Children's Medication Toolbox: Managing, Monitoring and Improving Your Child's Response to Medication

By Dr. Bill J. Duke

This book does not debate whether medication should be used with a child. Many children receive medication and in those cases they monitoring and measurement of the effects is beneficial.
A related downloadable software program from DCC Publishing (www.dccpub.com) provides computer tools needed to make the process easy and useful.

• Language: English
• Publisher: BookBaby
• Release date: Oct 31, 2015
• ISBN: 9780964883871

Book preview

Definitions

INTRODUCTION

Managing, Monitoring and Improving Your Child’s Response to Medication

It is hard for parents not to feel angry, overwhelmed and fearful when dealing with a child that has significant emotional and behavioral difficulties. Difficulties that I consider significant impair social, academic and/or psychological development, or have the potential to do so.

Understanding that there are biological elements underlying certain types of impairments reveals a dimension that most don’t fully appreciate. Neurological functions, for example that regulate our ability to inhibit and manage emotions and behavior.

Realizing a child needs or benefits from medication provides a view that others often don’t see.

Those who have not had this experience often mistakenly view parents, with ADHD, Mood disordered, autistic or developmentally impaired children, as bad parents unable to set boundaries. A severely anxious child may gain little sympathy from a relative who is removed from the level of distress the child is experiencing and expressing.

Many parents have described relatives who have disguised, thinly disguised or openly blamed them, suggesting the parents won’t make their child behave. I have also shared parent’s embarrassment over children’s inappropriate behaviors and their anger and anguish when their child has rebuffed and opposed their best efforts. Parents respond to behaviorally and emotionally challenging children in many different ways.

Out of control children often intimidate parents. Out of control behaviors are especially difficult in public settings. The parent who tries to avoid such instances, by giving in to demands, will soon have a tyrant on their hands.

Leaving a store empty handed and returning later, alone, may, at times, be the best option. But, what is driving the demanding behavior? Often it has little to do with the issue at hand but it an attempt by a desperately demanding and anxious child to have control or in other words, have their way.

It is an often heard comment, everything is fine as long as he (or she) gets what they want.

If allowed, children quickly learn to get their way through demanding persistent behaviors. In some circumstances poorly regulated mood and anxiety states play a role. Poorly regulated mood and anxiety states often are unresponsive to behavioral or otherwise adequate parental guidance and responses.

The type of medication benefits that can occur vary widely and depend on all of the factors involved including the types and severity of difficulties, environmental circumstances and developmental history.

Considerations include:

What is the nature of the difficulty?

How motivated is the child?

What is the child’s capacity or potential for improvement.

What is likely not to change?

What will require strong, clear consequences, boundaries or rules?

How can we help our child and have a better relationship with our child?

How can our child be someone we like to be around more?

How can our child become more successful getting along with others?

How can my child be more independent?

Emotionally and/or behaviorally unstable children who are able to be stabilized or otherwise functionally improved are often responsive to behavioral reinforcement and other supportive methods that may have previously been unsuccessful.

Methods such as parent directed play therapy and behavior techniques are helpful when combined with a positive pharmacological treatment response.

When parents witness a strong positive medication response in their child they have a greater appreciation of the biology at work. This recognition often helps parents feel less frustrated and more understanding, hopeful and supportive toward a child who is less difficult.

This book was written to illustrate and describe the tools and the benefits of monitoring and measurement of medication effects and to describe additional supportive methods parents can use.

Despite love, support and guidance there are many children with impairing developmental, neurological, emotional and/or behavioral states that threaten the child’s positive family development, participation in normative environments or otherwise threaten developmental progress. In many cases these conditions can be improved and their negative effects reduced with the thoughtful use of medications.

This book provides instructions and directions on how to more clearly define, monitor and measure changes that occur during any form of treatment.

Easy to review reports and observations will make your clinician recheck visits more meaningful. Pharmacological treatment of a child is best achieved through a collaborative effort between the prescribing clinician and a parent or guardian.

Medications, referenced in examples, will be referred to in terms of the class of medications they represent. This is done to reduce any tendency to over-identify with example elements that may cause some readers to attribute characteristics of a specific medicine to an outcome described, positively or negatively. Outcomes described may or may not apply in a reader’s case.

This book is about reducing impairment, when possible, optimizing functioning and developmental progress.

We all wish for our children to have as much emotional and occupational success, happiness and satisfaction as possible.

This book serves as a companion to the CPI On-Line Observation and Monitoring methods and software programs, providing a description of the method’s uses, limitations and teaching examples of treatment monitoring and analysis of treatment.

These methods are valuable in managing treatment issues and facilitate collaboration with care providers.

Others who use the CPI On-line observation system include CPI research participants, participating clinicians and individuals by subscription through DCC Publishing.

Subscribers receive an ID number and access to enter initial circumstances data and observations.

Subscribers receive by secure e-mail a PDF Report of the initial circumstances and first observation (two days after entry) then weekly PDF Observation reports for the period of the subscription. On-line monitoring is an option for those who wish to enter observations using mobile devices or those who don’t have a compatible Windows platform to accommodate the desktop software version. Subscribers receive initial circumstance and observation reports and weekly observation and graph reports through the subscribed or authorized period.

The downloadable software program can be installed on the user’s personal Windows 7 or higher computer and provides options for saving, reviewing and printing observation and treatment response reports (is available by download from DCC Publishing http://www.dccpub.com ).

How to use the Treatment Management and Observation Program™ video tutorial is at the following link:

https://www.youtube.com/watch?feature=player_embedded&v=_vey9b9Jx7o

The following chapter will provide an introduction to using medications with children and the simple steps to establish an observational series. Subsequent chapters will teach you how to consider and assess the changes you observe by reviewing actual cases of treatment monitoring. Actual case examples illustrate observation circumstances and lessons related to analyzing and benefiting from the documentation and measurement of treatment response.

It is my intention and hope that you will find the book helpful in:

Better defining issues of concern

Better communicating, identifying and agreeing on the nature of issues and symptoms of concern with your care providers

Providing you with greater confidence and success in your efforts to help your child, whether it is through a transitional circumstance or continuing difficulties.

Providing documentation and data review that can assist in refining and managing treatment.

Once you complete the initial (baseline) data and first observation you can periodically and quickly make repeated measurements that allow a valuable method of monitoring and analysis of treatment response. The computer tools make the process easy and useful.

These methods and associated software applications have been developed by DCC Publishing and the Child Psychopharmacology Institute (CPI).

BJD

CHAPTER ONE

When Children Need Medications

As a very young man I began working my way through college with the help of the GI Bill and by working and becoming licensed as a psychiatric technician in a State Hospital where I worked with severely developmentally and mentally disabled children. It was in these profoundly disabled children and adults where the benefits of medications in severely dysregulated states and behaviors were indelibly impressed upon me.

In these most severe situations psychopharmacological interventions often allow individuals to live without physical restraint