Dual diagnosis can be very complex and overwhelming. Look at the big picture from birth through the child's life. Use your child's entire team to help make decisions. This team can consist of doctors, parents, support coordinators, teachers, family, friends, behavioralists, pharmasists, and more. Your input as a parent is critical because you provide the constant care and environment for your child. Ask questions on why your team members would like to make decisions from prescriptions to tests to goals at school. The team approach is fundamental.
The one thing you can count on with individuals with dual diagnosis is that there will be constant change. When a change in health or behavior happens, be thorough. The new issue may be due to an underlying issue. It could be a stressor from school, a UTI, a change in thyroid levels, an ear infection, sensory processing difficulties, etc. Look at the antecedents to what is happening. Often the issues are due to a change in routine or a change to their environment. Did your family move a month before it started? Did the child's diet recently change?
The next step is to look at changing behavior by working with a social worker or behavioralist. Look at motivators, preferably non food motivators. Take one behavior at a time. One method is to give the child a sticker on a chart for doing the behavior correctly. Once the child gets a certain number of stickers, they can receive a reward or positive reinforcement. Try to filter stimulants that distract the child.
If caregivers are working with medications, try one at a time and take brief notes of how they react. Give each med at least two weeks. "Start low, go slow." Sometimes a child on multiple meds even needs to peel back meds with help from their doctor. Some children do not need the meds they are taking if the symptom being treated is not being manifested anymore. Pay attention to side effects. Notice if the meds effect the child's mood, gate, energy level, or awareness. Be sure you are going to the right doctor and that they know how all of the medications interact.
In the end, communication with your team matters. Remember that you are the expert on your child.
