Age 9, Pending Expellsion...?

[doubletroubledoublethefun]

Brace yourself this is a long winded story... please excuse my spelling as well... i am trying to do this quickly.


Good morning,
I have been on this forum a few times, mostly to vent or to get advice, i find myself here as i am in need of both this time. it has been a VERY long month for my family, and with the holidays coming up i find myself not even interested...

history:

We have almost 10 year old twins (boy/girl) and a 5 year old son. My oldest son has been diagnosed with Conduct Disorder/ ADHD.
the twin were born 10 week preemie, they stayed in hospital for 10 long weeks, until they were strong enough to come home.
He has always been a demanding child, but i started to notice, behavorial issues at about age 4, went to a "behavioral doctor" then who and i quote said "boys will be boys" I hate that saying and preseued other doctors.

We finally found one that was wiling to help, but didnt seem too interested in actually finding the root of the problem, just throw some medications at it and no follow ups were nessessary. He has been on Risperidone, Adderal, Concerta, Vyvance, Bifenton, Abilify, Strattera, and now Chonidone.

He had minimal ussues at school until age 6 (grade 1) When he got his very first suspension. He got a few that year, and a few in Grade 2, Then the real fun began....

Grade 3, he was suspended over 10 times, usually for short periods of time becuase they knew if it was a long period of time that he would just keep getting suspended to continue his holiday. At the end of Grade 3 we moved and he needed to change schools...

In July he was hospialized on a childrens ward and properly diagnosed (because the doctor hasnt actually ever given him a diagnoses)

The diagnoses was Conduct Disorder and ADHD. When we went back to our doctor, she was not impressed that he had been admitted into hospital and in not so many words said that there was nothing more that she could do for him, we should go back to the doctor that refered him to her and find a new doctor. so the Presute began all over again...


Present:

New School:

Day 1 - First month
Went into the office to let them know that my son was a frequent Flier at the office and to please call the old prinicpal to be well informed of things that they might see. I advised that they should have a plan in place in case of any behaviours that they might see.
they took this warning lightly. They did nothing, For the first month we looked at school as a "Honey moon" period. The teacher, and staff had nothing bad to say about him, he was completing work, being polite, not melting down, i was starting to believe that he was turning a corner... NOT SO FAST!

First week of October - 3 day suspension, for an outburst and leaving the classroom
Third week of October - 5 day Suspension for a violent outburst, distroying the Schools office. (police presence, they were there on another call)
1st day back after 5 day suspension - 10 day suspension for distroying the library, police were called and i was called, I redirected the situation and got him to calm down.
1st day back from 10 day suspension - 20 day suspension pending expellsion - mild outburst, left the classroom, bite me, was restained by a EA and Police were called, while transitioning from the EA restraint to police restraint the EA got kicked in the head. this is why it is pending expellsion. he was then transported to the hospital to defuse.

back to the school, they have suggested a behavioural program for him, and if that doesnt work they are out of options, and suggest we look at resdiential care...I dont feel that we are there yet, we havent tried anything...thats suppose to be a last resort.

family Doctor put him on Dexidern

Home
Explosions when challenged
suspended from after school program for an outburst
not sleeping - night terrors, and halloinations
fighting with siblings more then ususal
can't travel to other family members houses because he cant seem to handle it.

so needless to say this has been a downward sprial, i have a in house worker, that comes once a week, i waited over a year for her to come to our house. since she has started to come, he has been in crisis, so nothing has really been put into place as of yet.

Meanwhile of all of these suspensions, i found a new doctor and after waiting over a month for the appointment, I had it yesterday, His medication was adjusted,

He is now back on Risperidone (1 mg) and Cholnidone (0.10 mg), three times a day
HE SLEPT LAST Night!!!!!!!

So from what i can see, the next steps are to do some damage control, and try to get him into this program. and hopefully the medications will take some effect so we can reason with him even if its just a little bit.

There are so many things that are missing, in this situatuion... Can any of you tell me what else i need to do to try and help my child and my other children who are also suffering, overly frusterated parents who have no idea what to do now...

