Where to go from here? 1st grade boy -- impulsivity, aggression, bothering other kids, antsiness

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don't agree with starting with your pediatrician, unless you are asking for a referral. This is not their area of expertise. If you are concerned you should see a) a developmental pediatrician or b) a child/family psychologist. Either one could be extremely helpful.

And while you are doing this, you should formally request an IEP -- they have up to 120 days in DC, so it could take a while. Document all the issues that the teacher is reporting to you; if the teacher tells you something verbally, send her an email summarizing the conversation.

Many developmental pediatricians have long waits. I suggest Paula Elitov, a developmental psychologist who will do school observations as part of her evaluations and has more reasonable availability. If you are seeing these problems at home, I also suggest Dr. Dan Shapiro's parenting class: http://www.parentchildjourney.com

DC special Ed laws changed recently to shorten the wait times. But anyway you should request an eval stat since his behavior is affecting his classroom performance. Are you in DCPS or a charter?

Op here: Do you mean request an evaluation from the school or a psychologist? He's in DCPS.

Not the immediate PP, but you could request one from school AND go to an outside neuropsychologist. There is a risk that they might administer some of the same tests, which is not advised. Most times the school ones will be truncated and less thorough.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don't agree with starting with your pediatrician, unless you are asking for a referral. This is not their area of expertise. If you are concerned you should see a) a developmental pediatrician or b) a child/family psychologist. Either one could be extremely helpful.

And while you are doing this, you should formally request an IEP -- they have up to 120 days in DC, so it could take a while. Document all the issues that the teacher is reporting to you; if the teacher tells you something verbally, send her an email summarizing the conversation.

Many developmental pediatricians have long waits. I suggest Paula Elitov, a developmental psychologist who will do school observations as part of her evaluations and has more reasonable availability. If you are seeing these problems at home, I also suggest Dr. Dan Shapiro's parenting class: http://www.parentchildjourney.com

DC special Ed laws changed recently to shorten the wait times. But anyway you should request an eval stat since his behavior is affecting his classroom performance. Are you in DCPS or a charter?

Op here: Do you mean request an evaluation from the school or a psychologist? He's in DCPS.

Not the immediate PP, but you could request one from school AND go to an outside neuropsychologist. There is a risk that they might administer some of the same tests, which is not advised. Most times the school ones will be truncated and less thorough.

Op here: Thanks. So sounds like an eval could be done by (among other people presumably) a developmental pediatrician, developmental psychologist, or a neuropsychologist. Will check the archives for names.

[Anonymous]

Op here: One more piece of info, if that's helpful. He's way ahead in reading -- and on or above grade level in math. So it hasn't affected his ability to learn in those areas. But has affected his classroom behavior generally.

[Anonymous]

You need to evaluate so you know what you’re dealing with. You have a couple of options.

1. Email your school’s principal for your public ES, whether or not your kid attends public and ask for an evaluation for X, Y, Z reasons that affects your kid accessing the curriculum and/or educational impact.

2. Call KKI or Childrens and self refer for a neuropsychological evaluation (by a psychiatrist) or for an appointment with a developmental pediatrician. You’ll probably be given dates way far away and you take both. Inevitably there will be a cancellation sooner rather than later and you take that appointment and cancel the other. (Just as a head's up, generally health insurance doesn't reimburse for neuropsych evaluations b/c they're considered educational vs. medical. They often will reimburse for a developmental pediatric visit. Check with your insurance.)

An OT can be helpful if they do something like “How does your engine run,” program. They’re not for diagnostics.

I would read, Greene- the explosive child, Kenworthy- Unstuck and On Target, and Kazdin - the Kazdin approach.

You don’t need to wait for evaluation results to do behavioral therapy or a social skills group for your kid, e.g., Ivymount Outreach in Potomac. Kingsbury in DC. You could also try a ST near you. KKI has a behavioral outpatient clinic in Columbia, MD but there are other practitioners.

[Anonymous]

Anonymous wrote:Op here: One more piece of info, if that's helpful. He's way ahead in reading -- and on or above grade level in math. So it hasn't affected his ability to learn in those areas. But has affected his classroom behavior generally.

This is why you will have better luck going with a private neuropsych evaluation. The school may argue that any issues are not affecting his ability to access the curriculum. It's clearly affecting him in many ways, but you will want a more complete picture (social, emotional, educational, etc.) Sometimes it's more cut and dry with the school evaluations when they are falling behind academically.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op here: One more piece of info, if that's helpful. He's way ahead in reading -- and on or above grade level in math. So it hasn't affected his ability to learn in those areas. But has affected his classroom behavior generally.

