what you need in a therapist that much. I am amending my post above to include the websites of both of these approaches to working with behavior.

 

In rereading your original post, what pops out at me is the language based difficulty. You might consider getting an evaluation with a SLP whose practice is mainly focused on language processing difficulties. One of my daughters was first evaluated when she was 9.5yo, by both a psychologist who did a psychoeducational eval and a SLP who did a language evaluation. This child's difficulties were subtle enough that I kept putting it off, even though I had concerns since she was 2.5yo. She was "getting by" in school, and to casual observers seemed to be just fine. In fact, she was bilingual and was "getting by" going to school in her second language. But I knew she really wasn't "just fine." Sure enough, the evals picked up that she was 1-1.5yrs behind her age mates in certain language skills while having extremely strong visual-spatial abilities that were significantly ahead of her age mates. With therapy for language and auditory processing difficulties and a home-ed program that focused on building up her weak language areas, her negative behaviors gradually began to fade away.

 

When looking for a neuropsychologist, look for someone who uses terminology like "understanding a child's strengths and weaknesses," "finding islands of competence," "helping a child to build resilience," etc. The more we can tap into what helps a child to feel competent, the better we will be at helping her to lose the negative behaviors.

 

I wish you well as you continue to try to solve the puzzle of your child and figure out what will help her blossom and become an engaged learner and a loving family member.

 

 

[Tokyomarie]

Finally, there is also the option of putting your younger DD back in school and continuing to homeschool the older. Younger would keep learning, you'd have the time to focus on her the older one needs, and you can focus on behavior/support with the younger when she gets home.

 

Another thought, which is similar to the direction we went for a time: Put the older, better functioning daughter in school. If she was thriving in the ps school setting before, she likely will be just fine again. This will give you the ability to give undivided attention to the younger child who needs to build better relational, coping, and educational skills.

 

Another thought, for sometime after you've gotten through some evaluations, is to hire an educational therapist- someone who is skilled at helping children build cognitive, language, and academic skills but is also well trained in helping children work through the emotional barriers to positive learning and family life. When my son was 15yo and we had just gotten through his neuropsych eval, we were referred out for remediation in reading and writing. The referrals were to some highly qualified people who knew how to work with a highly resistant student. They were people who appreciated the benefits that homeschooling can offer and worked with my to support my work with my son.

[Ravin]

Another thought, which is similar to the direction we went for a time: Put the older, better functioning daughter in school. If she was thriving in the ps school setting before, she likely will be just fine again. This will give you the ability to give undivided attention to the younger child who needs to build better relational, coping, and educational skills.

 

 

I made the suggestion I did because she said that the younger did well in school and the older wasn't being challenged. Neglecting the older's education because she isn't a "problem" isn't much of a solution.

[geodob]

You wrote; ' she has trouble with sequences (before/after, left/right, and particularly numerical sequences and greater than/less than questions).'

Though perhaps you might reflect on these words before/after, and how intrinsic they are to our thinking?

Where they are not simply words, but concepts that we use to structure our life as we plan and work through things.

Be it a plan that might take minutes, hours, days, weeks, months or years?

Where we have a sense of where we are up to, as we work through these plans.

But you might consider working through a plan where you have no concept of before and after, and where you are up to as you work through a plan?

Not knowing whether you have the greater part done, and only the lesser part to complete?

Also no sense of how long something will take?

While at the same time, you observe other people developing and working through plans with no problem at all?

Who have no understanding of how difficult and frustrating you find something, that comes easy to them?

Where you also don't understand why you find it so difficult?

You might then take your frustration out on them, and sabotage their plan?

So that they might slightly relate to your frustration?

Only to be told that you have a behaviour problem?

[Innisfree]

There are good arguments to be made for putting either of the girls back in school, which is one reason I'm stewing about this.

 

Unfortunately neither was at her best in school before. Elder wasn't being challenged and was being bullied. If she goes back next year, she'll be starting middle school in a school which is having some problems. However, she sees the problems at home and would be willing to do this if we must.