Also have any of you had experience with these two medications together? The medication was given to him at 7am and he has been sleeping according to my day care provider... i have asked that she wake him every once and a while to make she he wakes easily.

Thanks

Cyndi

 

[pasajes4]

A difficult situation for your family. Lots of gentle hugs. Where do you live?

 

[BusynMember]

Are you in the US? The type of help you can access for your child and how "problem children" are handled varies country to country. If you live in the US, I would be leery of a CD diagnosis in such a young child, although he is certainly not going in a good direction. However, it doesn't seem to me that the medical professionals involved with him really know the real reason he is so difficult. It also sounds way beyond the realm of ADHD, but other countries diagnose ADHD when it would be something else here...so it is sort of important to know which country you live in. That way somebody in your neck of the woods can guide you in the right direction.

My psychiatrist doesn't like to prescribe more than one medication at a time to see if that one works or if there are side effects. If you start two at the same time and there are side effects, it is hard to tell which medication is causing it. I agree with that, but all psychiatrists are different. I hope the medication combo really does a good job.

I am sorry for your hurting mommy heart. How is your other twin doing?

 

[doubletroubledoublethefun]

Ontario, Canada

 

[BusynMember]

Ah, thanks. We have a lot of Canadians here.

 

[Malika]

It also sounds way beyond the realm of ADHD, but other countries diagnose ADHD when it would be something else here...so it is sort of important to know which country you live in. That way somebody in your neck of the woods can guide you in the right direction.

MWM, I'm sorry to seem argumentative but REALLY this is not true! You have said this several times and I feel beholden on behalf of European amour propre to state clearly that ADHD is diagnosed in the same way, using the same criteria, the world over!! That is to say, in Europe it is diagnosed using the DSM and the Connors scale, just like in the States. The only difference being that it is HARDER to get a diagnosis for ADHD in France, where they are more likely to attribute symptoms to psychological factors, though that is thankfully disappearing as associations grow more active in publicising ADHD and it is more and better known among the public at large.

So that little detail cleared up, I'd like to say to the original poster that I'm afraid I can give no advice about medications but I really feel for you in your situation. What a lack of understanding and true help it seems you have faced from the school, even if it is not their "fault". I wish things had not got to such a painful point for you all. ADHD children DO have outbursts, as I have repeatedly seen with my son - although he tends to hold things in at school, where the routine and structure are what helps him. I wish I could offer more concrete words of help. Many others here have great experience and knowledge and hopefully someone else will have ideas. Good luck.

 

[InsaneCdn]

Sounds a bit familiar... and I'm north of the 49th parallel.

My difficult child didn't really "blow up" until HS, but... the trend was there long before.

I'm going to suggest you ditch current doctors and most of the current dxes. ADHD "may" be partly accurate, at least - or may be a marker for other things that look like ADHD and/or include ADHD. Conduct Disorder? At THIS age? I'd be guessing there's too many other missed dxes.

Obvious things to consider.
1) sleep problems = behavior issues. Sleep problems cause behavior issues. If sleep is a factor, you have a medical problem... or a mental health issue. For example, restless leg syndrome is medical, high anxiety can cause sleep issues, etc.
2) He's at an age where he may have "flown beneath the radar" for a few years... managed to fake his way through school. Now that the work is getting tougher, his skills may be seriously lagging - academic, social, emotional...

So. For a start...

What is he like in terms of social development. Is he able to maintain long-term healthy relationships with same-age peers? Has he been bullied? Is he a bully?
Would you consider him to be emotionally immature?
How are his motor skills - fine and/or gross, either one causes huge problems at school.
Ever been tested for sensory processing/sensory integration issues?

 

[doubletroubledoublethefun]

Thanks for your replies.
This morning he has been sleeping a lot (according to my babysitter) i know this is a side effect of risperidone.

His twin is taking this well, she is mortified by it, but deals with it ok. in past years ( i know its not fair, but i couldnt find a way to make it work) when he got tossed out of programs she would have to leave too. but i have now found a way that she is un effected by it. She is thrilled, it gives her and my younger son a chance to be away from their brother, and be "normal" kids! its nice to see the other two smile and it also gives me a chance to work on things with my older son... things will turn around. i think the medical piece was a huge factor.

