What to expect with several diagnoses

My advice would be to envision her as the most extreme end of the disorder, then decide if you could handle that most extreme end. Sure, she may not be on that end---and may improve and never be on that end. But it is equally likely that the disorder could progress. Hope for the best, but plan for and expect the worst.

PP did a good summary of Bi Polar (I have one of those families too; heck I've got some bi polar in myself). The mania is a great feeling. Unfortunately, it can lead to risky behavior as the person can feel indestructible A further complication is mania with delusions of grandeur. My best friends brother thinks he's the so n of god when manic and unmedicated :p I cant imagine raging when manic, however. You feel to darn good ;) this link is a pretty good primer: [url=http://helpguide.org/mental/bipolar_disorder_symptoms_treatment.htm]Bipolar Disorder: Signs, Symptoms, and Treatment of Manic Depression[/url] the ODD is the one that would most worry me

My DH works in mental health and deals with individuals with bi-polar on a regular basis. Generally, they are not violent. They are usually really "high" where they feel they conquer anything or really "low" where they just crash. With medication, it can be controlled very well. But, this in combination with other issues such as ODD and ADHD would be hard for ME to deal with. I have a daughter with attachment issues and ADHD, and there are days when it is just too much. She's a screamer. She is not violent, but the screaming is ear piercing. Combine what you know with the possibility of attachment issues and go from there. Think of the worst case scenario, and if you can deal with that, then you can parent this child, if not, then you know what your decision needs to be. Good luck. :)

No medication has helped my friend (adult male). So far everything he has tried for the past 8 years has made him absolutely psychotic. His wife just got an emergency protective order against him, that will last a year. This is not him. He was fine unmedicated (high and low yes, but not psychotic). Some behaviors may be related to the medications she's on.

Our disclosure meeting is today and I'm feeling pretty down after getting more information yesterday. I was pretty clear with everyone that we cannot accept a child with a history of violence towards other children. They assured us that she loved children and has never had an issue with that but her records say otherwise. There is nothing really specific and it all takes place right after she was rejected by her family that took her siblings, so I'm willing to hear them out and see if the change in circumstance made a difference. It breaks my heart for this girl but I think we are leaning towards not accepting this placement. I have a question though - it seems the ODD is very concerning to many people. Her current therapist was very insistent that she thinks this diagnosis is incorrect. How much stock would you give to a therapist that says this? She seemed pretty disdainful of the psychiatric care available to kids in foster care. I got the impression that she believes the doctors around here just medicate no matter what (with a made up diagnosis to get medicaid on board) rather than deal with the work to address the reason for the behavior. What do you guys think? Even if we turn down this placement, I'm sure that question will come up again.

What age is this child? FWIW, I can't imagine getting any child through the system, yes including as young as 1-3, with no history of violence towards other children. Just a question of how severe, how prolonged. I think in a different home, with work, they turn around. Peacefulness feels better, easier way to live life. I had 3 brothers, 4, 5, 6, they were hitting/pushing/shoving about ever 30 seconds to 1.5 minutes. They started to ease off in just 5 days. Well... I did tell them that if anyone hit anyone in the store, we'd put the things out of the cart and leave w/out food... then followed thru when the first WHAM happened. Now I knew the house was still packed with food, I think that wasn't so real to them. We ate leftover spaghetti... and they learned I followed through about no hitting.As far as the ODD is concerned. To me, it's just an adaptive response to a crazy situation. Everything around these children was nuts, horrible, and often mentally ill/drug addicted parents are invasive in weird ways. So I think the child builds a pattern of refusing first, thinking later. This pattern can be changed with consistent parenting, safe home, caring, etc. I see ODD as a description of a behavioral style, not a "diagnosis" of a problem in the mind. Even if it is, maybe it's like dyslexia: the person's initial response to letters is upside down, but they can learn to read with help.ADHD = speedy kid. That works well for speedy families. Is that you all? I'm very fast-paced, don't do well with slow-paced children. Some love them.PTSD = jumpy child, child who has experienced trauma. To be honest, probably every child in the system has a mild form of it -- here someone is being honest about it. The PTSD child needs to have you define where all noises are coming from, where all stray bits of light glinting in the room are coming from, to not move aggressively towards them, need same from teachers/ daycare. They need you to add fun to their lives, so they learn to appreciate that. And calm.AFA over-labeled, over medicated, system not dealing with real problems so the child can grow past them. Here, that is 400% the case. Some children come on 5 meds, 3 uppers, 2 downers. Huge problem in WA. Multiple people/groups here trying to reform system in that regard. Think common across country. Debralous took her foster son off meds when he first arrived (meds didn't arrive with child), her doc was horrified at the bag of meds when they did arrive and suggested not re-prescribing. He started doing better. I'd want to experience any child at base level -- who are they sans drugs, but maybe that's just me.The comments tell me this therapist is on the ball.

