New Stepmom needing help .... | ADHD Information

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My husband and I are 45 and 49 respectively.  We've been married for 2 1/2 years.  His children live with their mom in another state, my youngest is in college.  His 14 yr old son is moving in with us in July.  And while I know it's absolutely the best thing for the child (he lives with an abusive, alcoholic, RX abusing mother), I feel like I've just received a 4 to 5 year prison sentence and have been told to report to my cell in 2 months. 

My SS has been here for numerous extended visits in the 5 years that my husband and I have been together, so I know what lies ahead.  It's not that I'm imagining the worst without basis.  Life in my home is calm, comforting and would probably be pretty boring for a lot of folks.  It's a nice place to be.  HOWEVER, it turns into Mardis Gras, 24/7, when my SS is here.  I don't know how to describe it without sounding like a real witch.  But it really is severe.  Watching tv, reading a book, sitting outside by the pool, having a conversation with someone else (in person or on the phone) without continual interuption and turmoil is virtually impossible. I've got a pretty patient, long fuse, but by the same token, I'm one of those people who really would like to have just ONE cup of coffee when I get up in the mornings in relative peace before getting hit with utter chaos.  Even getting up at 5 am for a few minutes of peace before starting the day doesn't work because my SS seems to never sleep.  Just the sound of someone downstairs flushing the toilet in the middle of the night has him bounding down the steps in search of the party.  He has no "off" button.  Not even a "slow down" switch.  And to make matters worse, I find myself counting the hours and minutes until my husband will get home from work and provide some "back up,"....only to realize after his arrival, that the way my husband interacts with his son (without realizing it) seems to make him far worse than he is when he's home alone with me.  So......I dread getting up in the mornings and dealing with this poor child......and then I dread my own husband coming home at the end of the day and pouring fuel on the already wild fire.  I don't enjoy being in my own home any more when my SS is here.  And I feel horrible about it all. 

While I think I'm pretty easy going, I don't have a lot of tolerance for adults who are always loud, crude, and in your face all the time.  Now, I feel like my home is turning into a permanent war zone.  While my SS can be the sweetest kid you've ever met, he can't seem to keep friends around.  He makes them easily, but drives them away quickly with his behavior.  Because of that, the family is usually the only 'social' group he has.  Others don't tolerate him well at all because he comes on so incredibly strong. 

My SS is on a TON of medication (5 stimulant pills daily and 1 tranquilizer at night).  We intend to have that situation reevaluated immediately upon his move here.  Surely, that can't be good for him.  His mom does nothing to work with him at home, so he's never had any behavioral modification whatsoever.  Just more pills, please.  (Baby sitter in a bottle from the mom's perspective, I think)  But aside from the obvious things we need to do (reevaluation, counseling for both him and ME), can anyone who deals with this kind of situation offer any good, solid, logical advice on how I can learn to cope with this?  More than anything, I want to help this child and I know that the move here is the absolute best thing for HIM.  How do I accomplish anything positive on a consistent basis considering the absolute hell my life is about to become?  I become utterly exhausted every single day before noon when he's here.  It's a terrible feeling to have worked hard enough to be able to retire at 45 to the peace and quiet of your own books and flower gardens and working on your home and then find yourself dreading being in your own home.  I know that sounds absolutely horrid, but I don't know any other honest way to describe it.  I feel like I'm losing my otherwise fairly easy going (bordering on BORING) mind when this poor child is here.  There is not ONE minute's peace. 

Any suggestions from anyone who's been there/done that for adjusting to this complete 180 degree turn in my life for the next 4 or 5 years?  Especially a step parent who found themselves in a similar situation that is totally new for them?  And for the child?  I feel certain that I have to learn to cope and keep myself together in order to have even a chance at helping my SS learn to improve HIS life.  But how do you save a drowning person who is fighting you and pulling you under?  Those of you with ADHD or with ADHD children, please understand that this is foreign to me and I'm just in fear of losing my home as I know it, my new marriage, and my very peace of mind.  We all have different stressors and different levels of tolerance for different things.  Constant stress of this magnitude, regardless of the fact that my SS can't help and didn't ask to be born with this disorder, can result in disaster for all concerned when you find yourself almost constanty just wanting to retreat to the bathroom and lock the door and turn off all the lights. 

 

 

Wow, I read your post and dropped a few tears for your SS. I can only imagine what HIS life has been like with his bio mom. How horrible. I also agree with some of your comments like giving him meds to babysit. I am sure you are right on that one!

