medication

Your grandson is struggling with out-of-control behaviors to the point where intervention is needed. If you have not done so already, have your grandson evaluated for mental health conditions. Has he had substance abuse treatment?  Does he receive counseling, or is he on medication? Do you go to family counseling? Have you tried any special academic programs or day treatment programs?  

It sounds like you want your grandson to be placed outside the home. It is important to exhaust all local resources before placing your son at Boys Town. There are documents you will need to gather before going through the admissions process. These are a psychological or psychiatric evaluation performed within the last six months by a psychologist or psychiatrist; pertinent school information such as transcripts, individualized educational plans and behavioral reports; and a letter from the youth explaining why he wants to come to Boys Town.  

This letter needs to include at least one personal goal that he wants to work on while he is at Boys Town (anger issues, academics, coping skills, etc.). This letter usually is the most difficult thing to obtain because many kids do not want to be placed outside of their homes. 

Explain what his alternatives are if he doesn’t participate in the program. Once you’ve sent in all the information, the process takes about 30 days if the youth qualifies. Visit our website at www.boystown.org to learn more about the residential program.  

It is important that you take care of yourself at this difficult time. Do you have someone to offer support? Though we are not right there with you, we are here 24/7 to support you and your family. Call us anytime at 1-800-448-3000.

It is not uncommon for youth with an ADHD diagnosis to come off as having a poor attitude toward school. Sometimes it's easier to give off the vibe of "I don't care" instead of just saying "I don't get it." If she is still struggling with schoolwork or if she's still having a hard time concentrating, that may be where this sort of attitude is coming from.

If she hasn't had a medication management checkup recently, we would suggest that you schedule one to assess how her current medication (dosage and type) is working for her. At 13, her body is changing, and her ADHD can change along with her. It's important to monitor that closely because medication can have a huge impact on her concentration.

If you would like to help your daughter succeed in school, consider the following suggestions. Ask about her day, visit her school, volunteer at school events and/or attend sporting events. Studies have shown that the level of parental involvement is closely tied with a child's success in school.

Focus on your daughter’s homework by establishing a central location for completing it. Make sure the workspace is clean of clutter. Try to keep the area as quiet as possible. Shut off the TV, and try to limit distractions such as phones and computers. Set aside a specific amount of time (45 to 75 minutes) for studying and homework each school night. If she struggles with concentrating for that long, you can break these up into smaller sessions. If she doesn't have homework to do, then encourage her to read a book.

Set a positive example by using this same block of time to write a grocery list or pay bills, or use it as quiet personal computer time. As parents, we encourage our children by always setting aside time for learning and reading.
 

Parenting, whether step or biological, can be frustrating and challenging. When this young man was taken to Doctors, was he diagnosed with a mental illness? Does he have a counselor, or does the family?  It may be helpful to have someone who can gather the historical information of this young man, stay updated on the current behaviors, help develop a treatment plan to address his behaviors and guide you and his father along your journey of raising him.

Not knowing where you live makes it difficult to offer referrals for specialized schools that deal with behavioral issues and academics. There are a number of them and perhaps you would consider that as an option to help him experience some academic success.

Parenting a child who requires extra care makes an already tough job that much more challenging. Children who are diagnosed early on in life with bipolar disorder face many challenges, as does their family.

It can be common for their disorder to change as they do. Changes in the disorder may require adjustments in medication of either type or dosage. We always encourage parents to be completely forthcoming with how the medications are going because it can have such an impact on the child's treatment. Have you recently had him evaluated? Sometimes other types of disorders will co exist with bipolar, which may better explain some of the behaviors he's been displaying.

It can be overwhelming to think that his disorder might be in constant motion and some parents have found it helpful to keep a daily record that includes specific behaviors, eating patterns, medication status and sleeping patterns. Examine the record for patterns that might be developing. 

We encourage you to consider family therapy if you haven't already done so. Sometimes parents caring for a child who needs more attention often put their own needs last. However, it's hard to care for someone else if you're not caring for yourself first. Continue with positive and negative consequences consistently to create a stable environment for your son.

Parents are not always going to agree on how to approach their children concerning their actions or what consequences should be delivered for those actions. Your daughter’s health and safety is the most important thing. Taking another's prescription medication is not only illegal, but it also could be harmful and put her health at risk.  Since she has confessed to using marijuana as well, it may not be a bad idea to talk to her physician about a possible drug test or an actual office visit to make sure what she has ingested recently is not going to cause harm. Your husband was probably shocked and upset, as you were, and the fact that it was his medication might have struck another chord with him. 

If your daughter has never had a mental health evaluation, this might be a good time for that. Some teens experiment for the sake of experimentation, but others could be self medicating for one reason or another. If depression runs in the family, now is the time to see if your daughter may actually be showing some symptoms of the same disease.

Talk with your husband and come to an agreement about what the consequences should be for your daughter’s behavior.  She is old enough that if it takes some time for you to come up with a reasonable consequence, she can wait. Let her know that you are glad that she is okay, you want to get her help if she feels that she needs it, and that you love her, but because of the severity of what happened, there will be a consequence.

Thank you for contacting us with your parenting concern. Parenting is never easy, especially when you have a child with very unique and difficult behaviors such as your son.

You are completely right in stating your son is able to learn new positive behaviors to replace the existing negative behaviors. It sounds like your son has a lot of things going on right now; however, the most alarming is his violent and aggressive behaviors toward you.

