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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Schuyler on July 18, 2002, at 7:26:14
Please help. My girlfriend's son, 14, has pretty severe Downs Syndrome and just entered a residential school last year. Recently he started new behaviors that got her worried: hitting his head against the wall, scratching himself hard, and crying for no apparent reason.
Several years ago he was diagnosed with ADHD, and now he has just been diagnosed with BPD, and the pdoc prescribed Depakote. This situation raises a *lot* of questions, I know, but I only want to ask 2:
1. Assuming that he *is* BPD, what is the best med to give a boy who cannot talk to report side-effects to you, and whose side-effects might not be recognized immediately by his care-givers, who have several other children to care for?
2. Can you reliably diagnose BPD in someone who cannot even talk (beyond single words for objects in his environment)?
I know that my gf has to be alert (and she is) to the possibility that his new environment (and even abuse) might be triggering these behaviors, but please, I am not asking that question, OK?
Thank you very much. ---Schuyler
Posted by somebetter on July 31, 2002, at 10:37:33
In reply to BPD, ADHD, and Downs Syndrome, posted by Schuyler on July 18, 2002, at 7:26:14
I'm sorry I didn't answer this sooner and I hope you're still around to read my answer. I think you are right to be concerned about what is happening with your girlfriend's son. I would question a diagnosis of BPD in an individual with severe Down Syndrome, especially if he is essentially non-verbal. (But keep in mind I don't know anything about this child.) I would look into the treatment center for possible explanations for the new behaviors. I'm not accusing anyone of abuse, but is this place the best place for him, are his particular needs being met there? Are there reasons for his frustration? Also, he is 14 and he will go through adolescent changes the same as children without disabilities. None of us escape that. How he experiences it and how it is expressed remain to be seen...or you may be seeing some of it already. I hope your girlfriend will consider another physician's opinion, if she can locate one who is familiar with children with disabilities. (even if this guy was) Check with your local disabilities board or chapter of the American Association on Mental Retardation for names. I know you said you didn't want input on the environmental aspects,but the diagnosis of BPD shoots you right back there. If this child has severe Down Syndrome I find myself questioning the ADHD diagnosis as well. But, again, I don't know this child's history. You do, and you're expressing doubts and the best I can say is that they are intelligent doubts that you probably should act on.
I don't know how to answer your question about side effects other than there are visible things to watch for with different drugs. I'll ask around and try to come up with a better answer for you on that one. I'm glad she has your support. Good luck to you all.
Posted by schuyler on August 3, 2002, at 6:17:47
In reply to Re: BPD, ADHD, and Downs Syndrome, posted by somebetter on July 31, 2002, at 10:37:33
Thanks for the thoughtful and detailed reply. I'm going to discuss it with my girlfriend today.
I'm still very eager to hear suggestions for medications that might treat BPD with a minimum of side-effects, or with side-effects that would be recognized by the boy's care-givers, since he won't be able to report side-effects himself.
--- Schuyler
Posted by somebetter on August 3, 2002, at 9:01:10
In reply to Re: BPD, ADHD, and Downs Syndrome, posted by schuyler on August 3, 2002, at 6:17:47
I'm so relieved you got my answer. I'm going to ask someone tomorrow for advice on that. I'll get back to you then.
Posted by somebetter on August 3, 2002, at 9:15:59
In reply to Re: BPD, ADHD, and Downs Syndrome, posted by somebetter on August 3, 2002, at 9:01:10
Posted by somebetter on August 4, 2002, at 10:16:00
In reply to Re: BPD, ADHD, and Downs Syndrome, posted by schuyler on August 3, 2002, at 6:17:47
Schuyler, I hope you don't mind, but I started another thread to see if we couldn't attract a little more attention. I directed it back to this thread. There are many knowledgeable people on this board. With so many posts sometimes there are those which don't get noticed.
This is the end of the thread.
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