Medication for children

[hollytree1]

I wanted to ask if anyone uses/has used medication for their young child to support in regards to their mental health/aggression/anxiety type needs.

I've raised it with the paediatrician but she did the usual, oh we could refer to the team and a support worker could help you identify triggers. My head was a bit mashed as the clinic always runs way behind so by the time we got in I'd been wrangling DD in the waiting room for over an hour and she had absolutely had enough. I will go better prepared next time and spell out what our day to day looks like, my responses and pro-activeness etc. and also what my therapeutic parenting looks like, doing a parenting course is not going to cut the mustard. I cannot keep going on with the current level of anxiety and resulting violence, but also she is only 6, but I honestly can't see another thing to try. I just think there is no way it would be okay to let an adult live with such anxiety, and so it shouldn't be for her either.

@hollytree1

I look at it this way, if she was poorly would you give her Calpol, if she had cancer would you want chemo, if she was diabetic would you want insulin ?
You get my drift.
People have no issue for appropriate medication for physical illness but back right off for mental illness or anxiety disorders etc.
If you think medication would help then go for it. You and her are the ones living with it.
I know so many children and young people on medication. The ones old enough and able to articulate their feelings about it say that the medication gives them the capacity to function 'normally', to focus at school, take part in activities etc.

When you’re thinking about medication are you meaning anti-depressants, which are often prescribed to adults who struggle with anxiety? The reason I ask is that in the UK it would be very unusual for a child of 6 to be medicated in that way - GPs won’t prescribe for one so young so you’d need a referral to paediatric psychiatry. Part of the issue is concern around how psychoactive medication might affect the developing brain. While I completely agree with @Ted27 that medication for mental health is no different than for any other health issue, in that if it’s needed it needed, in many cases doctors won’t prescribe for children in the way they do for adults because of the potential impact on their development.

With a child so young I’d expect to see therapeutic interventions first so different types of child centred therapies, helping her to learn how to self regulate etc. Referral to a support worker isn’t a criticism of your parenting, it’s because at her age any support for mental health issues is by necessity going to have involve to you working with your daughter helping her identify her own feelings and supporting her to use different strategies to manage this. I also think what’s termed therapeutic parenting can a) be a bit hit or miss and b) isn’t always helpful in anxious children because there are too many moving parts and some children just aren’t able to cope with the closeness that therapeutic parenting tries to engender. So being able to think “is what I’m doing working for this child in this circumstance” can be an incredibly helpful process to go through with an impartial other.

Even with medication it will be important to do therapeutic work with her to address the underlying causes of her anxiety and aggression. Sometimes medication can give enough emotional capacity to do that work where someone otherwise might be too overwhelmed to address their underlying trauma etc but even in adults medication is far from curative, you’d still be looking at her needing good long term therapeutic support the nature of which would change as she grows. That’s next to impossible to access through CAMHS, so you might be looking at post adoption support for that.

I don’t want to minimise your experience or the impact anxiety is having on your child and on you, but I honestly think you’ll have a challenge persuading a doctor to medicate your child without having tried a lot of different interventions and supports first.

Thanks both that's really helpful.

Apologies I should have said in my post, I've posted before but the brief overview is that DD has a brain injury from NAI and so has severe/profound learning disabilities, functioning around the 12-18 month stage, communication is only via reading facial expressions and body language. I know that communication and language development is affected for children who have trauma but this takes it to the next level and means we get really 'stuck' as she can only learn from experience/repetition but can't relax enough to allow anything to happen (small things like getting a familiar toy out, going to a familiar house). My goal is to 'take the edge off' to allow her to develop, then reassess if it's needed.

@Jellycatspyjamas What you said was really helpful, thanks. Yes it was anti-depressants I was thinking of, I wasn't aware of the effect on young children's developing brains so will research that more. It would be a referral to the psychiatrist on the children's learning disability team that I would seek. The problem is that I don't think they have much experience of adopted children although I'm sure (hoping?!) they have lots of experience of trauma in children. I absolutely understand what you are saying about the support worker not being a criticism of my parenting, but my experience of similar professionals does not fill me with any confidence and I have had a lot of input into my parenting of her and feel I've worked incredibly hard and yet everyday is such a significant struggle. We have tried theraplay and music therapy but both therapists quickly withdrew because of her behaviour and distress in the sessions and didn't feel they had the skills to support us, I then had theraplay 'sessions' 1-1 with a SW to then go and input what I'd learnt but don't feel we got very far. And I suppose ultimately I feel that while she is living with such high levels of anxiety it's unfair expecting her to manage anything anyway. However I do take what you're saying on board and will reflect on that.

I know that communication and language development is affected for children who have trauma but this takes it to the next level and means we get really 'stuck' as she can only learn from experience/repetition but can't relax enough to allow anything to happen (small things like getting a familiar toy out, going to a familiar house).

That makes sense and is one of the times when medication can really help - she can't learn when she's feeling so anxious, medication can ease things enough for her to take in new information at a pace she can cope with. That isn't going to be eased much by you changing your parenting of her because presumably anything you change heightens her anxiety which brings you back to being stuck. Therapy is going to be tricky in those circumstances because the very act of seeing someone new and them trying therapeutic work is likely to spark the same kind of anxiety and get in the way. I also wonder if they are working with her developmental age - for example I wouldn't do art therapy as such with an infant beyond using it for sensory input because the cognitive processing isn't there. Theraplay is a good low key intervention but, again, the child needs to be relaxed enough to cope with it.

Where I am the CAMHS team have a specialist service that assesses neurodevelopment, trauma and learning disabilities in one which means they take an holistic approach instead of splitting X as neurodevelopment, Y as trauma and Z as something else. They're under the umbrella of looked after/care experienced children and are pretty good at combining medication with other types of therapy. If there's such a thing in your area it would be a good call to seek referral there rather than under learning disabilities because, as you've said, the learning disabilities team may not have a good understand of the adoption/trauma aspect which may be keeping her on high alert.

In your shoes I would be strongly pressing for a psychiatric referral and the need for her to have something that settles her anxiety. They are very reluctant to medicate small children but there are exceptions to the norm and your DD sounds like she would benefit from the emotional space that drug therapy can give.

It might also be worth looking at third sector organisations that work with acquired brain injury in children - you might find they have a better understanding of what you're dealing with day by day and more useful resources or support.

We have medication for our youngest which has been a game changer. It was prescribed by psychiatrist at CAMHs. Feel free to pm me.

@Jellycatspyjamas thanks all that info was really helpful and you articulated what I have struggled to put into words about it being hard for the change to come from my parenting as that adds to her stress and anxiety because it's a change. That's really helpful to hear about the camhs team, I don't think that exists here (I think there is only a looked after team for those who are currently looked after, not PLAC) and it was the paeds consultant who said it would need to be the learning disability service but I will double check. Without outing yourself could you let me know what the team is called or the names of similar teams, that might give me a better chance of finding it if it exists? I will push hard with the paeds dr when we see her this autumn.

She has been unusually settled and calm yesterday and today, (this happens every couple of months or so) and it got me thinking; lots of people have said to me that she goes from '0-100' in a second, but what it actually is it that she lives at '98', so at any point can tip over to meltdown at 100. Today although it was still tantrum city and we had lots of issues, and I as always was very low demand in my parenting, we weren't constantly at crisis point and that would be my goal for medication.

@Therapeutic70 thanks so much I will message you