I have quite a dilemma going on - I have a six year old son who's been diagnosed as bipolar (runs in the family) currently in 1st grade in Humble ISD (in Texas). He has alot of rage issues - gets easily frustrated when trying to write or do fine motor skills. He will tear up his work, throw books, hit the teacher. Took me months to get them to evaluation him for Special Education last year when he was in Kindergarten. They did finally at the end of March '10. Up until this past January they were doing behavior charts, BIP plans while having him in mainstream ed. Had another ARD meeting in Feb when they started in class support with a Special Education teacher assisting him in his hard times - writing and math in the regular class. Month later they started him in resource for those classes. Now I'm being told after a month in resource they want to put him a self-contained "Adaptive Behavior Class" at another elementary school. This class is based on a Crane-Reynolds level system, where the student has to graduate from level to level, after level III they try to mainstream him back into regular ed classes. For the first two levels the students are not allowed out to eat in the cafeteria, they have to eat in the class, and during level I they have to eat alone in the class. They are allowed to go to the bathroom 3 times a day with an escort. I think they are allowed to go out to recess, but that is not written into the Crane Reynolds system, the teacher told me she does it out of the goodness of her heart because "they are kids". Also they don't get music like the regular kids and not much art either. I was told it takes about two years for a child my son's age to get to level III. And was told some kids never graduate out of the program. I went to see an attorney last week who says that her feeling was that the school district prides itself on this program and keeps them longer in levels I and II to boost their success scores. I have an upcoming ARD meeting in two weeks and I'm bringing an educational advocate with me. Two of my biggest concerns are that my son will get frustrated and depressed on loosing levels and will give up emotionally, my other concern is that he is VERY bright, reading on a 2nd grade level, and I'm worried he's going to loose out academically. He would be in the class with three other ED/BD kids , one teacher and one aide. Oh and forgot to mention, my other worry is that he has bipolar..i'm worried that one bad day will drop him and he will be caught in an endless cycle of failure. I would really, really appreicate any advice on this....I'm heartsick over this. I know his behavior has GOT to stop but I'm worried I'm also giving him a death sentence. I eat lunch with him 2-3 times a week at school and won't be able to do this until he's level III. This is breaking my heart as he won't be 6 forever.
School wanting to put Bipolar son in "adaptive behavior class" please help!
- Thread starter beandawgs
- Start date
JJJ
Active Member
My first reaction is that is can't be legal to place a child in a program that requires them to earn their way out rather than allowing the IEP team to make the decision; nor can it be legal to isolate them for lunch or not give them daily pe/recess. Then I saw you were in Texas 
Have you observed at the school they are suggesting? I was really resistant to putting my son in our district ED program and the first 3 months were brutal due to bad staff; after the staff were fired and outstanding staff were hired, my son has made HUGE strides. In fact, all of the kids in the ED program spend a minimum of 1 hour in with a regular ed classroom (lunch, recess, and pe/fine arts). Most of the kids spend 2-3 hours in a reg ed room.
I would try and get a joint-placement where he spends part of each day in the ED room and part of the day in a reg ed room. Are there certain classes or times of day when he usually does well?
What medications is he on? Does he see an psychiatrist and therapist regularly? If so, have the psychiatrist write a letter to the school stating that it is "very important that difficult child spends the maximum amount of time with non-disabled peers" and that lack of consistent daily contact with his non-disabled peers would "significantly impair difficult child's mental health progress" or something similar. If you like and trust your therapist, it may be worth paying her to come to the IEP meeting to help drive that point home.
Ross Green (author of The Explosive Child) has written a great book "Lost At School" that can really help with creating an BIP and IEP that actually work.
Have you observed at the school they are suggesting? I was really resistant to putting my son in our district ED program and the first 3 months were brutal due to bad staff; after the staff were fired and outstanding staff were hired, my son has made HUGE strides. In fact, all of the kids in the ED program spend a minimum of 1 hour in with a regular ed classroom (lunch, recess, and pe/fine arts). Most of the kids spend 2-3 hours in a reg ed room.
I would try and get a joint-placement where he spends part of each day in the ED room and part of the day in a reg ed room. Are there certain classes or times of day when he usually does well?
What medications is he on? Does he see an psychiatrist and therapist regularly? If so, have the psychiatrist write a letter to the school stating that it is "very important that difficult child spends the maximum amount of time with non-disabled peers" and that lack of consistent daily contact with his non-disabled peers would "significantly impair difficult child's mental health progress" or something similar. If you like and trust your therapist, it may be worth paying her to come to the IEP meeting to help drive that point home.
