Hello!
Harrison is doing well at school and waits at the door for about 20 minutes each morning because "there's nothing to do at home". He was upset this summer when he learned he would be switching classroom, and it has ended up working well for him. 

He had a neuropsychological assessment at UMN on Monday with Dr. Amy Esler, who has followed him since he was 3. The county team seemed hopeful she would uncover a new diagnosis that would explain the behaviors. She did a lot of digging, but the diagnoses remain the same: Autism Spectrum Disorder and Disruptive Mood Dysregulation Disorder (DMDD). I'm hopeful the new children's mental health case manager can help the team understand that DMDD is real. It's a mood disorder that shows up as intense irritability and annoyance. I had a lot of back and forth this summer with a couple of team members who dismissed it as a manifestation of is autism. It shouldn't really matter, but it gives him access to more appropriate services when we can name things as a developmental disability (his autism) AND a mental health condition. Dr. Esler recommends a psychiatric residential treatment facility (PRTF) for him because of the severity of the behaviors. 

I'm hopeful the program we have begun will help us avoid a PRTF or hospitalization (or police calls...or aggression). Behavioral Dimensions and Dakota County Children's Mental Health created a program called Critical Care Unit for Behavioral Supports, known as CCUBS, that isn't like other in-home programs we've tried. The programs we've done have either had a mental health focus or a behavioral focus, but this has both. They specifically work on the connection between parental stress and the child's behavior--in most programs/setting, all the ideas come at parents to implement and train other staff to implement. This is a flawed model because parents tend to be emotional in their responses, therefore less consistent, and on top of that, we're exhausted. We are currently in the consultation phase in which a clinician meets with Chris and me for 2 hours each week to problem-solve and assess. She is creating a safety plan that will shut down behaviors more quickly, rather than having us try to manage at home. They'll train us in consistent redirection, blocks, and holds. We learned yesterday they'll have an opening for their intensive program sooner than expected, and we could get started in December. Two clinicians will be assigned to us. Three mornings per week for three hours Harrison will work with one of them, and Chris and I will work with the other. The program typically last three months.

If he can begin to stabilize, we'll have more energy to address the fall-out of the past several months. Odessa holds herself together and eventually lets it out when things are more calm. Townes has been having a tough time. I'm working .5 this year, which feels like a lot--my main job seems to be attending meetings for the kids or doing paperwork.  

Otherwise, no news is good news!