I want to say first how important the neuropsych evaluation is to Bear's treatment. That evaluation gave us what I feel is an accurate diagnosis and told us more about where we need to head. It also told us part of why he was not responding to Attachment therapy. He has sensory integration dysfunction. Don't you love all these names? One part of that is a tactile dysfunction. In other words, physical things bother him: touching, the way clothes fit, being barefoot, flying insects, a wobbly desk. If you think about those things in a home setting or a school setting you can see how they are disruptive. We went and had a new family photo taken a couple of weeks ago while the oldest was home. He was so upset about the gnats he would not stop leaping and swatting. We were all standing their waiting while he yelled "The bugs! Why are they swarming me." He really thought they were only around him. If I touch his arm he sometimes says "ouch". He does not like tight touch, tight clothes, tight ANYTHING. It is possible even a tight hug hurts. All of these things interfere with attachment because he is so irritated or hurt by so much of human contact he is completely focused on that discomfort and not people. He does brushing, puts on lotion and walks in the grass barefoot daily to work on these things.
He has some mood disorders I don't feel comfortable going into because some of you know him and I feel they are personal. They of course interefere with attaching to other people. When you are dealing with these types of emotions you do not and cannot focus on other people. Hopefully the right medication will help with this. We are still working on it.
He also has some memory issues. This is tricky because one of the things kids with RAD say often is "I forgot." So now we throw in the fact that he really does forget and try to deferentiate between real forgetting and not wanting to answer. It requires some careful answering on my part as I do not want to assume either one. The games to help with this are Concentration or Memory. The difficulty is that most games you purchase are for preschoolers. Guess Who is another good one. We use a deck of cards to make our own memory game.
And last is his visual perception. This is mainly an issue at school but even in every day life may look like a lack of common sense. He sees things differently. So he does a variety of puzzles, games and such to help. There are times he is sitting there doing a puzzle and it looks so obvious to me that he has a part backwards. These are mainly tangrams, parquetry and any of the ThinkFun Games. You can find these logic games at Target by the way. Yesterday at OT we discovered he not only has great difficulty copying from the board (which we knew) he has an even harder time copying from hard copy right next to him. So we are going to request that he try to take notes when they want but that the teacher give him a typed copy of notes for tests and such as well.
People are complicated. If only it were as simple as RAD or ADHD or Visual Perception. Combining several diagnosis makes it more challenging to treat. We can do our best, find professionals we trust and pray. After that we must trust and wait. Not two things that are always easy.