 

Younger wasn't a discipline problem, but also wasn't receiving any extra help to sort out her LD or behavior issues. Because the teacher couldn't see any behavior issues, she objected to dd being pulled from class for therapy, and gossiped about dd with other teachers, who then spoke about it to dd, leading to meltdowns at home. Because dd was trying to hold things together at school, she'd come home every day and melt down. Because she was not failing, the school didn't think there were LD issues that needed addressing. If I can get appropriate diagnoses and work out an IED, I could perhaps improve this situation, but dd strongly objects to the idea of going back.

 

I've read The Explosive Child, but will go back and reread it and Greene's other book and Glasser's book.

 

I wish I had a better grasp on what's at the root of the problems. The answers we've gotten from professionals have tended to focus on either behavioral problems and solutions as a matter of consistent parenting (i.e., charts and a token economy) or biochemical issues. So far the first has yielded no results and the second only limited ones. I know there are some anxiety issues, though they don't seem to be acute. There are some suggestions of sensory issues, though nowhere near what I know some kids experience. We do have an evaluation scheduled for that, though it's months off. I will pursue the neuropsych evaluation, because that could certainly be a missing piece of the puzzle.

 

I appreciate everyone's thoughtful advice. You've given me a lot of food for thought, and I'm going to spend some time reading and digesting your ideas and the books you've recommended.

[Tokyomarie]

Innisfree,

 

I want to encourage you and say that it sounds like you've done some really clear thinking and have worked hard to figure out how best to meet your children's needs. Bravo!!!

 

You haven't yet gotten to where you want to be, but you've tried some potential solutions that haven't been effective. That can feel like failure, but in reality what you've tried gives you data points on what isn't helping either at all or not enough. Another challenge is, as you might have already heard or read, that solving the puzzle of a complex child is like peeling an onion. Even when you find something that helps, it's rarely the only thing that needs to be done. Peeling one layer of the onion can allow other issues to come to the front. The other cliché statement is that raising these kids is a marathon, not a sprint. Now that I am (mostly) on the other side of raising my complex children, I can say that it is really true.

 

Younger wasn't a discipline problem, but also wasn't receiving any extra help to sort out her LD or behavior issues. Because the teacher couldn't see any behavior issues, she objected to dd being pulled from class for therapy, and gossiped about dd with other teachers, who then spoke about it to dd, leading to meltdowns at home. Because dd was trying to hold things together at school, she'd come home every day and melt down. Because she was not failing, the school didn't think there were LD issues that needed addressing. If I can get appropriate diagnoses and work out an IED, I could perhaps improve this situation, but dd strongly objects to the idea of going back.

 

This is exactly why I threw out what seems to be a counter-intuitive solution: putting the older child in school so you can focus one-on-one with the younger. I see that there are considerations that make that choice not ideal, which complicates the matter. I see your dilemma. I will say that my son didn't begin to make some of his best progress until his next older sibling left home for college (she is much older than he). They had a dynamic going on that was cute on the surface but unhealthy as far as helping ds become a more competent, engaged, mature learner. When she left home, that all changed and made it easier to work on some of ds's behaviors.

[Ottakee]

I have TWO with mood disorders, one bipolar nad one one mood disorder NOS.

 

I have to disagree a bit with some of the others as here, medication was THE answer----well at least 90% of it. Seriously once the medication was correct, all of the parenting, therapy, discipline, etc.could fall into place. Without it, nothing really mattered.

 

Have you read THE BIPOLAR CHILD? Check out www.bpkids.org and www.bipolarchild.com They have lists of doctors and there might be one for you in driving distance. Once we found a good pediatric psychiatrist we followed her to 5 different offices in 4 different cities to keep her.

