My child’s mental health is eveyone’s business

M was officially diagnosed with

ADHD and anxiety when he was in Grade 2, while in a school-based treatment program. The diagnosis and subsequent treatment – medication and weekly counselling – was done by a psychiatrist who worked with the program.

As the end of the year, in discussing his transition back to his home school, for a referral to a child psychiatrist in the community for follow-up. M was on several medications and I was concerned that his family – a general practitioner – wouldn’t be sufficiently familiar with them to ensure adequate follow-up, especially since the vast majority of her patients were adults. Moreover, despite improvements in his behaviour, he still had frequent bouts of rage and aggression. M has never been a child who talks about his feelings easily, but he had made some progress with the psychiatrist. His dad and I felt strongly that it was important he continue with counselling on a regular basis. Given the complexity of his challenges and the necessity for ongoing monitoring of the meds, we felt a psychiatrist was the best option.

But when I asked for the referral, I was told it wasn’t possible. There simply wasn’t anyone outside the program to refer him to.

Despite living in a city with a children’s hospital affiliated with a teaching program, there was a severe shortages of children’s mental health services, including psychiatrists. The best we could do it go back to our family doctor and request M be placed on a waiting list for psychiatric services through the children’s hospital.

That was 3 years ago.

The closest we have come to getting M into see a psychiatrist has been a 90 minute consultation with a doctor who worked one day a week for the school board (who has subsequently resigned, apparently because the workload was too intense).

At the present time, M’s ADHD meds are supervised by a pediatrician who specializes in ADD/ADHD. His family doctor manages the anxiety medication. He sees a psychologist to help him deal with his anger and to talk about things that are bothering him.

We are lucky to have health insurance, so it is not a question of money. It is a question of resources. More properly, a lack of them. If M was over 12 and in crisis, it would probably be easier to get him help. Ironically, if he was charged with assaulting another child or a teacher, we would probably be able to get him into see a psychiatrist (presently, he is too young to be charged as a youth).

We are not the only family caught in this limbo. I know a parent who practically had to camp out in the emergency room to get help for her 9-year old who was in crisis.

According to the literature and child experts, children like M are highly vulnerable to  mental health issues as they get older. Added to the fact that there is a strong history of depression in my family, I want to do everything I can to help him now. So that he doesn’t end up in crisis. I want to be proactive, and head off potential problems now, rather than wait and see what happens.

So why should anyone else care about whether or not my child has timely access to mental health services? Or any other child?

Because they are the future. Future employers and employees. Future taxpayers. And as a friend recently reminded me, our future caregivers. We will all benefit by ensuring that every child grows up to be a healthy, contributing member of our society. This means acknowledging that some children need a little extra help. It will require financial resources. But if we consider that a high percentage of people who are currently in the criminal justice system have mental health issues, doesn’t it make sense to intervene early?

Despite the fact that there is an acute shortage of mental health services in my community, I am still going to push to get M the psychiatric care I think he needs. In the short-terms, we will continue to rely on our patchwork of services. Hopefully, the powers that be will begin to invest more in children’s mental health. I can’t control the future, but I want M’s to be as bright as possible.

Random acts of craftiness – pennant moneyholder card

I could write about the fight M and I had this morning about going to karate. Or about my frustration with the fact that the report prepared by the psychiatrist the school board requested we send M to contains numerous factual errors.  There’s plenty of  bloggy fodder  in my life.

But today, I am going to mix things up and talk about something I do just for me. 

Crafts. 

Yes, I am closet crafter. And  craft blogs are my secret vice. I particularly like  tutorials – step-by-directions (with photos) on how to make a bag, scarf, necklace, etc. I will never make most of the projects, but they are fun to read – creative escapism after an argument with M, a meeting at the school, long day at work, etc.

Sometimes I actually do make something. Lately, it is birthday cards for friends and family.  They are quick and easy – using simple techniques and basic materials, I can start and finish a unique birthday or special occasion card during an episode of “What Not To Wear.” And when I am feeling stressed, just that little burst of creativity is enough to recharge my batteries.

