Ok, so I was trying to be brief in my original post.
My son has been diagnosed as having a mild intellectual disability (neuropsychologist testing). Obviously it is hard to separate his attention issues from his impairment but he does still meet the requirements for an ADHD diagnosis. We have tried a couple of different medications that had too many side effects to continue. This particular doctor does not want to use stimulants with my son because he has heart problems (his cardiologist has OK'd).
I understand what the Dr. was saying about him acting out because things are hard for him and it is a learned coping behavior to get out of the work. What I fail to understand is how it is different when he does this at a school and when he does it at home.
My son had been in the public system since he was 3 (he was at an early intervention facility). He has received therapy since he was 6 months old. He had an IEP since kindergarten. He was making slow but regular gains in kindergarten and 1st grade. His behavioral problems really started causing problems towards the end of 1st grade into 2nd and 3rd where his progress really slowed down. I started homeschooling him for his 4th grade year (and 3 months at the end of 2nd when we moved) and we are now 3 months into his 5th grade year.
We have completed an ILS program at therapy. He has been referred for vision therapy but insurance does not cover. Unfortunately, his early therapists (or me) did not know about retained reflexes, but he is getting that attention now.
Normally I would not hesitate to just change doctors but it seems to be the consensus around here that this particular doctor is quite good. It just struck me the wrong way when he mentioned several times that he was concerned about me and also my relationship with my son even though I did not raise any concerns with him about that. I would rather deal with him at home than send him to school to always be in trouble there. He did mention structure but again I fail to see how the structure at school helped him in any way. They would have to interrupt his schooling to deal with the behavioral problems at school just like I have to at home. I have each school day scheduled in half hour increments. I have consulted a behavioral therapist and her only input was to adjust my schedule slightly to provide rewards after schoolwork. My son can be frustrating in the way that when something seems to work as far as motivation/rewards it may work for a few weeks or just that day and it may never work again. Again, this is not new for me, but what we have been experiencing in public school also.
The doctor also mentioned how the professionals at school could work with him on the basic foundational skills he needs to progress higher. I don't understand how it gets more basic than kindergarten level.
What point am I missing?