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Thread: need Advice

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    HIU8 is offline Red Diamond level (10,000+ posts)
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    Default need Advice

    DS is 6 1/2. This fall he started K at a new school. Last year was K lite and it was a 3 hour/day program. This year is a full day (8:15-3:15). DS has ADHD-combo type. He also has SPD (going to OT for the last 2 years already--he has made good improvements overall). He is also a slow processor. We see a developmental ped. We were seeing a behavioral therapist who decided that DS's issues were more situational and he didn't need to be seen on a regular basis (we did see on a regular basis for about 6 months).

    DS is currently not medicated. He was diagnosed at 5 1/2. He holds it together at school and outside activities. However, at home DS is a mess. He thinks everything is funny. He plays "I will hide from you, come and find me" for everything (bath, dinner, getting in the car, etc...). This has gotten somewhat better. However, DS was doing ok and since school started he has literally been having upwards of 5 MASSIVE tantrums a day at home. He does not get out of bed unless forced. We have to dress him usually. He screams at the top of his lungs in tantrum mode. He hits his sister. He tells DH that he doesn't want him near him. DS also works ONLY in absolutes. Answers to his questions have to be yes or no/black or white. He will ask over and over again if you say I don't know, or give any type of a vague answer. We see his anxiety level skyrocket if we cannot give that absolute answer.

    We have been wondering if this is just a symptom of DS getting used to a new routine (and we do picture stories with him) and we give more than the what would be considered normal amount of time for any and all transitions (we have been doing this for a long time already). OR, is it time to consider medication so DS can function?

    Anyone BTDT? I really need some help with this.
    Heather

    DS 2004
    DD 2007

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    Gena's Avatar
    Gena is offline Emerald level (3000+ posts)
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    Quote Originally Posted by HIU8 View Post
    DS is currently not medicated. He was diagnosed at 5 1/2. He holds it together at school and outside activities. However, at home DS is a mess. He thinks everything is funny. He plays "I will hide from you, come and find me" for everything (bath, dinner, getting in the car, etc...). This has gotten somewhat better. However, DS was doing ok and since school started he has literally been having upwards of 5 MASSIVE tantrums a day at home. He does not get out of bed unless forced. We have to dress him usually. He screams at the top of his lungs in tantrum mode. He hits his sister. He tells DH that he doesn't want him near him. DS also works ONLY in absolutes. Answers to his questions have to be yes or no/black or white. He will ask over and over again if you say I don't know, or give any type of a vague answer. We see his anxiety level skyrocket if we cannot give that absolute answer.

    We deal with many of these same issues, particularly the stuff I bolded. I can't tell you what this means for your child; I can tell you what it means for mine. I know our boys have different diagnoses, but they do seem to have some overlapping symptoms and issues, so maybe some of our experience can help.

    DS had a very rough start to the school year. As background, this is his first year of (nearly) full mainstreaming. In previous years he was in a special ed classroom for all or part of the day. This year he is in the regular classroom almost all day, except for his pull-outs for services and some time in the resource room. From the start of the school year he did pretty well in the classroom. He had some minor behavioral (self-control) issues, but for the most part he could hold together during school. He enjoys being in the regular classroom and doing the work. But after school his behavior was very challenging. He acted out both at his afterschool program and at home. At home he had major tantrums with screaming and hitting. He alternated between pushing us away and clinging to us desperately. He refused to do simple tasks. His sleep was terrible. He dried about going to school and told us that he didn't know what was going on.

    For DS, these were signs that he was using all of his emotional and psychological resources to get through the school day and had nothing left to help him get through the rest of his day. The problem started at school, even though his behavior at school was pretty good and DS enjoys being in the classroom. We called an emergency meeting with everyone who works with DS, all his teachers and therapists, as well as the district Special Ed coordiator and the parent mentor (so really the whole IEP team). The team has seem this type of behavior pattern before in other kids and agreed with us that it meant that the school day was using up all of DS's resources. We are very lucky that our school personnel recognize that this situation means that things at school are not working for the child. i know that some schools believe that what happens after 2:30 (or 3:00 or whenever) is not their problem, but our school staff take the view that if school is messing up the rest of the child's life, then something is wrong at school.

    So the Team was eager to brainstorm ideas and implement new strategies to help DS get through the day better. We (the Team) decided that DS would get a couple of "sensory breaks" during the day and more pull-outs into the resource room. Additonally he would get a 20-30 minute sensory session at the end of the school day to help him physically work out his stress. (Our school has a wonderful sensory room with all kinds of things: trampoline, swing, spinning chair, weighted objects, fiber-optic features, various music, etc.) After this sensory session, he does some journaling to help him process what happened during the day and self-evaluate. This also helps prepare him for the transition for after-school. Additionally, the teacher and aide make sure to clarify directions for him and implemented a visual schedule. Also DS has the option to use a weighted lap-pad during class, which helps with his anxiety and concentration.

    Another factor for DS is that he has a hard time going from the very structured environment at school to the less structured environment at home. So we have added more structure in to our home life. For us this means more set routines, more checklists/visual schedules, star charts to earn privledges, etc. We had done all these things previously, but had gotten lax on them, so we realized it was time to renew our efforts on doing these things. We also continue to manage DS's sensory diet at home with things like mini-trampoline, doorway swing, weighted vest, compression shirts, brushing, etc. We are planning to buy or make a weighted blanket to help with his continueing sleep issues.

    DS has responded very well to these changes at school and home. School does not use up all of his resouces and he able to better function in the rest of his life. We and the school staff continue to tweak the system based on his needs, but we are on the right track.

    I'm sorry this got so long, but I hope some of it helps. Hugs.
    Gena

    DS, age 11 and always amazing

    “Autistics are the ultimate square pegs, and the problem with pounding a square peg into a round hole is not that the hammering is hard work. It's that you're destroying the peg." - Paul Collins, Not Even Wrong

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    karstmama is offline Sapphire level (2000+ posts)
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    heather, i hope some tweaking makes things better.

    gena - i'm in awe of all you do to help your ds, how in tune with him you are. mine is younger, but i'm hoping to hold your actions in my mind for when i may need them.

    yay for all our ds's, a toast that they may come through this with more skills, more tools, and growing resilience!
    mama to j karst, former 25 weeker, 12/06

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    Gena's Avatar
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    Quote Originally Posted by karstmama View Post
    gena - i'm in awe of all you do to help your ds, how in tune with him you are. mine is younger, but i'm hoping to hold your actions in my mind for when i may need them.

    yay for all our ds's, a toast that they may come through this with more skills, more tools, and growing resilience!
    Thanks, but I do a lot of stumbling along the way. It's a lot of trial and error to figure out what works and what doesn't. As DS gets older, we keep building on what has worked in the past and continue to try new things. Every age presents new challenges. A key thing is to have good resources you can draw support and ideas from: books, other parents, teachers, therapists, doctors, etc. And a really important aspect I've learned from adults with disabilites is to try to look at situations from my son's perspective and consider how he experiences things.

    And I'll join you in that toast to all our kids!
    Gena

    DS, age 11 and always amazing

    “Autistics are the ultimate square pegs, and the problem with pounding a square peg into a round hole is not that the hammering is hard work. It's that you're destroying the peg." - Paul Collins, Not Even Wrong

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