Thank you! That was really helpful, especially in giving me ideas about how to deal with issues if she comes home with us. She is fourteen and is said to be doing well in her current therapeutic foster home. She's been there for a year and it is the first stable placement she's had since she was removed at 8/9 years old. I'm hoping that having the space to feel safe and accepted has started to heal some of the damage. She was a very angry kid 2 years ago.

The therapist is so correct!! foster kids are dx'd ADHD and ODD and medicated for that. I've had to tell a therapist that maybe there's some PTSD. It's more the child is on survival mode. Just think about you can handle.

We had the match meeting and it went pretty well. We were nervous and leaning towards not accepting the match based on the comprehensive assesment written a year ago when she was moved back here after her adoption disrupted. According to the therapist, who works with the most troubled of the kids in foster care, this girl is one of the easiest she has ever worked with. She is compliant with therapy and the rules at her home. The therapist has not seen her without meds so isn't sure how accurate the diagnoses are, but she says the child is doing very well in her current placement with her current meds. Apparently in this state the medications a child comes with are not allowed to be changed without a court order. We would not be allowed to make any changes until after finalization. I was planning on letting her stabilize in her new home before trying to taper off meds, but that seems a bit extreme to me. There were some episodes of fairly minor violence (way less than what my siblings and I did to each other), defiance, lying and stealing just after her adoptive family disrupted. The social worker is convinced the family disrupted because the mother could not handle the hygiene issues. At the time she was soiling and hiding clothing so I can kind of see that if the woman was a neat freak. I can't imaging being that upset over a mess, but I swim around in swamps for a living. She has been very stable over the last year and made a lot of progress in therapy. They are close to discharging her from therapeutic so that's a good sign. My only worry is that she has not shown her worst behavior to the current family because she knows they aren't permanent and hasn't been required to trust them to care for her no matter what. It's possible she will test us severely to see if we really will stick with her. If her worst behavior is what happened after her last disruption, I'm pretty confident I can handle that. All in all, I didn't see any giant red flags so I'm kind of hopeful today. I'm going to speak to her current foster parents and GAL today. I'm supposed to be given the contact info for the adoptive family that disrupted also. I'm hoping to get more information on the stuff in the assesment to make sure we are not missing anything. The only bump right now is that the adoption coordinator is a burned out, bitter woman that doesn't seem to like adoptive parents very much. She has been very antagonistic about our questions and accused me of trying to talk myself into the adoption, as if I was reluctant but didn't want to say so. I don't think that's the case. I'm cautious, but I have to be. It's not just me and my husband that will be affected by this decision. I think she also expected a firm commitment before we even meet the girl, which I find unrealistic and bizarre. I'll update after I talk to everyone - if anyone thinks of more things I can ask or has advice on the first meeting, I'd love to hear it.

