Scholastic History
IEP in place for language delay from enrollment in daughter Preschool until end of first grade school year, when difficult child 1 reached peer-level competency with spoken language.
IEP in place for AES Math placement from end of first grade school year.
Behavioral Plan in place from Jan 2013. Behavioral plan is currently based on precision command training recommended by therapist.
Social History
difficult child 1 and easy child 1 were, at times, left un-observed before early 2007. They were frequently left in front of the television without adults present, when they woke up before adults in the house.
difficult child 1's day care teachers noticed a tendency to prefer solitary play, similar to how Deaf children act in a hearing classroom " consistent with his early hearing loss. There were multiple behavioral reports from the day care teachers during difficult child 1's enrollment there, including reports of chasing other children, pulling down his pants on the playground and showing other children his genitalia, urinating on the playground, and throwing objects at other children.
difficult child 1 has been lying about his behavior " both the cause and what he did " since this time. He will often twist facts to suit his interpretation of events; his parents suspect this is an unintentional cognitive distortion, but are not sure.
When father and step-mother moved into a house together in 2007, difficult child 1 and his sister easy child 1 shared one bedroom, and easy child 2 and difficult child 2 shared the other. At first, some inappropriate sexual play was observed between easy child 1 and difficult child 1, but it was quickly corrected and not observed again until much later " shortly before Father and step-mother moved into a new house (with 4 bedrooms for the children) in 2012. easy child 1 seems to have been the instigator of this play, with difficult child 1 simply not knowing to stop it.
During the 2010-2011 (kindergarten) school year, difficult child 1 received multiple reports, both verbal and written, of poor behavior from the after-school care program teacher. All reports were of poor responses to challenging social situations " such as hitting other students, throwing rocks at them, etc. Once, difficult child 1 threw rocks at other students " and then threw rocks at the feet of the teacher who tried to get him to stop. Teacher said that if the behavior did not stop, he would not be able to continue in the program. difficult child 1 was pro-actively removed from the program for the remainder of the year, and grandmother took over after-school care.
In May 2011, difficult child 1 was at home with step-mother on a Saturday, while Father was at work. easy child 1 and difficult child 1 were playing with two neighbor children at the neighbor's house. difficult child 1 and easy child 1 came running home; easy child 1 had violently-red marks around her neck. easy child 1 told step-mother that difficult child 1 had choked her. After things had calmed down, we learned that the children had been playing video games when one of the neighbor kids put his feet in difficult child 1's face. After some teasing, which easy child 1 got involved in, difficult child 1 lost his temper and choked easy child 1.
As punishment for this behavior, after calling Father and Morher, step-mother spanked difficult child 1 and put him in time-out. On Sunday, when the children arrived at Morher's house, she observed bruising on difficult child 1's buttocks and reported Step-mother for child abuse. This resulted in an on-going court case, and a court order prohibiting step-mother from spending any time with difficult child 1. The court order was revised in January 2012 to allow step-mother to be around difficult child 1 so long as either Father, grandmother, or grandfather was also present. This restriction impacted visitation for several months, and has made step-mother very hesitant to interact with difficult child 1, although there have been no further incidents.
Reports of poor behavior at school continued throughout difficult child 1's first-grade year. difficult child 1 had problems interacting with his first-grade teacher. difficult child 1 did not respond well to teacher's disciplinary methods, and was able to visibly frustrate her when she attempted to correct his behavior in the classroom. This had the net result of undermining her authority with her students, and led to severe frustration for both parties. AES coordinator stepped in to help, often removing difficult child 1 from teacher's classroom as a mitigation.
Father, Morher, and step-mother all noticed that difficult child 1 had begun trying to self-harm when punished around this age. He would often call himself stupid, hit himself in the head, or bite himself on the hands or arms when he was put in time-out or otherwise called to task for his behavior. All three adults immediately told him that this was not appropriate or correct, with varying results.
difficult child 1 often reacted inappropriately while playing with friends at Father and step-mother's house during this period. Responses observed including verbal outbursts, teasing/bullying, hitting and kicking others. When asked, difficult child 1 justified these behaviors with skewed understanding of the situation, including cognitive distortions and a strong illusion of central position. Often, the other child/ren simply did not want to do things difficult child 1's way, and he could not respond appropriately to this.