 

[soapbox]

Has he ever been tested for the FULL spectrum of auditory processing disorders?
I'm guessing... not.
Unless kids have the classical form of Auditory Processing Disorders (APD), which affects language development, it usually gets missed.
We had to pay privately for a Speech Language Pathologist (SLP) screening... which flagged enough of a problem for the family doctor to refer to the PhD-level audiologist who specializes in APDs.
Two forms that are often missed are auditory figure ground and auditory discrimination. Note that the various flavors of Auditory Processing Disorders (APD) are not mutually exclusive... they can have more than one form.
Auditory figure ground is where the person hears "everything" - has a problem figuring out which sounds are "foreground" and which are "background". SO all they hear is this wall of sound that they get lost in.
Auditory discrimination is where the person hears everything "fuzzy". So, similar sounds are hard to distinguish, which makes accuracy difficult in listening.

APDs have a HUGE impact on school.
For us... the single biggest impact was the Auditory Processing Disorders (APD) diagnosis, and the accommodations and technology that came with it. You won't get either the accommodations or the technology, without a specialist-level diagnosis.

 

[doubletroubledoublethefun]

We are working hard to get him to a point when he can be tested at all right now. I will keep this at the back of my mind for the next doctors appointment.

Thanks

 

[Tiapet]

Forgive me if I didn't see or don't know (because you are in Canada) but what about the IEP process? Did the school do any of this? Did he have any kind of Behavioral Intervention plan or any manifest determination? Since he's had so many suspensions I would have hoped so because it could offer him "some" protection but not completely. As you are seeing and understand, there is obviously a lot more to what's going on with him. Way more. I too would be very leery of the conduct disorders label at his age. I'm wondering if all the different medications earlier might not have also "tripped" a trigger in causing some of the problems too that lead up to this. For example, many of us have really bad problems with our kids that go on Adderall, like violence! Mine did. My oldest child, who's now an adult (still has many issues) often paradoxed medication she was put on at such a young age. The behaviors were so severely the opposite of what they expected (much like what you son is displaying). If I hadn't have come to this board and learned when she was 6 and it all was going haywire and continuing, I don't know what would have happened. I imagine I'd be where you are now as she was where you're son is. I learned enough to change it all. Learning the right path like finding the right doctors who will listen, doing the right testing with the doctors and the school made a big difference. Also having and IEP in place and providing her the necessary tools to help. I do hope that you are able to get the help you need and that your son is able to get into a better situation for both his sake and your families.

 

[InsaneCdn]

Tiapet... this is Canada. We don't HAVE the kind of protections afforded by the US-style IEP process. We have the "plan" part of it, but not the "protection" part.

 

[InsaneCdn]

We are working hard to get him to a point when he can be tested at all right now. I will keep this at the back of my mind for the next doctors appointment.

Thanks

In Canada... Unless your province has implemented some major leaps forward that the rest of us don't have yet... You won't get Auditory Processing Disorders (APD) testing via doctor at this point... you will need Speech Language Pathologist (SLP) testing first. We found school would not touch it, Speech Language Pathologist (SLP) staff stretched too thin with kids in K-3. We had to pay out-of-pocket for a good Speech Language Pathologist (SLP), but it was worth it - and not that expensive.

We found that difficult child was less resistant to Auditory Processing Disorders (APD) testing than to other things. Auditory Processing Disorders (APD) is more like a hearing problem, even though it isn't hearing at all, it's easier to explain to other kids and doesn't have stigma attached. Because it didn't come with potential stigma, he was open to the testing.

