Devil's Advocate

I keep getting madder and madder as I read over the old e-mails and information. One thing the Facilitator stated was that this meeting was not about placement, and therefore talk about moving Kitty to the special school wasn't even supposed to be on the table. Which of course is totally ridiculous.

I admit we should have gone in with more legal advice… part of the issue is the cost. Most of the Advocacy places won’t touch us because we want a MORE restrictive environment. At the last IEP meeting, we brought a friend who was a lawyer in NY (she gave up her practice because she has a kid like ours, is a single parent, and had a serious heart attack awhile back). She was our “NAMI advocate” (if you bring a lawyer then they can bring one too, and she really does do work with NAMI). They steamrolled right over her (they just kept stating their hands were tied until the assessments were done). Everyone we have ever brought in with us has said that we’re great advocates so they just stand back and watch, or this group steam rolls right over them.

Hubby pointed out that the facilitator is the same one that wwwaaaaayy back when Bear was in 7th grade wanted to know HOW we knew about the special school (because it is a big secret). She seems to be determined to make sure the school has no liability for providing services and to that end just continually repeats that Kitty is not showing behaviors in school and it is not effecting her academics. I think the school is going to make sure they follow the rule book to the letter, so they won’t get hung with a bill for residential treatment.

Honestly I didn’t see how they could argue with ALL the evidence we had, but I didn’t count on the fact that we were going to have a bogus FBA completed. I figured the worst it would say is that they didn’t observe her behavior (shut down, self-harming, depressed...), not that they were going to only use full meltdowns as the only quantifiable data. Sucky part is that Kitty’s going to have a new FIE full of this BS and we’re going to lose what little credibility the old FIE gave us.

I guess next steps is to contact ARC or Advocacy Inc again and see if they can help us fight this bogus FBA and what our option are. We can get some legal advice from Pre-paid Legal, but they’ll start charging us pretty quickly. I’ve been so focused on trying to get funding for Kitty to get into RTC that I probably let this slide.

I have to admit that a small part of me is wondering if the special school really is right for Kitty.

After 5 years of basically getting Bear as stable as possible in a structured environment that minimizes the damage his issues can cause… he is now an “adult” who is one handful of pills away from being back to his old psychotic, trauma-ridden self (in other words if he ever goes off his meds). He has never really addressed his trauma because there has been no reason for him to bother, and therefore, in many ways, nothing has changed. On the other hand, it did give him some relief from the trauma so he could mature a little. It’s a fine line.

Should we protect Kitty from the stress of “real school”? The academics are definitely worse at special school. No one cares if they’re spoon fed the answers. If we leave her at the high school will she have more breakdowns sooner so she qualifies for more services? (I have to worry that right now she’s on an upswing so if someone were to assess her right this minute they’d find that she’s not currently actively suicidal or self-harming – will we not be able to get her into residential treatment where she can work on her trauma issues and we don’t have to deal with the emotional repercussions?)

The other half of this is that while Kitty is ALWAYS suicidal (how could she not be when she thinks/KNOWS she is worthless, unloveable, unwanted, stupid, ugly and forgettable), BUT she is terrified of actual pain. EVERY time she has threatened/attemted suicide it has always been with a rescuer 5 feet away to STOP her (standing in front of an open window, laying down in the street, running away, holding a knife to her wrist - when I didn't stop her she actually put the knife down and tried something else). I do not believe she is doing this for attention. I believe this is a cry for help from a miserable child who doesn't have the ability to fix it. It can't be ignored, but at the same time I hate to rely on it too heavily when we're trying to get her services because it's NOT actually a risk.

We're 99.9% positive that Kitty would never kill herself at school. When she feels like hurting herself, she will gouge herself with her fingernails enough to cause pain, but a pain that stops immediately. Erasing the skin with an eraser was an escalation of this, but I don't believe she will ever do it again - it continued to hurt after she stopped and therefore was out of her control, plus it left a mark that was difficult to hide from others and will probably scar. On the other hand, Kitty will report to the school when she feels like hurting herself because she needs the emotional support of someone watching her.

We brought up to the school that they are risking that she will kill or hurt herself by not listening to our concerns, because they should not be able to make this determination themselves. The school's position seemed to be that this was out of their hands (hence the comment, she could be struck by lightning too). Honestly if we believed Kitty was this much at risk, we would have her in the hospital again, but we were trying to get them to acknowledge the point that she can quickly become suicidal and there is nothing they would be able to do about it under the current system (unless she decides to tell someone).