So here’s a card I made for my niece’s birthday. 

Completed birthday card

I decided against doing a tutorial on how I put the card together – my photography skills are still a work in progress. But here’s a quick run-down of how I put it together.

Since my niece’s gift this year is cash, I decided to make a card with a “pocket”. I cut a piece of card stock into an 11 by 6 inch rectangle and folded up a 2 inch section along the shorter side. Then I folded the card in half. A little glue on each of the edges of the “pocket” and voila –  a money holder card (would also work for a gift card).

Making the "pocket" to hold money

I decided to decorate the front of the card with little bunting flags (or pennants) – a popular project in craft magazine’s and on craft blogs. But I needed something to hang the flags from.  I didn’t have any skinny ribbon or baker’s twine (currently one of the “in” things in the crafty world) to match my (purple) colour scheme.  But I did have embroidery thread in different shades of purple. Plus some white glue.

How hard could it be to make my own baker’s twine?

It was surprisingly easy. The end result was a bit stiffer than regular baker’s twine, but it worked for my purposes. I don’t have “how-to” pictures – my fingers were covered in glue – but here’s what I did:

• Cut two lengths 12 – 18 inch lengths of embroidery thread (I used light and dark purple) 
• Tie a small knot in one end
• Pour a small amount of white glue into a small bowl – dilute with a small amount of water (it should still be thick, as opposed to runny)
• Starting at the end with the knot, twist the thread and apply glue with your fingers – keep twisting and spreading the glue along the twisted thread, so it doesn’t separate. I wanted it to look like baker’s twine – equal amounts of each colour showing, so I twisted mine fairly tightly
• When you have finished twisting and applying glue to the entire length, remove any extra glue with your fingers. Hang it up where it can dry.
  

  Embroidery thread into "baker's twine"

(I hung the “baker’s twine” up using a thumb tack and let it dry overnight. I think you could use it the same day – you just want it dry enough so it won’t stick to your fingers).

The rest of the card came together fairly quickly and easily.

I used pinking shears to cut out the pennants. I didn’t measure them (too much work), so they aren’t necessarily identical. It’s a home-made card – it’s not supposed to look perfect.

To attach the “baker’s twine” to the card, I cut a piece about 2 inches longer than the front of the card and taped the ends to the back. As I was putting it together, I decided I didn’t like the look – the ends made the card look lumpy. So I took off the tape and cut the ends short – I just glued top layer to a slightly larger piece of printed paper in a coordinating colour, glued to the card.

(In the interest of full disclosure, I had actually glued the rectangle with the bunting to the rest of the card before I decided I didn’t like it. So I pulled up the edges, took off the tape and re-glued the edges. This is why I prefer to use a glue stick, as opposed to other adhesives – way more forgiving, as well as bring amenable to my “trial and error” method of crafting.)

A bit more glue for the pennants and the “baker’s twine” so it would lie flat, a couple of glittery stickers to jazz up the pennants, and a couple of stamps (to add birthday wishes), the front of the card is done. Very cute, if I do say so myself.

Card front

I finished off the inside of the card by covering the” pocket” with a piece of printed paper. Because the card itself was a dark purple colour, I added a little rectangle so we could sign our names (so my niece would know who had sent her such a lovely card) and decorated with some stickers (same ones I used for the bunting on the front). 

Finishing touches to the Inside of the card

It did take me a bit more than an hour to complete the card – picking my colour scheme, finalizing the design, etc. But an easy project  to finish during a “What Not To Wear” double bill.  

I will be posting this to a “linky” party on another blog. This wasn’t my primary motivation for starting a blog. But it is something I have thought about doing, as part of my new philosophy of “living in the moment.”

Linked to Get Your Craft on Tuesday at Today”s Creative Blog

I bribed my child with gumballs

Image by gwilmore via Flickr

While M a selective eater, his list of possible breakfast items is fairly broad – waffles, pancakes, chocolate croissants, bagels with cream cheese and cereal.

