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My husband’s 13 yo cousin is in foster care and has a lot of behavior problems and different diagnosis. I feel like everyone is spinning their wheels trying to make improvements when there’s a new problem/diagnosis every new person she sees and no progress.
The social worker wants her tested to see if she’s on the autism spectrum, and she was bounced from the foster home she was in because they said she acted autistic and they can’t deal with autistic kids.
She has seen therapists and a psychiatrist, but they’ve never said anything about autism (so far she’s just been diagnosed with anxiety, depression and recently ODD and PTSD were added), but I worry that they’re treating just the symptoms and not the root problem, and normal treatments like talk therapy are never going to work.
Part of the issues with any sort of therapy is she barely talks and is not social at all, and everything has been focused on all the other problems with abandonment and trauma. But after 8 months of therapy and there has been no progress and her behavior has gotten worse.
She's not profoundly autistic, but she could be on the spectrum. While we're related, it's been a very strained relationship with her parents and their extended families, with long periods of estrangement. Her parents have battled mental health, drug problems and homelessness. We don't know when she started talking or if there were issues when she was little. We've always known her as a very shy, withdrawn kid.
Other issues/symptoms:
- No friends, no interest in making friends, eats lunch alone at school and has been downright hostile to some girls who have tried to be nice to her.
- No interest in being around people and doesn’t want to participate in family time or family activities. Doesn’t care about her grandma being seriously ill.
- Does okay in school, but is severely behind which is blamed on being constantly uprooted and in bad schools when she lived with her mom. She is doing better in math, science and social studies than she is in English, music and art.
- She has sensory issues, doesn’t listen to music and yells at people for playing music too loud (one of the issues at the foster home). She also has issues with lights being too bright. She will only wear a few things- mainly hoodies and sweatpants.
- She overreacts if you try to touch her. She doesn’t like to be hugged or cuddle and she’s like this with her grandma, not just strangers. She’s always been rather prickly and isn’t from a touchy-feely family and I’m not sure if it’s worse now or we’re just noticing it more since she’s living here.
- She has meltdowns over practically anything especially when she doesn’t want to do something, generally more at home than at school, but they have happened at school, mainly during her English class.
- Frequently after meltdowns she will bolt and take off. If she can make it out a door, she’s gone and we have to track her down.
- At night she frequently snuck around the house after we went to bed. Her doctor called it insomnia but we feel the main reason she was doing it was to do whatever she wanted without us there
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- Serious issues with defiance and just being non-compliant with things that make no sense. She does normal kids things like refusing to clean her room or homework, but she also will refuse to do things like get in the car so we can go to a movie or go to the grocery store.
- Trying to talk to her has been incredibly challenging. I’ve been reading a lot of parenting books, trying to use positive parenting tactics and talk to her after behavior incidents, help her problem solve better actions and understand consequences. Frequently during these types of conversations, she has absolute total meltdowns. This also happened a lot when she was living with her grandma.
From reading what other families dealing with troubled kids, and their kids at least have some redeeming qualities. One minute they might be raging, but the next they’re funny, silly or charming and apologize and want to cuddle.
Dealing with this girl is so draining because there aren’t good days, she’s completely unapologetic and doesn’t care about the problems she’s caused. She’s told us that she would rather be on the street than live with us.
Pretty much the only thing that works is to just let her do what she wants and what’s normal for her - which is highly dysfunctional. Integrating her into our family has failed miserably.
What I wonder is how can you tell if she is on the autism spectrum with all the other problems? I’m sure her psychiatrist and therapist have seen plenty of normal kids with Autism and Aspergers diagnosed as toddlers, but I’m concerned if they have any idea what it would look like in a teen without a normal upbringing? How do you find someone who’s used to working with kids like this?
Maybe the foster home just claimed she was autistic as an excuse to get rid of her, but she does have communication issues. Maybe expectations are too high that she'll ever be able to talk and open up to a therapist or anyone if she is on the spectrum.
We're struggling to figure out a permenant living arrangements for her and potentially what type of facility she needs to be placed in, since family members can't handle her. If we don't have the right diagnosis, it might not be the right place for her. If she's expected to communicate in therapy and she simply can't because of how her brain works, then it's never going to work.
