help needed

Discussion in 'General Parenting' started by lmf64, Oct 6, 2009.

  1. lmf64

    lmf64 New Member

    Hi all. I need some help in guiding a young mother with a 6 year old dxd ODD and mood disorder. They tried risperdal and it worked at a low dose, but the effectiveness wore off and when dose was increased it did nothing. They also used anti depressants (I know) which if anything caused an escalation of behaviors (ya think? lol) At this time he's not on any medications.
    The problem we're dealing with is the school. Hmmmm probably should have posted this in Special Education 101, move it if necessary. Anyway, he is in a program staffed at a ratio of 3 staff to 7 students. They can't handle him. They set him off and then send him home. They are looking at a manifestation hearing if they keep this up. He is extremely intelligent, reads at a 4th grade level and does math at 3rd. He's all of 40 pounds and manipulates adults.
    I am trying to help her get a better IEP to teach the school how to deal with him. Any ideas?
     
  2. rlsnights

    rlsnights New Member

    If he's not stable (with medications) it will be nearly impossible to get improvement in the school setting in my humble opinion if they can't handle him now in a classroom with 7:3 ratio, assuming the staff has adequate training in teaching and managing kids with psychiatric issues.

    Sounds like a 2nd opinion from a child psychiatric who knows what they're doing should be the priority over everything else. pediatric neurologist would be second choice if child psychiatric is impossible to get anywhere close to where they live.

    If they're in the boonies, they will probably have to go to Minn/St. Paul for a really good work up or they might want to look at Mayo in Rochester assuming they have insurance or $$ to pay privately. Chicago is another option but even farther away. However there are some great research programs out of Chicago that might help them with travel expenses or at least with cost of ongoing care and the study docs might be able to coordinate care with local psychiatrist.

    I guess my suggestion would be either homebound while medications are implemented or getting him a 1:1 aide who can manage him at school. Probably a shortened school day in addition to the aide at first. Possibly a different classroom placement if (except for the behaviors) he's the highest functioning kid in the class. Alternative would be supplemental instruction using a different modality (i.e. computer or internet classes) to deal with his boredom and manipulation of staff. Hard to manipulate a computer program.

    Have to be a pretty special aide and lots of input from parents on triggers and management once triggered. Aid would have to be capable of dealing with potentially manipulative behaviors effectively. Which means the aide would have to have some power over his schedule, instructional materials and consequences or the teaching staff would have to be really on board with listening to the aide.

    Ideally either option would be a short term solution until he is stabilized to some extent with medications.

    ODD isn't a diagnosis in my opinion - it's a description of behavior that is irritating to most adults. (At my house, ODD stands for Only Doorknobs Dummy since they are the only thing around my house I consider oppositional besides my thumbs.) Generally there is an underlying issue that is resulting in that behavior.

    My laymom's opinion is they should probably be trying a mood stabilizer coupled with an AP but it all depends on his presentation as we all know. Risperdal is supposed to be good for aggression but every kid is different and the brain adapts so, if it doesn't work in combo with a mood stabilizer then there are several others to try including the older AP's.

    If you need more specific input on crafting the IEP I'd post on Special Education 101. Identifying his needs comes first and then placement is supposed to flow from that. SDs often want to put the cart before the horse and decide on a placement (usually on what's easily available or that they have used with other problem kids) and then shoehorn the kid into the existing program.

    They may want to ask for a IEE paid for by the district if they haven't already gotten their own IEE or one through the school district in the past year. They are guaranteed one a year and they get to pick who will do it as long as the person chosen meets the school district's requirements in terms of licensing, etc. They can choose pretty much anyone they want.

    Any really thorough IEE should include recommendations for goals and information that can be used as baselines.
     
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