My Forum Comments
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!