OK at school Not OK at home?

Discussion in 'General Parenting' started by rlsnights, Feb 17, 2011.

  1. rlsnights

    rlsnights New Member

    I am wondering how many (if any) of you have a kid who is doing OK at school - provided you overlook his unwillingness to do homework that is hard and other things that are probably typical for 15 yo boys like not wanting to organize his backpack.

    But this kid is a mess at home? Angry, confrontational, irritable, quick to fall apart in the face of frustration, trying to engage in power struggles at every opportunity.

    He's now a freshman and over the past 3 months he has gradually gone from doing a full day but rarely more than 2-3 days a week to doing 2 periods (out of 6) a day plus 1 hour of tutoring afterwards 3-4 days a week.

    He is barely attending school because his sleeping pattern is all messed up and he can't wake up until 11 or later most days. Plus he's tired when he's awake. Some days he's not sleeping at all at night but he's able to lay in his bed in the dark awake most of the night so I don't think it's hypomania you know?

    We have ruled out sleep disorders like sleep apnea, medication side effects, neurologist has cleared him after a clean MRI and getting his headaches under control with Topamax, his labs are textbook perfect, his thyroid is fine. In other words all possible physical explanations have been explored with his doctors. After a couple rages, we have removed his Xbox and are uncertain if/when we are going to return it for his use. (He raged for 3 hours after I set the family timer on it to 2 hours a day.)

    When he's at school, the teachers and RSP say he is focused, sometimes anxious but nothing severe, generally polite and respectful. He's doing well enough on tests to get B's so his grades aren't suffering unless you consider the fact that he's only carrying 1/2 load.

    We are getting ready to hold an IEP meeting 3/1 and all of us are struggling to figure out an appropriate placement. His psychiatrist says he's depressed and anxious and should be in at least an ED classroom and best case would be residential placement. School says he should be going to regular school on a full day schedule because he has no problems at all when he's there. They say there is no justification for an ED classroom let alone an NPS or other more restrictive placement.

    A young family therapist with a research program that we've been doing for about a year - she talks to us by phone 1x month and we see her in person maybe 3 x a year in addition to the initial length intake process - talked to me yesterday. She says she thinks that my son is just rebelling against me and that explains everything. Her take is that we need to let him make his own bad decisions and back off/disengage from him about school.

    I know there are power struggle issues here and because of my son's long standing physical health problems we are more enmeshed than most parents would be with their 15 yo son. I doubt most of you find yourself asking your son if he pooped OK and if there was any blood when he tells you his stomach hurts, for example.

    Anyway, I'm just trying to figure it all out. We don't have a family therapist at this point as I haven't found someone I felt could do a good job so far. I have a private, very experienced older therapist who worked with adolescents inpatient and outpatient for 30 years. She has been a godsend to me. She says he should be in residential treatment too and that we have done as much as anyone could do for our son.

    If you have a similar experience or some wisdom to share I'd love to hear it.

    Sorry this is so long.

  2. DaisyFace

    DaisyFace Love me...Love me not


    Well, not quite the same thing - but we shouldn't have to ask our 15 nearly 16 year old whether she is wearing clean underpants either - and yet, here we are!

    I do sometimes think we get into unhealthy patterns, (all of us...not just difficult children) but it definitely hinders the progress difficult children could be making if they weren't so enmeshed in old routines.

    At the very least, a residential placement would take the family dynamic out of the equation. Then it would no longer be a power struggle...

    And then - what? Just difficult child's issues...whatever they may be - or not.
  3. gcvmom

    gcvmom Here we go again!

    Hi Patricia, looong time no hear! I'm sorry to hear difficult child 2 is still struggling. We've just come off what was undoubtedly the worst four years of my difficult child 1's life with very similar issues and are now finally seeing some light thanks to medical interventions he needed, medication changes he needed, getting him back in to see a therapist and giving him a quarter off for home/hospital instruction due to one of the medical issues.

