March 8, 2019 at 12:19 pm #110615
My son has had an IEP for “other health impairment” since second grade. He had early intervention services (a mobile therapist and TSS) beginning at age three for biting, being excessively active, and hitting other students in the pre-school setting. He is a very bright kid; at one time (in third grade) he was approved for a GIEP. His official diagnosis is ADHD/ODD. He is no longer medicated because we didn’t observe any noticeable difference with impulsivity or focus and when the medications would wear off, he would become strangely paranoid and aggravated. Last year, was the worst for him and our family because a terrible rumor was spread at school about him that prompted a visit from the local police. This visit affected him so greatly that by the end of that week we admitted him to an inpatient 10-day hospital facility because he threatened suicide. He and our family have worked extremely hard over the last year and have gone through intensive individual and family therapy. This year, although the school offered it, he refused to attend social skills several times a week because he didn’t want his friends to see him going to special ed and he wanted to take Spanish like everyone else. His special ed teacher says that because he isn’t receiving any “direct instruction” that she is recommending stepping down to a 504 plan. He had in school suspension once this year; once for fighting (he was not the instigator); and detention a couple of times (once for fighting back at a school dance when an autistic student attacked him and another time when he threw a book at another student for taking his iPad). We also get a phone call or email at least 2 times a month from his teachers reporting that he’s still doing impulsive and immature things, most recently he put a rope around a colleague’s neck in science class because he thought it would be funny…they were working with ropes and pulleys as part of the lesson. He has an extremely hard time working in groups, especially in science. He also can’t contain his thoughts. Whatever he says, he blurts out, regardless of how disrespectful or uncaring it is. Finally, I feel like much of his behavior follows a period when there is either little physical freedom or when there is a hands-on projects. Since there is no longer recess, I’m trying to secure funding for standing or elliptical or bicycle desks for the school to help. But who knows when/if that will happen. Whenever he’s offered help at school (and many times at home) he turns it down. The school continuously reaches out to me and my husband to “see if we have any other ideas” but quite frankly, short of sending him to military school, we don’t know what to do. We’re kind of at our wits end. And think that other than offering consistent positive discipline and bribing him to choose a sport other than skateboarding (which is hard to do in the winter and without a skate park nearby), there is not much more that we can do. Although we will continue take him to see a psychologist every two weeks. Any advice? Kindest regards.
March 11, 2019 at 2:44 pm #110798
It sounds to me like he needs to keep the IEP and many more goals and accommodations need to be added to it. If behavior is an issue, the school should do a Functional Behavior Assessment (FBA) and draft a Behavior Intervention Plan (BIP) from it.
I’d say it’s time to have a meeting and review and reassess the IEP, not just decide to get rid of it altogether:
ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism
March 14, 2019 at 8:56 am #110861
The details really matter in a situation like this, so take anything that I say with a grain of salt.
However, based on what you share and absent additional facts, it appears that the teacher may be viewing things with too much academic tunnel vision.
In addition to Penny’s advice, I would share this with a school psychologist and/or school-based mental health practitioner and inquire about the potential for an social-emotional-behavioral disorder (or whatever the local lingo is in your state. In CA, it is officially called “Emotional Disturbance”).
This should push the right people on the team to look more holistically and not just from an academic lens.
March 18, 2019 at 10:05 am #112017
I am a school counselor and have been for 21 years. Our school does FBA’s and BIP’s and do our best to write an appropriate IEP or 504 to accommodate a student’s needs. We are a Pre-K thru 5th elementary school. We have helped many students but there are a few we seem unable to identify appropriate accommodations. We offer mental health services at school for any student. Our principal has a heart for those children who struggle academically and with social/emotional issues. I say all that so you know we do our very best by students like the one mentioned in this post.
There is another side to this. Think of the other students. We have two students currently and have had others in the past whose behavior and refusal to leave the classroom have required us to remove the other students for anywhere from a few minutes to as long as 30 minutes or more. This hurts all students academic progress. With an IEP he can be educated in a classroom with fewer classmates and a more controlled environment. With 504 it states “reasonable” accommodations.
I honestly don’t know the answer for your son. I wish I had one. When it comes to threats or physical violence of any kind it is difficult to find the right intervention in a regular classroom.