 

http://www.bpchildren.org/files/Download/TreatmentGuidelines.pdf Is a great (but older) article on the treatment of mood disorders in kids. It is VERY good.....but I will say that they didn't like Lamictal as a med for these kids but further research in the past 8 years has proven it to be a very effective and safe choice if you start with a low dose and go up slowly and don't use with Depakote. The main point you will see here though is that most kids need TWO and very often THREE medications.

 

It could be that the Risperdal is helping your daughter but she still needs a mood stabilizer---Lamictal, Tegretol, Depakote, Lithium, etc. to go with it. We certainly needed the combo here.

 

As we also have ADHD we have VERY VERY carefully added a stimulant to the other meds but that should be done only after the moods are stable.

 

Seriously my one that struggled the most before the correct meds is now my easiest child.

[Ravin]

The more you describe your younger DD, the more she sounds like my DD. Meds DEFINITELY helped here (she was developing compulsive behavior and having some scary uncontrollable thoughts before, along with the mood swings, and I have a sister who is bipolar so the family connection concerns her psychaiatrist). But also with the learning problems.

 

We, too, have been unable to get to the root of the learning problems. We had an eval done in 3rd grade by the public school, who said they might give her extra time for assignments if she was in one of their classrooms, but no IEP because she was performing at grade level and not 3 grades behind in any area.

 

Since one-on-one homeschooling from the get-go with constant tailoring to what did seem to work for her was barely keeping us above water at the time with her learning progress--and at that treading for over a year before the evaluation--it was not a very satisfactory answer. The best thing I've been able to do so far is consciously make a point to remember that everything is HARD for my DD when it comes to schoolwork. And I acknowledge that and praise her for working through her frustration, for getting a handle on it, etc. Meds help, so does lots of patience and, I hope, over time, maturity. I focus on how she should be proud of her accomplishments because she fights so hard for them. Focusing on the positive and giving it attention while not giving too much attention to negative behavior has been a key part of the way we've modified parenting her along with her therapy--and the therapist works with her on recognizing the proportions of her problems and when and how much drama is appropriate.

 

We're currently on a wait list for a psychoeducational evaluation at the university.

 

The meds HAVE helped with schoolwork...shes got a bit longer fuse, and can calm herself down faster than before. Give your DD time and patience and seek evaluation.

 

As far as your older daughter, how much of your time does she need, and how much of a self-starter is she? Can she do her work in a separate space, at least some of it? That would keep her sister out of her way while she works. I would make peer interaction and recognizing how to give her sister the time she needs with you for her learning a priority in working with your younger DD as far as behavior. Maybe a positive reinforcement/reward specifically for that?

[Lindi]

I guess I missed this post. I don't remember it. But it's late so if this is a repeat, I'm sorry. I have been homeschooling a recently turned 16 year old bipolar foster for a year now. We've had our ups and downs, but over all, I think she is in a better place than she was. We have not had neuro tests done but are currently trying to get her onto our state's child's insurance so that we can (she is not technically a foster child but has come to live with us and we do have guardianship but not full custody. Her med insurance currently comes from her father's work insurance in another state and it is not very good. K was very moody when she first came - as only a bi-polar can be, I suspect. She would have meltdowns. I once chased her all over Barnes and Nobel when she got upset that I said "no" to a very dark book. Other times, she'd be totally cooperative and really try. She often had insomnia even when not acting manic. At Christmas, she went home for a week to visit her father and came back not doing well. Her father does care about her but has problems of his own and no ability to understand or care for her. Her mother abused her, is schizophrenic and is considered dangerous. So you can just imagine what she has been through. Anyway, things were worse when she came back after Christmas and there was a half-hearted suicide attempt. It really was half-hearted this time although in the past, before she came, she had two serious ones. She stayed a couple of weeks in the hospital where they readjusted meds. She came home on high doses of lithium, lamectal and seraquel. This made her go to sleep at night for sure and it did level out her moods, although I also noticed that she has more troublefocusing and concentrating. Last week, we had her scheduled blood test and the Dr. called and said the thyroid was way out of range and would be have it redone. We did and it came back the same. It should be 3.5 and hers was 304. The doctor (psychiatrist) had never seen one that high (as you may know, a high TSH indicates low thyroid function.) Why wonder she was tired! So, the psychiatrist pulled her off the lithium immediately and upped the Seraquel and we have an appointment with a endocrinologist on Tues. Hashimoto's Thyroiditis also runs in our family (I have it) so this could also be a factor along with the lithium. Anyway, she is doing surprisingly well without the lithium so far although she doesn't want to sleep again. Please feel free to email me if you need someone to talk to. I probably don't know more than you, but I'm learning and I am very sympathetic. I wish I had someone to learn this stuff with. She is a precious child with great potential and I love her dearly.

