ocean_eyes Posted May 22, 2009 Share Posted May 22, 2009 I'm new here (duh, right?) and wanted to see what you all thought about my step-son's situation. DH and I are really at a loss as to what the next best step would be for DSS. He is finishing 5th grade and turns 11 in June. His grades are abysmal (Ds and Fs). Attitude and behavior are not good either. All of the classic ADHD and ODD symptoms--diagnosed @ age 5/6. We've tried almost every ADHD med on the market and sometimes, no matter how much Ritalin (or whatever) he's had, he is just totally out of control, destructive, manipulative, sneaky, etc. Other days, he's fine even if we forget a dose. (I've been with DH since DSS was 4 and it's always been very apparent that there was something "off" about his behavior so these diagnosis weren't a surprise at all.) Also, and the psychiatrist is hesitant to label him, but he thinks he probably has some kind of mood/personality disorder in addition to the very apparent ADHD. A little about him: When he actually puts forth the energy to complete classroom assignments and homework, DSS does very well, provided the subject matter is something he wants to pursue and it isn't deemed "boring"! Very easily annoyed and distracted. Poor handwriting (regular printing), unable to write in cursive at all. Hates any type of creative writing. Almost always does the absolute bare minimum of what is asked of him. Comes to a complete stand-still if required to come up with his own ideas (vs being able to simply look up an answer in a book). Loves reading (and reads very well--about a 9th grade level), science, animals, building things with Legos, movies, independent physical activity (like playing by himself at the park or during open gym at Gymnastics). Seems to be behind socially...doesn't do well working in groups, doesn't make or keep friends easily, doesn't seem to realize why his socially inappropriate behaviors would annoy other people. DH and I have spoken to his teacher about not feeling comfortable with him going on to 6th grade/middle school next year. A less structured environment, added to his long history of very poor decision making seems like a recipe for total disaster. Not to mention that he's done next to nothing at school this year...I can't see him being able to keep up with the 6th grade curriculum next year, KWIM? And I doubt very much they would go out of their way to help him with things. It just feels like we'd be setting him up to continue failing. At first we were just considering keeping him in 5th grade for another year, but the more we think about it, the less comfortable we are with that option, and with public school in general. Last year (4th grade) at the psychiatrist's request, we asked to have him evaluated for an IEP. The group of "advisers" assigned to his case decided his behavior wasn't chronically bad enough to warrant the label of emotionally disturbed (or whatever) and that his grades "weren't too bad" (Cs and a couple Ds) which meant he didn't qualify for services. This year he's failing and they've done nothing at all. I spoke to him about homeschooling and he was fairly receptive. Lately, his behavior has been manageable and during these periods I'm hopeful that it will last, but it never seems to. In the last 6 1/2 years, I've yet to find anything that will motivate him for any length of time. I'm worried that we will pull him out, but that he'll regress again and I won't be able to get him to do anything. I have read about unschooling (specifically for history, reading, and science) which seems like it would work well for a child like D, but I have no idea what I'm doing! Also, he is definitely behind in penmanship, math and language art-type subjects and I have no idea what kind of curriculums might be a good fit for him. So sorry for the length of this. I'm pretty overwhelmed and stressed out about what to do (if you couldn't tell, lol). Any thoughts or suggestions would be greatly appreciated, truly. Quote Link to comment Share on other sites More sharing options...
moosemomma Posted May 22, 2009 Share Posted May 22, 2009 Request an IEP again - in writing citing the drop in grades. If the psych thinks he needs it, try again Did he get an assessment of adaptive skills (social behavior)? Did he get an OT eval? Did he get a functional behavioyial assessment? You can request those at the initial IEP. Also, did you get a copy of your rights in the IEP process last year. If not get a copy and know your rights before you go into your next initial meeting. BTW- academics are not enough - if he is having difficulty emotional or socially they need to address that to if he has a diagnosis (ODD with a probable mood/personality disorder). Start here http://dpi.wi.gov/SPED/pcrights.html and here http://www.specialed.us/Parents/plainlanguageindex.htm and sure you have no other option. Jill Quote Link to comment Share on other sites More sharing options...
