Update on James

James has been working with a BHRS (Behavior specialist) and Mobile Therapist for about three months now. I really like them, they don't totally get it, but nonetheless they have given me some things to think about and implement at home.  We've focused our house rules on three things:  Be Kind, Be Respectful, Be Safe.  Ive tried to stop talking as much and just focus on these three rules.  So instead of a long rambling lecture I just say, "That's not safe".  I think it has been helpful, not so much with James actual issues, but helpful when trying to wrangle all three boys and in a general household control and structure way.

Im still waiting on James' medication to go through the insurance.  That has been a complete debacle of back and forth, however I think something should come through this week.

We had a three month check in with the counseling agency in order for insurance to continue funding the BHRS and Mobile Therapist.  Once again I had to go through James' life story.  Why cant these people just read the freaking file.  After talking for awhile I mention that at one point Matthew was diagnosed as RAD.  A big sigh of relief came over her and she said "OH so you wouldn't be SUPRISED if I tell you I think James has some attachment issues?!"  LOL surprised??  NO.  She proceeded to tell me in front of both Matthew and James that I had taken on a "burden" and they were "brain-damaged".  I was livid at that point, I really cant stand some of these therapists! She then proceeded to tell me how I should parent him with a one page summary sheet, cause you know, she went to a training once......

Whatever, over and done with and insurance approved therapy for the next three months.

James has been doing better than expected in preschool.  There have been a few incidents like choking a peer and hitting the teacher at the beginning. It seems as though he really wants friends.  The other kids in the class will not play with him when he is "rough" and will flat out tell him.  He seems to get that the other kids don't like it, but still struggles with what behaviors he can replace it with to get them to play with him.  Despite this the kids seem to quickly forgive and invite him to play.  He has trouble focusing and listening during group time.  He is more apt to try and push his chair into the person next to him or look around the room.  Im hoping the medicine will help with this.  He is "behind" academically, but does show interest in learning things that seem fun to him.  Right now he likes writing.  The teacher thinks it is more so the fact that they get to work one on one with her, which I'm sure is true, but works for me.

We've got a meeting Wednesday with James' BHRS and Mobile Therapist to update the plan of action for the next three months.

James' Medication Appointment

We have been trying to get James started on medication for the past two years.   We are constantly told he is too young by the doctors/psychiatrists who see him for all of 10 minutes and are constantly told by the therapists/counselors/teachers/behavior specialists that work with him on a daily basis that they don't think he will make much progress without the medication piece.  Yesterday we finally had the medication appointment with a psychiatrist at the mental health agency we work with. I had to go through his history for the fifth time with this mental health agency.  It is so irritating and a complete waste of time, read the file people!  Of course if they actually read the file and reports from everyone working with him the appointment would last about 15 minutes and then they couldn't charge the insurance an exorbitant amount of money.  After an hour of going through his history, concerns, and issues she started to say he was too young for medication and that he would need to be in a special class next year in Kindergarten.   After slowly counting to ten so as not to explode, I as calmly as I could told her she was completely wrong.  The reason we are here now is to try and get all of the pieces together BEFORE he gets in Kindergarten next year.  This is not my first rodeo, I waited two years to get all the pieces in place with Matthew.  If I would have stood my ground and told the "experts" they were wrong maybe Matthew would have made more progress sooner, I was NOT doing this dance again.  She gave me a long speech about how he certainly shouldn't be on a stimulant and in the end she recommended to start him on Tenex after he had an EKG. If she would have asked me at the beginning of the appointment what I wanted for him.....I would have said Tenex, the appointment would have lasted 10 minutes and we would have been at the same place.  BUT what do I know, I'm just a highly educated, experienced therapeutic parent.

