Advice on school options for violent child

[Anonymous]

I have a third grader who has been diagnosed with ADHD, ODD, impulse issues and on the spectrum. His therapist thinks a lot of his behavior problems are stemming from anxiety. We have him on Adderall and Risperdol and are considering switching meds this week. Our son started at the AAP school this year with a fairly extensive IEP. It has not been going well. He has been suspended five times for violent behavior. He has done things like this - when he was pushed into a coat rack accidentally he reacted by biting the girl who did it. He does fine academically except for writing (he will often rip up his papers and get upset at writing time). His behavior problems are usually related to when he doesn't get his way, or is someone slights him (kid cuts in line in from of him). We have had him in outside therapy, OT and speech for a year. We pay out of pocket for OT and speech as our insurance limit was reached this past summer.

We think he needs to moved to a different setting and the school is encouraging us to move him to the special ed center school. We are in the FCPS system. We are very distressed about this situation. He is our oldest and my husband and I are rule-followers and have never had a detention in our lives. We both work and he has a stable happy home.

We are at a loss on what else we can do? I am thinking we should look at the other med options and with moving to another setting might help. I don't want my son hurting or stopping other kids from learning. It is breaking my heart that he has hurt other kids. We just want our son to get the help he needs to succeed.

The schools we have been at seem to be supportive but I don't know. I am wondering if there is someone out there that we could talk to to get an objective opinion of what our next steps should be. Should we move him to that center? Should we push to just move him to a private school setting (at the county expense - we cannot afford the tuition), should we have home-based learning, move him to his base school or even keep him at his regular school?

Any advice is greatly appreciated.

[Anonymous]

First of all, I'm really sorry you are going through this. Many of us know the struggle you face and how difficult it is. You are not alone.

Are you working with an advocate/consultant? If not, I strongly urge you to check the archives and find one that works in FCPS. You should not navigate this road by yourself - and by that I mean you cannot rely on FCPS to do what is best for your DS. While there are many talented and caring educators, there are even more pressures on them that lead to them pushing/advocating directions that better suit their needs than your DCs. They many not even offer choices that are available. You need guidance and assistance from someone whose only concern is what's in the best interest of your DS. You, unfortunately, don't likely have the time or resources to learn what you need to learn in order to determine this. A good advocate/consultant will also have contacts in the medical community to help you find a great person to help with medication management.

My advice is not to make any big educational decisions until you get an advocate/consultant. Hugs.

[Anonymous]

OP, adderal is a stimulant and should not be given to kids with anxiety disorders, it magnifies their behavior. I would start by seeing your psychiatrist or getting a new one if this one isn't diagnosing and medicating correctly.

I also agree with getting a consultant, that is excellent advice.

[Anonymous]

First step,this child needs to be seeing a psychiatrist who specializes in pediatrics and has experience with pediatric bipolar disorder.

Dividing fractions is one of the last things the adults in his life should be concerned with right now. He is clearly not getting the mental health treatment that he needs. He needs to be stabilized, first. Bipolar Disorder and major mood disorder are commonly missed in kids younger than 10.

[Anonymous]

Does he have a neuropsych eval? It will diagnose anxiety if your DS has an anxiety disorder.

Stimulant medication like Adderall is generally not used for kids with anxiety disorders. It makes the anxiety and the coping (bad) behaviors worse.

What does the psychiatrist say about the behaviors?

I would get him evaluated by Dr David Black who is a neuropsych. He has extensive experience with kids with ASD with complicated profiles.

Is the OT for behavior/sensory integration? We found this to be a complete waste of money for our kid with ASD/ADHD.

I would not move your DS unless you get the anxiety treated and see how that goes first.

Good luck!

[Anonymous]

Anonymous wrote:Does he have a neuropsych eval? It will diagnose anxiety if your DS has an anxiety disorder.

Stimulant medication like Adderall is generally not used for kids with anxiety disorders. It makes the anxiety and the coping (bad) behaviors worse.

What does the psychiatrist say about the behaviors?

I would get him evaluated by Dr David Black who is a neuropsych. He has extensive experience with kids with ASD with complicated profiles.

Is the OT for behavior/sensory integration? We found this to be a complete waste of money for our kid with ASD/ADHD.

I would not move your DS unless you get the anxiety treated and see how that goes first.

Good luck!

And we have used a consultant since DS was diagnosed at 4. We did not find him particularly useful when our DS was having issues last yr in 2nd grade. They are useful if you definitely decide that you want another placement but not for improving the behaviors at the current school.

At least get a functional behavioral assessment and behavioral intervention plan in place. Having a behavioral plan will lessen the anxiety because expectations are clear cut. Just realize the FBA/BIP may not work 100% if the behaviors are caused by anxiety. Diagnose and treat the anxiety first.

[Anonymous]

OP, my heart breaks for you and your son. Without knowing the full details of the case I would consider as one PP to immediately take him off the Adderall which can increase aggressive behavior and starting an anti-depressant given that his therapist seems to think the behaviors stem from anxiety.

If you haven't already I would hire a behavior therapist to do a really good FBA and I would actually pay this therapist to sit in class for a full two or three days to really get a sense of what is going on and what the school has already tried to get a handle on the situations.

What is in his IEP already? What's in their BIP?

For schooling, I would seek private placement and my vote would be for Ivymount with the hope of getting him out of there in a few years if he gets better and I would be hopeful a child that smart would improve in the right environment. There are no good special ed centers for a child that bright in FCPS IMO.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Does he have a neuropsych eval? It will diagnose anxiety if your DS has an anxiety disorder.

Stimulant medication like Adderall is generally not used for kids with anxiety disorders. It makes the anxiety and the coping (bad) behaviors worse.

What does the psychiatrist say about the behaviors?