Laurie4b Posted May 22, 2009 Share Posted May 22, 2009 I'm new here (duh, right?) and wanted to see what you all thought about my step-son's situation. DH and I are really at a loss as to what the next best step would be for DSS. He is finishing 5th grade and turns 11 in June. His grades are abysmal (Ds and Fs). Attitude and behavior are not good either. All of the classic ADHD and ODD symptoms--diagnosed @ age 5/6. We've tried almost every ADHD med on the market and sometimes, no matter how much Ritalin (or whatever) he's had, he is just totally out of control, destructive, manipulative, sneaky, etc. Other days, he's fine even if we forget a dose. (I've been with DH since DSS was 4 and it's always been very apparent that there was something "off" about his behavior so these diagnosis weren't a surprise at all.) Also, and the psychiatrist is hesitant to label him, but he thinks he probably has some kind of mood/personality disorder in addition to the very apparent ADHD. A little about him: When he actually puts forth the energy to complete classroom assignments and homework, DSS does very well, provided the subject matter is something he wants to pursue and it isn't deemed "boring"! Very easily annoyed and distracted. Poor handwriting (regular printing), unable to write in cursive at all. Hates any type of creative writing. Almost always does the absolute bare minimum of what is asked of him. Comes to a complete stand-still if required to come up with his own ideas (vs being able to simply look up an answer in a book). Loves reading (and reads very well--about a 9th grade level), science, animals, building things with Legos, movies, independent physical activity (like playing by himself at the park or during open gym at Gymnastics). Seems to be behind socially...doesn't do well working in groups, doesn't make or keep friends easily, doesn't seem to realize why his socially inappropriate behaviors would annoy other people. DH and I have spoken to his teacher about not feeling comfortable with him going on to 6th grade/middle school next year. A less structured environment, added to his long history of very poor decision making seems like a recipe for total disaster. Not to mention that he's done next to nothing at school this year...I can't see him being able to keep up with the 6th grade curriculum next year, KWIM? And I doubt very much they would go out of their way to help him with things. It just feels like we'd be setting him up to continue failing. At first we were just considering keeping him in 5th grade for another year, but the more we think about it, the less comfortable we are with that option, and with public school in general. Last year (4th grade) at the psychiatrist's request, we asked to have him evaluated for an IEP. The group of "advisers" assigned to his case decided his behavior wasn't chronically bad enough to warrant the label of emotionally disturbed (or whatever) and that his grades "weren't too bad" (Cs and a couple Ds) which meant he didn't qualify for services. This year he's failing and they've done nothing at all. I spoke to him about homeschooling and he was fairly receptive. Lately, his behavior has been manageable and during these periods I'm hopeful that it will last, but it never seems to. In the last 6 1/2 years, I've yet to find anything that will motivate him for any length of time. I'm worried that we will pull him out, but that he'll regress again and I won't be able to get him to do anything. I have read about unschooling (specifically for history, reading, and science) which seems like it would work well for a child like D, but I have no idea what I'm doing! Also, he is definitely behind in penmanship, math and language art-type subjects and I have no idea what kind of curriculums might be a good fit for him. So sorry for the length of this. I'm pretty overwhelmed and stressed out about what to do (if you couldn't tell, lol). Any thoughts or suggestions would be greatly appreciated, truly. Addressing the underlying issues is important to do first. If psych. thinks he has a mood disorder, that should be pursued. Medication for ADHD makes mood disorders worse. If your current pysch is hesitant, seek a 2nd and 3rd opinion from other psychs that have a good reputation. It wouldn't hurt for some other folks to take a second look. Also Asperger's Syndrome is a possible diagnosis to rule out. Are you receiving help with managing his behaviors from someone experienced with ODD? You won't be able to homeschool if those behaviors aren't under check. Will you have respite from dealing with his behaviors? Right now, the hours he's at school are hours that you don't deal with him. With homeschooling, it's 24/7. Will his dad be actively involved in the homeschooling? Then: the homeschooling. Make sure that he eats protein at breakfast, lunch, and snacks for good concentration. Allow him to chew gum. That also helps concentration. Try short class times (like 20 min) with a physical activity and/or outside play break. Both exercise and being outside in nature improve concentration. Get a math book at the grade level he should be going into. Take comfort in the fact that any grade only introduces about 20% new material. Just work through the material at a pace that he needs. Same with writing. There are good programs that are not graded. IEW is nice and step-by-step and is good for reluctant writers. Can he read on grade level? If you take care of reading, writing, and math in a structured way, you can pursue other subjects as it interests him. Your biggest challenge is his social skills. Those will make or break him. Some of those skills can be taken care of by the way you interact at home, but it will also be important to find a social skills group for him to participate in. The group will have other kids like him and is structured to teach them how to interpret events (I bet he gets upset at things that are accidental, has an overly developed sense of territory, and an overly developed sense of justice, right---if so, he's "reading" social cues incorrectly and reacting to what he perceives them to be--in which case his reactions are much more understandable), how to get what he wants/needs in socially appropriate ways, how to play with other kids, etc. + Quote Link to comment Share on other sites More sharing options...