First of all, we really want to praise you in being able to momentarily remove yourself from the situation and call your husband and then your dad. In situations like this, it can be really hard to think clearly on what to do next. You did the right thing by giving yourself a timeout to reach for assistance in gathering your thoughts.

Whenever children become aggressive to others, we always encourage parents to call the police. Not only does this ensure the safety of others in the home, but also your son’s safety. Often police will come to the house and say there’s not much they can do, especially given his age. However, they will assist you in de-escalating in the situation and will give a stern talking to your son. Many children respect police officers and are more likely to comply in the future if they know you’re going to call the police again. In addition, this creates a paper trail and will record the amount of times that you’ve had to reach out for assistance due to your son’s out-of-control behaviors.

If you are unable to maintain your son’s safety and he is posing a threat to himself or anyone else in the home, we encourage you to take him to the closest emergency room. There he will be evaluated and his safety to himself and others will be assessed. If you can’t physically get him to the hospital because of his aggressiveness, the police can escort him to the hospital.

You mentioned that your son was prescribed with three different medications. Were they prescribed by his pediatrician or a psychiatrist? We recommend children on psychotropic medications be seen by a psychiatrist as they specialize in medication management and mental health disorders. Have you been able to identify any progress with these medications? It’s essential that you keep ongoing communication with the doctor who prescribed these medications. We would also suggest individual therapy and also family therapy. Medications work most effectively when they are paired with some form of therapy. Also, in therapy your son can learn new ways of dealing with his emotions (specifically his anger). Therapy can also help you can learn new ways to respond and parent to his specific behaviors.

We’d like to continue to offer you support in any way we can. If you need assistance locating a mental health professional in your area, let us know your city and state, and we can offer you referrals in your community. We’re only a phone call away if you’d like to discuss specific behaviors or just need someone to talk to. If you feel more comfortable with email, please continue emailing us.

You may be at a point where going to see the school counselor or a school administrator is a good idea. Start by talking about your financial situation and that your son is capable of doing well in school, but he is not being medicated right now. They may already know this, but go in looking for alternatives. Public schools, especially, should have some background knowledge about getting your son some kind of financial aid. Depending on the resources available in your state, there might be a lot of help for him.

If the school has no financial resources to help him, then it might be a good time to start working with a social worker. Try contacting the Department of Health and Human Services, the National Alliance for Mental Illness, or the Department of Education.

If your son can’t be treated with medication, then you could consider an alternative school that is more prepared to deal with behaviors like this. There are counselors and schools all over that offer treatment funded by the state or on a sliding scale.

Ultimately though, it’s important to find a way to get some kind of support for you and your husband. There’s no way your son will be successful in your custody if you aren’t able to support yourselves.

Start at the school and then give us a call or write back with some information about your city and state so we can start looking for specific referrals in your area.

Thanks for contacting us with your dilemma. As you know, children of all ages do best in consistent and predictable environments. Your grandson does not have this with the issues that are occurring.

Going through puberty and ADHD are not excuses for his inappropriate behaviors, but both contribute to his inappropriate language and disrespectful, noncompliant behaviors. The key is not to allow him to continue with these behaviors.

You and your husband must clearly define your expectations for his behaviors. Let him know what the positive consequences are for meeting your expectations and what the negative consequences are if he does not. Use rewards that he likes and are meaningful to him. If he meets your expectations, then perhaps he should get to watch TV, talk on the phone and have some time with his friends. Remember, these things are only available if he meets your expectations and uses appropriate language, does his chores, takes care of his schoolwork, is up and to bed on time, etc.

If, because of your illness and the energy it takes to parent, you are unable to follow a parenting plan, please let us help you find some support in your community.

You are in a very difficult situation, and it took courage to reach out for help. You did the right thing. You are not alone. Unfortunately, many parents are feeling the same types of emotions and frustrations that you are right now. You mention that you want to do something for him; it is great that you are focused on this; he needs your help now.

It is important to find the positive things he is doing and remind him of his value and importance to you and your family. Many kids who are angry and violent have gotten the label as the “bad kid” from others as well as from themselves. They end up living up to that expectation.

Try to remind him that he is a great kid. Give him choices and responsibilities; when he completes them, praise him, but try to minimize your praise if he chooses to not complete the tasks. Some examples may be to work in the yard, do the dishes or clean his room. Point out even the smallest things he does that help you. If he takes off his shoes at the door or comes home on time let him know that you noticed.

If your son sees a therapist or is on any medication, it may be time to reevaluate his treatment to help him learn proper ways to get what he wants and express his anger.

Also, sit down with him at a time when things are calm and establish a plan. Make a family contract stating what rewards he can earn by showing respectful behavior. Rewards can include his cell phone (if he has one), driving privileges or going out at night. These are rewards/privileges he should earn, not just have handed to him. If he is rude and disrespectful or “raging,” as you mentioned, then he loses these privileges for a period of time. But let him know how he can earn them back so he can be successful.

Your situation can be frustrating. It is important to take care of yourself, as well as to find help for your son. Do you have support — friends, family or a therapist to talk to? We encourage you and your son to call us at the Boys Town National Hotline (1-800-448-3000). Please keep in touch and let us know how you are doing or if there is anything else we can help you with. He is still your little boy in there, and this, too, shall pass.