[PeterPan]

Lindi, I just wanted to say I saw your thread on the hs board and wanted to reply but stopped. I'm glad you got her thyroid checked. Ironically, that could explain a lot of her symptoms. The standards on the TSH have dropped lower (below 2.0), though it varies slightly with the lab. Anyway, spend some time learning about that, read Mary Shomon's book on it, free T3 and free T4, etc. I used to be on thyroid meds. Now I eat lots of salad and take kelp. Low thyroid causes really nasty brain fog. Some of what you were describing on the hs board could be that or side effects of the psych meds or both. There's a psych in Indiana I think who finally gave up traditional psychiatry and went into thyroid treatment, because it seemed like so many of his psych patients turned out to have thyroid problems. And yes, having your thyroid that low can leave you suicidal and having strange thoughts.

 

Just for your total trivia, when you said *recent*, do you mean since she moved to be with you? (Or recently turned 16? I must be having a moment, lol.) I ask, because my thyroid crashed after I got married. We moved into a house under high tension power lines, and I was very sensitive to the EMF. We finally had to move, because it was making me so sick. So when you have something that is recent and wasn't that way before, you want to look for environmental causes.

[Innisfree]

Thanks, Lindi, and thanks again to everyone else who responded. It is so valuable to know there are are others within reach who are dealing with this and making progress, since I don't know anyone with similar issues IRL.

 

I've been rereading The Explosive Child and trying to start applying it again, though I suspect the route to getting that approach to work may lie through continued adjustments of medications and sorting out learning disabilies. She tends to respond to "How can we solve this problem?" with silence, and I'm not sure if the reason is mood, or difficulty thinking through options, or difficulty verbalizing, or a (varying) combination of all three. If she's in a really bad mood, her answer is "I don't care!" combined with destruction of anything within reach, but when she's in a good mood she's sweet, helpful and cooperative, but decidedly disinclined to think about the bad moments.

 

We're on waiting lists for evaluations.

 

Again, I appreciate everyone's help.

[Ottakee]

Glad you got the thyroid done. Our pdoc does all of those tests as well as so many kids/people with mood issues have thyroid or other medical issues that need attending to first or along with the mood stuff.

[dbmamaz]

couldnt quite read all the responses, mostly just sympathy here. My 17 yo was always in trouble in grade school. the first two times we took him to be evaluated (1st and 2nd grade), they said 'not adhd, call us if you need anything', which i found very unhelpful. end of third grade he was dx'd aspergers, adhd and gifted. During 4th grade, a more thorough evaluation, said pdd-nos (milder than aspergers), adhd symptoms probably due to sensory issues, anxiety, disthymia (mild depression), tic disorder, processing disorder, gifted. wow.

 

Finally we got in with a med doctor because the doc who did the last eval insisted he needed anxiety meds - and he started having panic attacks, too. We started with SSRIs, added risperdone - which was his miracle drug - and have slowly shifted things.

 

Before getting the drugs right, nothing worked. after getting the drugs right, he's still challenging, he's still super immature (one doc said he'll always be about 2/3 his age, maturity wise - hitting puberty late didnt help), he still has some learning issues and a ton of organization and 'executive funtion' issues . . . but we make progress now.