You are so on target with my next comment - get him reevaluated. Start fresh, all of you! Then you will be able to have some type of control over the situation. He is probably suffering inside and you are about to set him free!

You as his step mom are the best thing to happen to him! Just look at you, you are here asking for help for him! You are awesome!

Please post any updates with you and your family! I am excited for you all. Keep in touch!

Beth

Okay, first of all, know that you are NOT alone, and try to breathe!  You don't sound horrid; you sound human.  Yes, this is going to be a tough adjustment for everyone involved, but you are tougher, and you will make it through this and be stronger, kinder, and more loving for it.

Next: definitely need to have the SS re-evaluated, and all the meds.  Get a second or even third opinion as well.  What are the diagnoses or diagnosis?  Ask about intervention programs, behaviour modification programs, support groups, counselling, school support, everything you can think of.  How does SS do at school?  The friends issue is concerning; what drives them away?  Is he violent, inappropriate, rude, what?

Also: have a heart-to-heart with hubby.  Where is he with all of this?  What are his concerns?  What are the ground rules of the house going to be?  What is acceptable behaviour and what is not?  Who will discipline (and how)?  Some family counselling with a parenting specialist may be in order.

I know that's a lot, but looking into every possibility will help come up with a feasible game plan.  Hang in there, and let us help if we can.

Gin
What a great thing you are doing to help get him out of that situation with his mother! The number of stims he is taking could indeed be the issue, depending upon the strength of course. I agree that the best thing to do is to take it one day at a time, get him reevaluated once he is settled in, and try to adjust the meds, while incorporating some therapy/counseling, and perhaps an ADHD coach as well. Learning coping strategies is important as he grows toward adulthood. Perhaps after he is moved in and on a more even keel 24/7 365 days a year, he will tone down a bit as well.

Keep us posted, and ask any other questions...I am afraid I cannot be too much help right now, but hopefully someone else will chime in...

(((hugs to you))) and keep up the good work!

Welcome to the board! Everyone in the messages above had GREAT advice. I'll just add a few humourous tips...

I was there with a foster kid if that's any help. And you're describing EXACTLY how I felt about this brilliant, troubled kid. I wanted to run away from home.

I did a few things and I don't know if any will help but you can try. His family was stunned by the difference in him although to me--he still had the attention span of a gnat. In 15 years they had *never* seen him sit in a chair for 10 whole minutes. When he did that--they thought I walked on water.

Now I *have* ADHD so I could keep up with some stuff but he even wore ME out!

BTW, he was on NO meds and I had no legal right to give him any. So you can imagine the mess.

I can't guarentee any of these WILL work..but some *might*
ROUTINE ROUTINE ROUTINE. Routine is comforting to kids who are bouncing. It helps us keep track of day/time/event because we have no internal clock. He may fight it but believe me, over time--it's one of the greatest gifts you can give.
If you can afford it, or check out the free activities he likes-- so you get a few minutes peace. You know he can't function with a social group at this point but you'll go nuts if he only depends on your company. I had this kid in a school that had a jazz choir. The teacher was spectacular with him. That got him out of the house and gave him some confidence as well.If he likes music--get him the instrument of his choice. He will HAVE to function and it will increase his focus. Find SOME interest that can increase his focus. If he's not violent I know ADHD parents who swear by karate.
Get him some wild video games that move fast. Put a computer somewhere YOU aren't [like the basement]. If he's busy shooting ghouls he's not bugging YOU.You and hubby make SURE that you go places without him. Otherwise you will start plotting homicide in the bathroom together.Morning coffee. Oh yes, me too. I actually TRAINED him not to speak to me before my morning coffee. I wouldn't respond to a word he said. After my 1/2 hour was up [timer]--I immediately had a conversation with him as a reward. Took months.Don't use "grounding". The only one who is going to suffer is YOU. Be more creative. Punishment rarely/never works on these kids anyway. Make HIM come up with a solution when he misbehaves. If you can--get him to agree to it. Try making him take responsibility instead of using punishment. I'm sure there must be books about this online.
Plan a WIN. Yes, I know it's very manipulative. Find something he *can* do. Ask him to do it. When he does it--praise him. You need leverage. It's cheap and sleezy but hey--if you can get SOME compliance, go for it.Keep your sense of humour. Most of these kids can be incredibly funny.
Make sure DAD keeps up his end of the deal. After all, the kid will be out of the house one day but he's also his father's responsibility.You've got TIME. Rome wasn't built in a day and you aren't going to straighten this kid out in a week.
I'd tell him straight up, "If you talk all the time, I can't listen anymore. My ears have limits. Is there something you NEED from me?"
When you speak to him make SURE he's looking at you and get him to repeat what you said back, in his own words to insure he heard you correctly. Do not use more than 3 sentences.
If, after all this you haven't tossed him in a wood chopper you've done an excellent job and pat yourself on the back with both hands then hug your husband!