ocean_eyes Posted May 22, 2009 Author Share Posted May 22, 2009 Request an IEP again - in writing citing the drop in grades. If the psych thinks he needs it, try again Did he get an assessment of adaptive skills (social behavior)? Did he get an OT eval? Did he get a functional behavioyial assessment? You can request those at the initial IEP. Also, did you get a copy of your rights in the IEP process last year. If not get a copy and know your rights before you go into your next initial meeting. BTW- academics are not enough - if he is having difficulty emotional or socially they need to address that to if he has a diagnosis (ODD with a probable mood/personality disorder). Start here http://dpi.wi.gov/SPED/pcrights.html and here http://www.specialed.us/Parents/plainlanguageindex.htm and sure you have no other option. Jill Thanks so much for posting with your ideas! Last winter (January) when we requested that he be evaluated, they didn't get around to a final decision meeting until MAY. At that time, they deemed he didn't qualify for further testing, an IEP for either academics or behavior (regardless of dx). DH and I had no idea if that is actually "procedure", but it felt like they didn't want to provide services and were trying to make it seem like the problems he's having at school were a result of DH and I not "making" him do his homework, rather than an issue that could be helped at school. We get the same feeling this year when the principal tells us DSS "will be fine" being pushed through to 6th grade. Interestingly enough, our psychiatrist's wife homeschools their children. He told me he isn't surprised at the schools lack of assistance. I feel like we "trusted the system" and it has totally failed DSS. Quote Link to comment Share on other sites More sharing options...
ocean_eyes Posted May 22, 2009 Author Share Posted May 22, 2009 Are you receiving help with managing his behaviors from someone experienced with ODD? You won't be able to homeschool if those behaviors aren't under check. Will you have respite from dealing with his behaviors? Right now, the hours he's at school are hours that you don't deal with him. With homeschooling, it's 24/7. Will his dad be actively involved in the homeschooling? Then: the homeschooling. Make sure that he eats protein at breakfast, lunch, and snacks for good concentration. Allow him to chew gum. That also helps concentration. Try short class times (like 20 min) with a physical activity and/or outside play break. Both exercise and being outside in nature improve concentration. Get a math book at the grade level he should be going into. Take comfort in the fact that any grade only introduces about 20% new material. Just work through the material at a pace that he needs. Same with writing. There are good programs that are not graded. IEW is nice and step-by-step and is good for reluctant writers. Can he read on grade level? If you take care of reading, writing, and math in a structured way, you can pursue other subjects as it interests him. Your biggest challenge is his social skills. Those will make or break him. Some of those skills can be taken care of by the way you interact at home, but it will also be important to find a social skills group for him to participate in. The group will have other kids like him and is structured to teach them how to interpret events (I bet he gets upset at things that are accidental, has an overly developed sense of territory, and an overly developed sense of justice, right---if so, he's "reading" social cues incorrectly and reacting to what he perceives them to be--in which case his reactions are much more understandable), how to get what he wants/needs in socially appropriate ways, how to play with other kids, etc. + Thanks so much for your reply. You have brought up so many good points. I totally agree about the respite thing. This year, he isn't as bad as he was last year, behaviorally. He's not physically fighting with anyone, but can argue like he's in law school if he thinks it will get him his way. He's actually doing very well at the moment b/c I told him if he wanted to be homeschooled, he would have to dramatically improve his behavior