    Given what I know about your family and what I know about difficult child 2, I'm inclined to agree with the psychiatrist's assessment. I think if you took the depression away completely, you'd still have some of the oppositionality, which is normal to a degree for this age, but likely nowhere near what you are seeing now. I think he needs a break and I think you need to look into whether there's an alternative program you can enroll him in for the short term to remove some of the school pressure. Then I think you and psychiatrist need to take a hard look at his medications to see where they can be changed or adjusted to better address his symptoms. And finally I think he needs to go back into counseling until he starts turning around.

    In our case, difficult child 1 was put on home/hospital instruction for the last half of his first semester because he was having a lot of medical issues, which at the time I'd attributed to anxiety because they looked a lot like IBS (PM me for the long version). The district sent a tutor who was actually a credentialled teacher to our home for up to 5 hours a week. At the end of the semester, the tutor's grades were averaged in with the grade he had at the start of the program and that was his final grade for the semester. He ended up going from C's, D's and F's to all B's. We got his medical issue resolved so he his feeling LOADS better, and he's seeing a therapist every 2 weeks to work on some of his behavior issues. AFTER that H/H program concluded, we opted to enroll him in our district's independent study program which allows him to take up to 2 classes at his home campus and the rest of the subjects through independent study. (PM me for more details). So far, he is getting A's in all his work. Our plan for now is to re-enroll him at his home campus full time in the Fall.

    In tandem with all this, he's being re-evaluated for an IEP -- mainly to get him into a Critical Skills class which I think he still needs... but it's moving slowly.

    I still believe in Ross Greene's affirmation that a child will do well if he/she can. Right now I think there are too many roadblocks in your difficult child 2's way for him to do as well as he can.
  4. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I think Jean makes a whole lot of sense given that she knows the most about you and your son and has some insider knowledge. I would defer to her expertise.
  5. gcvmom

    gcvmom Here we go again!

    LOL Janet -- actually, Patricia knows the most about her and her son :winks: But... much of what she's describing rings familiar.

    I find it very odd that I know five families who have kids with bowel diseases and all five ALSO have bipolar disorder in the family. Not that I think there is a causative relationship, just that the genes for the two must be very near eachother.
  6. tiredmommy

    tiredmommy Site Moderator

    My mother had bipolar, her sister and niece have Crohn's and I have IBS.
  7. rlsnights

    rlsnights New Member

    Jean - I wrote a tome and decided not to post it. It runs 3 pages in word. :( I might pm you with it but really, I can summarize it if I have to. It just won't answer some of your questions/observations in any detail.

    Bottom line is there are not good alternative schooling options available in our district. He was on H/H last fall and he got worse not better. We've had 3 psychiatric hospitalizations in the past 9 months with major medication changes at 2 of them. Except for possibly adding an AD (which his psychiatrist and I are both rather afraid of trying for fear of mania and/or full blown psychosis) we think his medication cocktail is doing a pretty good job, believe it or not.

    What's going on is an ugly confluence of bipolar depression/mixed moods and disordered thinking. During his hospitalization last April/May he was diagnosed with thought disorder - specifically "ideas of reference". The partial program staff felt he was actually delusional but the psychiatrist didn't agree. When that diagnosis was really explained to me it was one of those "ah ha" moments. It explained sooo much about his behavior, all the way back to kindergarten.

    Given his life experiences and our family milieu of illness and disability (all nuclear and 5 of 7 extended family members we see regularly are living with with chronic and/or serious (1 terminal) health problems including MS, end stage renal disease and severe short bowel syndrome that requires TPN) the disordered thinking is manifesting rather predictably as a web of maladaptive beliefs centered on his physical health.

    He has come to believe that there is 1) something physically wrong with him that is causing his fatigue and disordered sleep that the doctors haven't discovered yet 2) that he has absolutely no control over when he goes to sleep, when he wakes up and how he feels during the day 3) that nothing he does will change these things 4) that he is unable to go to school or perform any "difficult" tasks if he feels tired/bad/didn't sleep well 5) that it is wrong for anyone to expect him to go to school when he feels tired/bad and 6)expecting him to keep up academically is not just unreasonable but punitive.