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It definitely sounds like the Autism Spectrum Disorder. My child has been diagnosed with it and at first was 2 paediatrician ruled it out. At first one thought she had ADHD and later suspected she may have the ASD. We had her tested and she has mild Asperger's. What you described sounds a lot like the ASD (autism spectrum disorder) with all the characteristics of it.
Hope this helps. She would definitely need Speech Language Pathologist to help her with language. It helped my daughter a lot. Sensory issues would require a occupational therapist.
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In case anyone is in a similar situation, I thought Id post an update. After all of that, none of the doctors she has seen think she is autistic.
While we can find examples of her behavior that exactly match the characteristics of autism, her psychiatrist feels there are just as many examples of ways she is not, and he believes her behavior is likely the result of her mental illness, trauma, personality and possibly drug exposure in utero.
Since she refuses to speak so often (itҒs not selective mutism since its primarily around her family and to doctors and therapists. She will talk some in school), its so difficult to have her properly diagnosed. One of the few things she will say when weҒve tried to talk to her about all of this is that shes is adamant she isnҒt autistic. She refuses to cooperate at all with any sort of testing or talk to the psychiatrist at all now.
Her psychiatrist did agree that she likely has some sensory processing problems (sensory defensiveness), but doing occupational therapy for that with a teen who isnt cooperative, doesnҒt want to change, frequently completely shuts down and has been a habitual runaway isnt going to work. Sensory issues seem to be common in kids with fetal drug/alcohol exposure but no one wants to bring that up. ItҒs so much more difficult when the biomom is still involved and still is treated by the child as if she can do no wrong.
Her grandmother doesnt want to continue trying to get the autism diagnosis by doctor chasing, but it would make things far easier for things like school, camp or even sending her to some sort of residential program.
WeҒve been trying to find a summer camp for her that meets her needs and would help with social skills, but trying to explain her problems to admissions counselors and how she acts makes it so impossible. She doesnt fit into normal programs for troubled or mentally ill teens. If we could say ғshes autisticҔ then it would simplify everything, people might understand how she acts and there are programs to deal with kids that are autistic.
All the camps weve found assume teenage girls are highly social and want to be around other teen girls. She doesnҒt. She would rather go hide somewhere rather than interact with anyone and has absolutely no understanding of other peoples feelings nor does she care if she hurts other people. But sheҒs not manipulative like a RAD kid. Shes completely aloof and cold.
IҒm not sure what our next step would be. I would like her to see a neuropsychologist, but shes unlikely to cooperate with that. Insurance isnҒt covering most of this, so its paying out of pocket. Which is incredibly frustrating since none of these doctors seem to have any clue whatҒs going on, just more guesses and no concrete plan to fix the problems.
mumofone
I'm certainly no expert, but it sounds like either autism or attachment related. I have a child with attachment issues, and some of the symptoms you mentioned...defiance, no empathy, etc. are definitely attachment disorder symptoms, too. I'd definitely do lots of research on both.
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Has she been evaluated by the school psychologist recently? I read she has an IEP, but METs are done only every three years unless a member of the team requests otherwise. Also, do you know what her disability at school is? A special education teacher or school psychologist will be able to tell you after observations, data collection, and info. from teachers and you. How is she in social situations? Does she know to shake hands, social boundaries (not too close), eye contact, reading body language, fire alarms, changes in routines, monotone voice (especially when reading), flapping, obsession with something and hard to redirect, etc.? I am not certain it is autism, but there are definitely some emotional disabilities that are of concern and should have goals aligned to them.
The school psychologist only referred us to take her for additional mental health screening (besides the counseling she was in at the time). No one at the school knew what to make of her. Its an amazing school (9/10 on Great Schools) for normal kids but there arenҒt many kids like my cousin in our school district.
She doesnt have IEP. While living with her biomom, she went to at least 8 different schools, frequently didnҒt attend school while homeless and her bioparents have very strong negative opinions about the whole mental health profession and would never take her to see a therapist or psychiatrist. When she moved here, everyone wanted to see how she was when things settled down, but they kept snowballing. By the end of the year, she went to live with my brother-in-law and he let her do online school but that didnt work out.
When she was going to school, she was very withdrawn and quiet, barely talked, frequently didnҒt take notes, sometimes wouldnt even write anything on tests or quizzes. SheҒs behind from not going to school and is highly sensitive to being called stupid so shed rather do nothing than risk being wrong. She did get into arguments with teachers and cussed out her English teacher several times in class while refusing to do what she was told.
