One of Bub’s therapists — as she should have — made a referral for behavioral therapy because of the bite marks, bruises, and wounds that he leaves on me as a result of meltdowns. A few days ago, during one such meltdown, he managed to score a direct hit on me headbutting me, and he did this so hard that I briefly lost consciousness. As a result, his initial behavioral therapy will be crisis management until things can be gotten under control, and then we are looking at therapy meant to help him better learn to cope with overwhelming feelings (or, in whatever communicative way works best for him, inform an adult that he can not do this so that the help he needs can be gotten for him), as well as to recognize when he is beginning to melt down so that he can take measures such as isolating himself when he does not want or can not safely have comfort.

I did the first part of the intake for the crisis management therapy yesterday over the phone, and I will finish what should be the last part of it today. Obviously I am completely amenable to all of this because I want Bub to be safe, and I want to be safe while providing him care. I am continuing to wait on his developmental pediatrician to increase the dose of the Risperdal that he is on, although that should happen in the coming days without complaint. The Risperdal has been helping out… he just needs a slightly stronger dose of it.

His developmental pediatrician chose to start him on Risperdal, which is another fun medication that is going to take time for me to learn how to spell… but I am. He will take this one during the day when he wakes up, and he will take the other medication before he goes to bed until further notice (or unless something comes up that causes us to have to retool his medication regimen, which I’m hoping is not the case because I want him to be able to take the medications that he is on without problem for awhile).

One day I will properly be able to spell clonidine on the first try. Anyway…

Clonidine wound up not working that well for Bub. Sometimes it was a hit, other times it was a miss, and it tended to be more misses than hits as far as consistently helping him achieve restful sleep went. So he was switched over to Mirtazapine (another medication that I am continuing to learn how to spell), which has actually worked really well helping him restfully sleep almost all of the nights that he takes it. The only problem with that is that his meltdowns have worsened over the last few months, and Bub is beginning to hit, kick, and pinch during these, which in turn is wounding the people that he does it to… and he’s even begun to have these meltdowns during therapy sessions with his therapists, which is particularly problematic since I would not mind as much if it were just me that his frustrations were focused on (“bad cop”). I put in a call to his developmental pediatrician asking if he could be put on something during the day to help him better cope with overwhelming moods, and I’ve been corresponding with them over the last few days to fine-tune what I hope is a helpful change to his medication regimen. We may try trazodone out.

Trazodone is not normally given to children, but it can be in some cases when benefits outweigh risks.

Luckily Bub was just seen by his developmental pediatrician though, so we’ve been able to start to sort this out over the phone rather than commute and bring him in for yet another visit… during a global pandemic.