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ADHD/ODD

Hi there,

I am new to all of this. I have a 6 year (turning 6 on Thursday), he is repeating Kindergarten again this year. We had such struggles last year, he has ADHD/ODD with sensory issues. I was called to the school repeatedly. We are on a waiting list for occupational therapy with his developmental delays. The new year has just began, and I have been called twice in the two days he has been there. I actually had to pick him the last day due to his behavior. He doesn’t want to listen, he can’t sit still, he gets over stimulated by all of the activities. He is currently on Concerta 27 mg and Ritalin 5 mg. He will throw fits, hit, throwing things, disruption of class. No matter what discipline we try, it doesn’t seem to affect him. The only one that seems to work is at home, I give him so “time” usually in a chair or sitting on the floor to pull himself together. Anyone have any other suggestions, I am at wits end. The school is constantly pushing for more meds, we have an intervention plan in place from last year, I just don’t know what else to do.

Replies

My heart goes out to you. The situation I had with my son was very similar.  In the middle of the third grade I pulled him out of school, stopped the meds and started homeschooling.  He is starting the 4th grade this year, and he showed many improvements from last year.  The school just wanted me to keep giving him more meds also.  For my son, he just ended up being so very behind with his education, the school would just remove him from class, and call me to come get him also.  He ended the middle of third grade with a first grade reading level.  I just hope this does not happen with your son.  If you are able to homeschool and give him the extra therapy, OT on your own time, that is my advice.  That has worked the best for our situation so far.  Do not worry, each year he will grow and improve, just stick with what works for him, and keep trying different ways to help.  You will get there, although it is not easy.

Posted by myson2005 on Aug 25, 2014 at 4:11pm

First, let me tell you that I wish my son had repeated Kinder, not because of academics, but just to allow him to catch up emotionally. Next, second grade was our worst year. I got calls 2-3 days per week to come an pick him up early from school. That was the year we finally got an IEP in place. We also started my son on Intuniv, a nonstimulant medication. Both those things helped. He also takes Ritalin. I got just two calls in third grade. Now, he went of to his first day of 4th grade. He has lots of community support and a great treatment team and I hope I don’t get any calls this year. The reason I am telling you this is that it is really hard the first couple years. But, after he gets the proper supports and treatment and he gets a little older, things should get better.

I hope this helps you.
Sue H in PC, Ohio

Posted by SueH on Aug 25, 2014 at 4:13pm

Does your son have an IEP?  Have you worked with the school to create a workable behavior plan?  Taking him home from school can be operating as a “reward” for his behavior - he is learning that when he acts out, he gets to go home.  If you want him to remain in the public school, you must insist on the school creating a plan to address his needs.  If he *needs* OT to be successful in school, there cannot be a waiting list.  If it is identified as a need on a document like an IEP, then the school must provide it.  Look at http://www.wrightslaw.com for info about the law as it relates to children with special needs. 
With regard to his diagnoses, do you & your son see a therapist regularly for counseling?  ODD is best managed with parent training.  A good therapist is a must.  We have had some success using “The Nurtured Heart Approach” by Howard Glasser http://www.childrenssucessfoundation.org  It is an excellent approach for dealing with challenging children but it works best when you have a professional walking you through the steps.  Also “The Explosive Child” by Ross Greene is very good.  If his medication is not being managed by a child psychiatrist, find one.  Many children require a combination of meds and most pediatricians are not trained well enough to oversee that level of care. 
If you have not asked for an IEP for your son, do it immediately and tell the school that taking him home every time he acts out is not the best solution - you need to solve the problem together.  Sorry it is so hard for you, I have a 12 year old with ADHD and ODD.  You are not alone!

Kelly

Posted by krtsinohio on Aug 25, 2014 at 6:32pm

We are in an “intervention” phase, which is the first step towards the IEP. I believe after the week we have had, they agreed to get him “tested” for special Education. I tried to get an OT through the school, but I have to be Medicaid Eligible, so I am on a ridiculously long waiting list through my insurance. Thank you for the links and advice, I am definitely going to start reading.
I feel so alone, and I feel like it is only my child. When we go somewhere, I have this fear because we never know what might trigger the outburst. I have learned what times of the day are best for him which helps.

Posted by marlonslove on Aug 25, 2014 at 7:44pm

Hi Marlonslove,

First, you are NOT alone. I know what you are going through, and so do hundreds of thousands of other parents.

Second, Sue is right, the first few years are so very hard.

Third, Kelly’s recommendations are spot on as well. Read “The Explosive Child” - changed our lives. And push the school for *appropriate* accommodations and a Behavior Intervention Plan. Their plan canNOT be to send him home every time his behavior is out of line. He has a disability so that is discrimination and against federal law. Follow this step-by-step guide: http://www.additudemag.com/slideshow/102/.

In the meantime, you need to talk to his doctor about his medication and lingering ADHD symptoms. It’s a myth that younger kids should take smaller doses of stimulants. Stimulants work to fill the gap between a person’s neurotransmitter level and the level they need to be more attentive, etc. You son may need a greater dose due to body chemistry. Or, the medications he’s taking just may not work for him. There are many other stimulants, even a whole different type of stimulant to try. Here’s some advice on fine-tuning medications: http://www.additudemag.com/adhd/article/6581.html and http://www.additudemag.com/adhd/article/741.html.

There’s a steep learning curve to parenting a child with ADHD. You CANNOT improve everything at once or quickly. Take it one day at a time. Your first two issues to tackle are (1) appropriate plan at school—no more sending him home for behavior and (2) getting his medication adjusted to actually be helpful.

