It must be very exhausting for you and your husband. I commend you because it sounds like you are doing all you can to help him succeed. I agree with a previous poster. It is so important to get the medication right before you can work on the issues. I would suggest getting a tutor for after school to help him with school lessons and homework. You probably would need someone 5-6 days a week. You could even hire a senior high school student who will not charge an arm and leg and are often very patient. Contact the local high school and ask if they can recommend someone. Hang in there!

Anonymous wrote:What about non-stimulants? Intuniv has worked wonders with emotional regulation for my DS. He can roll with the punches a whole lot better now. It's even helped a bit with attention. I know others have used this in conjunction with an SSRI to help with anxiety.

Unfortunately, Intuniv and SSRIs both carry elevated risk of suicidal ideation. With DS, he had the one incident of trying to self-harm post Focalin, plus another incident in elementary school where he had been pulled out of class for 1:1 time within he SN para-ed and told her he just wanted to die. I don’t think he meant it at the time, but we did have to have an emergency psych consult. Since then, DC psych has said no to anything with SI in the side effects list. Wellbutrin is on the shortlist, and it seems to help with ADHD & depression too.

What about non-stimulants? Intuniv has worked wonders with emotional regulation for my DS. He can roll with the punches a whole lot better now. It's even helped a bit with attention. I know others have used this in conjunction with an SSRI to help with anxiety.

Since you're overseas, I would focus on teaching him executive functioning skills. You can order a book, I like Ann dolin's homework made simple. She runs a business in the dc area and maybe she'd consider skype sessions if you can't find a local tutor.

There are many things you can implement yourself and since your child is older and seems bright get his input in developing systems about homework/classroom strategies. CHADD does lots of webinars. You may want to contact the local chapter of the international dyslexia association:
https://dyslexiaida.org/in-your-area-with-global-partners/ Even if your kid isn't dyslexic, language based LDs like dysgraphia and ADHD have a lot of overlap as to effect strategies.

I would re-investigate medication. Reconsider the usefulness of CBT unless he really likes it. Boarding school seems a little drastic. That might prove more anxiety inducing. Also in terms of interests, lots of kids just naturally grow out of things like legos. Wanting to sit and veg seems pretty typical of pubescent kids. In terms of IEP strategies, he should start to have a say. There's more than one way to skin an apple, so there maybe supports that don't make him feel as self conscious.

OP here, Thanks all! We are here for the long haul. But just because we are doesn't mean DS has to be - that's why we were thinking of boarding options. But it's been great to get feedback and bounce ideas around further than my own head with people that have btdt.

I think my order of approach will be as follows:

1) Psych. We've asked the psychologist to see if she can cut through some of the tape and get us in sooner.. or at least find out what test (neuropsych eval?) the psychiatrist will need before prescribing. We also have two more leads for other centers, so will call monday.

2) Review other local school options. I already suspect the answer to this. Locally, there are no special options that are good. It's just not that progressive. We do have meetings with 2 of the other international schools to see what their capacity might be.

3) Speak with an edu consultant. Will try T. Harvey above, and we also got another through a friend. Still need to research consultants in the UK, which is geographically much closer. But I think we need to try medication here first, before jumping to boarding school. I know it can take some time to find the right balance. And I can't imagine having my poor kid have to negotiate this solo at a new school. It still may be the case that we transfer for Y12&13 or something where he can both avoid the horrible mega projects of death where we are and get specialized study skills at a level that will carry him through uni. They don't do SATs here, just intense year-end exams starting in Y10 (2 years from now).