Seeking guidance with teen's rigidity and slowness

[Anonymous]

This will be long, sorry. I would appreciate your thoughts on how to proceed.

I had an epiphany this evening, as my husband and I observed my 13 year old struggle through homework. We realized that rigid and inflexible thinking about how to answer the questions was contributing to his abysmally low processing speed (and also perfectionism and anxiety?). It's incredible how we hadn't understood it like that before!

More details: in more than 3 hours this afternoon, DS answered only two questions out of 100+ questions on a book they're reading in class. Students are supposed to write on the handout, and there is about an inch of space for each answer. DS wrote small and went over the space into the margins for each, like he always does. Each "question" actually had two sub-questions about the plot and students were supposed to cite the text to support their answer. I've read this particular book and could have answered both sub-questions in one very brief sentence (they were related), and perhaps found one quote to address both parts, or two separate quotes. Point is, I would have kept it short, because it's obvious to me that if there are more than a 100 questions and so little space, the teacher doesn't want or expect a dissertation. DS got upset and started crying when we told him this and said that he had to answer each question separately and insert each quote in their separate sentences. His sentences were long because they were very precise and detailed.

DS is like this for everything in his life. He has internalized rules of living, and applies the rule the same way (as perfectly and completely as he can) for every situation. If he does not know the particular rule for doing something, instead of inferring it like all the other students because it's so obvious (handing in stuff, looking up information), he goes and asks the teacher. He refuses to even consider that often rules need to be bent to fit the many vagaries of life, and that often it's better to do things fast than well. One consequence is he has no friends, because socializing requires constant, on-the-go adaptation to other people's unpredictable reactions, and he cannot do that. The other consequence is that he spends all his free time doing his homework, literally, because he is very slow in general and he has to do it in a certain way. He used to not be able to put his thoughts on paper in elementary school, but we hired an excellent writing tutor, and now he won't write anything but great sentences with correct citations (which this handout was not made for).

Known diagnoses and treatments: DS was diagnosed with moderate to severe mixed-type ADHD at 10, and concurrently with dysgraphia, dyscalculia, and very low processing speed. The psychologist was on the fence about a possible Asperger's assessment, but since it cost extra to have that done, we refused, thinking the ADHD would give him all the services and accommodations he would need at school (extended time and resource class), and that we would treat him with stimulants. He takes meds for ADHD and does well at school. His teachers love how intellectually curious he is and how well he works (duh!). His work is pretty much perfect all the time.

Suspected diagnoses: I would say... anxiety, certainly. He cries when he's overwhelmed with work and has trouble sleeping. For the rigidity and failure to adapt: I don't know. OCD? Asperger's?

Here are other non-homework examples. He had memory issues with his ADHD before he was medicated, so I taught him routines so he would remember doing basic life things. The problem now is that he can't do them any other way. Before and after every meal or when he returns home from somewhere, he washes his hands (intended for when he returned home from school). Even for a small snack, even when he's just been out for a walk with winter gloves, has touched NOTHING, he comes back and washes his hands - and gets chapped hands all winter. He has a particular anxiety around toilets, even though I've explained that germs exist on doorknobs, faucets, water fountains and keyboards nearly as much as in toilets (I've had training in microbiology). He has a fit if someone does not flush: my husband was trying to save water for a period of time, and the two ended up having HUGE fights about this. He can be mind-bogglingly inattentive to the most obvious things around him, but forget to flush when you're leaving the bathroom, and he'll be able to tell even if he's on another floor of the house! He'll be positively angry, and this kid is super calm and usually never gets angry.

What do you think this is all about?
What should we do?
How do we best manage this, keeping in mind that his limitation is time: he spends all available time on schoolwork and doesn't have much left over for other stuff.
Depending on what this is, can his IEP be tweaked to address it, or is this best addressed outside school?

I feel like I'm playing wack-a-mole. Every time I feel like I've faced one problem, another one crops up! It's exhausting, for him and us, and we've GOT to get off this train.
Thank you for your help.

[Anonymous]

Yes it feels like whack-a-mole.