Ross Green (author of The Explosive Child) has written a great book "Lost At School" that can really help with creating an BIP and IEP that actually work.
I have to say that a 2 to 1 ratio of students to teaching staff is amazing in a public classroom. If your child needs that kind of intensive therapeutic setting and they are doing a good job providing it, that may be worth a try.
Will the school let you observe the class? Did the teacher or anyone talk about how they measure success and what has happened to other kids who were in the program? Would they let you talk to other parents with kids who are in or have graduated from the program?
I understand your concerns about your son feeling like a failure if he were to lose a level. But is it possible he feels this way in a regular classroom now?
You are worried that having a bad day in the program will trigger a bipolar crisis. Is this happening now? How would it be worse if he was in this classroom?
You are worried that his academic needs will not be met. Are they being met now? Is he able to learn in the classroom setting now?
I can't say whether this is the right thing for your son or not. I don't know if the other interventions that have been tried were done effectively or for long enough.
What I can tell you is that my son has a bipolar diagnosis although he was diagnosed later than yours. He does much better in a very structured setting. He does not have the severe behaviors your son has at school but he has always had problematic behaviors at home. When he was 7 he tried to throw himself out a 2nd floor window after a 3 hour rage. Somehow he has always held it together enough at school that he managed to pass - up until this year. At his IEP on Monday I expect that we will be moving him into an ED classroom with 10 children and 1 teacher and 1 aide. I have wanted him in such a placement for a long time but could not get it for him because his behavior at school was so good. So I may not be the right person to give you advice right now.
But, since you asked, here's my advice.
If you have checked it out and feel that your child will be safe and that you will have the ability to closely monitor what happens in the classroom then I would seriously consider a trial placement in that classroom.
If the teacher and aide are well trained your son should be receiving two things:
1.Therapeutic interventions that simply cannot be delivered in a regular classroom or Special Education classroom and
2. A highly individualized educational curriculum that may meet his academic needs better than what he will get in a regular classroom.
He is not getting these now. It sounds like he needs both.
You can insist that the IEP team reconvene in one month (or less) from the start of the placement to review the placement. If you already have that on the calendar it will help to deal with any concerns that have come up during the trial period. You can bring up your concerns about the isolation and lack of recess to the IEP team and, at the minimum, have those concerns documented in the meeting notes. It sounds like the teacher already provides some modification of the level system in that regard. Your advocate should be able to help you with that aspect of the process.
I hear your anguish. I am so sorry you and your family are going through this. I am very sad that your son is in such distress. His world must seem very scary and unreal.
In your place I would be grieving. Our children "grow into" their disabilities when they fail to reach the developmental milestones on time. Some do this earlier than others. When that happens it isn't just a crisis for them. It's one for us too.
When your child was younger and at home you may have been able to hold on to your dreams for him - that he would grow out of these behaviors, that he would do better once he went to school - somehow you held on. You can't hold on to those dreams anymore because he is not growing out of them and he is failing at school. If anything he may be getting worse.
So you are grieving for that child. Which is actually a good thing. Because until you have let that imagined child go you will have a hard time seeing the child you really have. And you may discover that you have new dreams for him that are based in reality and are much better than your worst fears. Because if you can see the child before you for who he is and what is hard for him you will be able to make better decisions when you have to decide what is going to be best for him.
These are hard decisions to make. I hope you have the support of your spouse. I hope that he/she is coming to the meetings with you if at all possible.
I send you Warrior Mom strength and wisdom vibes.
May you have the wisdom to choose the best course, the words to help others see your child through your eyes, the ability to find joy and progress in even the smallest signs and the breath to calm yourself and bring perspective when you are afraid.
Patricia
Will the school let you observe the class? Did the teacher or anyone talk about how they measure success and what has happened to other kids who were in the program? Would they let you talk to other parents with kids who are in or have graduated from the program?
I understand your concerns about your son feeling like a failure if he were to lose a level. But is it possible he feels this way in a regular classroom now?
You are worried that having a bad day in the program will trigger a bipolar crisis. Is this happening now? How would it be worse if he was in this classroom?
You are worried that his academic needs will not be met. Are they being met now? Is he able to learn in the classroom setting now?
I can't say whether this is the right thing for your son or not. I don't know if the other interventions that have been tried were done effectively or for long enough.