MetisRebel39212.4100810185

Diane,

What kind of evaluation are you advising that I (we) request of the school?  Do you mean an academic evaluation to determine what grade he should be placed in when changing schools? 

 

MetisRebel:

Thanks for the dose of humor.  But shame on you for making me think of something else to dread.......(kidding, of course)

My SS joined his middle school band this year.  Trumpet.  (thank God it's not the clarinet or the drums)  He calls us often, demands being put on speaker phone so he can give us a concert.  All joking aside, he's really horrible with that thing.  He brought it here with him once (Christmas break).  I thought I'd die one night when I woke up at about 2 am to the sound of that trumpet blaring from the bedroom above me.  If he chooses to continue in band when he moves here, I guess I better get ready for that horn, hadn't I?     

Hey MetisRebel, You are so OK in my book!! Anyone who fosters children is an A+!! You have a fun sense of humour, however, you did bring back a memory that I had forgotten for the past 8 years!

I too wished he had stayed with you longer. Just look at what you had done for him. His family obviously wasn't interested in helping him, poor guy!

Keep posting with your personality, we need it around here! Your awesome!

You go Foster Momma!!

*blush*

If I didn't have humour I'd have gone bananas long ago with this.

Hallowell said ADHD'ers are irrepressible and I believe that's true.

We go "down" but then we forget what we were "down" about and like Tigger--UP we bounce again!

We are the people that need humour the most.

Speaking of bouncing--if I don't swamp out the dishes I will soon starve
[QUOTE=chasesmom79]If you are planning on medicating him once he is with you, the meds will have to be divulged in entrance paperwork, so the school will know what he is taking day to day in case of an emergency. Good point.  And I think I've heard from someone that if a child in this school has to take meds during the school day, the school has to dispense them.  If they get caught with meds on their own, everybody's in trouble.  Probably a really good rule.   Just the list of meds will tell them of his disorder, as will his records that will have to be transferred from the old school to the new, making your husband's stance moot. Even if you don't tell them, they will have the proof in front of them.  I don't guess either of us have thought about that. I'll point that out to my husband next chance I get.   

That being said, since they will already be aware that he is ADHD through the paperwork, you may as well get in there and begin the process of accommodations to help him succeed to his best ability. Accommodations such as reading tutors, and someone to read the problems aloud to him , if that would help him to be able to solve the algebra problems, fewer problems for homework, extra time on tests, a quiet room to go to for test taking....anything that you think will help him to do his best in school.

I agree with him repeating the 8th grade, considering that it is a new school, and no one will be the wiser, and that he is struggling. A year of less demanding work while you adjust the meds will be a boost to his self esteem. Thanks.  Given my husband's fairly significant opposition to this thinking, it's of some comfort to know that someone else sees this as being the best for him.  Granted, if he repeats a grade, given that the plan is for him to live with us until he graduates, that adds a year to the time he'll be here with me.  But......

As soon as you can, you need to see what kinds of things are available to him at the school. Since you have a friend there, she may be able to discreetly find out some things for you. Sometimes accommodations can be a battle, with the school fighting you every step of the way, sometimes a school is very willing to help in any way that they can....you won't know how this school is until you try. Look in the "school issues" forum for some good websites to go to so you are aware of what the LAW requires...the schools sometimes skirt the law, and if you are informed to refute anything they claim that you know to be false, it will help. Again, there are some schools that are quite accommodating (mine is one of them), so go in with the attitude that you can catch more flies with honey....there is always time to bring out the big guns later if need be....

Also, get in touch with a good child psychiatrist in your area..is there a children's hospital close by that you can call? No children's hospital here.  Very few psychiatrists here either.  Small community.  Not a lot of resources, but it's my understanding that the options we have here locally are pretty good ones.  Look into a social skills class that he can possibly attend over the summer, to help him learn the skills he needs to know to better fit in with the other children his age. Sometimes these things need to be taught to the child, and social skills classes can do this for them.[/QUOTE]

hay MetisRebel, how is your foster son doing? I am interested in the end of the story. Did they ever try meds?