 

[doubletroubledoublethefun]

Forgive me if I didn't see or don't know (because you are in Canada) but what about the IEP process? Did the school do any of this? Did he have any kind of Behavioral Intervention plan or any manifest determination? Since he's had so many suspensions I would have hoped so because it could offer him "some" protection but not completely. As you are seeing and understand, there is obviously a lot more to what's going on with him. Way more. I too would be very leery of the conduct disorders label at his age. I'm wondering if all the different medications earlier might not have also "tripped" a trigger in causing some of the problems too that lead up to this. For example, many of us have really bad problems with our kids that go on Adderall, like violence! Mine did. My oldest child, who's now an adult (still has many issues) often paradoxed medication she was put on at such a young age. The behaviors were so severely the opposite of what they expected (much like what you son is displaying). If I hadn't have come to this board and learned when she was 6 and it all was going haywire and continuing, I don't know what would have happened. I imagine I'd be where you are now as she was where you're son is. I learned enough to change it all. Learning the right path like finding the right doctors who will listen, doing the right testing with the doctors and the school made a big difference. Also having and IEP in place and providing her the necessary tools to help. I do hope that you are able to get the help you need and that your son is able to get into a better situation for both his sake and your families.

Hi there,

He does have a IEP he also have a Safe intervention Plan in place at school.. problem is he hasnt been there to use it at all, he has a EA in the classroom with him to help him with any of the needs that he has... Right now we are doing damage control, trying to find the correct medication to keep him uner control to figure out what is going on.

 

[Liahona]

I don't know if your school will do this, but if they won't it'll be worth it to do it yourself. It is called a FUBA. Where you go and sit and observe and take notes. Write down what happens right before, during, and after behavior problems. This will give you good data that can then be used to help him.

It is the start of a behavior plan. Also, writing down very specific instructions of what you do at home to help his behaviors will help school deal better with him. And having everyone react the same way will help him as well.

 

[stressbunny]

Sorry that you are going through this. It is hard, for sure.

Just wanted to say that severe ADHD (I stress the "H") can involve temper tantrums and outbursts that are wildly inappropriate for the affected child's social age. I have read more scientific articles than I can count over the years (my oldest is 20 now), and the best that ADHD has been explained is a lack of the ability to self regulate, which includes emotions and behaviors. Our son's psychologist told us JT was the worst case of ADHD she had ever seen. She wasn't able to complete the testing on him because he never stopped moving or focused, etc. He just couldn't do it. To this day, he has GREAT difficulty motivating himself to do things and persist with tasks. When he was in the 4th - 8th grades, especially, he was in trouble a lot for getting into arguments and altercations with other kids. Once, he became so upset, he tipped over his desk and broke his pencil, he was so upset. When the lack of self regulation is combined with severe impulsivity and poor cause-and-effect thinking, you have a recipe for lots of school problems. JT was never diagnosed with full-blown conduct disorder, but he definitely is oppositional; always has been. He doesn't have an Autism Spectrum Disorders (ASD) or mood disorder at all. Yet, these issues he does have are causing him great difficulty in life.

Has your son always been hard to care for, i.e. difficulty with following directions, getting along with other kids, moody and/or argumentative, etc.? Do you think any of it may have something to do with his premature birth?

You may want to keep a journal/log as to when and where the problems are happening and what precipitates them, along with the medications he is taking and foods he is eating, etc. Is it happening more commonly at the afternoon/evening timeframe? If so, could his medications be wearing off and creating a negative rebound? Would backing off to a single medication at a time help isolate potential side effects and benefits? It may take a lot of trial and error to see what helps. Clonidine has helped our Bubby a lot with his temperament. Does your son have any symptoms of Autism Spectrum Disorders (ASD)? Our younger Autism Spectrum Disorders (ASD) boy has major difficulties with his emotions. He seems very immature for his age, but he also has ADHD and much trouble self regulating. How about seeing a pediatric neurologist to determine if there may be any neurological issues at the core of this. I think your son's issues are most likely organic, versus learned. It sounds like his twin is doing fine.

 

[doubletroubledoublethefun]

I don't know if your school will do this, but if they won't it'll be worth it to do it yourself. It is called a FUBA. Where you go and sit and observe and take notes. Write down what happens right before, during, and after behavior problems. This will give you good data that can then be used to help him.

It is the start of a behavior plan. Also, writing down very specific instructions of what you do at home to help his behaviors will help school deal better with him. And having everyone react the same way will help him as well.

