ADHD becoming intense

[Anonymous]

I’m very worried about my 4th grade son who has adhd. He’s very smart but his difficulty focusing in class and impulsive and disruptive behavior are causing problems in his classroom. He is in a co-taught 4th grade classroom. His classroom teacher reports that:
- he is allowed to walk around/pace in the back of the room during lessons if he needs to move. During this time the special Ed teacher monitors him and will cue him for attention if instructions are being given, he seems to be not paying attention to the lesson, etc.
Despite this, he very very frequently comes to sit with her after lessons and says he wasn’t listening, doesn’t know what to do, etc. there are very specific step by step instructions on the board for independent work, always when students are working on a task.

-impulsive/disruptive behavior: during lessons, he will be moving around in the back of the room and will also sometimes bang on the table, stomp on the ground, bang his metal water bottle on the desk, yell out random comments. Some of this has devolved into class clown behavior where he is looking to make kids laugh or distract them.

-he has a 2.5 hour block of instruction (2 subjects) that is very long for him. Breaks and snack are integrated but at the end of the day it’s a very long period of time of instruction for him to sustain. He starts to fall apart as the time goes on add when offered a break to take a walk, etc, he refuses. The issues escalate as the time goes on.

-he rushes his work, doesn’t read or follow directions, makes small errors that necessitate correcting which causes him frustration. He does not like having the teacher sit with him to slow down and be careful with his work either, because he wants to be done.

He is not on medication but I’m wondering if it’s time. What can I expect of the teacher? Is it her responsibility to reteach him everything he misses on a daily basis due to adhd? Should I request pull out? He is smart but his struggles with adhd are really impacting him. There are probably 7 kids with iep’s in the classroom altogether.

[Anonymous]

Does he have an IEP?

[Anonymous]

Yes, it's time for medication. It's not fair to expect him to "try harder."

[Anonymous]

Yes he does have an IEP.

[Anonymous]

He shouldn’t be allowed to walk around during class not paying attention and disrupting. That is not a helpful accomodation at all. A defined break may be ok, but this is a kid that needs structure.

I’m not a big fan of ADHD meds but one thing they definitely do is reduce disruptive motor behavior.

[Anonymous]

It is time for meds, way past time. This situation is incredibly unfair to the teacher, the other students and your son, who is not learning. I say this as the parent of a child on medication. Even medicated they need movement breaks and other accommodations, I’m not saying it’s going to make everything easy. But that’s insane to allow things to get that bad without even trying the one thing that is known to help most with hyperactivity.

[Anonymous]

It is time.

[Anonymous]

Definitely time for medication. There is no "try harder" there is only you, and his advocates creating a better environment, which surely involves medication.

[Anonymous]

Way past time. It’s hard to notice when you don’t have a benchmark to measure against. You get used to things as normal that really aren’t.
He’s falling behind and that’s not fair, especially to a smart kid like him. The teacher doesn’t have the time (and probably not the energy) to reteach him.

[Anonymous]

I’m confused why you are doing this to your child, his teachers and his peers. It’s incredibly selfish and pointless and I’m sure medication has been on the table for a long time. So unfair to everyone involved.

[Anonymous]

Anonymous wrote:It is time for meds, way past time. This situation is incredibly unfair to the teacher, the other students and your son, who is not learning. I say this as the parent of a child on medication. Even medicated they need movement breaks and other accommodations, I’m not saying it’s going to make everything easy. But that’s insane to allow things to get that bad without even trying the one thing that is known to help most with hyperactivity.

+1

[Anonymous]

Anonymous wrote:I’m confused why you are doing this to your child, his teachers and his peers. It’s incredibly selfish and pointless and I’m sure medication has been on the table for a long time. So unfair to everyone involved.

In OP’s defense it sounds like she has gotten extremely poor advice on appropriate behavioral interventions to get to this point. But yeah, even I (who have a documented record of believing kids are overmedicated!) would be fully in favor of trying meds - as long as OP understands the limitations. They are highly effective for disruptive motor behaviors, but you’ll still need to make sure he is learning.

[Anonymous]

Anonymous wrote:Way past time. It’s hard to notice when you don’t have a benchmark to measure against. You get used to things as normal that really aren’t.
He’s falling behind and that’s not fair, especially to a smart kid like him. The teacher doesn’t have the time (and probably not the energy) to reteach him.

+1

OP it takes time to find a good ADHD medication. You need a doctor who can see you through this process. There are side effects such as lowered appetite and irritability especially when coming off the meds in the afternoon. Keep in mind that what works now might not be the same as what works when your kid hits puberty. Do you have any questions for those of us who have been through this already?

[Anonymous]

Elementary teacher here. You know it is time for medication when he is not successful in school and is likely feeling like a “bad kid” because he requires so much more help than the other kids. He knows he is not doing well and his self-esteem is going down the toilet and he’s adopting the class clown persona because he likes that better than being the class dummy, which is probably what he feels like.

It does take time to find the right med and it is important that you be very clear with him about ADHD and reassure him that you are going to get him extra help because he needs it, and it’s not his fault that his brain is wired differently so that school is hard.

Imagine what you would feel like at work every day if you had to correct your work all the time, your coworkers watched your supervisor constantly help you, and you couldn’t sit still and concentrate, and the list of tasks seemed overwhelming as your mind jumped from topic to topic? You would hate going to work.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m confused why you are doing this to your child, his teachers and his peers. It’s incredibly selfish and pointless and I’m sure medication has been on the table for a long time. So unfair to everyone involved.

In OP’s defense it sounds like she has gotten extremely poor advice on appropriate behavioral interventions to get to this point. But yeah, even I (who have a documented record of believing kids are overmedicated!) would be fully in favor of trying meds - as long as OP understands the limitations. They are highly effective for disruptive motor behaviors, but you’ll still need to make sure he is learning.

What behavioral interventions should be implemented?