I know I caused some of this...my reactions of course reinforce some of the behavior but it is so hard to not react negatively to being hit or called names. He doesn't have concerta on board yet or the clonidine extra morning tab dose (he has the patches on and they were bumped up). Every single morning I try to keep a routine. I wake him only 1/2 hour before the bus because when I have tried earlier to let medications kick in it only gives us the same 1/2 hour of no medications and 1/2 hour of his now being stuck in what he started...at least this way the bus comes and he usually snaps out of it. I make oatmeal, he is already dressed (I admit that is strange but it makes him feel better, he wont miss the bus so he changes at night and sleeps in his clothes-not a battle I choose to fight--he looks clean and is not smelly) after oatmeal he brushes his teeth (sometimes needs prompts) and gets rubber bands on braces. But lately every response ends with an inappropriate name...I ignore the name but not the request if possible, but he increases the name and louder and louder, if I ask to stop he says ok but it continues (perseverative) and may add stomping or wall banging. If I ask to stop he says ok, sorry but then laughs and pretends to punch me (like a game) but eventually starts slapping (like the boys do sometimes but he never can contain it) and eventually I have to touch him to block his hands...he ges mad then and really starts hitting. He also then pats the dog and he is too old for that, not hitting but bugging him so I say if he can't be gentle then I have to say he can't pet the neighbors' puppies because I have to protect them too and he loses it. This is what happens every time I give any even small consequence. I still follow through because he needs to know I mean it, but I have learned not to give huge consequences or he panics and there is nothing for him to earn (he is not motivated by much so there are only a few things to choose from and a few things to use for consequences) Unfortunately one of the things that stops him is to threaten to call the bus company. (remember this is because he is in a place where our zones are not working, smile) And I do...if you can't be safe at home then I can't risk you being on a bus unsafe.... Safety issues are not negotiable with me. When those medications kick in, it is like night and day. SOOOO frustrating. If it is frustrating for me I can only imagine how it feels to him. Every morning lately I can count on being hit, grabbed etc. I hate mornings like that. Today it included pounding on the doors and walls. SInce I live in a large townhome complex that just doesn't fly with the neighbors. He is going to start a new seizure medication/behavior medication soon (appointment is on 13th I think and we have already talked on the phone). There are signs this is not just a morning thing in that he gets stuck in other behaviors that typically we can redirect him to. (yesterday started putting a sucker near the Integrated Listening Systems (ILS) worker's head while driving when she asked him to stop he says ok but puts it in her hair over and over....she of course pulled over) When he has an issue in all settings I tend to think more medications...when it is only in one then I look harder at the setting. But in the mean time, I have to work on my responses (I will be calling the in home psychiatric) and working on the deep breathing. I was just not in a good mommy mode today and he could see he got to me. So now, in combination with a sub at school, I am sure of a call. I already warned them of a tricky morning so they usually do a much better job with him...take him to "his" office first thing (funny I think there are staff who dont have space to work but my kid has his own room, more than the class sensory room...he got a window because he likes to sit and count things outside to calm himself.) Usually I dont tear up about this stuff but it really got to me today. I need to check my PMS schedule, he is always assured of getting more consequences when I have pms. Not fair to him at all so I try to pay attention.