Here is my two cents worth. A student who need social skills training should not be allowed to refuse to attend. Also, I have learned that students know already they are different. Personally, it took years for me to teach my daughter to embrace her difference and advocate for herself (violence was not part of her ADHD or Dyslexia) to get her needs met. Other students would tease her for spelling and would make comments like, “Did you take your meds today?” Initially she would become angry and let them know. She eventually learned to let it go. She would say often that she liked herself off the meds but I knew others didn’t. She could never see it. I often felt I had failed her. She is now 32, has a master’s degree, and is married with two beautiful boys. I can already see her oldest has her ADHD but he has the violence. When he goes to school it will be interesting although he does well at daycare in spite of a rough start – hitting, biting, pushing. We are still working with his tantrums at home.
I hope something I have said will be of use to you. I say all this so perhaps you will not be offended by this next statement. If the school has attempted all interventions they can provide; in the end, a school is an academic institution not a mental health facility. Life is tough and requires self control from all of us. This is what your child needs to understand. Once my grandson and you son reach 18, the courts will not care about their diagnoses. The younger they learn their behavior is their responsibility, the better their life will be.
March 18, 2019 at 10:07 am #112018
Look at his most recent IEP to see what his written goals are and what percentage of these need to be met for the intervention to be deemed successful. Keep in mind that an IEP is a legal contract, to which the school district is a party. If these goals haven’t been met they’re still bound by the terms of the IEP. If it’s time for the IEP to be renewed, you don’t have to agree to new terms, the Section 504. Check on this, but I think the current support services stay in place until new terms are agreed on. Also check to see if there are any Special Ed/legal agencies in your area that can advise you. You have more authority than you think you do, though this whole process can be very intimidating. Good luck!
March 18, 2019 at 10:08 am #112020
I’m sorry that you are going through all this. I know exactly how frustrated you must feel. I will recommend sitting down with the EIP Coordinator and change the plan if you have to. Make sure they established in that plan what your son really needs and make sure teachers follow through.
About the medication, I recommend sitting down with his doctor and try different medications, until they find the one that will help him. No kid with ADHD can go through life having all these symptoms without medication. My daughter is in 8th grade and has ADHD, Executive Function Disorder, Anxiety and Depression caused by all the other conditions. For a few years she struggled in school without medication because the first one the doctor prescribed wasn’t doing any good. Later on, she started taking Aderall 20mg and a second dose of 5mg around 2:00 pm at school. In the afternoon, she takes Fluoxetine 10 mg to calm her down and a natural supplement called Melatonin 6 mg at night to sleep. At the beginning I was mortified by the fact that my daughter was taking all these medications, but if she is able to function, I’m happy. Also, these kids need to sleep because usually their minds keep going at night without stopping, and if they wake up tired, that aggravates their behavior. Also, you have to remember that ADHD symptoms are more severe in boys than girls.
At one point, my daughter started showing signs of ODD, because of her frustration. When kids with ADHD don’t know how to deal with something, the first response is driven by impulsivity. Of course, they are going to get in trouble! What I did with my daughter was make myself available, I gave her a phone and whenever she feels she is going to lose it, she texts me and I calm her down. Every single morning when I drop her at school I ask her “How long would it take mom to get to school to help you? And she says “a few minutes” and I will say: For you it will take me a few seconds”. That reassurance gives her the tool she needs to feel comfortable that if she needs help, I will definitely will be there. Believe me, it has been only a few occasions in several years that I had to go and “rescue” my daughter. Our kids need to feel that they have support no matter what. Teachers need to understand that these kids need help, that’s why they have a plan that needs to be followed. I think it is wrong for your son to be disciplined for defending himself. If he got punished by something that he thought it was his right, of course he is going to get frustrated. If your son starts showing frustration, the teacher should help before it is too late. When my daughter gets to that point her teacher ask her to go take a walk in the hallway and come back and that usually helps her. Also, when kids with ADHD turn down the help they are offered is because the way people are trying to help are insulting their intelligence. We have to remember that these kids are brilliant. My daughter is so smart that she is currently in a Talented and Gifted School, but she still struggles. Your son needs to be reminded that he is very intelligent but sometimes we need a little help to focus and keep working. They need to give him the help and at the same time make him feel like everybody else.
You should sit down with the EIP Coordinator and establish the help he needs and once that it is established, ask the coordinator to make sure every teacher gets a copy. This plan is to meet your son’s individual needs. Another thing that has helped me with my daughter is to send a letter at the beginning of the school year explaining my daughter’s struggles, her frustrations, likes and dislikes and some information about ADHD. When she struggles with her writing I send out newsletters with that type of information to all her teacher’s emails.