This is why you will have better luck going with a private neuropsych evaluation. The school may argue that any issues are not affecting his ability to access the curriculum. It's clearly affecting him in many ways, but you will want a more complete picture (social, emotional, educational, etc.) Sometimes it's more cut and dry with the school evaluations when they are falling behind academically.

Disagree. Aggression toward peers affects his ability to access the curriculum.

Also, forgot to mention in PP...

Dr. Shapiro offers parenting classes in MD and DC and Dr. Hackney offers parenting classes in VA.

[Anonymous]

Op here:

Thank you. I'm going to read over all of this carefully.

On the parenting classes, we have done many, many, many parenting classes. Many.

[Anonymous]

Anonymous wrote:Op here: One more piece of info, if that's helpful. He's way ahead in reading -- and on or above grade level in math. So it hasn't affected his ability to learn in those areas. But has affected his classroom behavior generally.

This is my first grade son as well. Impulsive, can't sit still, can't organize his thoughts to get the words out of his mouth, aggressive, and easily frustrated. On an academic level, he's reading at a 4th grade level and working on 3rd grade math topics. His behavior impacts his ability to be in the classroom. It doesn't impact his academics though because he's already ahead so the topics that they are covering he has already mastered. It's a frustrating cycle.

OP--get a full neuropsych eval and that will tell you what you are dealing with.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op here: One more piece of info, if that's helpful. He's way ahead in reading -- and on or above grade level in math. So it hasn't affected his ability to learn in those areas. But has affected his classroom behavior generally.

This is why you will have better luck going with a private neuropsych evaluation. The school may argue that any issues are not affecting his ability to access the curriculum. It's clearly affecting him in many ways, but you will want a more complete picture (social, emotional, educational, etc.) Sometimes it's more cut and dry with the school evaluations when they are falling behind academically.

Disagree. Aggression toward peers affects his ability to access the curriculum.

Also, forgot to mention in PP...

Dr. Shapiro offers parenting classes in MD and DC and Dr. Hackney offers parenting classes in VA.

This is my child as well. Above grade level, but because aggression and classroom disruption was such a problem, the school was actually happy to provide services to manage the behavior.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don't agree with starting with your pediatrician, unless you are asking for a referral. This is not their area of expertise. If you are concerned you should see a) a developmental pediatrician or b) a child/family psychologist.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I don't agree with starting with your pediatrician, unless you are asking for a referral. This is not their area of expertise. If you are concerned you should see a) a developmental pediatrician or b) a child/family psychologist. Either one could be extremely helpful.

And while you are doing this, you should formally request an IEP -- they have up to 120 days in DC, so it could take a while. Document all the issues that the teacher is reporting to you; if the teacher tells you something verbally, send her an email summarizing the conversation.

Many developmental pediatricians have long waits. I suggest Paula Elitov, a developmental psychologist who will do school observations as part of her evaluations and has more reasonable availability. If you are seeing these problems at home, I also suggest Dr. Dan Shapiro's parenting class: http://www.parentchildjourney.com

DC special Ed laws changed recently to shorten the wait times. But anyway you should request an eval stat since his behavior is affecting his classroom performance. Are you in DCPS or a charter?

Op here: Do you mean request an evaluation from the school or a psychologist? He's in DCPS.

DCPS historically takes their sweet old time - up to the limits of the law or beyond. Our charter was faster, as they wanted to solve the problem, and were generally (some exceptions) fairly cooperative.

You can look at Wrightslaw for for how to word the request for an IEP eval. or people here may have suggestions. But I wouldn't wait long. Unfortunately DC still has up to 120 days, until that part of the law changes next June: http://www.childrenslawcenter.org/sites/default/files/attachments/resources/2015%20Special%20Education%20Legislation%20Effective%20Dates%20Chart_0.pdf

My son was like this and getting supports in place was important to the improvement (along with the eval, etc). For one thing, such behavior is likely affecting his ability to form and maintain age-appropriate friendships, and if he's sent to the office, that may be having an effect as well, even if he's not below grade level.

[Anonymous]

Anonymous wrote:Op here:

Thank you. I'm going to read over all of this carefully.

On the parenting classes, we have done many, many, many parenting classes. Many.

