Q. We have an 8 year old granddaughter who had a brain scan SPECT and the doctor said Kassie has no Attentional difficulties, but impulsivity, Hypoxic Brain Injury, OCD, ODD, BPD, Auditory Processing Disorder, ADHD and Fetal Alcohol Syndrome. We adopted her when she was 12 days old. The doctor has her on Ritalin for ADHD, but she has no problem staying focused nor sitting still. She is hyperactive and has been very impulsive since she was very young. Heard today that physicians can no Diagnose BPD in very young children. We are the only parents Kassie has ever know but our doctor acts like the BPD is nothing to worry about but The Ritalin for ADHD and Luvox for ODD do not seem to be helping her very much, Our doctor doesn't seem to take us too seriously as after all we are only her grandparents, but can you suggest a better treatment program for her that would calm done some of the outbursts she continues to have?
A. All good questions. I am not aware that SPECT scans are good for anything except research and making money for radiology departments. Most certainly you cannot diagnose OCD or impulsivity from them. All of your child's diagnoses are clinically made. That is, you see how she acts, and call it what you see fact to face, not via a radiology examination.
It is hard to say what will work, or if anything will work. Perhaps she will do better on Effexor, maybe Remeron, or even Zoloft or Prozac. Most doctors tend to under medicate children. In our studies, 8 year olds needed as much medication as adults. This means 300-400 of Luvox, 300-400 Zoloft, etc. It seems high, but they metabolize quicker. I would suggest getting a second opinion from someone who does a good deal of work with a population of patients like you child.
My suggestions may not be appropriate, since I have little clinical data to go on. That said, if you or anyone in your family is doing poorly on their current treatment, get another opinion.