When M has cereal for breakfast, he likes it dry or with lots of milk. Swimming in milk. The other day, he was half-way through a bowl of multi-grain Cheerios with milk and he asked for more milk.

But there wasn’t any more. The carton was empty.

We had forgotten to get more. And it was only 7:45  – too early to go next door and borrow a cup from our neighbours (they have teenagers who don’t have to be at school until 9am).

M took another bite of cereal and announced he was full. For M, “I’m full” is generally code for something else – “I don’t want to eat anymore,” “I’ve found something more interesting to do,” ” I don’t care for the menu.” In this case, however, “I’m full.” meant “This cereal is too dry.” (there was still milk in the bowl, just not enough).

Every morning, after he has finished his breakfast, M takes his meds for his ADHD and anxiety. While they help him better manage his behaviour, the downside is that they suppress his appetite.  Most days, he doesn’t finish his lunch. So for M, breakfast really is the most important meal of the day.

I spent a couple of minutes unsuccessfully exhorting M to finish his cereal, when it comes to me:

I will give you a gumball for every spoonful you eat.

M loves gumballs. His class made gumball machines in December and he has spent hours since them playing with it.

So he starts eating.  At first, he tries to eat one or two Cheerios per spoonful. But we’ve played this game before and I insist on decent-sized mouthfuls.

By the time he has finished the bowl, we are up to 8 gumballs.

He tries to convince me to give him two more – as a”reward” for finishing. But 10 gumballs seems somehow excessive, so I stick to my guns and we settle 8. He finishes getting ready for school, stuffs his pockets with gumballs and heads out the door, more or less on time.

So am I a terrible parent? It all depends on how you look at it. Yes, he probably got a massive sugar high from all those gumballs. But he finished his breakfast, which meant he had a full stomach for most of the morning. I know from experience that this increases his chances of having a good day.

So we’ll stick with cereal …and the occasional side order of gumballs.

Sometimes you have to ditch the yardstick

Image via Wikipedia

Yesterday afternoon, I received an email from my husband saying that the principal at M’s school had called. Apparently, he had a conflict with another child during recess and was having trouble apologizing and moving on. However, before I could call him to discuss whether one of us should leave work early to pick him up, my husband sent me another email to say that the issue had been resolved and M had gone back to class.

For the rest of the day, I didn’t give this incident much thought. I may have mentioned in passing that I’d heard he had some difficulty during the day, but he handled it well. Quite frankly, the school has called us so many times in the last couple of years that unless one of us has to drop everything and rush to pick M up, it doesn’t even rate as a real incident.

This morning, I ran into the principal in the lobby of the school and she mentioned that M had handled himself really well. So well, that she was almost doing cartwheels (her words). The other child had thrown some ice at him and M had reacted. Since these sorts of conflicts are pretty common among middle school kids (boys in particular), the general approach used at the school is to bring the kids involved together to discuss it. The challenge with M is that he rarely agrees to sit in the same room with the other child, particularly if he is the “injured” party. Yesterday, M was reluctant to talk to the principal about what happened at first, so she let him read a new Myth Busters book, while sitting in her office. She checked in with him a couple of times, until finally he said he was ready – they talked and he went back to class for the rest of the day. She casually mentioned that it took him some time, an hour and a half, but he pulled himself together without trashing her office, kicking a teacher, swearing – his usual modus operandi when  he gets into a conflict at school.

For M this is big progress. He usually gets so wound up when something happens at school that he has to be scrapped off the ceiling. Most times, I arrive to get him after the storm has passed and he is a little puddle of tears. But the truly amazing thing is that the principal, who is incredibly busy and is in demand every minute of the school day, spent 90 minutes waiting for my kid to calm down enough so he could have a rational conversation about what happened.

At any time during that period, she could have pulled the plug and called us to come and get him. But she has taken the time to get to know M and knows he struggles with his temper. Once the beast is out, getting it back in the cage is almost impossible. And then M feels badly about himself, because even though he can’t stop himself, he knows getting angry and smacking another child isn’t right. So the principal gave him a book and let him wait until he was ready. She created the conditions for him to succeed and he did. So the next time he has a major blowout at school and doesn’t pull himself together, the principal will call me to come and get him. And as we are walking home, I can remind him about yesterday.