PEP classes are pretty useless IMO, whether or not your kid is SN. What Shapiro, Kazdin, and Unstuck Parenting classes (at Ivymount) teaches parents is based on lots of research and will be effective with all kinds of kids. I'm guessing most of the classes you took weren't evidence based. If you don't want to do a class, try behavioral therapy. A behavioral therapist will help you develop more constructive and effective ways to communicate with your kid.

Your kid most likely doesn't want to be aggressive with peers but for whatever reason--whether is a social communication disorder, AHDH, anxiety, etc. He needs ways to scaffold his behavior for appropriate responses. In addition to an evaluation whether it's done through the school or privately, you can ask for a Functional Behavioral Assessment (FBA). Through observation, they can help identify the triggers and put in behavioral supports in place.

[Anonymous]

Op here: Thanks for the suggestion! I signed up for a parenting class with Dr. Shapiro.

[Anonymous]

OP, I absolutely cannot believe that no one has told you to have him assessed for ADHD before this. The professional you have been working with have failed you, I fear.
What you're describing sounds like very classic ADHD. My son is now in second grade (and reads at a 4-5th grade level), and has significant ADHD. Without his medications, he is as you describe. We struggled through preschool without medication, doing OT and therapy and none of it helped much at all. We started a very small dose of medication (using a conservative psychiatrist as the prescribing doc) after he started K, and I was so, so glad I did not wait longer. We've gradually increased the dosage as he grows. Even with the medication, he still struggles and we have accommodations in the classroom. But when his medication is out of whack, it's really awful. Kids that age very quickly get the reputation as the "trouble maker" kid, and its so heartbreaking when that happens. There are pros and cons about meds, obviously, but when it comes to the impulsivity, nothing else works nearly as well.

We did our initial neuropsych with Stixrud, FWIW. Insurance paid part of it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op here: One more piece of info, if that's helpful. He's way ahead in reading -- and on or above grade level in math. So it hasn't affected his ability to learn in those areas. But has affected his classroom behavior generally.

This is why you will have better luck going with a private neuropsych evaluation. The school may argue that any issues are not affecting his ability to access the curriculum. It's clearly affecting him in many ways, but you will want a more complete picture (social, emotional, educational, etc.) Sometimes it's more cut and dry with the school evaluations when they are falling behind academically.

Disagree. Aggression toward peers affects his ability to access the curriculum.

Also, forgot to mention in PP...

Dr. Shapiro offers parenting classes in MD and DC and Dr. Hackney offers parenting classes in VA.

I agree also, but I think that PP was just making a statement of reality as to what the school may say. My school definitely took the position that because his reading and math skills were way above the grade standard, they did not have to do any evaluation. Even when he essentially failed a bunch of the stupid standards for the year, they still said tehre was no affect on his ability to access the curriculum because his "average" across areas was a passing grade. (I was like "Ummmm...they why do you have all these things on the report card, if they are not reflective of the curriculum and you don't really have an expectation that children will get a passing grade in them?" They just stared at me.) We're in MCPS, though--DCPS might be better on these things.

[Anonymous]

Anonymous wrote:OP, I absolutely cannot believe that no one has told you to have him assessed for ADHD before this. The professional you have been working with have failed you, I fear.
What you're describing sounds like very classic ADHD. My son is now in second grade (and reads at a 4-5th grade level), and has significant ADHD. Without his medications, he is as you describe. We struggled through preschool without medication, doing OT and therapy and none of it helped much at all. We started a very small dose of medication (using a conservative psychiatrist as the prescribing doc) after he started K, and I was so, so glad I did not wait longer. We've gradually increased the dosage as he grows. Even with the medication, he still struggles and we have accommodations in the classroom. But when his medication is out of whack, it's really awful. Kids that age very quickly get the reputation as the "trouble maker" kid, and its so heartbreaking when that happens. There are pros and cons about meds, obviously, but when it comes to the impulsivity, nothing else works nearly as well.

We did our initial neuropsych with Stixrud, FWIW. Insurance paid part of it.

Thanks for this. No one has told us this! I promise. Ugh. Not the psychologist we went to, not our pediatrician (I now recall we talked to our ped too). And not his teacher from last year. I met with the teacher and the school psychologist and asked them whether I should have him evaluated, in their opinion, and they said not yet, in their opinion. Because the accommodations they had in place (informally) seemed to be working. But I think we just had a great teacher last year who knew how to handle our kid. And I did take seriously their thoughts because they know our kid well. I have been feeling so lost, and the responses on this board have been so helpful. I really appreciate it.