and attitude, that I couldn't deal with his previous behaviors day in and day out, etc. He's been making his bed (!!), speaking respectfully, asking permission before taking things. It is such a nice change, but I am sitting here kind of waiting for the other shoe to drop, KWIM? He has told his psych several times that his behaviors are all choices he's making and that he didn't really care about behaving. Perhaps he is just that miserable in PS that he has finally found something (being schooled at home) worth changing his behavior? I don't know. He was such a sweet kid, despite the ADHD, until about age 8. I incorrectly stated before that his ADHD and ODD were dx together around age 5/6, but thinking back the ODD stuff didn't come until about 3 years ago. DH is also ADD (refuses to take any meds, despite our psych offering to prescribe him something as a trial), and he and DSS often clash simply because they are so much alike...they will aruge with each other over tiny issues, simply b/c they both want to be right. However, they are both very good at the sciences and like a lot of the same types of books, and my hope is that they can do those types of things together as a way to strengthen their relationship. We also have a 2 1/2 year old DD and I am starting a light preschool cirric with her soon so I know I won't be able to do everything for DSS. He does pretty well with me b/c he knows I don't tolerate disrepect and will not argue with him. (I'm a nurse and worked at a psych hosp with kids just like him for 3 years.) We absolutely agree about the social skills and finding a group for him!! And you totally hit the nail on the head about over-developed sense of justice. Lord, that is him to a tee, lol! He is sooo entitled and if he is "wronged" in any way by kids at school, they are on his list from that day forward. As you can imagine, it did not take him long to be at odds with nearly everyone in his class. Quote Link to comment Share on other sites More sharing options...
moosemomma Posted May 22, 2009 Share Posted May 22, 2009 Thanks so much for posting with your ideas! Last winter (January) when we requested that he be evaluated, they didn't get around to a final decision meeting until MAY. At that time, they deemed he didn't qualify for further testing, an IEP for either academics or behavior (regardless of dx). DH and I had no idea if that is actually "procedure", but it felt like they didn't want to provide services and were trying to make it seem like the problems he's having at school were a result of DH and I not "making" him do his homework, rather than an issue that could be helped at school. We get the same feeling this year when the principal tells us DSS "will be fine" being pushed through to 6th grade. Did they test his IQ, get him an achievement test, anything before the final meeting? My son's eval took from the first week of February to week after vacation in April. He did have a DX for Aspergers/ADHD from a ped. neurologist which DH and I got from someone who studies AS and ADHD and that did save us a few weeks. They have UP TO 90 days to complete the eval process from the first initial IEP meeting. If you have problems last year, I would suggest finding an advocate - not cheap but can give you a lot of advice if you sit down and explain your situation and explain what your rights are in Wisconsin. I would suggest getting that 2nd opinion about mood disorder or AS dx (suggested by Laurie 4b) I have an 6yo Aspie and the lack of social skills and ADHD dx making me wonder if he could be an Aspie. I would ask your ped. or psych for an eval by a neurologist or developmental pediatrician. Now, AS is a form of autism and is eligible for services no if, ands or buts. A personality disorder and being seen by a shrink should too. But you need a diagnosis. If the diagnosis changes, for example, he is diagnosed with AS or a psych DX then you can write the CST and ask f (ALWAYS IN WRITING!!! - make a paper trail in case you need to go to mediation - you do know you can appeal a decision if you don't agree with the CST's evaluation ) Jill Quote Link to comment Share on other sites More sharing options...
