To Medicate or Not

I often get asked about medication for OCD in our children. First let me say the medications mostly used for OCD are anti depressants. I am not for medicating every child for every thing there is, but I am also not opposed to medication when it can help.

We did choose to medicate, before I go any further let me explain that our daughter does not just suffer from OCD but is also on the Autistic Spectrum. We tried the anti depressants with no real relief. We now treat the Autism and that has helped her a lot.

My point being is never let anyone pressure you into giving your child medication, you do not have to unless you feel it is necessary. We chose to look at medications because our daughter was physically making her self ill. She broke out with stress hives, would retain her bowels and have constipation, was this due to OCD or Autism? I believe it border lined both.

It is not an easy journey to move into meds, my advice is to have them start at the lowest dose possible and move up from there. Note any side affects you are seeing. Weigh it all out.

I also know many swear by diet, many can control OCD and behaviors by using dietary changes. The one that comes to mind is to cut out all Gluten. I emphasize though if this is something you are considering, everyone has to be on the same diet. I remember when my Sister tried to put her son on a diet thinking he had ADHD, but did not apply it to the whole family, that kid was worse then ever before, was it from the diet? No it was because it was not fare for him to not be able to eat what everyone else was eating. When ever we put our young children on a restricted diet it is very important as a family to support that decision by doing it as a family. Children do not understand.

So do we medicate or not? This is not an answer I can answer, it is a difficult decision and one that I will not support one way or the other. That is not to say I will not support you in your decision but I feel very strongly it is a decision that needs to be made by you as the parent. Never lose control of your role as a parent, you have to stand strong to what you feel is right for your child. Never ever, think just because you try medication and discover it is not right, that you do not have the right to stop it all. Never loose sight of the role you play in knowing your child.

Sometimes You Just Have To Listen

As we have been working with some of the techniques that Sunshine’s Psychologist suggested to us to try (you can rediscover some of these here) we began to realize that many of his ideas just seemed to spin Sunshine from one panic attack to the next until she got to the point she was giving up and not even trying. I can’t say I blame her since everything just seemed to be so based on her behaviors and truly not addressing her anxieties. One thing I have to say is that Sunshine is a well behaved child so long as her anxiety level is low or she stays calm. We finally just backed off quite a bit from what he wanted us to do and began to ask Sunshine what she felt would help her.

Last night as I was tucking her in bed she told me that she wanted to make an anxiety chart. I asked her what she imagined this chart to look like. She explained it to me by saying, “So many times my anxieties run at 130, at church they are mostly at 110, but I need them to be empty or at 0.” The thought that came to my mind was a thermometer. I promised her that we would put something together. This morning we set out to do just that. (I hope to get some pictures of our chart for you soon, but wouldn’t you know it my camera batteries are dead.)

To make this chart have more meaning I created a journal for Sunshine to write the information she was gathering from her chart. This has proven to be very interesting. She woke up too early this morning and was very crabby, I asked her what she would rate her anxiety level at. She answered with a 40. I drew a small thermometer on the page and we marked it with a value of 40. Then she had to answer several questions: 1. Why do you feel your anxieties are at a 40? 2. What might bring your anxieties down? 3. How do you feel with your anxieties at this level, happy, sad, mad, or anxious? 4. How is this affecting your behaviors? After all the questions were answered and the data entered into her journal we were ready to move on to taking action to improve her overall anxiety level. Since she decided her anxieties were up due to lack of sleep, she chose to take a short nap or rest to bring her anxiety level down. We did just that took a short rest. When we got up we again made a new journal entry with all the same steps above. At one point she got in trouble, so I made her enter this data in her journal. We then ended our day by re-examining where she was on her chart before bed, as well as looking back over the day. At the bottom of the page I wrote two sentences describing her BEST moments or accomplishments of the day.

I know this is kind of hard to follow as I try to explain it without pictures. I will be doing another post down the road here complete with pictures as to our progress. I truly believe sometimes the answers lay inside our child, they know how they want to feel, as well as have great ideas to make this happen, but sometimes we just need to stop and listen and allow them to express themselves. I truly believe that Sunshine learned a lot about her own anxieties today, and she definitely took away a sense of empowerment over them or ownership to some of the reasons they maybe occurring, and an understanding that she does have the power to do something about them.