Accentuate the positive – 5 great things about my kid

 

Image by Mike_fleming via Flickr

As a parent of a child with multiple challenges, it is pretty easy to focus on the negatives – after all, the principal has never called me in the middle of the day to tell me that M has done a great art project or that he went our for recess and played really with the other children. But M is a great kid and it is important to focus on the positives.

1) He has a great sense of humour – we sometimes make up silly jokes to tell each other – one of hisecent ones – Q: why do cows get really bad grades at school A: because they are “udderly” stupid. Cracks me up every time.

2) He is curious – today in the car, we had a long conversation about advertising, the Khardasians and the Olympics (not all at once). His favourite shows on TV are “Myth Busters” and “How It’s Made.” He didn’t want to come into the pet store yesterday to get a new fish because he was listening to a science show on the radio. 

3) He loves to read – while he would always prefer to play Wii or DS, he will pick up a book and sit on the sofa reading for a couple of hours at a time. Ok, I’d like it if he read a little less Garfield and a few more chapter books, but he’s reading. And enjoying it.

4) He gives great hugs – he’s 10, going on 11. I know that in a couple of years, he may be much less willing to give hug me, let me hug him or engage in any other sort of parental PDA. So I am taking full advantage while hugs are still plentiful.

5) He still plays with toys – he’s increasingly interested in music, loves anything electronic and complains that we won’t let him have a Facebook page (for so many reasons, including the fact that the age limit is 13). But he still plays with Lego, Hot Wheels and other toys. He loves Clue, Monopoly and Scrabble. He is still a kid and so far, isn’t in a real hurry to grow up.

Sunday morning – how we got past “no”and had a good time

This morning, we decided we were going to go cross-country skiing. We planned to go to a nearby wilderness park that has tons of good trails. We gave M plenty of advance warning that we were going and when.  As he was getting his outdoor gear on, he asked if we could go up to our cross-country ski club, instead of the park. The club is only about 20 minutes from our house and since we had been up yesterday, we knew the conditions would be good. As we were leaving our house, I mentioned casually that I thought the club was holding a ski race this morning, but we would still be able to ski.

When we arrived, the race was indeed going on – it wasn’t a huge group, but the skiers, who were older teenagers and adults, were zipping past at a fair clip. According to one of the organizers, there was no problem with us skiing – we just had to ski out of the race area, up to another trail and it would be clear sailing (or skiing) from there. We put our skis on and got ready to head out. But all of a sudden, M wouldn’t move. We asked him (repeatedly) what was wrong, but all he would say that was he was tired. Never mind that the race was almost over, he wasn’t going anywhere. We stood for 10 minutes in the cold, watching the skiers go by, when finally his dad suggested that we take off our skis and carry them up to where we were going to start. Bingo! M agreed and skis in our arms, we trudged through the snow up to our starting point. We passed the finish line and a few minutes later, a few more racers passed us. But they were turning around on an adjacent trail, so we put our skis back on and off we went.

Despite a bumpy start, we all had a good time. My husband and I are learning to skate ski – a different technique from “classic” skiing, where you ski in a set track and alternate your arms and legs to move forward. Skate skiing is more like ice skating (unless you are Patrick Chan – any jumps we do are completely accidental). M takes skiing lessons every Saturday and is also learning to skate ski – but from people who actually know how to do it. We are teaching ourselves and so far , M is much better at skating that either of us. He showed us how to use our poles properly and how to go up hills. I find this rally hard and I tend to fall back on classic techniques, despite the fact that the skis are completely different. But after a couple of demonstrations and some practice, it got easier.  We finished off by coming down a big hill that leads us back to the hut and the parking lot – M in the lead.

I am not entirely sure why M refused to ski at first – it could have been embarrassment since he doesn’t think he skis that well or the fact that he just wasn’t expecting anyone else to be at the club this morning. But we got past it – no one got angry and no one yelled at anyone else. We enjoyed each other’s company and had fun. Success!

