Question re. medications & IEP

[klmno]

My son is on lithobid (which takes care of most raging and manic symptoms), depakote er (which takes care of hypomanic symptoms- at least to some extent) and risperdal PRN. When he's hypomanic, he will talk in class when he shouldn't, has problems sitting still, sometimes get a little rowdy in the hallway, etc., but nothing like the completely erratic behavior that I see with full-blown mania. The problem is that since he was put on the depakote, a year ago, his memory and a few other abilities have plummeted and it has greatly affected his ability to learn, retain knowledge, and get decent grades.

The psychiatrist is willing to try reducing the depakote, but when I mentioned this briefly to the principal at school, she didn't seem too thrilled. I'm sure she isn't thrilled and that none of his teachers would be and of course, they have no authority in this decision. But, I'm wondering if anything can be done regarding the IEP to ensure that if we try this reduction (in depakote only), my son won't be written up for disrupting class or something every time he's being hypomanic? I realize the rest of the IEP team (which are all from the school) would need to agree. Also, my son is in mainstream classes- regular science, collaborative English and Soc. Studies (meaning there is a teacher's aide in the room) and Algebra (which is an advanced class).

He's been working well with The Explosive Child techniques and I believe that they should be able to send him to a "safe place" or something if he's hypomanic and disrupting class. Actually, that is already written in his IEP but has never happened because they tell me the teacher's can't possibly be qualified to determine if he's hypomanic, so if he's disrupting class, they will send him to the office. Then, the administrators talk to difficult child and difficult child says he realizes he shouldn't be doing XXX so he gets chastised, and sometimes punished. difficult child realizes that he shouldn't be disrupting class, however, I don't think he can help it when he's hypomanic. The administrators look at it like if difficult child acknowledges he did something wrong, than it was willful and deserves the same treatment as anyone else.

So, it is already a strain and I feel this would just make that worse. on the other hand, the whole point of the IEP is to make sure the kid gets accommodations needed to get his education. And the medication is putting a damper on that.

Suggestions?

 

[Andy]

The school needs an all staff update on difficult child's needs. If something is in the IEP, the school must meet it. Stating teachers are not qualified is not an excuse - if they are not qualified, then the school better provide training to teach the staff how to recognize when to implement the IEP.

Of course difficult child knows what he did was wrong - that doesn't mean he was in control at that moment. Being punished like anyone else is not teaching difficult child to work on this. If staff would work on identifying the early signs, that will help difficult child to also recognize them.

You do what is right for your son and hold the school responsible to uphold the IEP.

 

[klmno]

True, Andy, and our last IEP meeting in the spring was about topics like that. It took a year to get to that point! Anyway, I did write a letter to higher ups stating that the sd needed to provide training to teachers and staff. That resulted in the sd ed. spec. joining the IEP team- whoopee!!! (The only thing she ever said was once, she understood because she had a great aunt who was BiPolar (BP), and then several times, she agreed with the sd)

difficult child had one teacher last year who must have caught wind of a possible BiPolar (BP) diagnosis- she used to be a cop too and difficult child has been in major legal trouble. This teacher was flipping out over red ink or paint on difficult child's notebook, claiming it was blood (difficult child had just gotten out of art class and told her it was from art when she asked and he, nor any other student, was bleeding). But, she felt the need to document that he came to class with blood on things.

Then, there was another teacher who wrote me that difficult child "was not paying attention and cut another student's paper instead of his" -this was in art class- but wrote up to the front office and difficult child's file "he was intentionally slashing other people's work".

So, after I brought written evidence to everyone's attention that this sort of s*** was going on, it seemed to get better, however, the principal told me in an IEP meeting that we cannot expect the teachers to have the same education and attitude about this BiPolar (BP) diagnosis if they are all aware of it. And, that I am welcome to bring in someone to the iep meeting and they will concede if I am sure that I want all difficult child's teachers being taught about his diagnosis, but I need to remember, it might give them more ammunition than sympathy. That was pretty much it- maybe not in those exact words. on the other hand, the principal and others have been known to use scare tactics with me just to prevent me from expecting more from the sd. Keep in mind- we are in Virginia and the Va Tech shootings are still fairly fresh in people's minds.

That actually worked a little in my favor when I testified to the judge- she asked me why I thought everyone should try to help my son. I told her because he'd be 22yo walking around on a college campus someday. Amazing how effective that statement was!!

 

[Andy]

At the 1st meeting, "As a teacher, it is your job to open up the world of education for every student. I would like you to work as a team to do this for difficult child. You may need to be creative in keeping his attention. You also need to recognize when he is about to shut down. His energy will fool you but it is a sign of shutting down. difficult child will work on recognizing this also but will need your help in encouraging him to get control. He has procedures such as calm down pass to help with this. These steps must be implemented. Waiting for the melt down to end and then punishing him for it is not getting him or you anywhere. If you can be proactive and assist in recognizing a melt down you will have an easier year also. Some examples are ............... When you notice.............. you need to .........."

Use some of the classroom behaviors he has gotten in trouble for as examples and show how it could better be handled. "When he starts talking too much in class give him a calm down pass"

The teachers do not have to know about BiPolar (BP) if there is a chance it will be used against difficult child, they just need to know how to handle difficult child's normal behaviors. If there is a teacher willing to learn more for the right reason to help other kids, then teach more on what BiPolar (BP) is.

To have teachers who appear to be giving up on their ability to teach difficult child is so sad. They are the ones who should be working hard to teach - they need to be creative!

 

[klmno]

Thanks, Andy!

Does anyone have any thought on how the depakote (cognitive dulling) plays into this and whether or not I should try lowering it and getting some supports to deal with it in the iep?

 

[Sheila]

Adrianne has some good points. Couple of things to add:

#1 - There's only 2 votes at the IEP meeting -- one for the sd and one for the parent(s).

#2 - It's a good idea for the parent to request a meeting with all teachers and IEP team members to discuss the issues the teacher's will likely see in the classroom and effective ways to respond to them. It works great when you can have a professional to come to the meeting to explain things to the educators, however, parents can effectively do this also.

#3 - I try to locate on-line resources for teachers. Have you searched for examples of hypomanic symptoms? I've found different types of examples related to my son. One potential on-line resource for you is All Kinds of Minds.

#4 - From OSEP, "Every individual involved in providing services to the student should know and understand his or her responsibilities for carrying out the IEP. This will help ensure that the student receives the services that have been planned, including the specific modifications and accommodations the IEP team has identified as necessary." If the teacher's needs additional training in your son's disability, you are within your rights to ask for it (by CM of course).

#5 - If difficult child is very disruptive while going through a stage, he may need to be in a different environment. As hard as it is to accept, sometimes our kids are so disruptive that it truly impedes the learning of the other students.

 

[klmno]

Thanks, Sheila! I have some material printed out from bpkids- I will check out your link as well.
Regarding medications- if we lower the depakote, will sd say "she took him off his medications so we can't help him"? Or, are they still required to since I'm not taking him off all medications and the only reason we're considering the reduction on depakote is due to it's effect on ability to learn? Maybe what you were trying to say is if we went that route, it might mean having to remove difficult child from mainstream classes...??

 

[Sheila]

Parents are not required to medicate a child in order to attend school.

What I said is that parents must be realistic. If a child is out of control, the student may need a more restrictive environment. This can range from 1:1 aide, being pulled from mainstream; even an Residential Treatment Center (RTC).

IDEA fully supports mainstreaming. But as parents, we have to be reasonable. Regular kids are entitled to an education also. If a student is so disruptive in class as to preclude the learning of others, a more restrictive environment may be needed -- even if it's on a temporary basis.