Ottakee Posted May 22, 2009 Share Posted May 22, 2009 I would see the psych again and take a look at a mood disorder. What you mention (and his reaction to meds) can really fit something like bipolar or other mood disorder. IF that is what is going on, once you address that you can start working on the other things. Quote Link to comment Share on other sites More sharing options...
ocean_eyes Posted May 22, 2009 Author Share Posted May 22, 2009 Okay, after trying to reply 3 times and having IE crash each time, I finally got smart (?) and switched browsers, lol. Here we go, again. Jill, thanks again for your thoughts! As far as I know, they did not test his IQ or do any kind of achievement tests before the meeting; if they did, we were never given any kind of report on the findings. We filled out a bunch of questionnaires, and gave them his early developmental history (he met all his mile stones on time or early), and the social worker also interviewed and observed DSS in the classroom and spoke with his teacher. At the meeting last May, where they decided his behavior wasn't chronically disruptive enough to warrant a behavioral IEP and his grades weren't bad enough to warrant an academic IEP, we received a report detailing their opinions, observations and scoring from the questionnaires we filled out. I, too, have considered AS occasionally over the years, though the pyschs (this is our second) have conferred with us, and don't think it fits him in enough aspects to qualify for a dx. He does have a lot of the social skill issues, but at the same time, can be quite charming and socially appropriate if he thinks it will help him get what he wants. Other reasons they said he doesn't quite fit AS is the lack of narrow and specific areas of interest, and not having any repetative motor movements. (I don't know a lot about AS to begin with so I'm sure there were more professional findings, I just can't think of them at the moment.) They have hesitated to formally dx a personality disorder simply b/c he is so young and also because there are periods of time (sometimes even 1-2 months at a time) where he does quite well dealing with school and has very little negative behavior and that dx doesn't exactly fit either. Albeit this year, he has not gone longer than 1 or 2 weeks without getting in trouble at school for arguing, not doing assignments, etc. He has soooo many ODD characteristics. I've read entire books about ODD and every single symptom rings a bell in my head. I will ask our psych what he thinks about a neurologist and/or developmental ped consult. Couldn't hurt. As for the school stuff: We are aware that we can appeal the school's decision, but we are really do not feel public school (particularly this district where we live) is benefitting him. The teachers and kids have pretty much labeled him as a troublemaker and "weirdo" (DSS's words, not mine). It is a possibility that we will move out of the district in the next year or two, so we were really considering homeschooling him until that happens or permanently, if it works out. Either way, we will be looking into social skills groups as LaurieB suggested. I think that would help him so much. Quote Link to comment Share on other sites More sharing options...
ocean_eyes Posted May 22, 2009 Author Share Posted May 22, 2009 (edited) I would see the psych again and take a look at a mood disorder. What you mention (and his reaction to meds) can really fit something like bipolar or other mood disorder. IF that is what is going on, once you address that you can start working on the other things. Thanks for your thoughts! For a long time, I have wondered (still do at times) about bipolar or something similar. We tried Lamictal (3 month trial with titrated doses) about a year ago, and it had no affect on his behaviors or moods whatsoever. Most days, if he were to go without a stimulant, he is a total train wreck (cannot concentrate, do any school work, super annoying behavior-wise, etc). But I know stimulants can trigger manic episodes and aren't necessarily the "drug of choice" for mood disorders. He doesn't have any of the classic BP mood swing-type symptoms, but his psych said once he starts puberty and the hormones kick in, we could see more classic sx and he might respond better to mood stablizers vs. stimulants at that time. We are hesitant to try Depakote or Lithium at this time, due to the lack of response from the Lamictal and the higher risk of side effects. The psychs have said he is such an interesting, difficult "case" to diagnosis, but they have all been very nice about trying to help him. Sigh. Edited May 22, 2009 by ocean_eyes Quote Link to comment Share on other sites More sharing options...
Ottakee Posted May 23, 2009 Share Posted May 23, 2009 If you haven't done so, you might want to read the book THE BIPOLAR CHILD to see if that makes sense to you or not. I know the meds have risks to taking them but on the flip side, you need to look at where he is functioning now and those risks--failing school, having social trouble, behavioral issues at home, etc. (or what ever he is struggling with). Sometimes the "side effects" of not medicating are worse than the risks of using meds. Has he seen a neurologist before? Seizures can cause some mood/behavioral issues as well but can often be missed. On the Lamictal, did his blood level get high enough to be therapeutic? It took us months to get near a therapeutic level for my dd. Quote Link to comment Share on other sites More sharing options...
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