 

I was on a few lists . .. and thats usually the consensus . . . unless there is some other issue, like an abuse issue or a bonding issue, no progress can be made until the meds are right.

 

Oh, not sure if anyone mentioned - but good supplements - fish oil, vitamin D - both help a lot. and food - my youngest was super reactive to dyes and preservatives, and we all do better without gluten and dairy - but not everyone reacts the same

 

Older daughter is getting to the point where she could be doing more work independently, yes? And younger one - i'd focus on finding ways to make progress without stress. My youngest is super stubborn and i say we have to work on every subject ever day, but our LA is super light because it just freaks him out. (youngest has never been evaluated)

 

good luck - hang in there! as a family you can decide what is best, but dont let guilt be your main guiding emotion. Can you and older dd work together to build a school plan that is realistic and gets her closer to HER goals? Try!! certainly I think sending younger dd to school would be counter productive, at least judging from my kids. Oh, and the threat of going back to school is useful - i know you dont like doing your school work, but the option isnt school or no school, its school or homeschool, and if you wont do your work here, you'll have to go back to school.

[LMV]

Thanks for this thread. Our foster daughter will be five later this month. She has been miserable since she came to us in February. Our pediatrician did a very targeted but thorough workup (including CMP, CBC, T4, TSH, Vitamin D, Zinc, Copper, and B-12, Folate and MRI of the Brain) and then agreed that it was likely a mix of malnutrition (which we're fixing), grief, and depression. We saw two different child psychiatrists and eventually ended starting her on Prozac about three weeks ago. She is maybe improving a little with this but not significantly. I'm hoping it is just that the medicine hasn't had enough time to get into the system (and I know it does take awhile with the SSRIs usually at least a month or longer).

 

She is the right age to be starting kindergarten in the fall and her CP/FS caseworker (who in general really listens to us and trusts our judgment) feels that is what should happen. At this point I don't see how she can function in school. I'm also not sure if she is prepared well enough to succeed from a cognitive/academic standpoint there. I suspect that her delays are due to the depression but I really have no idea. She would probably benefit from a full educational evaluation but I don't think it would really be accurate at this point. We live within walking distance of a really good neighborhood elementary school. Her older sister is attending there part time in a special gifted program and they have a really neat kindergarten program that we had been anticipating sending our younger daughters (who are currently three and seven months so neither will be going next fall) to for kindergarten and then assessing where to go from there. I would like to just give her another year at home to assimilate into the family, and heal and then let her go to kindergarten the summer after she turns six. This would be legal (although atypical) by our state education laws but my impression is that the CP/FS caseworker will not want to go along with this. For this reason I'm considering homeschooling kindergarten. I'm also trying to assess whether maybe just being required to be up and out of the house and functioning might be necessary nudge for her. I'm a bit afraid it would just make the whole process more traumatic.

[Ottakee]

In our state it would not be unusual at all to start a child in K who had just turned 6. They offer a "Young 5s" program for kids who are wanting/needing schooling but aren't ready for K.

 

Have you seen a neurologist at all? Not knowing all the issues you are dealing with, etc. there are other medical conditions that can look like depression, low energy, etc.

 

It is hard putting the pieces together with foster kids. I have one now that is doing quite well in many areas but lots of medical appointments just to get him caught up and figure out a few other issues. Hard when you have no good history to go on.

[Tiramisu]

In our state it would not be unusual at all to start a child in K who had just turned 6. They offer a "Young 5s" program for kids who are wanting/needing schooling but aren't ready for K.

 

Have you seen a neurologist at all? Not knowing all the issues you are dealing with, etc. there are other medical conditions that can look like depression, low energy, etc.

 

It is hard putting the pieces together with foster kids. I have one now that is doing quite well in many areas but lots of medical appointments just to get him caught up and figure out a few other issues. Hard when you have no good history to go on.

 

Besides thyroid, what other medical conditions can look like depression or low energy?