    This is really very helpful to me. Having to summarize this for you all has helped me really get a handle on the things he believes about himself and what's happening in his life. Maybe there is some hope of getting the school psychiatric to see this after all. When you put it all together like that it really does sound delusional don't you think?

    My plan at this point (the psychiatrist is on board with it 100%) is to ask for support for getting him to school from the same system that helps parents of kids who are truant. I am going to ask for a truancy officer to come to our house to get him up and to transport him to school. I'm going to tell the school that he isn't "truant" in the traditional sense but he has developed maladaptive behaviors because of having been sick so much and those are causing school refusal. He's a strong young man and we are unable to physically force him to get up and go to school. So we need someone else to come in and help with that piece.

    The psychiatrist and I both expect that, once truancy is involved, it will quickly become clear to everyone that he is in fact mentally ill and suffering from both depression and disordered thinking. I suspect that this will provoke a crisis and he may have to be hospitalized but maybe not.It is criminal but this seems to be the only way of getting the school district to recognize that his mental illness is substantially limiting his ability to benefit from his education.

  8. ML

    ML Guest

    Manster is similar and I still ask about poop habits as he is prone to constipation. Due to his anxiety the emeshment factor is huge. I so get that. I don't have any insight or suggestions just a big hug and a "been there done that". xoox
  9. JJJ

    JJJ Active Member

    Kanga was like this -- very good at school and hell on wheels at home. We were able to use the fact that she missed so much school due to psychiatric hospital stays to get a 'diagnostic placement'. I'm pretty sure our Special Education director made that term up but feel free to use it! Basically the logic was that the disability was interfering with her education because, even though she held it together when she was at school, she was unable to consistently attend school due to her disability. The psychiatrist (with the M.D.) wrote a letter stating that due to her current instability with her Bipolar that she needed to be in 'a small, therapuetic classroom that could adjust their curriculum to Kanga's varying needs and to decrease the risk of suicidal ideation and attempts'. The Special Education director used that to place Kanga at a TDS (she knew we were working on getting her into a Residential Treatment Center (RTC) and was willing to what she could to help us). The MD cannot dictate placement but he can state what her needs are and by stating that she needed the 'small, therapuetic classroom' to avoid a suicide, most schools are going to err on the side of going with the special placement because they have been put on warning that their current placement in a risk factor for that child.

    It sounds like you are going in that direction as well. I hope your school gets it -- soon.
  10. rlsnights

    rlsnights New Member

    An update -

    I called the school psychiatric first thing Friday am about getting difficult child 2 assessed. I felt like grinding my teeth when I found out the program specialist (district Special Education person) had not even told the school psychiatric about the March 1st meeting let alone that it would be really helpful to have some initial results for that meeting. Fortunately I was able to set up an initial interview with her for next Thursday and she said she had some time that day and the next to do some testing with difficult child 2. She said she would put the March 1st meeting on her calendar and try to have some preliminary results for the team.

    When I took my daughter to her school, I had a minute with the principal and asked her about the truancy services in our district. She said there really was no one who would come to the house that she knew about. She said she did that herself at her school about once or twice a year and the result was that she rarely had to do it more often since none of the kids wanted the principal standing in their bedroom wanting to know why they weren't at school. :) She asked if I had talked to the Parent Advocate at difficult child 2's school and I said no - didn't know there was such a person.

    Made a beeline for the Parent Advocate, Mrs. W., when I took difficult child 2 to school. I nearly cried - I finally found someone who seemed to understand my frustrations, didn't think I was the reason my son wasn't going to school and could actually help right NOW.

    She said she had talked to my son a couple times when he was waiting for me to come pick him up. He was very angry and impatient, way out of proportion in her opinion, certainly much more than the other kids who had been waiting just as long (as in 5 - 10 minutes). She had no problem at all thinking he should be classified as ED. She was right with me when I told her the district wanted me to home school him. She said "Right, if you do that, they get rid of the problem. No way. I wouldn't agree to that either."

    She asked what the district was offering for a placement and was speechless when I told her the program specialist had no suggestions at all, that as far as she was concerned difficult child 2 was "just an RSP kid" and there was absolutely no reason to think he needed an ED placement.