I hope this information helps your family. I know dealing with ADHD is a struggle, that’s why I like to share my experience. My email is firstname.lastname@example.org if you need more information or someone to talk to.
March 18, 2019 at 11:04 am #112043
I feel like you are writing about my son, who’s in eighth grade. He just had his IEP tranasition meeting for high school and it went much better than I thought it would. Here are my two cents based on my experience:
-your son absolutely needs to keep his IEP
-social skills training is essential, even if he lacks the social skills to be on board
-use forced choices and incentives to get him to participate in available IEP resources
-encourage the school to keep data on his other health impairment issues, which for my son are defined as following instructions, annoying others and touching
-focus on decreasing the frequency of his targeted behaviors rather than eliminating them
-expose your son to regular physical activity such as going to the Y as a family, even if he is playing with kids much younger than him
-consider boy scouts or other groups where your son can be involved and you’re in the background as needed
-find physical volunteering experiences (we load shelves at food pantry and cut underbrush in forest preserve) you can do as a family – be prepared to be happily surprised when your son interacts in positive ways outside of your family dynamics
-look for opportunities for you son to play with/mentor much younger kids, particularly with similar issues – it may be very stressful for you to monitor at a distance but he may rise to the occasion and amaze you
-network to find older kids with issues similar to your son to play with/mentor/watch him – also with the inherent stress of potential “double trouble”
-remember that though it feels like it’s only all on you (because by default it mostly is!), your son is taking everything, learning, processing and maturing, but damn, he’ll make sure you’re the last to know
Good luck, been there, done that, still there, still doing it, exasperated, exhausted, and hopeful as I ask “What is the lesson in this for me right now?” Anders aka Adamsdad
March 18, 2019 at 11:49 am #112060
Hi – I feel for you and your son. I would not let them downgrade him to a 504, that would only be if he was improving and the school environment was effectively working. The dr we see swears that medication doesn’t effect behavior yet Focalin has been very effective in a way that enables my son to be much more attentive in school and less disruptive, impulsive with language. As he gets older Strattera is the other option but we went through 3 medicines before Focalin and the effect of Focalin is subtle without side effects so what we want. Negotiating with son to give a medication a trial but also be firm with it and exercise as the behavior is disrupting his life too. My son hates ever being pulled out so push in worked to support the classroom and the amount of designated IEP time has gone down and as freshman in HS is going down from 5%.
He will still having IEP with social and academic goals. (In your case I would feel threatened if they suggested changing him to a 504) If socially he is doing well with Spanish and is learning in that class I can see why that might not be effective but he may complain no matter what so have to look at what they wish to accomplish and whether pull out will help. You did not say exactly how old he is but if able to have an Advocate come with you to the meeting that maybe helpful too especially if they are pushing for a 504. Rock climbing might be a good winter sport or biking/hiking. Ours walks to the corner store to get lemon drops – gets him outside for half hour or more and there’s some personal freedom there.
March 18, 2019 at 12:41 pm #112082
This is not a direct answer to your question, but hopefully helpful given the behavior and emotional issues your son has had.
We found the book, Finally Focused, as truly a key part of helping our son. It’s written by a psychiatrist who feels that kids with ADHD, etc. need key supplements to nourish the brain. It goes far beyond “focusing” to improving brain health. It’s the first time I felt that someone could see my kid. (we found it thru this site because the author, Dr. James Greenblatt, did a webinar here).
I sped thru the book and started my son on the recommended supplements as a daily regime (that are all scientifically based). After the first few weeks there were clear positive changes. Now it’s been 4 months and both his teachers and us as a family have noticed marked changes in behavior, mood, self-regulation, peer interactions, etc.
We also added in OT which has been better than counseling because it allows him to move and learn tools for self-regulation (away from school so peers don’t see him).
Take good care of yourselves:)
March 19, 2019 at 10:41 am #112197
Re-evaluating the IEP seems like it may be better for your son at this point, and getting some assistance with how to do that and interact with the school successfully in that respect in important. I just wanted to mention that while you mention having tried some medications to assist your son unsuccessfully (with some terrible experiences to boot), I recently came across an article on atomoxetine (a SNRI) that may be worth considering given the impulsive behaviors that are challenging to monitor and control. My son also experiences difficulty with controlling his impulsivity as a primary problem, so when I read this article, I perked up because of the emphasis on improving impulsivity specifically.