The school has done this, thats a part of their safe intervention plan. It shows all of the behaviours that they see in one column and the next shows how to resolve the behaviour. THEY made this plan themselves, i have tried my best to try to explain that i dont believe that most of the things listed will work, but they feel it will. I have had to go to the school many times to resolve the problems myself. By the time they call me, its usually too late and hes being suspended. With Calvin, its very hard to tell when its going to happen, there is no clear indicator that its going to happen until it starts to happen, then it could be a matter of seconds before he is completely out of control. such a complex litle guy... Home isnt really the problem here, I read the book "the explosive child" and use that technique, it seems to work for him. The school doesnt seem to be able to do that in the slightest.
Thank you for the suggestion though, it verifys to me that i have been doing all the right things, trying to get him on track.

 

[doubletroubledoublethefun]

Sorry that you are going through this. It is hard, for sure.

Just wanted to say that severe ADHD (I stress the "H") can involve temper tantrums and outbursts that are wildly inappropriate for the affected child's social age. I have read more scientific articles than I can count over the years (my oldest is 20 now), and the best that ADHD has been explained is a lack of the ability to self regulate, which includes emotions and behaviors. Our son's psychologist told us JT was the worst case of ADHD she had ever seen. She wasn't able to complete the testing on him because he never stopped moving or focused, etc. He just couldn't do it. To this day, he has GREAT difficulty motivating himself to do things and persist with tasks. When he was in the 4th - 8th grades, especially, he was in trouble a lot for getting into arguments and altercations with other kids. Once, he became so upset, he tipped over his desk and broke his pencil, he was so upset. When the lack of self regulation is combined with severe impulsivity and poor cause-and-effect thinking, you have a recipe for lots of school problems. JT was never diagnosed with full-blown conduct disorder, but he definitely is oppositional; always has been. He doesn't have an Autism Spectrum Disorders (ASD) or mood disorder at all. Yet, these issues he does have are causing him great difficulty in life.

Has your son always been hard to care for, i.e. difficulty with following directions, getting along with other kids, moody and/or argumentative, etc.? Do you think any of it may have something to do with his premature birth?

You may want to keep a journal/log as to when and where the problems are happening and what precipitates them, along with the medications he is taking and foods he is eating, etc. Is it happening more commonly at the afternoon/evening timeframe? If so, could his medications be wearing off and creating a negative rebound? Would backing off to a single medication at a time help isolate potential side effects and benefits? It may take a lot of trial and error to see what helps. Clonidine has helped our Bubby a lot with his temperament. Does your son have any symptoms of Autism Spectrum Disorders (ASD)? Our younger Autism Spectrum Disorders (ASD) boy has major difficulties with his emotions. He seems very immature for his age, but he also has ADHD and much trouble self regulating. How about seeing a pediatric neurologist to determine if there may be any neurological issues at the core of this. I think your son's issues are most likely organic, versus learned. It sounds like his twin is doing fine.

Thank for the reply,

You are right i think that his low birth weight, being a twin and being born premature do contribute to all of this, I also think that the CPC that he was diagnosed with while a fetus also has a contributing factor, i just need a doctor to listen to me.
I do my best to keep logs day to day, and each episode, latley things have been so crazy that i have been slacking a lot. i need to get back on track.
We are trying to stabilize him in order to have any testing done, one by a phycytrist (please excuse the spelling) and a occupational therpist, to rule out sensory issues. now that he is back on risperidone, these things should become priority...willing he allows it... We also go to a new school next week, smaller classrooms geared towards behaviours, so it seems the board is not expelling him, they are just not allowing him to go to a "normal" school... we shall see!
Thanks for your comments

 

[InsaneCdn]

Make sure the program they are placing him in is not a "permanent placement", but a program that is designed to turn these kids around. Not that they necessarily CAN turn every kid around, but for your initial placement, you at least want that option. Otherwise, he will NOT be educated... just warehoused.

 

[doubletroubledoublethefun]

Thank you! i have often thought of this as well... i will make it a point to ask!

Make sure the program they are placing him in is not a "permanent placement", but a program that is designed to turn these kids around. Not that they necessarily CAN turn every kid around, but for your initial placement, you at least want that option. Otherwise, he will NOT be educated... just warehoused.