    Told her I had insisted on an ED assessment anyway and I'd just scheduled our first appointment with the school psychiatric on Thursday in hopes of having some initial results for the March 1st IEP meeting.

    In the meantime, I asked if there was anyone who could come to our home and help get him to school. Yes there is!!! First of all, she said she would be happy to make a home visit - just call and let her know he wasn't getting up and she'd see if she was available to come.

    Second she said "You need Mr. Johnson. No one messes with Mr. Johnson." Woo-hoo. Sounded perfect and I haven't even met the man. Mrs. W said there is a new department at the district that is supposed to be working pro-actively to prevent truancy and drop-outs. That group includes Mr. Johnson and she has sent him out to see boys (she said it's always boys) who aren't coming to school. She said it has worked quite well so far and she sent him an e-mail about difficult child 2 right then.

    She said she'd talk to the custodian about giving difficult child 2 a job on campus that might give him a reason to get there on time - like putting up or taking down the flags. Have I mentioned that I love this woman?

    Finally, Mrs. W told me there's a small ED class on that very campus. She thinks it has 10 kids and a male teacher that she says is terrific. A couple of the kids are mainstreamed but most are in a contained classroom. Of course she isn't in control of who gets into that class and didn't know if there was room in it so I'm trying not to get all excited about it.

    My partner L and I talked about difficult child 2 and the Xbox that afternoon. I had taken it away 2 weeks ago after he raged for 3 hours because I set the family timer on it. L really doesn't like conflict and wanted to give it back to him to avoid another weekend of constant attempts by difficult child 2 to coerce us into giving in to him.

    I asked her - what would we be doing if he was a "normal" kid who wasn't going to school? We would have taken everything away and told him to get his bu$$ to school if he wanted any of it back. We'd probably give him a bunch of extra chores and we'd demand that he performed well for at least a couple weeks before he got anything back.

    Since the school people were telling us he's a "normal" kid then I figured that we needed to treat him that way and see what happened.

    After school difficult child 2 started his usual demands to get his Xbox returned and accompanying rants about how we didn't have the right to take it, etc.

    We told him we weren't giving it back at this time and asked him when he was planning to get back to school full time. He said he wants to go to school full time, he just can't get up and stay awake. So we said that we thought it might give him some extra motivation if he knew that he'd get some Xbox time once he got back to school full time. I would have loved to offer him some Xbox time if he just went every day on the part time schedule but there are no half measures with him - I know you all know what I'm talking about.

    He said he would do that next week and we should give him the Xbox now. We said no it doesn't work that way.

    Predictably he blew up and said he was going to break into our room and get it back if we didn't give it to him NOW. We said no so he went and broke down our bedroom door (broke the door out of the frame cause we have a double deadbolt installed) and found his Xbox and took it. Then he stomped around crying and yelling at us.

    I quietly went and called the police and asked for help.

    The cops got here pretty quickly this time - it only took 30 minutes. He had taken off just before they got here and they picked him up on the way into the neighborhood. He was defiant but not so bad that they had to get in his face and we got a really great pair of younger officers who handled the situation really well. They calmly explained to him that our rules were reasonable, that his actions were wrong, that he had to abide by our rules until he moved out and paid his own way and had little sympathy when he tried the "I live with women and they don't understand me." line that he has used successfully with other officers in the past.

    They tried to reason with him when he told us all he would sell his Xbox and get his own place. He just repeated the same thing over and over about how he would get enough money that way to get a place to live. The officers gave up and left but not before they told us it was clear to them that he wasn't "thinking straight" and was mentally ill. They said they wished they could do more and to please call them again if he got aggressive.

    Got to run but I'll post more when I get a chance about how things go the rest of the weekend.

  11. Bunny

    Bunny Guest

    I'm a little late her, but it sounds like you are moving in the right direction and that there is someone in the school district who can help you and your son.

    My son says the same thing that your son did "Give me what I want first and then I'll do what you require." Uh uh. Nope. Not going to happen and you were right to stand firm, even if it ended with him breaking down your door.