 

 

[Ottakee]

Besides thyroid, what other medical conditions can look like depression or low energy?

 

Mitochondrial disorders are a big one.

[Ottakee]

Also, does she show just depression or are there times of hyperactivity,mood swings, etc? Mood disorders can also present as mostly depression but need a mood stabilizer for most kids.

 

Any signs of seizures---daydreaming where she doesn't respond when you call her name, etc? Petit mal seizures can cause behavioral symptoms as well.

 

I know just how tough it is to figure this out. It took us over 7 years to get the majority of the pieces to the puzzle here.

[LMV]

Besides thyroid, what other medical conditions can look like depression or low energy?

 

-Anemia

-Renal Dysfunction

-Various Vitamin/Mineral Deficiencies

-Sleep Disorders (with resulting fatigue)

-Brain Disorders/Malignancy **This is a real reach--the MRI of the Brain was ordered mainly because the pediatrician is very thorough.

[LMV]

Also, does she show just depression or are there times of hyperactivity,mood swings, etc? Mood disorders can also present as mostly depression but need a mood stabilizer for most kids.

 

Any signs of seizures---daydreaming where she doesn't respond when you call her name, etc? Petit mal seizures can cause behavioral symptoms as well.

 

I know just how tough it is to figure this out. It took us over 7 years to get the majority of the pieces to the puzzle here.

 

 

Basically this child would sleep for days if we didn't wake her. We haven't seen hyperactivity or anything that looks like a seizure disorder.

[LostSurprise]

I think a lot has been covered in this thread. I don't have much to add, mostly my sympathies. My son has a brain condition which creates mood problems. I agree with reading Greene, continuing to look for other physical/neurological/or learning disorders, and if the situation worsens considering public school for one of the girls or at least a tutor/aide to help you with daily teaching.

 

In my own experience I've had to decrease the amount and stress-level of the work by drawing it out over a much greater period of time. That means that we don't do school all at once. We may do some in the morning and some in the evening. Different people (dh or myself) teach at different times so he doesn't develop a stubborn attitude just by facing that person. We school (lightly) most days of the week. We school most days of the year. I schedule in catch up days for things that get dropped. If I see something hard coming, I schedule it alone, with no other subjects. I walk him through it step by step. Since he is a cuddle bug I usually allow him on my lap while doing it. I schedule something fun right after (baking! playing on his scooter!). If there's a meltdown coming we drop it and switch to the next subject (either tomorrow's or a subject scheduled later). Then we come back, and back and back and back. Always lightly, always encouraging but never pushing.

 

At first this seemed like it would be the wrong thing, that he needed to just "get used" to doing things the way the world does them. I felt like I was doing him a disservice if I was "easy" on him. I eventually came to the reality that he just can't do things that way. He needs the time to work up to a "normal" work load...or he needs better medication, therapy, etc before he can do that.

 

Right now my job is to make sure we keep moving forward...and that he develops some trust in his ability. My job is not to keep up with anyone or do something a specific way.

[Guest dkcountryman]

innisfree

 

Reading your post felt like I was reading something I wrote... I'm in a very similar situation. I have a 7 year old girl with mood disorder NOS and am homeschooling her. I have five kids: 10, 8, 7, 3, and 2. This is my second year homeschooling. The first year was a nightmare! and had all kids home and my dd had so many meltdowns that nothing got done. This year we did send the oldest back to charter school ( just the right choice for that child, and he wanted to go back). The other two were home. My dd sounds just like yours, but mine gets math and struggles with reading. she is on seroquel which works great so far and has made life alot better. We are in the process of getting nuro testing done too but I am very nervous for how she will behave for testing. The thing that has made a world of difference for us in being able to get work done is the book 123 Magic. We read the 'Explosive Child' and I liked what they had to say, but did not know how to implement it well. 123 Magic is very clear and easy to implement. We still have meltdowns but with me keeping a cool head (not always easy to do) and using timeouts effectively we are moving forward. Good luck, Hang in there!