What I can tell you is that my son has a bipolar diagnosis although he was diagnosed later than yours. He does much better in a very structured setting. He does not have the severe behaviors your son has at school but he has always had problematic behaviors at home. When he was 7 he tried to throw himself out a 2nd floor window after a 3 hour rage. Somehow he has always held it together enough at school that he managed to pass - up until this year. At his IEP on Monday I expect that we will be moving him into an ED classroom with 10 children and 1 teacher and 1 aide. I have wanted him in such a placement for a long time but could not get it for him because his behavior at school was so good. So I may not be the right person to give you advice right now.
But, since you asked, here's my advice.
If you have checked it out and feel that your child will be safe and that you will have the ability to closely monitor what happens in the classroom then I would seriously consider a trial placement in that classroom.
If the teacher and aide are well trained your son should be receiving two things:
1.Therapeutic interventions that simply cannot be delivered in a regular classroom or Special Education classroom and
2. A highly individualized educational curriculum that may meet his academic needs better than what he will get in a regular classroom.
He is not getting these now. It sounds like he needs both.
You can insist that the IEP team reconvene in one month (or less) from the start of the placement to review the placement. If you already have that on the calendar it will help to deal with any concerns that have come up during the trial period. You can bring up your concerns about the isolation and lack of recess to the IEP team and, at the minimum, have those concerns documented in the meeting notes. It sounds like the teacher already provides some modification of the level system in that regard. Your advocate should be able to help you with that aspect of the process.
I hear your anguish. I am so sorry you and your family are going through this. I am very sad that your son is in such distress. His world must seem very scary and unreal.
In your place I would be grieving. Our children "grow into" their disabilities when they fail to reach the developmental milestones on time. Some do this earlier than others. When that happens it isn't just a crisis for them. It's one for us too.
When your child was younger and at home you may have been able to hold on to your dreams for him - that he would grow out of these behaviors, that he would do better once he went to school - somehow you held on. You can't hold on to those dreams anymore because he is not growing out of them and he is failing at school. If anything he may be getting worse.
So you are grieving for that child. Which is actually a good thing. Because until you have let that imagined child go you will have a hard time seeing the child you really have. And you may discover that you have new dreams for him that are based in reality and are much better than your worst fears. Because if you can see the child before you for who he is and what is hard for him you will be able to make better decisions when you have to decide what is going to be best for him.
These are hard decisions to make. I hope you have the support of your spouse. I hope that he/she is coming to the meetings with you if at all possible.
I send you Warrior Mom strength and wisdom vibes.
May you have the wisdom to choose the best course, the words to help others see your child through your eyes, the ability to find joy and progress in even the smallest signs and the breath to calm yourself and bring perspective when you are afraid.
Patricia
This school district isn't going to budge that I know already. I'll have to talk more with my advocate. Sad fact is my mother is a retired Special Education teacher (junior high) - I talked with her today, she said when she had a self-contained class her kids ate with reg ed, had pe with reg ed (if they could, if not they had an adaptive PE class). Before she knew about this Crane-Reynolds system she was all for him going to a self-contained class but now is against it.
Thank you so much for your kind words Patricia, it made me cry. This is a grieving process. One thing I do think about this class is that there is little to no parental involvement. The teacher told me that the other parents weren't involved with their kids before placement in her class and now they're mostly relieved they aren't getting the calls from the school anymore. I *want* to know what is going on with my little one. I feel very protective over him, especially because he has been so sick. (Not sure if I mentioned that in my original post but he's been a patient at MD Anderson). My feeling was that they feel that alot of these kids are manipulative and are in control of their behaviors. However, at his current school his Special Education teacher even told me she felt that Mark was sometimes, but not always in control of the behavior. With his medical condition I have to be alerted if he looks ill or has a fever, he has to go to the hospital right away because he has a poor immune system. Two years ago he almost died from sepsis at Anderson. I worry that they may interpret that "ill" behavior as manipulating to get me to come or something and hold off on calling me. Things like this have me worried. Funny thing is he is so afraid of IVs and hospitals he would never ask them to call me because he knows he would go to the hospital. When he refuses to take medications I tell him "ok we're going to the hospital" and he takes the medications, works everytime.