Oh, and about OT. In most areas, a student needs an IEP to get OT in school. If he has OT in his IEP, there cannot be a waiting list—they have to accommodate by law. As for private OT, you should have access to that under your insurance with a referral from your GP/pediatrician. You can call private pediatric OT offices and ask them the process to get your child OT. OT helps my son a TON, but only private OT—school OT was a joke.

Penny
ADDconnect Moderator, Author & Mom to Tween Boy with ADHD and LDs

Posted by adhdmomma on Aug 26, 2014 at 1:14pm

My heart goes out to all of you. I haven’t had gray hair till after having a kid but now I’m really stressed. He is 6. He’s always been very hyperactive and impulsive, almost text book criteria. The last two years have been about the defiant part. He will push and push and fight and argue and deliberately antagonize until you’re spent. We have him in karate for discipline. We encourage choices and consequences and sure with all the defiance we make mistake at times like raising our voice, but the defiance is to a very impressive level. Unlike some of these stories he is brilliant, he reads at 5th or 6th grade level, math skill is appropriate and so without IEP no school district involvement. He also has some mild sensory behaviors. We are seeing pediatrician soon because his lack of self-control sometimes involves destructive behaviors like hitting himself or walls or slamming doors or hitting us, his parents, throwing things, yelling as loud as possible, tantrums, he used to bite and scratch but that’s resolved. He can perfectly verbalize exactly a situation that melted down and tell you every step of the way of his choices but in the moment seemingly has no control. Emotionally he is about 3 but acts like a teenager. We are taking him to pediatrician this week and I’m sure strattera is going to cost about $300 per month out of pocket until my deductible is met. We are seeking a therapist also, but this is going to be pretty costly due to our crumby insurance but he’s worth it.

Posted by GrantedFal on Aug 27, 2014 at 2:35am

Hi, I’m so sorry your going though this. First, they should not be sending him for poor behavior.  Not only is that rewarding the behavior, but he’s not learning any strategies to self regulate.  Does he have an IEP?  If you have a diagnosis and the testing to back it, ask the school special edu director and school psychologist to look it over. It should be enough to qualify him for an IEP without additional testing.  For my son, the best way to manage his classroom behavior are very simple accommodations, that I’ve been told by his teacher last year, helped the entire class.  My son needs a visual schedule to allow him to plan what’s next and prepare, he also needs frequent motor breaks (bringing a letter to the offices, getting water, etc), and most importantly, he needs constant positive reinforcement. As soon as a teacher turns things negative, my son shuts down and his behavior spirals out of control.  It’s not to say he can do what he wants but if he does misbehave, he does better to remind him of what he should be doing and. Not dwell on the poor behavior.  Then get him moving along to something else quickly.  Allowing him to be a helper is always huge too.  The teachers and school staff need to realize he is only six. He’s still so young and needs guidance.  Sending him home is the last thing they should be doing. 

One last thought on meds - if possible, try to see a psychiatrist and not a pediatrician for meds.  They just understand so much more than just increasing the dose.  My son, who is also 6, started on stimulants and they made him super anxious, which caused hi to act out more, when he wasn’t zoned out. Now, he’s on intuniv (been on it for over a year) and risperdal.  The intuniv helps with the aggression and the risperdal (been on that about 6 months) allows him to move on and not get stuck on things. This has been life changing for him. Good luck!  With the right plan and supports Iin place, things will get easier.

Posted by Sporty on Aug 27, 2014 at 10:46am

We are getting ready to get the IEP in place. I was working for it all of last year during the “intervention plan” but it never happened. Now finally, we are moving ahead. I am unsure about the teacher, it’s only been a week, so I will give her a little more time, but as of now, I don’t think she is the right fit for him. He is not responding well to her at all. I completely agree that sending him home is rewarding, it won’t take long for him to realize it. You are right, once they shut down and it starts to escalate, it is extremely hard to get him back down. I don’t think they realize this yet.
He currently goes to a psychiatrist for his meds, he is on concerta and Ritalin. He was on intuniv for a while but it seemed to stop working. The school just wants to increase the meds, but they need to help with a plan. His teacher last year, was awesome, she went above and beyond to help him and it showed.
I am so happy I found this site to get others that have been through this.

Posted by marlonslove on Aug 27, 2014 at 12:36pm

I have ADD, have a 9 year ADD daughter and am a teacher.  30 out of my 105 students have IEPs.  To be blunt, IEPs for ADHD kids doesn’t mean a whole lot.  They tell the teacher to redirect, provide a hard copy of notes, preferential seating (at front of class) and things like that.  They do provide some guidance.  But any teacher with any sense would do these things anyway if she were truly wanted to support these kids.  What is more important is the fit.  I understand these kids.  I have high expectations but am also very understanding and patient.  I’m not one to encourage getting a new teacher every time a student doesn’t like his teacher, but it sounds like you need to insist on a new teacher.  I have many students who work for me and don’t cause trouble but who will not work for other teachers and are always in trouble.  I strongly believe that the relationship between teacher and student is absolutely the most important factor in the success of ADHD / ODD kids.  You do need an IEP and possibly a behavior improvement plan (BIP) , but an IEP or BIP doesn’t do a lot of good without a supportive teacher behind it.

My daughter didn’t respond well to meds at all.  We tried both stimulant and non-stimulant meds with no success.  They helped to control her symptoms but she never slept.  I had her neurotransmitters tested and put her on Kavinase and Calm-PRT.  There is controversy over whether the testing works because it tests the levels in the body and not the brain, but her ODD all but disappeared and her ADD much improved. There are no side effects either.  It’s just another avenue to consider.  http://www.neuroscienceinc.com

Posted by deb5691 on Sep 03, 2014 at 2:44am

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