Pediatric 'Disorders' have this mama in chaos
"We're going with Disruptive Behavior Disorder," says the pediatric psychologist. She is young: the sort of young that goes with lots of experience working with parents and small children, seriously impressive degrees, knowledge, decisiveness. In fact, looking at her resume later, I decide she may be exactly my age. But her manner, her aspect, young.
The patient is my not-quite-three-year-old son, Monroe; I'd started this quest to get him diagnosed by a storied medical organization up on this hill of inquiry six months ago; for what? I ask myself in these spare moments after receiving the diagnosis. What did I expect? All pediatric psychologists and special education teams have for my children is a (damning) name for the symptoms I'm reporting to them. All they have is a knowledge -- from this brief interview, these questionnaires with acronyms and insufficient answer choices (there's no "it's complicated," or, "are you kidding me?" or, "but I love this kid with every inch of me" as options) -- that I've given them, that they've observed with the shapes and the little plastic bolt-and-nut. He can sort the shapes, he can screw the screw, he can tell you he's a boy and I'm his mama. He can say "I loff you!" and call blue "boo" and ask where "muffin" has gone ("my friend," I translate after a minute, a little boy only 11 months, Monroe was so sweet with him). He eats kale and garbanzo beans and picks raspberries right off the bush. He hits me, bites his brother so hard it bruises, stomps, throws things, breaks them, screams! screams! when he's angry. He's angry a lot, far more than is right.
What I wanted, I decide after much questioning myself, was a reason, if only a guess! a supposition!, something to look back to and say, "ahh," sorrowfully, to avoid next time, to purge from my life, from which to warn others away. I wanted to know how to wean this child so I can sleep better, manage better. I wanted a solution. Not a thoroughly bad name for what I already know.
She prescribes another evaluation in two years -- so they can, if in the fullness of time he has lived up to his early promise, give him the diagnoses of ADHD and Oppositional Defiant Disorder, when he's old enough for those names-of-behaviors, according to DSM-IV -- and respite for me. Through preschool. Really? And, no.
I try to say some of this to her; I've already told her colleague, whose name I don't get and whose resume I can't Google, how I don't want preschool. How I just want to know if there's anything else I should do. How I'm not going to put him in public kindergarten as he is, now, only to get him kicked out a month, a week, a day later. Sent to alternative schools where everyone kicks, bites, screams. I've done that once. No, no, no.
I ask her, why? Why would I put this child in preschool? What good is it? What are the benefits compared to keeping him at home? I explain how I do not want to be the parent in a community preschool with lots of first-time parents whose child is the biter, of whom other parents look at with a mixture of fear and thank-god-that's-not-me. I was told once that other parents didn't want to send their kids to preschool with my child. No more. And the other option? Albertina Kerr, a truly beneficial choice for many parents, but the classrooms are typically filled with little ones whose smarts are more on par with their social development. Monroe's a charming, frightening dichotomy (like his brothers): scary-smart, utterly without impulse control. She asserted herself that this would be difficult. He would not be "challenged."
After all of this, I do not really expect her to understand me, but still. I want something: an acknowledgment, perhaps, that I am indeed right. That all these names are insulting and there is no answer and everything I have done to get to this point was a big waste of my energy and time and (thankfully little) expense. That pediatric psychology does not help children with these names. I say, "this is a name for symptoms," I say, "I know him best, I love him best," I say, "he's better off at home, isn't he?" and explain to her how it is far more stressful to get a child ready for a preschool program about which you have doubts, and take him there, and wait by the phone, worrying, and go to pick him up, wondering what the teacher will be saying, today, than not to do any of this. And I wait for her to tell me a reason otherwise.
"But you need respite!" she says, and in the end I have to say "thank you" and "goodbye" and decide that no, I do not need respite. I will have this peace in my heart and in my soul knowing that what I am doing is what is best for him and that I know this child as well as anyone can, and better. "How well do you know this child?" one of the forms asks. Better, better than all that, I should have answered. Best.
There was no question on the forms for, "how much do you love this child?", nor, "how much of yourself are you willing to give?"
If you are struggling with a child whose symptoms need not be described by a pediatric Disorder, I will tell you what it is I am doing. I am trying to model calm. And I am doing so by reacting to his anger with as much patience and love as I can. I make things safe; running to hold him, restrict him, from hitting or biting or throwing things when I hear him begin to scream; talking as calmly as I can and urging he and his brothers to work for solutions on their own. That is the mantra they hear from me most often, "find a solution to your problem, calmly, sweetie, find a solution." And when they cannot I try to talk them through it, sometimes I must first wait for the screams to end and hold him, holding back tears at times, or laughter at others (because still, you must laugh!), sweeping all the breakable and destructive things off a table, out of reach. Waiting, taking breaths, telling him to take breaths, praying. I try distraction; even now, both little boys exclaim out the window, on the bike at white trucks, red cars, brown vans, monster trucks!, because this is what am I doing when all else fails. When I am angry, I calm myself as well and as fast as possible; I apologize, I set things right physically and emotionally, as quickly as I can.
Last night: last night, he was angry at me, I did not want to breastfeed him any more, tired, tired, tired. He swept the clock radio off the table; he threw a toy he'd left there the day before. In a minute, he calmed, and he scrambled out of bed and picked up the clock, then got back to bed and thought again, scrambled for the toy. He set it there, on the table, looking at me and I said, "thank you, thank you!" and in my eyes, there were tears.
[Update, July 1: I spoke to Monroe's doctor again, today; she is an urbanMama reader, and came across this post. Through her comments, I could see she felt it was critical of her. I understand how she could think that; and I did not intend to criticize her. I do intend to criticize the limits of pediatric psychology for very young children. I do intend to criticize the general inability of the medical establishment to give answers that are useful -- for prevention, for treatment. And for me, the answers that do help many mothers aren't very helpful. And one last thing: she told me she is a mother, of two. She understands, better than I realized, and for that I am also grateful.]