My son is ADHHHHHHHHHHHHHHHHHHHHHHD and in early intervention was described by a aide as having the attention span of a gnat, he was 2 at the time and they were throwing around autism. The aide was fired by someone at this program. I have NEVER heard that description before or since.

Also, your ending description of throwing the child in the wood chopper, is just as disgusting. Maybe they talk like that where you are from, but it is disgusting. I think of the movie Fargo with the wood chipper!

Oh, Lord !!!  Thank you for the support and encouraging words !!!!  Right now, I think that something like this forum is my only comfortable support system.  Besides, as a suth-un-er, I can type faster than I can talk.  And I don't talk so good when I'm blubbering with big tears (NOT a good crier here, folks.) 

With regard to the meds my stepson is on:  My first concern, aside from the volume, is that they're prescribed by a physician's assistant.  Not an MD.  No offense intented to PAs intended here, please. As I understand, his mom calls the office, reports behavioral issues that are driving her nuts, and the PA routinely increases and adjusts meds accordingly.  It's my understanding that he only goes in for check-ups (again with only the PA) once every six months.  Is this schedule normal? 

He's on 2 Strattera and 1 Concerta (or vice versa) each morning.  I'm not up on the mg's of each, but my husband recently told me that each med was being prescribed in its highest per pill strength.  He takes one more of one of those plus a Focalin tab in the afternoon.  I'm drawing a blank on the name of the tranquilizer mom is giving him at 8 pm daily. 

My husband can be a walking, talking contradiction on this issue from one day to the next.  My guess is that he is HD himself, but growing up in a military family and going to parochial schools through high school likely gave him the needed structure to cope in a day when medicating kids for behavioral issues hadn't even been thought of.  He's hyper, but it's usually great !!   You wouldn't believe his ability to keep things around this house in top knotch working order !!!  He's always on the go, working on something.    My girlfriends are constantly asking if we can trade husbands for a weekend because they've got something that needs fixed and they can't get their own husbands motivated and off the couch to deal with it. 

That having been said, my husband can be very defensive about other's perception of his son.  When we talk about it, I often sense (not always) that he resents the 'stigma' attached to all of this by others and that he sometimes can't see the forrest for the trees.  Don't get me wrong, he's a wonderful man.  But he is also a parent who wants so badly have a normal, well-adjusted, great kid that I sometimes think he chooses to ignore the problem instead of getting in "repair mode."  He doesn't want to put the new school his son will be attending when he moves here on notice that he's ADHD.  (he seems to think no one notices?!?!)  He has this notion that making arrangements, talking with the school, ahead of time will result in creating a prejudice against his son... that the teachers, etc., will have him categorized and pigeon-holed as a problem before they ever lay eyes on him.  He's very in favor of us all getting counseling and medically reevaluating his son, but I think he's got his head in the sand about "hiding" this from the rest of his son's world.  His determination to keep his son from being "descriminated against" and labeled as something other than your average old kid seems a bit bigger than dealing with the problem.  So, which comes first, the chicken or the egg?  If you don't deal with the problem, it seems a little backward to think nobody's going to "notice" and that, if we don't divulge the problem, it won't be a problem. 

Regarding how he's currently doing in school:  He's finishing the 8th grade.  Early in the year, his mom told us he was making nearly straight A's.  Now, we learn that he's in danger of failing the 8th grade.  I've noticed, when he's here, that his reading skills are at about the 3rd grade level, in my NONprofessional opinion.  I asked him about school and he actually told me that he's having a lot of problems in most classes as the result of his reading difficulties.  Hard to function in pre-algebra when you can't read the word problem, he says.  (and I think it's great that he recognizes this!)  Please understand, this is an incredibly bright child.  I honestly think he's capable, or could be, of being a straight A student if and when his behavior can be gotten under some semblance of control.  Given that his emotional/social maturity seems to be more that of a not-so-well behaved 6 year old, on top of the fact that he will likely end up barely passing the 8th grade, I've been trying to lobby for him repeating the 8th grade when he moves here.  My (again NONprofessional) thinking is that repeating the 8th grade would be much easier for him academically and might give the maturity issues a chance to catch up a bit.  I fear for him becoming the butt of every joke and every prank (given his current behavior) if he enters school here as a freshman who is behind the learning and social curve.  A friend of mine is a counselor at the high school AND she has spent time around my SS.  She agrees with me.  She says that the high school kids will have him for lunch.  We'll be fighting 10 fires at once (grades, peers, maturity, new school, etc) all at once, in my opinion, if he goes straight into high school as a freshman behaving like a 3rd grader.  If we could have one year of making things as easy as possible in adjusting to the move, it just looks to me like the chances of success would be greater.  There'll be no "stigma" attached to repeating the 8th grade because no one here will know.  But my husband is obviously VERY opposed to this for a number of reasons. 