I think that any child over the age of nine who is soiling themselves and hiding it, is emotionally disturbed. Whether it's attachment disorder or whether its PTSD or some combination, it's still worrying. I wouldn't go ahead unless you are very prepared to parent a very challenging child. I think you really need to ask yourself where your limits are at. I don't know how agency support works in the USA, but over here at this point, I wouldn't commit without my agency and I agreeing on and signing something which details the practical and emotional/counselling support they will be offering you.Speaking to her carers is a must, I hope the meeting is enlightening and useful. I would ask FM whether she feels there is an attachment, and to what extent is this girl actually pushed to be part of the family? Also, how does she feel about and talk about her former carers and her disrupted adoption? Does she seem to miss any of them, or dislike them etc?I would also be worried about having to wait until finalizarion to change meds. If she is very challenging, you may delay finalizing for a while and thats a good thing, BUT you will be more pressured to finalize if it becomes clear that her meds need removing or changing. Making it legal can't be rushedSeveral people including me have written lists of questions. Linny's list is good, but I'm not sure where it is. My questions are here - [url]http://forums.adoption.com/adopting-older-child/386680-weve-been-matched-now-what.html[/url] written for adopting a boy, just change for a girl

Thanks for the input, Carmen. I have Linny's list, I'll take a look at yours. Fortunately because she is already in a residential program she gets 60 days of in home counseling following placement. We actually can change meds but we would have to go to court to do so, it wouldn't be hard to increase the dose or switch medications, but taking her off altogether would be a fight. I agree that she is emotionally disturbed. We have researched the diagnoses we have been given and feel we can handle the behaviors associated with them. The therapist told us to make sure we put into the adoption subsidy agreement that she will need long term psychiatric care and/or counseling. We are not at the point of commiting to the adoption yet. That will happen after we have had several visits and everyone is comfortable that we are a good fit. She will also have a say in wether or not she wants to be adopted. She is very attached to her current caregivers and misses her siblings very much. Her attitude towards her previous failed adoption is mostly confusion. I think she is a little angry but doesn't really understand why they didn't keep her. None of the professionals involved understand the real reason either - the parents just weren't willing to try to get past the behaviors she had is what I'm getting so far. * Just got off the phone with the case worker. Our first visit is scheduled for this wednesday!! I'm so nervous!

Be sure to ask the current placement what they think about the ODD. Have a child who never raged but he had tremendous staying power. A teacher once decided she could make him do his work. He never did ONE more problem/question in ANY class. She spent 15 hours with him on a Sat and he did NOTHING. He approached all of life that way. He had no currency that mattered enough to make him change his mind once he had it set. The day to day parent is the best judge of what they are seeing and can clue you in to wether the ODD diagnosis is a response to having her life flipped upside down or true ODD. Hope you get the information you need to make a workable decision for you and get the right services in place if you decide to move forward.

I was kind of with you on the being prepared to handle her until this. "Hygiene" issues are a big euphemism for some of the things emotionally disturbed kids can do. Dismissing the former parent's concerns as being a "neat freak" kind of minimizes and suggests the reality of an emotionaly disturbed child may be way more challenging that the idea. Sure we call deal with a little poo smeared in the underwear...but what about logs dropped you walk through the grocery isle....smeared on your china....etc I has a referral once for a child that supposed "just" did a little poo smearing. He was committed before he got to me, but it turned out the "little poo smearing" was defecating to smear it on anyone and everyone that got within 10 feet---preferrably in their face.

I have to second this. I've never seen a kid with this type of issue that bad, but issues with poop can be a lot harder to deal with than you could imagine until you've seen it. I had a fs once who would smear poo on the walls of his room, and I mean all over, taking me over an hour to clean up, at least twice a week for the first few months he was with us. Whether you're a neat freak or not, that's HARD. I'm not saying this to chide you, but you should really look into the extent of this problem, because it can be totally different issues depending on degree of severity. It's just important to know what you're getting into. I wish you the best on your adoption journey, regardless of what you choose to do:grouphug:

What ever happened with the placement? Did you get her?