My honest feeling here is that this school system will not be willing to budge on anything because they are so proud of their system. :-(
My honest feeling here is that this school system will not be willing to budge on anything because they are so proud of their system. :-(
pepperidge
New Member
I hate level systems. Hate them, hate them hate them. They set children up for failure. I believe in Ross Greene--children do well if they can. That said, clearly if a child cannot maintain in regular classroom it is not doing their self-esteem much good anyway. It sounds like an incredibly rigid system. I would be looking for what do they do to help a child learn coping skills. Are they just holding our rewards or are they addressing his lagging skills? Trying not to trigger rages. The program might be better than it sounds, but i would sure check it out.
H
HaoZi
Guest
A little off-topic here, but you said he has issues with fine motor skills. Is he is any kind of occupational therapy to help him work on these? I would think art and music would help his motor skills (if he's working with instruments). Does he like to color and write at home? Do anything else that uses fine motor skills for fun, like crafts, models, etc?
He could always start with lower scale models of cars or something and work towards 1:72 scale as he gets better. The models usually involve using something sharp to separate parts and also sometimes to scrape a good surface for glue, so he'd need a good bit of parental help and supervision, but it would be something you could use as quality time together with a tangible thing to show his progress as he improves. And even people with great fine motor skills need a lot of practice to get models to look right, so if a few of you are doing different ones of the same scale he can actually see that it's not hard just for him, that everyone needs practice.
Jigsaw puzzles might also be a good way to work on his motor skills and can also be a good family bonding activity.
I know you asked about school, just wanted to toss in some ideas on things that might help outside of school, too. Figured if he has a way to practice and measure his progress (and family bonding is good, too), it might help his frustration levels all around.
He could always start with lower scale models of cars or something and work towards 1:72 scale as he gets better. The models usually involve using something sharp to separate parts and also sometimes to scrape a good surface for glue, so he'd need a good bit of parental help and supervision, but it would be something you could use as quality time together with a tangible thing to show his progress as he improves. And even people with great fine motor skills need a lot of practice to get models to look right, so if a few of you are doing different ones of the same scale he can actually see that it's not hard just for him, that everyone needs practice.
Jigsaw puzzles might also be a good way to work on his motor skills and can also be a good family bonding activity.
I know you asked about school, just wanted to toss in some ideas on things that might help outside of school, too. Figured if he has a way to practice and measure his progress (and family bonding is good, too), it might help his frustration levels all around.
Just a followup but my husband and I went to visit the adaptive behavior class again this morning so he could see it. There were a few things I didn't like - I won't be able to visit my son in the class as parents are not allowed, period. I also didn't get the feeling that many of these kids are maintreamed, ever and was told that he won't be able to graduate from high school if he doesn't mainstream. I talked to my sister in law's coworker (she's with another school district) and is with Special Education, she was appalled by the rules of this program. Her program is more inclusive, the BD/ED kids eat with the regular kids, etc. She said that her district used that crane reynolds program many years ago but it was not used in that fashion. Her thoughts were that she would not place her child there. I think Mark needs to be in a Special Education class but somewhere else. We're going to look at a private school.
Sounds like you are doing your homework and have solid reasons for going in a different direction.
I understand the issues about having a kid who is medically fragile. Got a couple here, one immune suppressed to maintain remission from an autoimmune disease.
Anyway, I have heard the same line here about the behavior of a kid who has been "spoiled" because he has been really sick. I am sure that is true and the complete explanation for some kids. It is not the complete explanation for mine and I'm not even sure that it's more than a very small part of the explanation.
For us, what looks like "spoiled" to other people is actually a combination of an inability to take another person's perspective, problems with pragmatic language and abstract thinking, mild thought disorder (ideas of reference) and grandiosity from the bipolar. All together - when he's on a roll fully hooked into the thought disorder and grandiosity he comes across as a defiant, entitled kid who just needs to be put in his place. But if you really try to talk to him, reason with him, get him to see things from your perspective? He cannot do it and you will never penetrate that irrational thinking as long as the disorder thinking is in the driver's seat.
Has your son had a neuropsychologist assessment? I expect if he's gone through intense treatment he has some significant long term side effects. Has this been explored as a possible factor contributing to his behavioral problems?
Has he had a thorough speech and language assessment? This turned out to be the one thing I would have skipped that provided some vital clues to what was going on with my difficult child 2.
I hope you and your husband are in therapy to help you. And that you have found a good child psychiatrist and child therapist.
It must be especially hard to have gone through so much to get him well and keep him well only to be faced with such extreme behaviors.
Hugs.
Patricia
I understand the issues about having a kid who is medically fragile. Got a couple here, one immune suppressed to maintain remission from an autoimmune disease.