I do honestly believe if someone tells Kitty a painless way to kill herself she would probably take it (and it wouldn't matter if they lied, it would be too late!). She may not do this today, but if she's in a downward spiral or in a fight/flight mode...

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After the meeting, trying to process the events, Hubby and I were playing Devil’s Advocate and proposed a scenario that included us saying to the school,

"OK, you don’t think she needs the special school? Then fine, show us why she needs Applied Classes {small class sizes and simplified material} at all? Academically she’s bright enough to do general ed with inclusion help, right?! {The teachers keep recommending it} She passed all her Modified State Skills tests. We'll put her back on the bus too. She's allegedly caught up on all her makeup work, so start giving her homework and treat her like a "normal student."

She’s not having “meltdowns” at school, so therefore she shouldn't need behavior staff support. She hasn’t actually killed herself at school or done more than slightly break the skin with self-harming behaviors so she shouldn't need the support of the counselor or nurse. So let’s say she can’t go to either of them at all unless she’s actually sick (fever, vomiting, rash…). She doesn’t qualify for therapy services from the school so she shouldn't need to see either the guidance or crisis counselors. Her teachers need to stop babying her as well, so no more being allowed to call Mommy or the behavior staff from the classroom phone, no leeway on homework, no excusing her from assignments like speeches, no letting her putting her head down on her desk..."

Ever since she'd returned from the hospital the second time, we'd slowed down on “applying therapeutic heat” (chores, holding her accountable, taking her to the trauma therapist she hates…), because we were too exhausted to deal with the emotional fallout, but now maybe we need to step it back up a notch. Dump the attachment therapist and go to 100% trauma therapist. The overly sympathetic skills trainer already fired herself so we don’t have to worry about her (her theory was that if she couldn't work with Kitty in school while the issues were current, then it became too much like therapy which she's not qualified to do with Kitty. Since the regular high school won't allow her to work in the school, then she "fired" herself until Kitty got into the special school which does allow skills trainers).

All I know is it’s going to be awhile (if ever), before we can get funding for RTC. Once she get in, she’s going to be out in probably a few short months. Then we’ve got to figure out what to do with Kitty next. I've contacted the partial day hospitalization program that said they could take her, except there was a "clerical error" on the part of TX Medicaid so they couldn't get funding right away. Haven't heard back yet.

I guess next steps are

• Contact the school and request information from the behavior staff on what kind of behavior they're seeing and how often they pulled Kitty from class.


• Confront Ms. BS about doing the FBA on Meltdowns instead of the school behaviors we'd discussed.


• Disallow the guidance counselor having "private sessions" with Kitty and go back to only allowing her to use the "calming techniques" taught to her by the skills trainer.


• Rewrite the "Crisis Plan" to include the behavior staff using calming techniques taught by the skills trainer and having to report episodes to me (this was discussed in the IEP meeting).


• Stop "babying" Kitty and go back to normal (for us!) chores and discipline, so we can see if this latest lull in meltdowns and self-harming behaviors is due to the latest med tweak or the fact that we've provided more structure and fewer expectations. Obviously it could be a shift in body chemicals from the bipolar, but there's no way to really prove that until the next up or downswing.


• Contact local Advocacy agencies and get ready for the next IEP meeting in 10 days.

In the meantime:

• Continue to pursue getting documentation that TX Medicaid does not pay for residential treatment before Nebraska asks for proof.


• Continue to pursue whether or not TX Medicaid will pay for partial day hospitalization.


• Push getting Kitty's clinicals to the chosen RTC.


• Get the clinicals ready to be sent to Nebraska when they find a psychiatrist who will review them (keep riding them on this).


• See if I can get Kitty's psychiatrist (once she's back from vacation) to recommend alternative education and partial day hospitalization.


• Pursue partial day hospitalization for the meantime and after release from residential.


• Deal with Bear's extensive vocational (trying to get him a job that works with his school and therapy needs) and legal needs (court date is Thursday for the ticket for driving without a license).


• The usual day to day stuff like grocery shopping, therapy (more therapy, and more therapy), neuropsych testing for Bear and Kitty...


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