My sister has a son, 11 years, who is an intelligent guys. He is diagnosed case of ADHD tried behavioural therapy.
Now it has become difficult to manage him at home due to extreme physical violence to siblings and parents, abusive words. Community living has affected us. Safety at home is anxious.
Is there a institutional care for ADHD where formal schooling is also provided? We have tried our best to support within family. We need round the clock expertise as he is better among non family members.
Please suggest and help.
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canthestarsberight
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I think many of us have wondered this question. I would ask if the 3 tools are in place before anyone makes a decision.
The first is medication ( with the proper type, dose and timing), counseling ( to help him better understand why his behavior is like it is) and a good educational tool ( helps to cut down on frustrating work overload). I strongly recommend getting him to see a psychiatrist to help.
One last question, are there any other assessment that could answer why he is have issues like that.
We are here to support them in this process, many of us have been there. Some have needed a placement outside the home.
Many times as a last resort, before placing the child outside the home, medication for aggression is prescribed. Would that be considered? Examples are Risperidone or Abilify.
This really could be the answer. One medication helps with impulsivity ( stimulants). One works on focus/ behavior ( Initiv). There are also short release and extended release. Most children will need a second dose to control thing in the afternoon. As far as the dose, they usually start with a small dose and increase it until behavior is controlled.
One last thing, medication only helps about %60 of behavior. The other %40 is controlled by behavior modification and thearpy. In addition, an educational plan needs to be in place to help with the academic need.
Thank you for the amount of information that you provided. I am a parent of a child with ADHD, but also a professional that works with children/families with mental health diagnoses.
The answer to your question is yes, places like you describe exist.
Considerations:
1. There typically is a staged approach to assist the child and family, before the decision to place a child.
- That approach starts with outpatient therapy (counseling) and psychiatry. In hopes that the parent is open enough to allowing these processes to work.
- Next, if those two are not working, it typically is a more intensive type of therapy and psychiatry. More intensive is something called intensive in-home therapy- trained therapist comes into your home two to three times per week, for up to ten hours to help the child and the family. This does not work without family cooperation. There are many forms and types of intensive in-home therapy that can also be done in stages. (So two or three levels here)
- Lastly, if no intervention in the community or home works, involved professionals may consider recommending placing the child. It is a last resort.
2. Placing a child is a last resort for many reasons.
- If they are primarily having challenges in the home, they typically need a caring professional to step in to help them in the home. That way the the child and the family can be impacted.
- Taking a child from their family for an extended period can be traumatic, especially if the challenge can be impacted in the home.
- Placing a child with behavioral issues, in a place with a lot of other children with behavioral issues, can lead to trauma and them learning more behavioral detrimental ways to act out. Those ways are then brought home.
- It is hard to know if the interventions at the placement are really effective or if the child is just ready to get back home. If the latter, which is what occurs often, there has not been a “successful” intervention.
- If the placement was successful, sometimes parents/families are not taught what the successful interventions that the placement used and the child returns to a home with either no structure or no substantial change in a family and the cycle restarts with a family seeking another placement.
- It should be understood that a placement is typically “effective”, because they have a structured schedule, rules with consequences and caring adults around to assist with emotional outbursts. These same things can and should be done in a home. The system should be applied to all of the children in the home and the parent typically needs to develop their skills to implement this kind of system with psychiatry for the affected child(ren).
- Placements like these cost hundreds of thousands of dollars. If you are discussing “boarding schools”, “military schools” or something like that, those are less expensive.
- It is always important to monitor any placement. Always.
It is an absolute last resort. I am going to send up a few prayers for your sister, her son, his siblings and you as you all try to navigate this. It is not an easy situation to experience and navigate.
P.S. One other tip, children often communicate with their behaviors. What is he communicating?
Thank you for posting this information as my Grandson has been court ordered placed with us and his mother was pushing for a facility. I just couldn’t in my heart say NO to the social worker and lawyer who asked if he could stay with us, which was against my daughters wishes. He ended up in court because his mother pressed charges against him for hitting her. So now my daughter will not speak to me, but my grandson seems to be doing well and we have been able to reduce his medication too. He is a freshman and will start in person school on 9/14! This is helpful to know that a facility is not a cure all. Puts my mind at rest a little thank you, been difficult to have my relationship with my daughter severed but honestly it isn’t the first time she has treated us like this and she always comes back for something..,
I’m sorry you are going through this. A few thoughts. If you are concerned that the timing, dose or type of medication may not be right, I would absolutely work with a psychiatrist to address that - the right medication can be life changing. If one type of therapy didn’t work, have you tried others? It’s possible that family counseling with a therapist who can work with the whole family could help. Many kids who have ADHD also have a second diagnosis. Can you get him tested to see if he has another condition that needs to be treated? Finally, a therapeutic day school is an option. If you can make the case that your nephew needs a therapeutic school, you may be able to get your public school district to pay for it. Then he would be getting an education fit for his needs and be in an environment with therapists and trained professionals every day. His family has a right to this under IDEA. Good luck with all of this - it sounds like you are all going through a very hard time right now.
We had to put my grandson in a temporary mental health clinic for a week last year. They took him off all meds and started over. He still has mood swings at times but is 100% better than before.
Could he also suffer from bipolar disorder, I have it and have read sometimes they go hand in hand or adhd is misdiagnosed instead of bipolar. My issues started as a teen
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