Need advice about J's school

smallworld

Moderator
I need advice about my son J, who is 15 and in a self-contained ED program for socially and emotionally fragile high schoolers.

First a little background: A year ago J spent 6 weeks in day treatment getting his medications straightened out. When he was discharged, he was taking 400 mg Lamictal, 400 mg Zonegran and 800 mg Seroquel. His outside psychiatrist was uncomfortable with the high dose of Seroquel so we’ve been able to get that down to 600 mg (on lower doses J became irritable and oppositional). This fall J said he felt flat so we’ve successfully just weaned him off of Zonegran. His affect seems a little brighter with no appreciable difference in mood stability.

We haven’t seen a rage in a year. At home J is pleasant, conversational and mostly cooperative (he still doesn’t like to take showers). He spends a fair amount of his home life on “screen time” – the computer, the Wii and the TV – but we can get him outside to rake leaves or take a bike ride or even go to a museum from time to time. He’s lost touch with his friends from his old schools, and he hasn’t made any new friends in his program so his social life is nil. Up until recently, he was doing his homework in his Resource period and during lunch so he didn’t need to do any at home.

Which brings me to school. J’s program of 50-plus students is housed in a large public high school (2,200 students). He is in his program for Geometry, Government, PE and Resource. He is mainstreamed for English (he hated his program’s English teacher), Biology (because of scheduling, he ended up being the only student in his program’s Biology class and we wanted him to have more social opportunities) and Art. He’s failing Art at the moment because he refuses to do the projects during class. He’s getting a D in Biology because he doesn’t do the homework. He’s recently begun sleeping through his first period Resource class, which is where he used to get his Geometry homework done. Now his Geometry grade is slipping because he’s not doing that homework.

We’re told that he won’t say a word to any of the teachers in his program unless he’s answering a classroom question directed at him. He refuses to talk to his program’s social worker or school psychologist, and he won’t participate in group therapy. He won’t talk to the other kids in the program because he believes he has nothing in common with any of them (from everything we’ve been able to figure out the program has a lot of kids with AS/High-Functioning Autism (HFA), and J does not ). He refuses to get involved in any extracurricular activities with mainstream kids.

We’re trying to figure out how to make things better. Any suggestions for what we might do medwise (his psychiatrist is considering Wellbutrin, but we’re worried about irritability as a side effect, and there’s always the risk of upsetting mood stability)? Any suggestions on the school front (this seems to be the only program for kids like J in our county SD)? Or is this something we’re just going to have to wait out until J matures and decides to take responsibility for his education?

Thanks for any insight you might have.
 

Fran

Former desparate mom
I remember vividly, when my difficult child didn't fit any specific niche. He didn't fit with emotionally disabled or MR but he didn't fit with mainstream. He didn't get why he had to learn or achieve grades. He learned simply because he wanted to know. It doesn't really compute to the public school system.

We were to the point of trying to develop a private school where a student was immersed in a topic using all the required classes to understand that one topic. PE would be one specific sport like golf. They would stick with it until they mastered it. Using their math and science to learn the sport. Same with other life skills. Why can't they learn math, science and history by being interactive with the world. It's how those subjects were thought of in the first place.

My difficult child is quickly bored and tunes out with rote learning. He knows lots of history and science but unfortunately schools are not set up and flexible for the different learner. My son slept through many a morning class to my embarassment. He simply wasn't "hearing" what they were teaching.

I don't know the answer. My son is horribly undereducated but his behavior is closer to mainstream. I always figured he could learn information as he aged.

medication wise, I don't know what medication tweak will work to make him more interactive and interested in learning. I wish I knew how to make one of our difficult children more social. It's almost as if they shoot themselves in the foot for whatever reason.
 

klmno

Active Member
I can offer what helped immensely last year but hasn't helped this year with my difficult child- I discussed things with several at school who I thought at least half-way understood my son's issues. Several teachers, staff, etc., then discreetly started trying to "reach out" to difficult child and show interest, make small talk, just greet him and smile more often, etc. Then difficult child kind of picked out a couple of people that he really liked and started becoming more interested in going to school, getting work done, going in clean with hair combed, etc.

One was his math teacher- she would go to his room during resource and discreetly ask him if he wanted to come to her room during that class that day and go over some work he'd missed or work on his homework. This way, she could see what he needed help on, he wouldn't get embaressed and she bragged on how smart he was a lot.

Are you sure that his lack of energy at school isn't indicative of some depression going on?
 

susiestar

Roll With It
I wish I had suggestions for you. In our SD the ONLY options you have for high school are the ONE fundamentalist Christian school (grades k-10 as of this year, will add grade 11 next year when the 4 10th graders become 11th graders), the public school, the alternative school, or homeschooling. That is IT. High school kids can, sometimes, take a college class. There is also a vocational program (and a large # of the kids who go through the vocational prog then pay for college with those skills).

but we have no special anything for kids with other needs. No pull-out program past elementary.

Would it be possible to enroll him in an online high school? Maybe, if it is all on-line he would be more interested and more able to do the work?
 

crazymama30

Active Member
SW, all I can say is that wellbutrin is an ad, But is not an SSRI. Below is some information that I found at http://www.crazymeds.us/. They have some good info there. It does sound like J may be depresssed, but I certainly do not blame you for being leary of ad's.

