Child Behavior Forum
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124426 tn?1239931600

We have a number of things to deal with!

I have a 7 yr old stepdaughter that has been dx w/ADHD and bi polar from a child psychiatrist.  It took three months to get in to see him.  In the meantime she was having so many problems at school that I took her to a behavioral center as an emergency.  The intake counciler suggested that we might be looking at ADHD, bi polar and FAS.  I had been reading and thought it was ODD...it really seemed to fit.
She has a twin brother who will be seen soon, another 3 months, and I'm pretty sure he has ADHD.  Their bio mother was ADHD and did a lot of drugs, and bio father is unknown.  My husband fostered them from 5 wks old because the baby girl was abused by the bio mother and had a double skull fracture and broken ribs.  
The behavioral center suggested that we get more testing done and we thought the more we know the better. They will have her see a second psychiatrist, check the skull fracture to see if there is anything there that could be causing problems and evluate her for the FAS.
What is the criteria to dx someone with ADHD, bi polar, FAS and ODD?
We have started her on Tenex for ADHD, and I have to say there has been a big improvement on her impulsiveness and anger.  Not a day would go by when there wasn't a morning melt-down and then she was uncontrollable at school, enough that she had been suspended from the bus and school.  However we are concerned that the FDA has not approved this drug for this use.
Any help you can give us will be greatly appreciated.
1 Responses
242606 tn?1243786248
I won't go into the specific diagnostic criteria here, because you can research these on your own. If you seacrh for DSM-IV Criteria, you'll find the prevailing diagnostic criteria for the various mental and emotional disorders. It is not unusual for doctors to prescribe medications for so-called 'off label' uses. Limited trials are accomplished when a drug is under development, and drugs are approved for use only in the instances which have been specifically studied. But your daughter's treatment is very conventional and does not invite concern. One factor to consider relative to the diagnosis of emotional disorders and neurodevelopmental conditions (like ADHD) in chuildren is that it can be difficult to pin down diagnosers in some instances. There often is mucgh overlap among ADHD, Bipolar D/O and Oppositional Defiant Disorder. And Fetal Alcohol Syndrome can yield a number of emotional, behavioral and cognitive difficulties, icluding limited IG, impulsivity and unstable/inconsistent behavior. But medication is used to address particular symptoms, regardless of the diagnosis (a particualr symptom itself can be symptomatic of any number of conditions). It's not the diagnosis that's treated, it's the symptom(s).
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