How we got here

One of the primary reasons I started writing this blog is that while there are lots of blogs and websites for parents whose children have specific issues – ADHD, autism, learning disabilities, etc – there didn’t seem to be much out in the virtual universe for parents whose children face multiple challenges, especially behaviourial issues. M has been diagnosed as having ADHD and anxiety, but in some ways, his behaviour has been the biggest challenge for us. When he was 4 or 5, he would fly into incredible rages, seemingly for no reason. He would throw anything and everything he could lay his hands on (we quickly learned to grab small and/or valuable items in his vicinity as we were ducking out of the way). Transitions from one activity to another were a total nightmare and we learned very quickly that giving M advance notice of a change (we are going to lunch in 30 mins; we are going to the cottage on the weekend) was essential; otherwise, he would explode or just refuse to do things. He hit other children, even his friends. His grade 1 teacher had an evacuation plan in case he lost it in class.

Having a diagnosis was helpful – it helped us understand why M behaved the way he did in certain situations – it isn’t because we are bad parents (clueless or deluded, maybe, but not bad) or because he is a brat; his brain is just wired differently. Once we knew what we were dealing with, we were able to adapt and begin to help him learn how to manage his behaviour and his reactions – yes, everyone gets angry but that doesn’t mean you get to hit that kid who called you “shorty” in the face.  We are very fortunate to have the support of our families and friends. M goes to a great school with an amazing principal and terrific teachers who work hard to give him the support he needs. He’s making progress – this time last year, he had been suspended at least 3 times; so far this year, he’s only had one suspension and that was several months ago. Knock on wood.

Is it easy? Absolutely not. Most days, it is a struggle to get him out the door in time for school., as he needs constant supervision just to eat his breakfast and get dressed. He rarely does anything he’s asked the first time, even if he isn’t on his DS or the computer. If he decides he doesn’t want to do something (like go to karate), no amount of persuasion, yelling and/or bribing will get him out the door. It is easy to get discouraged. But we have learned to celebrate the successes, no matter how little: when M asks for help in resolving a conflict with another child, rather than lashing out; when he turns off his DS when his time is up; and when eats his brocoli spear first, rather than refusing to eat his supper until it removed from his plate. These little victories add up and they give us hope to get up – and do it all again tomorrow.

Even when he’s late for school, my kid still makes me laugh

Everything described below really happened this morning…within 10 minutes.

• Instead of sitting at the counter, taking his pills, M is lying on the floor, bench pressing the stool above his head. It has a back on it and the metal piece holding it together is right above his nose.  A vision of the stool crashing into his face flashes through my mind – I suggest he get up before he drops it, but he keeps on going (although he does shift the stool down, so if it falls, the back of the chair will now hit him in the centre of his chest).  When he gets up, he flexes his arms and says to me, “That felt good, I feel like I could bench press a  Buick.” (even on a good day, M weighs less than 55 lbs.) I am reaching into the fridge, trying not to laugh.
• By the time I get back to the counter, M is standing a few feet away on a hot air vent. He tells me the air is going up one pant leg and down the next. I ask him 3x to come back to the counter and finish taking his pills and get ready for school.
• I go back to the fridge and suddenly an elastic band comes whizzing by my head. M grabs another one from somewhere on the counter and gets ready to fling it again – I tell him there will be consequences if he lets it go…
• Having finally taken his pills, M goes upstairs to brush his teeth. When he comes back down, he pulls 3 juggling balls from his pants and throws them into his knapsack. I suggest that his teachers may not appreciate him taking his balls to school. Much hilarity on his part as he is pulling on his coat as Mommy has said “balls.”

He is out the door at 7:59 (school starts at 8 am)…I am still laughing.

Home-made pizza

M, my son, is a highly selective eater.  The list of what he will eat is much shorter than what he won’t eat, especially for supper: fish sticks (only one brand), chicken fingers, flank steak, ham, and pasta. Lots of kids are selective eaters, so I try not to worry too much – my youngest brother survived most of his childhood on peanut butter sandwiches and baloney slices and he’s 6’3″.

