Just got back from the school meeting about Little Bear. He’s showing signs of destabilizing affect as well as exhibiting behavior that’s suggesting hallucinations. This is why we had him screened for pediatric on-set Schizophrenia and this is why he’s under observation for Bipolar Type I.
Aggression and defiance has increased while appetite has declined. (He turned down doughnuts yesterday in class!) He’s talking to himself and it takes someone physically touching him to get him to stop and bring him back to his surroundings. He’s claiming that people are laughing at him when nobody in the room is laughing and becomes aggressive about it. He told the school social worker he sees demons – among other things.
The school staff feels he may benefit from going back to the hospital day program for observation and a possible med adjustment. They told me if he goes they will be sending his academic work over for him the entire time he’s there. It won’t be like last time.
It’s equally heartbreaking and not surprising. So we put together an emergency behavior plan since he does have Clonidine prescribed as a crisis med. Legally they can’t administer it, but I can come in to give it to him and observe him to see if the med works or if he’ll need an emergency psych eval. It’s imperative to keep all the children safe. I expect that I’ll be receiving more phone calls in the near future.
I also signed a release so that staff could speak with his care providers at the hospital and report directly to them what they’re seeing. I told them to document every time he behaves in such a way that suggests a loss of reality – like hallucinations and delusional thinking. And to documents signs of disordered thinking. Send all of the reports to the hospital. They need to be kept up to date. It’s next to impossible for anyone of any age to learn anything when their brain is misfiring like this. Most importantly if it’s coming from them, they’re more likely to pay attention.
It’s unfortunate that even professionals in the field are quick to dismiss psychosis in children. Children typically don’t play pretend and make believe in such a way that upsets them. It’s their fantasy world and at that age is used as a coping mechanism to feel better. That’s what normal looks like. What’s not normal is when a child is convinced there are things threatening their safety to the point they become aggressive and violent that no one else is perceiving and the child can’t be redirected or talked down.
I have misgivings about sending him to the day program again since I now know they don’t just take in mentally ill children. They also take in children from the juvenile criminal system too. ALL of these children need these services. That’s not even remotely close to my concern.
My concern is what Little Bear learns from these much older kids. Granted, I can’t screen his life all the time forever but I would very much like to delay him learning things beyond what’s age appropriate the best I can. It’s hard when you know he’s actively seeking this information to start with.
So I’ve also signed a permission form to allow a behavioral specialist come into the classroom to observe him in that setting. This person will then consult with the school staff regarding in school behavioral supports.
This is a battle I have struggled with since Little Bear was a year old. I’m grateful to finally have a full team – both in school and at the hospital – that are willing to address what’s going on rather than sweep it under the rug.
So it was nice to see Little Bear do so well for the time he had, but clearly adjustments need to be made and hopefully we’ll get them into place before it gets much worse. Logically I know everything is going to be fine, and we’ll get him stable again, but I still want to cry just the same. I’m starting to feel like an anti-psychotic med may need to be discussed despite family history.