As far as the friends issue goes......this age is just a difficult time in anyone's life.  I've raised 2 kids of my own.  My husband has never really 'raised' his.  I would honestly place my SS's maturity level at about 6.  And even at that, my kids didn't act like this at 6.  In his mom's neighborhood, the kids his age just won't play with him or include him because he acts like a "baby."  Kids at 14 are going to movies, getting interested in girls, writing notes to each other and all that jazz.  My SS watches cartoons, plays "puppets" with inanimate objects (talks to himself), giggles and fidgets and just comes on very strong with other kids.  In their faces, picking and poking and begging for constant attention and interaction.  He wants to fit in so badly, but tries so hard he drives other kids nuts.  I have seen his frustration turn to anger when kids start shying away from him (their first course of action when they've had their fill of him).  When they start avoiding him, he comes on stronger.  Eventually, their reactions are stronger, sometimes just telling him to leave them alone, they don't like him, they don't want to spend time with him, don't want to be his friend anymore, etc.  That can sometimes provoke a fight, but not often.  The result of all of this is that he plays with 6 year olds all the time after school.  He's obviously bigger and stronger and probably rougher than they are, so their parents are always on the watch.  Let's face it, it's not necessarily a comfort to know that your 6 year old daughter's best friend is a 14 year old boy down the street.  Just kills me that his only "friends" are parents and older siblings. 

 

 

First, welcome. And everyone's right.......breathe.......so easy to say isnt it .

All the things you are doing are perfect. This si going to be quite and "adventure" for you all! I agree a PA should not be ther person managing the meds. He needs a psychiatrist. Ideally a psychopharmcologist. Has he ever had a full neuropsych evaluation? My daughter is 12, also reads at a third grade level. We just got the school to give us a tutor.  Will he be at the same school after summer? If not, call the new school and go in and meet them. Request an evaluation now. I takes forever. This will be a lot of adjusting for you all. It is going to take time and a lot of patience.

If you are planning on medicating him once he is with you, the meds will have to be divulged in entrance paperwork, so the school will know what he is taking day to day in case of an emergency. Just the list of meds will tell them of his disorder, as will his records that will have to be transferred from the old school to the new, making your husband's stance moot. Even if you don't tell them, they will have the proof in front of them.

That being said, since they will already be aware that he is ADHD through the paperwork, you may as well get in there and begin the process of accommodations to help him succeed to his best ability. Accommodations such as reading tutors, and someone to read the problems aloud to him , if that would help him to be able to solve the algebra problems, fewer problems for homework, extra time on tests, a quiet room to go to for test taking....anything that you think will help him to do his best in school.

I agree with him repeating the 8th grade, considering that it is a new school, and no one will be the wiser, and that he is struggling. A year of less demanding work while you adjust the meds will be a boost to his self esteem.

As soon as you can, you need to see what kinds of things are available to him at the school. Since you have a friend there, she may be able to discreetly find out some things for you. Sometimes accommodations can be a battle, with the school fighting you every step of the way, sometimes a school is very willing to help in any way that they can....you won't know how this school is until you try. Look in the "school issues" forum for some good websites to go to so you are aware of what the LAW requires...the schools sometimes skirt the law, and if you are informed to refute anything they claim that you know to be false, it will help. Again, there are some schools that are quite accommodating (mine is one of them), so go in with the attitude that you can catch more flies with honey....there is always time to bring out the big guns later if need be....

Also, get in touch with a good child psychiatrist in your area..is there a children's hospital close by that you can call? Look into a social skills class that he can possibly attend over the summer, to help him learn the skills he needs to know to better fit in with the other children his age. Sometimes these things need to be taught to the child, and social skills classes can do this for them. [QUOTE=BETHANN]

hay MetisRebel, how is your foster son doing? I am interested in the end of the story. Did they ever try meds?

