Maybe if I talk about this enough and write about it enough, residential placement will seem less surreal. My son was having a tough go of it recently, and consequently, so have we as a family. We're again considering the possibility of residential placement for him.
He's on the autism spectrum -- very mild. One of the psychiatrists he's seen said that he'll probably end up being more "quirky" than most people. He's not great in the social department, likes to focus on his topics of conversation (trains, dinosaurs, fish, trains, dinosaurs, fish), and often gets "stuck" on his mad feelings. But whatever. It's not a big deal, as far as being on the spectrum isn't a big deal.
He's also got ADHD and Sensory Processing Disorder (can you be on the autism spectrum and not have SPD?) and anxiety. It's the anxiety that is the culprit here. It's the anxiety that we're having such an awful time managing.
He doesn't do anxiety like most people with severe anxiety do anxiety. He glides past the heart-pounding panic attacks and goes from that very heightened frightened state to psychosis. Clinical psychotic episodes are pretty rare for anyone, let alone a six-year-old. I mean, let's face it, kids are basically psychotic and imagine things all the time. But when I say my son is psychotic, I mean psychotic in the most horrible of ways -- where the imaginary ideas threaten to hurt him.
I think if he were simply hallucinating and delusional without the aggression, we'd be fine. But added to his mix of breaks with reality is fight, as in "fight or flight." When my son gets scared, he does fight, and fight with a physically gifted child has become unsafe in our house. On the dramatic end, I've been kicked down 9 steps on our stairway because "Bowser, Jr. was on the wall and told him to do it." In more everyday circumstances, I am usually sporting some bruise or scratch due to him.
What's hard for us is that while the PDD-NOS spectrum symptoms are present nearly always, anxiety with psychotic features (my diagnosis) isn't always apparent. He could go for days and days and days without an incident. Hell, he went for nearly nine months without one. But when they come back, they come with a vengance, which is when our household becomes unsafe.
So the question is whether to ride out the storms, which can be excruciatingly intense but then can dissipate (in which case things are "fine"), or to place him outside of our home where he can get the help that he needs for those times of trouble.
This has been a question that my husband and I don't see eye-to-eye on. Why should we, though? He's bigger than I am and can take my son's physical aggression more than me. I think he's feeling guilty that he can't always be with us to protect us. But that's just the way life goes, right? I mean if we could be everywhere and everything to everyone, would that make us something more in the category of a god than a human?
We're taking the road to residential placement slowly. I want to get another neuropsych work-up on my son, which takes a while. He's on the wait-list to begin testing sometime in June, which should take some weeks, and then we wait for the write-up, which takes some more weeks. The point is to spend time observing and really assessing our household and family life to try to figure out if this is in the best interest of our son and our family.
I'm not sure how people ever come to accept or determine that it's time for their minor child to live somewhere else, but I guess I'm starting to learn.