One thing that M will always eat is home-made pizza. We usually have it on Saturday night, but it is pretty easy to make any time. The recipe is adapted from one I found a number of years ago – we use our KitchenAid stand mixer with the bread hook to mix up the dough, but a mixing bowl and a wooden spoon works too.

Dough:

• 1 envelope yeast (I use Rapid-Rise)
• 1 tsp honey
• 1 cup warm water (should be around 120 degrees F – 45 secs on high in the microwave is about right)
• 2-1/2 to 3 cups flour (1 to 1-1/2 c whole wheat and the rest all-purpose)
• 1 tsp olive oil

Combine the yeast, honey and 1/4 cup of water in a small bowl and let sit for 5 minutes – it should be frothy.  Add flours, the rest of the water and olive oil to a large mixing bowl or KitchenAid bowl. Add yeast mixture and combine – add more flour as required to get a firm dough, – if it sticks to the bowl or your hands, add more flour. Remove from bowl and knead for 2-3 mins on a cutting board or counter, adding more flour, as required – it should feel fairly dry and spring back when touched. Follow the directions on the yeast package to let rise.

Once the dough is ready, divide it up to make individual pizzas. I roll out the dough with my hands but a rolling-pin works too. Use cornmeal to ensure the bottom of the pizza doesn’t stick to the bottom of your pizza stone or cookie sheet (a pizza stone will cook the pizza quickly and evenly – nice to have but not essential). Cook at 425 degrees F for 6-8 mins (depending on the size of your pizza) – 375F if you aren’t using a pizza stone. 

M always has the same thing on his pizza – tomato sauce (basil and onion, with the onions picked out) and grated mild orange cheese. But he eats every bite.

If you have a go-to recipe for the selective eater in your house, please leave a comment and share it and/or the link.

Monday madness – the evening edition

Monday mornings are often tough at our house. School starts at 8am and none of us are morning people. But this morning, things went relatively smoothly – M (my son) woke up by himself (instead of having to be pried from his bed), ate breakfast and took his pills without having to be reminded every 30 seconds (the usual morning routine). There were a few minutes when it looked like things could go off the rails – he pulled a bunch of glow sticks out of the freezer (apparently this helps them last longer!), picked up some mini muffin tins on the counter and started juggling them from hand to hand, and crawled part way across the kitchen floor. But M did get out of the house and off to school before the bell rang. A successful morning all round.

So compared to most Mondays, I left the house in a relative state of calm this morning. And arrived home to find M in tears. Not only did he have a homework assignment, but his regular Educational Assistant (EA) was away for today and tomorrow and the replacement was “acting just like a teacher.” She told another child in the class not to do something and followed M around in the library and asked him what he was reading. According to M, this was not her job. And then at daycare, he and his friends weren’t allowed to throw icicles at each other in case someone got hit in th eye or chipped a tooth – who, I was asked, ever chipped a tooth on an icicle? And no one would ever throw an icicle at someone’s eye…

M started his homework with his dad’s help, but after a few minutes, he asked how much he had to do before he could play Wii. They discussed the relative merits of finishing as much as he could tonight so he didn’t have too much to do tomorrow – he has Cubs on Wednesday and Friday is a PD day. M continued answering a few more questions, albeit reluctantly. I was cooking supper and thought M was back on track, but then I heard he and his dad debating whether “average” was a sufficient answer to the question “What is the daily life of the character like?” Voices were being raised and when my husband walked back into the kitchen, he remarked that “average” wasn’t really enough of an answer to the question. M, who has hearing like a bat, burst into tears, stomped upstairs and slammed his door. It took 10 mins of negotiating to get him to come back downstairs. His dad did apologize and M ate his supper.

M doesn’t like homework assignments, even though the teacher gives the class all week to complete them. But the big issue was the change in routine with a new EA. This seemingly minor change threw him off for the entire day and every other little issue was magnified from a mole hill to a mountain. Hopefully, tomorrow will be a little less stressful for everyone.