I would get him evaluated by Dr David Black who is a neuropsych. He has extensive experience with kids with ASD with complicated profiles.

Is the OT for behavior/sensory integration? We found this to be a complete waste of money for our kid with ASD/ADHD.

I would not move your DS unless you get the anxiety treated and see how that goes first.

Good luck!

And we have used a consultant since DS was diagnosed at 4. We did not find him particularly useful when our DS was having issues last yr in 2nd grade. They are useful if you definitely decide that you want another placement but not for improving the behaviors at the current school.

At least get a functional behavioral assessment and behavioral intervention plan in place. Having a behavioral plan will lessen the anxiety because expectations are clear cut. Just realize the FBA/BIP may not work 100% if the behaviors are caused by anxiety. Diagnose and treat the anxiety first.

Also, you may want to get him to keyboard at school. My DS uses a laptop since 2nd grade and gets typing instruction from the school OT. This is in his IEP.

We toured the Model Asperger's Program (MAP) at Ivymount last fall. The private SN choices with funding for bright kids with ASD are very few. You should definitely tour if you think this is what you want and get an advocate to help you. MAP is very difficult to get into especially with behaviors. The curriculum will not be at the same level of rigor as AAP.

[Anonymous]

How was he last year? Could you try moving him back to his neighborhood school to start?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Does he have a neuropsych eval? It will diagnose anxiety if your DS has an anxiety disorder.

Stimulant medication like Adderall is generally not used for kids with anxiety disorders. It makes the anxiety and the coping (bad) behaviors worse.

What does the psychiatrist say about the behaviors?

I would get him evaluated by Dr David Black who is a neuropsych. He has extensive experience with kids with ASD with complicated profiles.

Is the OT for behavior/sensory integration? We found this to be a complete waste of money for our kid with ASD/ADHD.

I would not move your DS unless you get the anxiety treated and see how that goes first.

Good luck!

And we have used a consultant since DS was diagnosed at 4. We did not find him particularly useful when our DS was having issues last yr in 2nd grade. They are useful if you definitely decide that you want another placement but not for improving the behaviors at the current school.

At least get a functional behavioral assessment and behavioral intervention plan in place. Having a behavioral plan will lessen the anxiety because expectations are clear cut. Just realize the FBA/BIP may not work 100% if the behaviors are caused by anxiety. Diagnose and treat the anxiety first.

Also, you may want to get him to keyboard at school. My DS uses a laptop since 2nd grade and gets typing instruction from the school OT. This is in his IEP.

We toured the Model Asperger's Program (MAP) at Ivymount last fall. The private SN choices with funding for bright kids with ASD are very few. You should definitely tour if you think this is what you want and get an advocate to help you. MAP is very difficult to get into especially with behaviors. The curriculum will not be at the same level of rigor as AAP.

If you decide to use an advocate for private placement, try Susan Eisman.

[Anonymous]

Or Isman - not sure about spelling

[Anonymous]

OP here. Thanks everyone who has replied. Sounds like Adderall is not helping and possibly hindering my son. We will see his psychiatrist this Thursday and work on stopping this drug. Our doc is a pediatric psychiatrist and we are very happy with him. We had our son in play therapy for over a year and we felt we got nothing out if nor did he beyond doing fun crafts each week. We switched to a new psychologist a few months ago who is focused on results and he has been very helpful. He is the one who thinks anxiety is the major issue at play. We had a neuro-psych done already but apparently it wasn't good and my son's current psychologist is encouraging us to have it redone. We plan to do so. I will reach out to Dr. Black tomorrow.

We haven't hired an advocate yet, but I will do so this week - any suggestions for one who has experience in FCPS? We want our kid to get the tools he needs to succeed socially. Academics are definitely second right now. We just had a FBA done but we haven't really had a chance to get the BIP in place as he has been suspended twice in one week. The BIP was finalized on a Friday about 5:30 and then on Monday he was suspended for two days when he got in from an incident he had while he was waiting for us when we were in the IEP meeting. Sigh. I feel like the school isn't giving us a chance to get it started. Of course, I don't blame them when it comes to safety as my son is hurting other kids. It is frustrating.

I am so grateful for your input. I cried reading the replies - as I am sure every one of you can relate - this is so very hard emotionally. I am a bit of wreck.

[Anonymous]

Sheila Iseman. Yes, she can help make a case to Ivymount and to the school system to pay for it.

[Anonymous]

Also, look into classrooms and programs that use the Unstuck and On Target program. FCPS had classrooms that taught this. Ivymount outreach has a Saturday program.

The behaviors can be caused by anxiety and/or rigidity from the ASD. These kids HATE surprises and anything unexpected can cause them significant anxiety/stress.

[Anonymous]

I'd investigate changes in meds before I took the step of changing placements. Stimulants can cause dramatic increases in anxiety, aggression, and other problematic behavior for kids who have more than garden variety ADHD. I'd also ask for a high quality FBA by a BCBA who is not part of the school. If need be, I'd pay for that person to come in.

ED programs are less than ideal placements for the vast majority of kids. Although they often have dedicated teachers, the fact is that a placement with other violent kids is unlikely to be what your child needs to feel less anxious. In addition, it can be hard

Can you ask the school to provide a short term dedicated aide, or other short term strategies that will keep the other kids safe, such as increased resource room time, or reducing writing demands through the use of a scribe, or separate transitions, while you put your energy towards a medication change, and a really well done FBA by an outside BCBA. If things are at such a crisis point that the school doesn't think they can manage for another month or two, then maybe look at the partial hospitalization program at Dominion or another temporary solution.

Good luck, parenting kids with mental illness is incredibly challenging. Your son is lucky to have a parent who is advocating for the best for him.