Psychiatric assessment for a child
Discussion
Not entirely sure what I'm asking for here except to say I could use some advice. There is a 14 year old girl in my extended family who it's no exaggeration to say is tearing her immediate family apart. Her behaviour has always been on display but as she grows up is now escalating to the point an intervention of some kind is required.
In the past year she's been thrown out of school, started a new one & immediately got into trouble. Bunks off regularly, goes missing - the Police were involved in looking for her last week. Shoplifitng, stealing from the family, lying to her mother, took a swing at her mum last week, the list goes on and it's all accompanied by a lack of remorse, manipulation, aggression & repeat behaviour. Things came to a head yesterday apparently when the family decamped to the grandparents for fathers day & a blazing row erupted over of all things, a bag of sweets - don't ask, I wasn't there but by all accounts, everyone ended up crying, the day was ruined, except for the girl who did a runner & had to be retrieved,
As you can imagine, there's lots of discussion going on & keeps revolving around the suspicion of sociopathic/personality disorder. The family have another daughter who is autistic for whom CAMHS took three years to diagnose, so their confidence in involving them isn't high. I guess I'm asking whether there is some other pathway for assessment & whether it's even worthwhile?
In the past year she's been thrown out of school, started a new one & immediately got into trouble. Bunks off regularly, goes missing - the Police were involved in looking for her last week. Shoplifitng, stealing from the family, lying to her mother, took a swing at her mum last week, the list goes on and it's all accompanied by a lack of remorse, manipulation, aggression & repeat behaviour. Things came to a head yesterday apparently when the family decamped to the grandparents for fathers day & a blazing row erupted over of all things, a bag of sweets - don't ask, I wasn't there but by all accounts, everyone ended up crying, the day was ruined, except for the girl who did a runner & had to be retrieved,
As you can imagine, there's lots of discussion going on & keeps revolving around the suspicion of sociopathic/personality disorder. The family have another daughter who is autistic for whom CAMHS took three years to diagnose, so their confidence in involving them isn't high. I guess I'm asking whether there is some other pathway for assessment & whether it's even worthwhile?
You will be waiting a while with CAHMS I can imagine. My sister went to a company local to us in the north west for an assessment for my niece and said she couldn't recommend them more. It is called Meadows Psychology service if that is any help https://meadowspsychologyservice.co.uk/
lightningbolt said:
You will be waiting a while with CAHMS I can imagine. My sister went to a company local to us in the north west for an assessment for my niece and said she couldn't recommend them more. It is called Meadows Psychology service if that is any help https://meadowspsychologyservice.co.uk/
Thanks, appreciate the link.is there any suspicion of Autism and maybe ADHD, it does run in families, and girls can present much more different that boys.
Its a simple job to find the ASC, RAADS-R, and WURS tests online and these can INDICATE if that is worth taking any further to diagnosis, or rule it out.
https://embrace-autism.com/raads-r/ - Autism
https://www.thecalculator.co/health/Wender-Utah-AD... - ADHD
From there its CAHMS or going private for either an ADHD/AUTISM diagnosis or finding out further possibilities.
Its a simple job to find the ASC, RAADS-R, and WURS tests online and these can INDICATE if that is worth taking any further to diagnosis, or rule it out.
https://embrace-autism.com/raads-r/ - Autism
https://www.thecalculator.co/health/Wender-Utah-AD... - ADHD
From there its CAHMS or going private for either an ADHD/AUTISM diagnosis or finding out further possibilities.
ucb said:
Why would labelling her behaviour improve the situation in any way? What does saying "you have X personality disorder" do to improve your situation?
A label gets you more specialised care to treat that disorder. You wouldnt be happy if you got told 'you have cancer but we are not going to bother figuring out exactky what one, Heres some generic meds that should work, maybe'.
Many people in the criminal justice system have a personality disorder. This is a structural thing as well, where drug therapy / medicalisation won't help or make any difference in the long term. Many will end up in prison.
Most mental health issues make their first appearance in adolescence, often triggered by something happening in the family/school. So that should be looked into. Kids frequently take the brunt of poor parenting, where the adults/parents often have a complete lack of insight into their own behaviour.
Obviously there is a continuum and overlap between something like BPD and the other 'diagnoses' such as ADHD and ASD. In times of old they might have been sent to an approved school, or locked up on a psychiatric ward, or sent to one of the colonies. This rarely happens now as there a label that can be applied to the unfortunate neurodivergent child - once they get to the end of the waiting list for CAMHS.
My advice - let them do what they want and make their own mistakes. Learn that way.
Most mental health issues make their first appearance in adolescence, often triggered by something happening in the family/school. So that should be looked into. Kids frequently take the brunt of poor parenting, where the adults/parents often have a complete lack of insight into their own behaviour.
Obviously there is a continuum and overlap between something like BPD and the other 'diagnoses' such as ADHD and ASD. In times of old they might have been sent to an approved school, or locked up on a psychiatric ward, or sent to one of the colonies. This rarely happens now as there a label that can be applied to the unfortunate neurodivergent child - once they get to the end of the waiting list for CAMHS.
My advice - let them do what they want and make their own mistakes. Learn that way.
sherman said:
ucb said:
Why would labelling her behaviour improve the situation in any way? What does saying "you have X personality disorder" do to improve your situation?
