The Explosive Child

My wife and I are taking a parenting class. My youngest boy has an attention deficit that we help control with medication. He's been doing really well, but occasionally he's hard to handle. My wife attended a workshop through my son's elementary school, and she signed us both up for the six-week parenting course. We're reading Ross Greene's, The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children. The class started last week and we're reading through chapter 4 for this week's meeting. I planned to write about this more later, but it turns out yesterday's Los Angeles Times ran a front-page story on childhood psychiatric disorders, "Just what is troubling my child?":

The final straw for Carolyn Alves came last fall when she tried to help her daughter Cecelia dress for kindergarten.

The volatile 6-year-old had worked herself into a frenzy as she tried on outfit after outfit, rejecting each as unacceptable. The tantrum at full bore, she scooped up a pile of clothes and hurled them at the front door of the family's Spanish-style bungalow in Glendale.

The clock ticked past the school's 8 a.m. bell. Alves pulled her wailing child into her arms and held her on the couch. After several minutes, Cecelia stopped, took a breath and announced that she was ready to go to school.

"It was like watching someone who was having a mental breakdown," Alves said. Then "a switch went off and she went back to being normal."

Alves and her husband, Marcos, have consulted five doctors and therapists in the last four years. Cecelia has been diagnosed with a smorgasbord of psychiatric disorders — including the controversial diagnosis of child bipolar disorder — in addition to being called a normal kid.

Experts in pediatric mental health readily acknowledge that their failure to pinpoint the problem with children like Cecelia makes a difficult situation worse. And some of them are pressing for an unconventional solution: a new diagnostic category called disruptive mood dysregulation disorder, or DMDD.

Creating a diagnosis is considered a radical step in mental health circles, and the proposal has sparked much debate. The controversy underscores the fact that therapists simply don't know what to make of the estimated 3% of children in the U.S. who suffer from severe irritability and emotional outbursts.

"Everyone wishes we could have a genetic test or a blood test" to determine which disorder a child has, said Erik Parens, senior research scholar at the Hastings Center, a bioethics think tank in Garrison, N.Y. "Unfortunately, nature doesn't work the way we wish."

As a result, parents may be told their children have conduct disorder, oppositional defiant disorder, attention deficit hyperactive disorder, depression or bipolar disorder — if they get a diagnosis at all.

Continue reading.

My son wasn't diagnosed until he was almost in kidergarten, and it's taken a long time to reach a functioning routine that allows both him to do well and a little peace for mom and dad. And one thing I learned the other night at the class is that there's a social stigma attached to these disorders. And honestly, I didn't take them all that serious myself until I had to deal with these issues as a parent. And it must be hell for parents who aren't getting good medical advice. More on that at the Times.