The conclusions from the article with first author Samuel Chamberlain (BIOL PSYCHIATRY 2007;62:977–984) are below:
Atomoxetine improved inhibitory control, most likely via noradrenergically mediated augmentation of prefrontal cortex
function. These results have implications for understanding the mechanisms by which atomoxetine exerts beneficial clinical effects and suggest novel treatment directions for other disorders of impulsivity.
While I am sure another medication is not on your radar at this moment, it may be worth looking into, especially if impulsivity continues to be a focal point for some of the behavioral aspects of his ADHD.
March 20, 2019 at 9:40 am #112092
I’m a school psychologist as well as a mom of three kids who all have ADHD, and I also have ADHD. What I tell parents about the difference between an IEP and 504 is that an IEP is what we use when the curriculum needs to be altered (or modified) for the student. That can either mean that a student does not have to master the content at the same level as others, does not have to take certain classes at all (i.e. PE for kids with orthopedic impairments), or receives credit for a class not offered to the general population, for example. A 504 plan is what is needed for a student who is able to access the regular curriculum, but needs accomodations in order to do that. Accomodations can be assistive technology, extended time, movement breaks, etc. If the social skills class is a modification of the curriculum (perhaps offered in the place of other electives, but only available for kids enrolled in special ed, etc.) then changing to a 504 plan might eliminate that option. Otherwise, Reese should be able to get every accomodation he is currently receiving through his IEP from a 504 plan.
Regarding meds: I just saw this article about using saffron (of all things) for ADHD. I don’t know if you will be able to follow the link without a subscription to the journal, but here it is: https://www.medscape.com/viewarticle/910205?nlid=128750_2051&src=WNL_mdplsnews_190315_mscpedit_psyc&uac=208416MZ&spon=12&impID=1909064&faf=1
It was published February 11 in the online Journal of Child and Adolescent Psychopharmacology. Here’s that link: https://www.liebertpub.com/doi/10.1089/cap.2018.0146
Finally, it sounds like Reese would benefit from a social skills class, though not necessarily from the one offered at his school. Not all social skills classes are created equal, particularly when they may be tailored for different populations (autism spectrum/ODD/ADHD/social anxiety, etc). You write that when offered various forms of help, he turns it down. I would suggest that at this point, with the consequences that are resulting from his behavior, turning down help is not an option. The stakes are too high. I find that visual presentations of data can be very helpful and persuasive in situations when anyone (kids, parents, teachers) are resisting intervention. The most common, and often most persuasive is the most simple. I just draw a plain old bar graph with an X and Y axis. The Y axis (height) represents either frequency or degree of behavioral episodes, and the X axis represents points in time. So for Reese, those points in time could be the phone calls and emails you get, the times he has been given in school suspension, the time he was hospitalized, etc. The Y axis could be be labeled with severity of consequences. For every point in time, you mark how severe the consequences, and see if there is a trend. Generally, untreated ODD/ADHD problems trend upward in severity, and it’s easy to see that there is no reason to believe things will get better if we continue on the current path. You can also talk about how consequences for these same behaviors become increasingly more severe over time. An adult who jokingly throws a rope around someone’s neck will at the very least lose a job, and may likely go to jail.
Another way to present it would be frequency of reported behavior problems, with the X axis being weeks, and the Y axis being number of times you have been contacted by the school. That may show a trend of increased number of contacts, which would also indicate that things are not getting better on their own.
Refusing anything new is pretty much the definition of ODD, so it’s not surprising that Reese refuses help. That’s the ODD talking. What the ADHD and ODD brain likes to say yes to is positive reinforcement. The trick is to find the thing that is a strong enough incentive and then create a way for Reese to earn that by accepting the intervention that he needs. If it’s going to work, the incentive has to be something Reese identifies as something he is willing to work towards, and there have to be smaller reinforcements along the way, to encourage him to keep going. The tools Anders AKA Adamsdad recommended are all pretty solid.
Finally, I would ask for a consult with a licensed behavior specialist. The school district should have one. If not, they should pay for an assessment from an outside one. That assessment should include multiple observations across times and settings and interviews with you, Reese, his teachers, and administrators, etc. A good behavior specialist is worth her weight in gold, and may have more tools to offer than you or anyone else ever knew existed.
Hang in there!
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