Can’t diagnose over internet. But know that ADHD, anxiety and similar disorders can all run together.

Talk to your psychiatrist. They may recommend more testing or changing meds from a stimulant or treating the anxiety with medication and therapy.

But if your child has autistic tendencies, given the rest of the you describe get the ADOS to rule it in or out. You can and should treat symptoms but if he has autism, you are missing an important part of the puzzle that will inform treatment.

[Anonymous]

Also hand-washing is a really good habit and not flushing is gross, unless there is an actual water shortage.

[Anonymous]

I think this is all about having ADHD, anxiety, perfectionism, and OCD and the rigidity and self-defeating behaviors that come with it.

I think his medication is not helping him or not helping enough.

I think he desperately needs different medication or more medication.

I think he needs an IEP that limits the number of questions he answers because at this point he can't possibly answer 100 homework questions and even being asked to do so is triggering for him.

[Anonymous]

You need to test whether autism is an issue.

[Anonymous]

Anonymous wrote:I think this is all about having ADHD, anxiety, perfectionism, and OCD and the rigidity and self-defeating behaviors that come with it.

I think his medication is not helping him or not helping enough.

I think he desperately needs different medication or more medication.

I think he needs an IEP that limits the number of questions he answers because at this point he can't possibly answer 100 homework questions and even being asked to do so is triggering for him.

Excellent post!

[Anonymous]

I agree about OCD. And if he’s spending all of his free time now on homework he will never sleep in high school. You need new, comprehensive testing, an IEP that allows him less homework, and meds/therapy to address the rigidity and anxiety. Good luck.

[Anonymous]

Does he see a therapist ?

[Anonymous]

I wonder if CBT to teach him flexible thinking would help. For a child who is very rigid, it will teach him "rules" of when to be flexible if that makes sense.

[Anonymous]

Also, I realize you're writing about his challenges, but your child sounds amazing.

[Anonymous]

OP, I want to say first that this sounds like a challenging set of issues. I can imagine how your child’s inflexibility might effect the entire family, and I’m sorry.

You are describing a pattern of behavior that pervades all life activities, not just school-related tasks. While adjusting your child’s 504 or IEP may be appropriate, it sounds like more comprehensive treatment outside of school is in order. That’s the only way to help with the family and social issues. It’s probably the best course of action for remediating the problem as opposed to just acomodating it. Check it with a mental health professional as soon as you can. This may call for medication, counseling, and/or behavioral intervention.

Regarding homework, have you tried previewing it before he starts? Take a look at assignments and estimate how long they should take. Then, when it comes to something like the reading assignment, you can say “We estimated an hour for this task. That means a little more than half a minute per question. Let’s use a timer to keep track.” You might even do the first one or two questions together to model what that pace would look like. While your son was resistant to you helping in the middle of the assignment, he might go along better if you’re there from the beginning. One of the hardest things for inflexible thinkers is switching gears while in the middle of a task. If your son resists working with you, he might do better with a study skills tutor.

Wishing you all the best as you seek solutions.

[Anonymous]

Anonymous wrote:This will be long, sorry. I would appreciate your thoughts on how to proceed.

I had an epiphany this evening, as my husband and I observed my 13 year old struggle through homework. We realized that rigid and inflexible thinking about how to answer the questions was contributing to his abysmally low processing speed (and also perfectionism and anxiety?). It's incredible how we hadn't understood it like that before!

More details: in more than 3 hours this afternoon, DS answered only two questions out of 100+ questions on a book they're reading in class. Students are supposed to write on the handout, and there is about an inch of space for each answer. DS wrote small and went over the space into the margins for each, like he always does. Each "question" actually had two sub-questions about the plot and students were supposed to cite the text to support their answer. I've read this particular book and could have answered both sub-questions in one very brief sentence (they were related), and perhaps found one quote to address both parts, or two separate quotes. Point is, I would have kept it short, because it's obvious to me that if there are more than a 100 questions and so little space, the teacher doesn't want or expect a dissertation. DS got upset and started crying when we told him this and said that he had to answer each question separately and insert each quote in their separate sentences. His sentences were long because they were very precise and detailed.