Empathy: Resources

Resources:

Activities to Develop Empathy in Children
Developmentally appropriate Empathy by age
Empathy exercises for kids:  List of resources and activities

Back to school night for Matthew

It was back to school night tonight for Matthew, I found out about said back to school night at 4:30 this afternoon!  The boys grandma graciously agreed to come over and watch the boys.  I wouldn't have blamed her if she said NO and ran screaming.  The last time she came over to babysit involved some physical aggression, Matthew trying to jump out the window and pretty much a lng ride on the crazy train....but she came anyway :)  I take it all as a sign that the boys are finally really starting to attach to her and feel the need to push back on that attachment.   In light of previous events, I took Matthew with me and put Joel to bed early so really she only had James to deal with this evening.  James in charge of snack tomorrow so I had them put that together to keep him busy. 
The back to school night was uneventful, Matthew has the same teacher as last year and I communicate with her regularly.  This is his second year attending a special private therapeutic school that our local district pays the tuition for.  He is in a class with about 5 students, there is his teacher and her aide as well as some one on one aides for some of the students.  His teacher is great and Matthew is doing great at school most days.  This will probably be the last year the district pays for him to attend and I am anxious to see if the skills he is learning in this highly structured and monitored environment will transfer to a "regular" setting.  In all likelihood he will transfer to a emotional/behavioral unit of sorts at the local district, so he will still receive support but there will be a lot more interaction with typical peers.
There was only one other parent who showed up to the back to school night and the teacher is constantly thanking me for the amount of communication we have, I don't think there is much involvement from parents of other students.  This makes me sad, many of these kids are here because of a lack of parental involvement, I get that, but here I am desperately trying to help my son change his past and we are all still here in the same place.  Sometimes it makes you wonder if it is even worth all the effort, but I know it is and have hope that this is just the beginning of a successful journey to adulthood.

Medication Approval

The insurance finally approved Matthew's anti-psychotic medication!  Woohoo!  We are only using this in emergency situations where he is unable to calm down.  I'm hoping having this on hand will help us avoid anymore trips to the ER.

"Wait....what flowers??!!": My most embarrassing parenting moment thus far

If you've never had a child pee off a balcony at the beach house onto unsuspecting beach goers below....you haven't lived!  I really thought someone was just up there watering flowers....until I realized there was no flowers up there only a little boys wee-wee and the top of some red hair.

Updates

Over the summer James was finally evaluated by our local mental health agency, they gave him an ADHD diagnosis officially but admitted that there is certainly a trauma and attachment piece underlying his behavior issues.  The next step was to determine what services he would receive.  My biggest concern was school.  He was going to be starting preschool, 5 days a week in the morning.  This is our last year before he enters kindergarten and I am really trying to get as much of this under control as possible this year so he can have a successful start to his education....yeah I know, but I can dream cant I?  Anyway, my main concern and desire was to get him started on medication.  Never in a million years would I have imagined I would be that parent desperately trying to convince the professionals to put my 4 year old kid on meds.  He needs them, desperately, and given everything we went through with Matthew spending 2 years going through dozens of medications and even more combinations and dosages of those medications, I want to get this right before James starts Kindergarten.  SO, the only way that they would consider meds is if he was receiving in home services....you know those services that were a waste of time with Matthew, the ones we were finally discharged from mere weeks earlier....yep, those ones!  So much for a rest from people in and out of my home offering a million suggestions that have already failed or are outright contrary to all leading experts in the field of trauma and attachment.  Folks, these kids CANNOT be parented, counseled, taught like a "normal" kid and doing so just puts you farther behind....I've already been there and done that with one kid, this is not my first rodeo.  Regardless, I agreed to the services and so far the BHRS and Mobile Therapist are nice enough and certainly better than the last pair we had.  After the last few months the BHRS is definitely starting to not only see James for who he is but is making the connections that that his behaviors are attachment based.  She even said to me today, "You know I notice that James doesn't really seem to have a good grasp on emotions and feelings,  like he is missing the empathy piece."  BINGO lady and it is pretty hard to discipline, consequence, or help form cause and effect thinking with someone who has no desire to please others or understanding how they effect others.  She also feels medication is the only way we are going to have a chance to get his brain to slow down enough to try and get through to him....6 days...not that I'm counting or anything :)  6 days till our medication appointment which brings a whole different set of stressers with insurance approvals and prior authorizations and overrides...ugh!  I know what medication I want to start with, Intuniv, it was literally a lifesaver for Matthew and our family.  I don't know that he would have safely been able to remain in our home if we hadn't found that medication after 2 years of rages, door alarms, fires, and violence.  It was like a switch that allowed the healing to begin.  I want to start there, but I know the insurance wont.  It took us 6 months after we moved to get the new insurance to approve it for Matthew, and that was with clear documentation of everything we had tried and the positive effect the medication had had on him prior to moving.  Fingers crossed the psych will listen to me and the insurance will approve without hassle.