My son is ADHHHHHHHHHHHHHHHHHHHHHHD and in early intervention was described by a aide as having the attention span of a gnat, he was 2 at the time and they were throwing around autism. The aide was fired by someone at this program. I have NEVER heard that description before or since.

Also, your ending description of throwing the child in the wood chopper, is just as disgusting. Maybe they talk like that where you are from, but it is disgusting. I think of the movie Fargo with the wood chipper!

[/QUOTE]

Sorry if my comments offend you. I'm not particularly politically correct and diplomacy is not my strong suit. I am trying to describe feelings and observations in descriptive terms, not psychological terms that often not descriptive.

All two-year-olds have short attention spans so I just don't get why one would describe their attention span that way? Having been an auntie to 13 of them PLUS a foster kid that age I can't understand it. I understand if the kid rockets around the house like a ping pong ball--that might worry me.

The boy went back to his mother's house in a different town. He didn't do well. [for the first time he had A's on his report cards at my house]

A few years later I heard from someone who saw him.  He wasn't doing well [still no meds] had been kicked out of the house and was living with his sister. He told her he wished he could have stayed at my house longer because it was 'calmer' and he really liked the activities we had going for him.

Where he is now, since I live far away, I do not know.

I wish him the best though--he was brilliantly funny, creative and troubled.


MetisRebel39212.4810185185 [QUOTE=Stepmom1962]

MetisRebel:

Thanks for the dose of humor.  But shame on you for making me think of something else to dread.......(kidding, of course)

My SS joined his middle school band this year.  Trumpet.  (thank God it's not the clarinet or the drums)  He calls us often, demands being put on speaker phone so he can give us a concert.  All joking aside, he's really horrible with that thing.  He brought it here with him once (Christmas break).  I thought I'd die one night when I woke up at about 2 am to the sound of that trumpet blaring from the bedroom above me.  If he chooses to continue in band when he moves here, I guess I better get ready for that horn, hadn't I?     

[/QUOTE]



Are you telling me Gabriel he's not?

At least my foster kid played guitar--I let him have an old accoustic of mine. Much quieter. Maybe you can convince him to be a rock star instead.

Yes an academic and psych evlauation. Especially if he has never had these. As the parent you can request this. It obviously does not guarantee he will get services, but sounds like if he is reading at third grade level he needs them. Schools dont just repeat grades that easily either. I think instead of trying to figure all this out in your own head before he even comes is too much. Call the school and go see them. Dont hide anything from them. There is no reason to do this. Most school's want to help the child. I think being up front is best. Get his records and bring them with you. Try to do it now so things are in place for next year. Dont be defensive and afraid you wont get what you need. I get everything I ask for. I DO realize I am lucky, but I also have to think of it first. Some things I have fought for. That has all come with experience and some really hard knocks though. We live and learn.

As far as the other stuff, obviously he will be told no trumpet playing at 2:00am. There needs to be house rules. He probably doesnt have many now and that in itself is not good. I think you'll be surprised with some firm house rules, lots and lots of routine, lots and lots of love and attention, he will do well.

Well there's another bright spot. Make an appointment with a new pediatrican in your area. Maybe you can get his current medical records now and have a meeting prior to his initial visit. Some things may be best explained without him present.

Yes, he'll have new everything when he moves here.  He's coming from almost 500 miles away.  New docs, new school, new everything. 

I don't have access to a psychiatrist, either (small community too), but I have a WONDERFUL pediatrician, that manages my son's meds. Most people don't recommend using a ped, but mine is very good about 'counseling' both Chase and I at each med check, which have never been more than 3 months apart. And she has never upped a dosage, or added a med over the phone...we have to go in for an appointment for that. Each appointment lasts from 45 minutes to an hour with her asking Chase how things are going, how he feels with the meds, and if he has any issues at school or home, before asking me the same things and discussing options for any that have come up. I assume that this is what a psych does, but I have no experience with them so who knows?

Good luck and let us know how things work out. will he have a new pediatrician with you?You can start there. Maybe a complete break form the old caretakers and new start across the board will be good. There are plenty of pediatricians who do med management. We also live in a small town, but our pediatrician  is not comfortable with all the meds  and adjustments my daughter needs. We are lucky to have a pediatric psychopharmocologist in the area. Although it is quite difficult to reach him as he has well over 200 patients.