A Tiny Taste of Therapy

After I met with Sunshine’s Psychologist, we determined that when we first started we pushed too much at her at one time. Upon her first visit with him he spent almost an entire hour with her one on one, playing games and talking. His first and foremost rule for the child is that if they need their parent at anytime they just need to say so. For Sunshine though this would have meant a weakness to ask for me, so instead of speaking up she endured the panic attack that she was going through. Upon our second visit which was with Papa, myself and her, she was in a panic attack even before we went into his office. When he didn’t pick up on what was truly going on he suggested some ideas to use here in the home that actually made her anxieties worse. She began to do things that made us believe she was truly trying to tell us how she felt. Let’s just say it was not a pretty few days in our home, she was angry, trying to get us to listen to her nonverbal cues, and not understanding why we were not catching on.

Now we feel we have a system in place which will allow us to take smaller steps with her, move a little slower while exposing her to these things that cause such anxieties for her, but most important a way to communicate her feelings so we can then come and talk about them in a more appropriate manner. One of the first things we did was have Sunshine create her own Feelings Chart. She came up with the design and decided what colors would represent the different feelings on her own. All I did was draw the circles for her.

The larger the circle the more intense the feeling is. We also decided that it is alright for her to feel more then one feeling at a time. Does she use it, oh yes you bet she does, it is nothing for her to go directly to it and let you know how she is feeling.

The other part was to have Sunshine respond to our requests with only one verbal cue from us. She must respond the first time we ask her to stop doing something or to do something. If she doesn’t there are no chances to respond, she looses a privilege. These privileges can be anything from loosing a toy she might be playing inappropriately with to her TV or Computer time. She has to have a consequence of some sort. Then she has the right to earn her privileges back. We  brainstormed on how this would look. While the Psychologist gave me several ideas, I again wanted it to be something that Sunshine worked on with me.

We chose to use all the bottle caps we have saved for math over the years. When she responds the first time we ask of her she earns a bottle cap which she picks out and places in the pretty jar with the purple lid. When she has earned 5 bottle caps she then receives the privilege back. For instance right now she is trying to earn a couple of toys, her TV time and her Computer time back. We get to choose what she will earn back. She understands that just because she earns 5 caps does not necessarily mean she will get back what she wants, but what we choose to allow her to have. She is thrilled right now because she only has one more to earn to reap her reward. It is our hope that as we move on she will lose less privileges, and be able to earn things like craft kits, small toys, and books. Over time this will become a habit of responding when first asked and we will no longer need this tool to help her.

Our visits will change now with the Psychologist to be a family session where we will be able to talk about the things Sunshine is feeling anxious over or what bothers her. She will still have the opportunity to spend 5 to 10 minutes with him alone to play a fun game and build from there the amount of time she is able to tolerate. It is important that she is pushed to some point to do the things that causes anxieties but we do not want to push to hard to the point of panic attacks. 

Other Tips When Looking at Specialists

We met with Selena’s Psychologist last week to go over the numerous questionnaires we all had to fill out. The results were truly what we expected with Anxiety Disorders the main source of her problems. She was very different in his office from the calm we seen in the waiting room. We mentioned several times that her anxiety was high but the Psychologist misinterpreted her behaviors as not having the attention. He gave us a few things to try here at home to help her through the calming process.

We fully expected her to reject some of these things at first and that their would be other behavioral issues we would see. What we got though was not what any of us expected. I called and made an appointment for just him and I to meet. The morning of that appointment Selena was pretty anxious even though she was not going with me. She finally admitted to having panic attacks or in her words “Funny feelings in her heart.”

Her psychologist felt horrible that he had not picked up on how bad her anxieties truly are and misread her behaviors. He literally grabbed the information about the other psychologists there in the office. We could switch if we wanted to. Of course that was not something I wanted to do so I asked him to put the information back on his desk and just talk with me first. As we talked and I shared more about what behaviors we had seen, and about her panic attacks, he realized I was not in there as a mom under attack mode but more of a mom just saying you need to understand her more, listen to us more, and we need a new direction.

I can’t emphasize enough when ever you are looking for a specialist for your child first do your homework. You need someone who is going to be willing to say I am  human and do make mistakes, but we can still change. To often specialists just take the attitude that they know it all, but remember not any one  method will work for everybody especially when your dealing with a child.

Find someone who wants a relationship with you the parent, while their main job is to help the child, who knows that child better then anyone else…you the parent. They should always make time to listen, talk, and brainstorm with you the parent the options that will best fit the needs of your child.

We are glad that we took the extra time to meet one on one with our psychologist to discuss our concerns especially when we truly did not feel he was perceiving the whole picture of who Sunshine is and how she ticks.