ItҒs hard to know what shes like in any social situation since she avoids them. She doesnҒt shake hands, say hello or thank you. But her bioparents never taught her that when she was little. She does avoid eye contact. I dont think she does any flapping.
We think she reads at about a3rd grade level and getting her to read out loud is impossible. She wonҒt do testing to find out exactly how behind she is. She absolutely refuses to do the tests.
She isnt obsessed with anything typical of autistic kids like trains. Pretty much all she wants to do is watch tv, mainly a lot of bad reality shows on MTV. She also obsessed with going through Petfinder.com trying to find the dog she had when living with her biomom that was taken by Animal Control when her biomom was arrested. WeҒre absolutely certain he was put down since he was a Pittbull mix and aggressive, but she goes crazy if you take away her internet access since she has to keep looking for him.
My wife & I have adopted 3 special needs kids, two of which have autism. Our daughter was a foster child when she came to us at 2 days old. We noticed she'd avoid eye contact from the start, & when she was old enough she'd lock her arm out to keep from getting a kiss.
She was diagnosed around 2 yrs old and it was about that time we finalized her adoption.:happydance:
We know what her issues were from infancy, and that is an advantage, but some of the stuff that comes with autism will be there for the duration of the kids life, so a teen with autism will still have many of the same issues they've had since toddler years, but they may have learned to handle the issues differently due to many factors.
When I say "issues" I mean, no socializing efforts, ticks, twitches, "stimming" (repeated jumping, pacing, laughing etc), meltdowns, emotionally hyper sensitive. There is more but just to give you an idea of what I'm referring to.
My daughter has learned to talk, smile, laugh, joke, read write books, do artwork, play the Wii & Xbox, swim, dress herself, clean her room, etc. But her life is a schedule and when it's "off" she's OFF.
A teen with autism has puberty, social pressure, educational pressures, peer pressure, home pressure, sensory pressure, and all the visual & perceptual pressure that comes with the diagnosis.
I would suggest looking for an "Autism Specialist" in your area. Usually a large university hospital will have one on staff. They can make the diagnosis, and only them. Everyone else is just guessing or making a determination based on their own experience. She may also need medication to help with the anxiety of all her sensory needs that may not be getting met.
She needs an IEP which is a legal document. Or, the school doesn't really have to do anything for her that you ask. An IEP is in her favor if she needs anything out of the norm, like speech, OT, PT, or any specialized educational equipment for school to help her learn.
I hope some of the things here have helped. If you're on Facebook feel free to visit my page "ABOUT Autism Adoptions" [url]https://www.facebook.com/pages/ABOUT-Autism-Adoptions/605508092804169[/url].
Have a great day! :fish:
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wren24
I’m leaning more towards it being prenatal exposure to drugs and alcohol. This chart shows the overlap in the characteristics of Fetal Alcohol Syndrome, Austim, RAD and other conditions:
[url]http://www.mofas.org/wp-content/uploads/2010/12/Overlapping-Characteristics-3-23-10-CBT.pdf[/url]
Her biomom won’t admit to doing drugs or drinking during pregnancy, but I would be shocked if she didn’t.
But it’s hard to distinguish that from the effects of being raised in a neglectful environment as a baby. What is so infuriating is after everything her biomom did, we get all the hate from her and she’s obsessed with when her biomom is getting out of prison. She’s very clear that she wants her mom back, not to be part of our family, so I don’t know how we would do attachment therapy if it was needed.
CRAZY_WOMAN
Also what age was she taken away from her parents? She may have bee to young to understand how bad her parents were. She may need to be told, that theirs no way her mother is a safe person to raise her.
wren24
She was 12 when her mom went to prison. Her dad hasn't been regularly involved in her life since she was 5 or 6.
Her mom's parental rights haven't been terminated, so when she is released from prison, my cousin may go back to live with her mother. Her mom gave her grandmother temporary guardianship before she went to prison (it's federal prison, and she had a date to report) but her grandmother has been ill and passed away in December.
CPS was never involved, other than when her mom was arrested. Which goes to show how inept they are and how many kids fall through the cracks.
CRAZY_WOMAN
So true about so many kids falling through the cracks. I thought she was in foster care now. If the moms that bad they might give her a RU plan. Never take the moms word she didn't drink or do drugs. Most will swear they didn't, unless they're committed to cleaning their act and helping their child.
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