Anyway, I have heard the same line here about the behavior of a kid who has been "spoiled" because he has been really sick. I am sure that is true and the complete explanation for some kids. It is not the complete explanation for mine and I'm not even sure that it's more than a very small part of the explanation.
For us, what looks like "spoiled" to other people is actually a combination of an inability to take another person's perspective, problems with pragmatic language and abstract thinking, mild thought disorder (ideas of reference) and grandiosity from the bipolar. All together - when he's on a roll fully hooked into the thought disorder and grandiosity he comes across as a defiant, entitled kid who just needs to be put in his place. But if you really try to talk to him, reason with him, get him to see things from your perspective? He cannot do it and you will never penetrate that irrational thinking as long as the disorder thinking is in the driver's seat.
Has your son had a neuropsychologist assessment? I expect if he's gone through intense treatment he has some significant long term side effects. Has this been explored as a possible factor contributing to his behavioral problems?
Has he had a thorough speech and language assessment? This turned out to be the one thing I would have skipped that provided some vital clues to what was going on with my difficult child 2.
I hope you and your husband are in therapy to help you. And that you have found a good child psychiatrist and child therapist.
It must be especially hard to have gone through so much to get him well and keep him well only to be faced with such extreme behaviors.
Hugs.
Patricia
H
HaoZi
Guest
Danger Will Robinson danger! Maybe I'm wrong, but that would be a red flag to me that their ways of handling issues that come up might be objectionable.
Patricia -
One thing I know about bipolar is that these kids may look 'spoiled' to outsiders. Its part of the disease. I learned so much from reading "The Bipolar Child", and learned that many parents of bipolar kids have been told their child is spoiled, bratty, etc.
I'm a social worker myself, I've worked in the psychiatric and medical arenas. I've worked alot with medically fragile children and their parents, along adults who were medically fragile as kids, specifically on an adult cystic fibrosis unit. I would say that the majority have some emotional and social issues due to their growing up as a sick child. One problem we always have is that these "adults" come from Texas Children's where they were indulged to our adult hospital and have a difficult time making the transition. They still have their parents making all the decisions for them and expect to be treated as 'special'.
Mark has had some of that from his days at MD Anderson, but I think with him the trauma of the IVs and hospitlizations probably influenced the onset of his bipolar disorder. I've read that about bipolar - that when a person has the genetic tendency a major trauma can start it off. His illness started at 16 months, right at the prime of his emotional developmental period. A psychologist once told me that the age of 18 months -2 years is THE most important for psychological development.
Another thing that the doctors I work with have told me is that Mark could have had bleeds in his brain because of the extended amount of time he was with low platlets, but that it may not show up on a MRI. One doctor I've worked with in the ER told me he was almost certain Mark has had brain bleeds. Right now I just don't want to traumatize him more with a MRI - he had one done at two but I'm afraid he would be very scared and hard to get him to lay still long enough for the MRI.
Again thanks so much for everybody's input it really helps to hear from others.
One thing I know about bipolar is that these kids may look 'spoiled' to outsiders. Its part of the disease. I learned so much from reading "The Bipolar Child", and learned that many parents of bipolar kids have been told their child is spoiled, bratty, etc.
I'm a social worker myself, I've worked in the psychiatric and medical arenas. I've worked alot with medically fragile children and their parents, along adults who were medically fragile as kids, specifically on an adult cystic fibrosis unit. I would say that the majority have some emotional and social issues due to their growing up as a sick child. One problem we always have is that these "adults" come from Texas Children's where they were indulged to our adult hospital and have a difficult time making the transition. They still have their parents making all the decisions for them and expect to be treated as 'special'.
Mark has had some of that from his days at MD Anderson, but I think with him the trauma of the IVs and hospitlizations probably influenced the onset of his bipolar disorder. I've read that about bipolar - that when a person has the genetic tendency a major trauma can start it off. His illness started at 16 months, right at the prime of his emotional developmental period. A psychologist once told me that the age of 18 months -2 years is THE most important for psychological development.
Another thing that the doctors I work with have told me is that Mark could have had bleeds in his brain because of the extended amount of time he was with low platlets, but that it may not show up on a MRI. One doctor I've worked with in the ER told me he was almost certain Mark has had brain bleeds. Right now I just don't want to traumatize him more with a MRI - he had one done at two but I'm afraid he would be very scared and hard to get him to lay still long enough for the MRI.
Again thanks so much for everybody's input it really helps to hear from others.