My next posts will be on what we are doing, how they are or are not working. Just consider this as the beginning to a new life for Sunshine. 

Choosing a Psychologist and Our First Visits

When I began my search for a psychologist to work with Sunshine, I of course did a lot of research before selecting just one. I expected certain credentials as well as expertise in working with the areas we were concerned with. I wanted someone who would be experienced in all aspects and who would pick up on things that we might not be picking up on. With that said I found a psychologist who not only brought to the table the things I was looking for but also who was experienced in  many areas of a child’s development. Yes, what you see in the picture below is just what you get, a man who is kind, gentle, caring, and who takes his job very serious. He not only knows how to communicate with children, but has very good communication skills with the parents. I love the way his tone can go from the adult to the child in the matter of the same sentence, so that he is not only talking to the adult but also bringing the child into the discussion to confirm to them that they need to hear too. I admit at times it was confusing for me and I had to really watch his eye contact to make sure he was indeed talking to me, and not to Selena. Though I know she didn’t miss a beat in the discussion and came home able to tell me exactly why she is seeing this psychologist.

Meet Dr. David Callies and read about his experience:

His focus at Madigan was on the treatment of children and adolescents with emotional and behavioral problems, attention problems, anxiety, problems adjusting to life circumstances, depression, developmental delays, pervasive developmental disorders like Autism and Asperger’s Disorder, deployment-related problems and youth with chronic medical conditions and illnesses.

As the Chief of Child & Family Services at Madigan he provided outreach services and training on child resiliency to service members. In addition, Dr. Callies routinely collaborated with Developmental-Behavioral Pediatricians in the treatment of pervasive developmental disorders and was the lead psychologist in the Diabetes and Hematology & Oncology clinics at Madigan to meet the psychological needs of children with Diabetes, various cancers and other medical conditions.

While he is no longer at Madigan and has joined Gyro Psychology, he continues to strive in the health of a child. He also does a lot of work in the schools, educating staff, parents, and assisting with the children in his care, though he does not work in our school district.

I can’t emphasize enough the importance of seeking whoever you feel will be the best for your child. Don’t just rely upon who your Pediatrician recommends, who the school recommends, but do your homework, ask around and visit virtual websites to learn more. It is OK to disagree with your Pediatrician and schools and to seek outside treatment based upon what you feel is best for your child.

The very first visit was without Sunshine. Dr. Callies and I sat down and we discussed why we were seeking assistance. We also discussed what services he provides as well as to his techniques and views of what therapy should look like. He then sent me home with questionnaires for myself, Papa, and Sunshine.

Our second visit was for Sunshine to meet Dr. Callies, and to learn why she was there. He explained this to her while I was in the room stressing that Mom loved her very much, and acknowledges all her strengths including how smart she is, but that mom sees times of too much stress and worry which cause her to break the rules, and act out inappropriately. He then turned to her and told her that she was there to learn to understand this stress and worry and to learn how to make better choices when dealing with these things. At this point he asked Sunshine if it would be OK for Mom to leave the room reassuring her that Mom would be in the waiting room. He even told her that she could come and see Mom at anytime she needed to. She had a hard time letting me go, but gave me a big hug for reassurance and a huge kiss. She did have to come out and check on my one time during their visit. They played card games, worked puzzles and visited the entire time. I was brought back into the room at the end to go over his observations.

He complimented Sunshine on her communication skills, her attention to detail, and while he noticed her fine motor skills were a little behind, nothing out of the range for a child her age. No surprises there. He did get a good look at her photogenic memory when she asked to do one of the puzzles again, he was trying to show me how they broke it into 4 sections. Half way through his explanation she already had the puzzle put together and was ready tear it apart and restack the pieces back in the box ever so neatly.

From here now we begin to map out or journal her days, the times we see her OCD and stress, what we see as the trigger if we can pin point it. We will also begin to put some things together in our home for her to do during these times that will hopefully help her to calm down. A play dough area, a coloring area, reading area, and limited computer time. He really wants to see us get her a tablet, something that is more mobile then a computer so long as her time on it is limited.

On a side note his view on the public school down here was not the best. His opinion definitely matched ours in that they handled the situations of Sunshine very inappropriately. He said we did the right thing in bringing her home. I know for us should we choose to ever look at Public school again we will be prepared to pack up and move to an area where we have more options. We doubt we will ever put her back into the district here.