A label gets you more specialised care to treat that disorder. You wouldnt be happy if you got told 'you have cancer but we are not going to bother figuring out exactky what one, Heres some generic meds that should work, maybe'.
ucb said:
sherman said:
ucb said:
Why would labelling her behaviour improve the situation in any way? What does saying "you have X personality disorder" do to improve your situation?
A label gets you more specialised care to treat that disorder. You wouldnt be happy if you got told 'you have cancer but we are not going to bother figuring out exactky what one, Heres some generic meds that should work, maybe'.
Without the label you wont get the correct help . You cant get the label without help. Its a catch22 situation.
sherman said:
Im not.
Without the label you wont get the correct help . You cant get the label without help. Its a catch22 situation.
That. There is a pattern of deteriorating behaviour that needs to be adressed. It can't just be ignored or swept under the carpet for fear of hurting feelings. Yesterday her half sister was woken by the child going through her drawers, stealing makeup. Mum has put locks on the kitchen cupboards, dad has sewn an airtag into her rucksack in order to see where she is as she goes missing so often. None of this is acceptable. Nor is it isolated, Without the label you wont get the correct help . You cant get the label without help. Its a catch22 situation.
I'm giving a handful of examples for illustration but it is relentless and the fear is ultimately losing the child either to drugs, pregnancy, the local authority or the cops. All of this comes from a place of love, the desire to save someone spiralling. That should be easy to grasp for any parent.
sherman said:
ucb said:
sherman said:
ucb said:
Why would labelling her behaviour improve the situation in any way? What does saying "you have X personality disorder" do to improve your situation?
A label gets you more specialised care to treat that disorder. You wouldnt be happy if you got told 'you have cancer but we are not going to bother figuring out exactky what one, Heres some generic meds that should work, maybe'.
Without the label you wont get the correct help . You cant get the label without help. Its a catch22 situation.
OP it is important to understand whether the child is indeed on one of the various spectrums as the solution is very different to just bad parenting.
The behavioural symptoms you describe could be equally be caused by both.
The former is addressed - possibly - via family therapy and better parenting. The latter, by building a framework of support and 'accomodation' around the individual, which includes education of the family and those she interacts with (e.g teachers).
TGCOTF-dewey said:
OP it is important to understand whether the child is indeed on one of the various spectrums as the solution is very different to just bad parenting.
That is exactly what is being sought and without going into detail, I can categorically assure that the core issue is not bad parenting. Quite the opposite, it is a loving, cohesive family.President Merkin said:
TGCOTF-dewey said:
OP it is important to understand whether the child is indeed on one of the various spectrums as the solution is very different to just bad parenting.
That is exactly what is being sought and without going into detail, I can categorically assure that the core issue is not bad parenting. Quite the opposite, it is a loving, cohesive family.All opinons are on the table, nothing is ruled out. The child is from a previous relationship, different father, complicating factor but in a probably futile attempt to head off idle speculation, the family is rasing three other kids without any significant behavioural challenges.
I know from beng around them that the parenting is consistent, no favouritism, no corporal puishmnent, no red flags, It's also a big family, word gets around. I'm not so naive that I think I know what goes on behind closed doors. otoh, it's also one of those extended mobs where everyone knows everyone's business.
I know from beng around them that the parenting is consistent, no favouritism, no corporal puishmnent, no red flags, It's also a big family, word gets around. I'm not so naive that I think I know what goes on behind closed doors. otoh, it's also one of those extended mobs where everyone knows everyone's business.
President Merkin said:
All opinons are on the table, nothing is ruled out. The child is from a previous relationship, different father, complicating factor but in a probably futile attempt to head off idle speculation, the family is rasing three other kids without any significant behavioural challenges.
I know from beng around them that the parenting is consistent, no favouritism, no corporal puishmnent, no red flags, It's also a big family, word gets around. I'm not so naive that I think I know what goes on behind closed doors. otoh, it's also one of those extended mobs where everyone knows everyone's business.
Rule out the autism and ADHD if you can - its pretty easy with the tests I've linked to. If they indicate that's a possible reason then you will have another separate battle on your hands unless you have the money to go private.I know from beng around them that the parenting is consistent, no favouritism, no corporal puishmnent, no red flags, It's also a big family, word gets around. I'm not so naive that I think I know what goes on behind closed doors. otoh, it's also one of those extended mobs where everyone knows everyone's business.
You say 'biggish' family and not with birth parents, so could it, at its core, be attention seeking behaviour. Even bad attention is attention. She may perceive you treat her differently irrespective of your perceptions. Lack of self esteem, lack of belonging linked to family dynamics, 'three other kids' (fostered?) getting more attention, trust issues, losing her status in the family due to three other kids etc.
Good luck
Be aware that psych meds can lead to permanent chemical castration (PSSD) which I suffer from.
https://www.pssdnetwork.org
Patients aren't warned of this possibility.
https://twitter.com/PSSDNetwork/status/16708923601...
https://www.pssdnetwork.org
Patients aren't warned of this possibility.
https://twitter.com/PSSDNetwork/status/16708923601...
Gassing Station | Health Matters | Top of Page | What's New | My Stuff