Two rather big things came out of that appointment. The first is that she is encouraging us to try Applied Behavior Analysis (ABA), a kind of one-on-one intense therapy that has proved very effective with autistic kids who need help learning to develop stronger social and adaptive skills (two areas where Matthew really struggles). In order to help us access ABA, Matthew has officially been diagnosed with Autism Spectrum Disorder (ASD, or more commonly just known as autism). While we still are unsure about whether or not Matthew really has the kind of organic, brain-chemistry type autism that many children are diagnosed with these days, or whether his ASD mostly just explains and categorizes a series of behaviors that he exhibits that come from his significant early neglect, we don't know. But obviously Matthew's brain doesn't function like a healthy-developing child, and an ASD diagnosis gives us language to describe his challenges and some additional tools and resources to support him. It also, as I'm finding, opens us up to a whole community of families who are raising kiddos similar to Matthew, which is really helpful for us in not feeling isolated while parenting him.
The other path we've decided to pursue is to start Matthew on a low dose of Ritalin. To do this, he'll also be diagnosed with ADHD. We see the ways Matthew's body gets in the way of his learning--and we see a lot of impulsivity from him (throwing things, hitting, making loud noises, disruptions, etc with very little self control) and these behaviors are pretty typical of kids who have the hyperactivity/impulsivity aspect of ADHD. We don't enter into putting Matthew on medication lightly--it's something we've carefully considered. There are some side effects (like slower growth, sleep disturbance, and a kind of spacey kiddo) but based on Dr. Myers's recommendation and with everything we read, if medication can help settle Matthew down so he can learn better, the benefits greatly outweigh the risks. There is nothing life threatening or concerning about Ritalin other than the sometimes unpleasant side effects, and each kid responds differently to the medication. And if Ritalin isn't a good fit for him, there are many other types of medication we can try.
I hesitate to share this information about medication on this blog, since it is a public space of sorts, but I am committed to being honest about our experiences with Matthew, as I know many other adoptive parents read our blog as well. A few years ago I might have categorized myself as being "anti-medication" when it comes to ADHD and kiddos, but after living with Matthew for 2 1/2 years and trying so many attempts to help modify his behavior through routines, words, structure, etc., we realize that Matthew's brain chemistry is likely working against him when it comes to functioning in a healthy way with the rest of society. I'm excited to see if a small dose of medication can help him find a little more balance and give him a chance to focus on learning (rather than dealing with a rather out-of-control body).
We have an appointment with Matthew's primary care pediatrician next Friday morning to talk about meds and get the first prescription. We've also made contact with a clinic that does ABA therapy and hope that if our paperwork comes through in a timely manner, we can begin ABA within the month.
A couple days ago a friend asked me how I was feeling about getting an Autism diagnosis and an ADHD diagnosis all in one days. I told her that I was okay with it. First of all, Matthew is a human being and not a series of diagnoses. We came home from our appointment last Friday and Matthew was STILL Matthew--with his many challenges and all his humor and love and hilarity as well. These labels do help to define him so we can access more resources and support, and I suppose in some ways they help those around us understand Matthew a little bit more. They also define behaviors we already know existed.
We have been investing in Matthew for the past 2 1/2 years while also knowing that his brain wasn't functioning in a normal healthy way. Getting some clarity about what's going on with a clear treatment path is actually a relief for me and brings me a lot of hope about Matthew's future.
I know I say this a lot, but I can't end this post without expressing gratitude for all those in our lives who support and love us through these many ups and downs. Having a support system is such a key thing--and in some ways it determines whether things like this bury us or help propel us forward.
And most of all I feel gratitude for Matthew--for his presence in our lives and the gift that he is, and always will be, to us. I'm learning to let go of expectations, of fears, of worries, and just embrace each day as a chance to take a couple baby steps forward and help him move closer to reaching his full potential.
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