[louise]

I surely understand the feelings that can go along with receiving the kind of news you and your DH were given today.

And, as usual, I have more questions than platitudes.

As it happens, I attended, just today, a training on diagnosing and recognizing FASD/ARNDD. Much discussion was had regarding the differential diagnosis of FAS/E as opposed to RAD. And how do you then implement interventions and treatment modalities?

So, I would ask, did the doctors evaluating your son consider FAS/E or is their predisposition to look for and diagnose RAD? One thing I have learned, is there seems to be no such thing as a completely objective diagnosis when it comes to mental health issues. It all depends on which particular filter the practitioner happens to be operating from/behind. So, a clinic set up to look for FAS/E is going to find that more than a clinic looking specifically for RAD. A practitioner trained in looking for depression and with a particular interest in that malady will find depression to be the primary diagnosis. And then there are the professionals who don't or won't recognize one diagnosis or another. Everybody has an agenda, so to speak (can you tell I've been round the block a few times on this one??)

So, where does that leave us parents??? To me it feels like swimming in a swamp. Not only do I deal on a daily basis, with my children's immediate needs and complicated issues, I also have to try to figure out just exactly WHAT it is I am trying to wrap my brain around!

Here is the dilemma I see with ANY of the newer diagnoses being bandied around in the last few years regarding our children and others like them. Not only do the professionals not have the whole picture/all the information regarding FASD, RAD, childhood onset bipolar, ADHD or any other number of illnesses new to childhood, we and they tend to grasp onto the newest acronym as soon at it comes to the public's attention. And what a natural reaction that is for us as parents....we want so badly to assist our children with the best possible interventions/medications/treatments available to them and to us. We look for answers and solutions to the very real problems our children face and will continue to face in the future. I am beginning to wonder if there are no answers...yet.

The most apparent difference I see between RAD and FAS/E is that one is supposed to be fixable (RAD) and the other not. This poses a difficulty, mostly in expectation and mindset. Outcomes for a treated RAD child is supposed to be positive, outcomes for an FAS/E child probably more ambiguous. The actual interventions are not that different in terms of parenting and/or intervention IMO as many FAS/E children also have attachment related issues. Where the issue may become difficult is in the possibility of misdiagnosis, only recognized when the child fails to improve according to expectation and because an FASD the child CAN'T improve beyond a particular point. Then we and our children are left dealing with yet more disappointment and feelings of failure.

We have struggled with these issues in a very personal way. At this point in time, Olivia will be evaluated by a genetic specialist at Stanford Hospital in the next few weeks. I am positive that she clearly has FAE along with issues of attachment related to that. Her secondary disabilities are depression and suicidal tendancies and ideation. The reason we are pushing for a definitive medical diagnosis is future ease of service implementation and, to be perfectly honest, leverage in getting the other professionals involved in her care to take the implications of ARNDD more seriously.

To sum up my thoughts, Barki, I hope you and you family find whatever services you think might best meet your son's particular needs. Keep an open mind and don't be sold a bill of goods by ANYBODY, no matter how qualified they believe themselves to be! And if you continue to have questions about your little boy, do not hesitate to seek a second, third or fourth opinion.

BTW, have you looked at the FASD clinic in Seattle? Groundbreaking work being done, cutting edge...just a suggestion.

Fondly,