DS is like this for everything in his life. He has internalized rules of living, and applies the rule the same way (as perfectly and completely as he can) for every situation. If he does not know the particular rule for doing something, instead of inferring it like all the other students because it's so obvious (handing in stuff, looking up information), he goes and asks the teacher. He refuses to even consider that often rules need to be bent to fit the many vagaries of life, and that often it's better to do things fast than well. One consequence is he has no friends, because socializing requires constant, on-the-go adaptation to other people's unpredictable reactions, and he cannot do that. The other consequence is that he spends all his free time doing his homework, literally, because he is very slow in general and he has to do it in a certain way. He used to not be able to put his thoughts on paper in elementary school, but we hired an excellent writing tutor, and now he won't write anything but great sentences with correct citations (which this handout was not made for).

Known diagnoses and treatments: DS was diagnosed with moderate to severe mixed-type ADHD at 10, and concurrently with dysgraphia, dyscalculia, and very low processing speed. The psychologist was on the fence about a possible Asperger's assessment, but since it cost extra to have that done, we refused, thinking the ADHD would give him all the services and accommodations he would need at school (extended time and resource class), and that we would treat him with stimulants. He takes meds for ADHD and does well at school. His teachers love how intellectually curious he is and how well he works (duh!). His work is pretty much perfect all the time.

Suspected diagnoses: I would say... anxiety, certainly. He cries when he's overwhelmed with work and has trouble sleeping. For the rigidity and failure to adapt: I don't know. OCD? Asperger's?

Here are other non-homework examples. He had memory issues with his ADHD before he was medicated, so I taught him routines so he would remember doing basic life things. The problem now is that he can't do them any other way. Before and after every meal or when he returns home from somewhere, he washes his hands (intended for when he returned home from school). Even for a small snack, even when he's just been out for a walk with winter gloves, has touched NOTHING, he comes back and washes his hands - and gets chapped hands all winter. He has a particular anxiety around toilets, even though I've explained that germs exist on doorknobs, faucets, water fountains and keyboards nearly as much as in toilets (I've had training in microbiology). He has a fit if someone does not flush: my husband was trying to save water for a period of time, and the two ended up having HUGE fights about this. He can be mind-bogglingly inattentive to the most obvious things around him, but forget to flush when you're leaving the bathroom, and he'll be able to tell even if he's on another floor of the house! He'll be positively angry, and this kid is super calm and usually never gets angry.

What do you think this is all about?
What should we do?
How do we best manage this, keeping in mind that his limitation is time: he spends all available time on schoolwork and doesn't have much left over for other stuff.
Depending on what this is, can his IEP be tweaked to address it, or is this best addressed outside school?

I feel like I'm playing wack-a-mole. Every time I feel like I've faced one problem, another one crops up! It's exhausting, for him and us, and we've GOT to get off this train.
Thank you for your help.

This is my son to a t. A million things like : a teacher in 2nd grade told him not to erase when he made a mistake on a paper. 3 years later he won't erase anything. Goes into melt down mode if you try to force this issue.
He does have anxiety but the anxiety stems from the fact that hes a super rigid thinker living in a world that's all grey areas.

Hes autistic. Very high functioning in most areas.

Anyway my advice is to model flexibility and forest for the trees thinking as often as you can and get him into unstuck and ontarget or on target for life depending on his age

[Anonymous]

Address the issues: For the inflexibility, he needs a class like Unstuck and On Target, something to address the rigidity. At the very least, He needs counseling to help him cope with anxiety which will help him be more flexible and able to make friends.

For the slow processing speed, I would ask for limiting the amount of homework until he can get a handle on the rigidity. Taking 3 hrs to answer 2 questions is an untenable situation that will only get worse as he enters high school.

[Anonymous]

^Also, he needs help with pragmatics and social skills. I would recommend PEERS and/or Unstuck and On Target, plus a social worke/psychologistr who specializes in kids with HFA for behavioral therapy.p specifically on how to deal with stress like CBT.

[Anonymous]

You have diagnosis. Get him a tutor and supports.