AES coordinator picked difficult child 1's second grade teacher due to conflicts with first-grade teacher. Reports of misbehavior at recess tapered off during the second grade year, replaced by reports that difficult child 1 was refusing to do his work in class at least once a week. Reports of difficulties in after-school care continued until we took difficult child 1 and easy child 1 out of the program in September, placing them with their grandmother for supervision from 2:30pm until Father or Mother got home. Early this school year, difficult child 1 began running from the classroom, starting with hiding in the bathroom and in late April, standing on a toilet to avoid being found.
difficult child 1 regularly fails to report trouble at school to his parents. He seems to think that if he does not report the incident or the write-up, he will be able to delay or avoid punishment, despite repeated increases in punishment for the deceptions.
In March 2013, difficult child 1 told one of his teachers at school that step-father had hit him in the face, resulting in a small mark on his cheek. The teacher reported the incident and it was investigated by CPS, but was found to be unsubstantiated. difficult child 1 later admitted to therapist that he was lying, and that he had gotten the mark on his face from a ball at soccer practice.
During a trip to Tucson, Mother observed difficult child 1 playing on a playground with other children. difficult child 1, without apparent escalation, calmly and deliberately kicked another child in the face while on the slide. Inappropriate behavior with peers is also observed or reported at Father's house, including throwing his shoes at other children.
In April 2013, difficult child 1 received a formal written complaint from the school, resulting in a sexual harassment report being filed at the district level. difficult child 1 was standing in line behind another (female) student, and was spanking her. He refused to stop when asked by the girl, and the teacher became involved.
difficult child 1 is and has been aware that he has few (in his words, no) friends, and often complains of social isolation. He does not seem to connect his behavior with this condition. difficult child 1's interactions with his siblings range from strained to non-existent. easy child 2 largely avoids him whenever possible. difficult child 2 has avoided him in the past but is currently trying to connect with him; she has increased empathy for him after her recent treatment for anorexia and Obsessive Compulsive Disorder (OCD). easy child 1 is frequently annoyed with him, and often answers for him and tries to mother him despite having this behavior discouraged in both households.
Interventions - Past and Present
Precision Command Training was recommended by therapist in August 2012. She felt that difficult child 1 was beginning to show signs of Oppositional Defiance Disorder, but did not formally diagnose him. This did not seem to have any effect on difficult child 1's behavior. Therapist also provided individual counseling from August 2012 to March 2013, without apparent effect.
Father found an online support forum at conductdisorders.com and the book The Explosive Child by Dr. Ross W. Greene in April 2013. We have not yet implemented this technique. The approach seems to resonate with some of what we are doing with difficult child 1 that does work.
Grounding, taking away toys or electronics, physical punishment such as doing exercises or standing in a corner, and corporal punishment do not seem to be effective for difficult child 1. Charts and other visual messages are also ineffective. Step-mother did make him a chart that listed the steps he needed to take in order to maintain basic hygiene, and prepare for school each day, and bed each night. This helped to some degree, but none of the incentives provided " game or TV time, rewards, etc " proved sufficient to motivate him to comply once the initial impact had worn off.
The approach that seems to provide the best response from difficult child 1 is a combination of a punishment which makes him think through what he did wrong, such as writing a paragraph or sentences about the situation, with talking to him about it and helping him through the thought process he should have gone through before he made the choice.
Reducing unsupervised trouble situations also seems to help difficult child 1. When an adult is observing him playing with a peer, he is not as likely to lose control " and the adult is often able to intervene before he reacts physically and resolve the situation.
Father and step-mother have given difficult child 1 How to Take the Grrr Out of Anger by Elizabeth Verdick and Marjorie Lisovskis. He reads it and says the anger management techniques help him. difficult child 1 reports that sometimes he is angry, but is not sure why he is angry.
difficult child 1 is now able to recite what he should have done in most situations, including appropriate coping skills taught by therapist and his parents. This is true even when he is not able to use these skills in the heat of the moment.