Among the currently approved antidepressants Wellbutrin (bupropion hydrochloride) has the least chance of triggering mania in the bipolar, just so long as you're taking a real mood stabilizer, such as an anticonvulsant or lithium. None of the weight gain associated with SSRIs. Often a very effective antidepressant, as dopamine and norepinephrine reuptake are sometimes the answer for someone.

How Wellbutrin Works In Your Brain: There have been lots of conflicting data published. But I think I finally got it straightened out. According to Dr. Preskorn, Wellbutrin (bupropion hydrochloride) lets your brain soak in norepinephrine and dopamine longer. Those are two of the three neurotransmitters that, along with serotonin, my wild-*** guess / rule of thumb states will cover up to 80% of the problems with depression. Of course the trick is figuring out which of the three are screwed up, and to what extent
 

jal

Member
I'm sorry I don't really have any suggestions for that, but I wanted to comment on the Wellbutrin (Buproprion). My husband's aunt is bipolar and used Zyban (Buproprion) to stop smoking and she had a psychotic break and was hospitalized. Our psychiatrist recently wanted to add Wellbutrin. Since our son is diagnosis'd bipolar we flat out refused because we are concerned about an interaction and difficult child is only 6. Buproprion can cause psychotic episodes in certain people.

Good luck!
 

pepperidge

New Member
HI Smallworld,

We're in a somewhat similar situation with my 14 yr old. Maybe it is partly teenage thing which compounds all the mood disorder things.

We tried both of my kids on wellbutrin--didn't do much of anything. I am sure at some point you have, but have you tried a very small dose of stimulants in recent time? I see he has tics, which may rule that out. But a very small dose of stimulant (we've had lots of luck with 5-7.5 mg of Adderall) seems to brighten my son's mood (Lamictal really addressed the depression), and make him function at an all around higher social level. I am not sure he has classic ADHD, but I think it still helps his motivation.


As for school, I think there isn't much you can do at this point. I am beyond frustrated, because I see my son's chance for a regular diploma slipping away. The good news about my son--and it sounds like yours as well--is that he sounds like he is beginning to advocate for himself. The bad news is that I am not sure academic achievement is a concern for him, but at least he is willing now to talk to the Special Education teachers about what he needs.

I have two suggestions. The first would be to consider letting him sleep in for his first class--doesn't the HS start at some ungodly hour? and seeing if you can arrange an after school resource period. The second would be to see if your school has any online course possibilities. My son has just shifted into an on-line math program (part of an on-line web charter school here) which he does in the resource room because he just didn't want to be in the regular math class (which was still remedial). He finds the much smaller environment of the resource room better-though am not sure it is for good reasons! I worry that they are not setting high enough standards.

Perhaps he could do geometry on line, and get credit, and maybe even do it at home if he found the computer program engaging enough. I know that that isolates him even further, but at this point if he can learn that way it may take some of the social stress off and at least get him through HS.

I am not sure there is much you can do about the social aspects, given the age he is at. Our psychiatrist is telling me that at some point one just has to stand back and let them make their peace with the world, as long as they in reasonable mental health. Needless to say, I am still in the fix it mode. But maybe my son is ultimately going to have to take responsibility and figure out what he is going to make of his life.

Hugs. Its hard to stand back and watch when one has advocated so tirelessly to get things that are supposed to help.
P.
 

Jena

New Member
I'm just jumping in to offer support is all. :) I have no ideas! Just wanted to say i'm here and i hope that the others thoughts and ideas help.
 

totoro

Mom? What's a difficult child?
This was why we liked the idea of the Waldorf program, and the Montessori programs. But they had their negatives as far as my beliefs and kids with issues.
husband and I have talked at length kind of like Fran's idea about mixing these Schools ideas... but taking out the negative *rules*.
I know this doesn't help you. LOL
But the one thing I loved about K being in a Montessori at a young age, she was in a really good one, but she was able to teach herself to read at her own pace (before knidergarten) she was counting to 100 by 3.
She did these on her own with no pressure.
In the Waldorf she was taught to sew and all about nature... she was taught about culture.
I wish we could have melded these things... N is missing out on these things.
We are still looking into Montessori for N. She was so much happier last year.

Public School just seems like it is not the answer for so many of our kids...
He does sound like he is doing well on many levels at least!
 

Sheila

Moderator
If you ask him what he needs in school to help him, would he be able to tell you?

Will he or can he tell you why he's not doing his work? (bored stupid, unable to perform because of medications or ???

Geez, if we could just get to the root problem sometimes.....

I ask difficult child questions like this and often get an "I don't know." Unfortunately, it's the truth -- he just doesn't know.
 

Steely

Active Member
Gosh, as far as medications smallworld, you seem to know more than most, so just trust your gut. Trust what you really feeling about this, and I am confident you will make the right decision.

My personal experience is that my difficult child's medication mix does not seem to adequately help him without 2 mood stab, an AD, and an AP. It all has to be timed perfectly, however - because if you start the AD without the proper MS in place you are doomed - as you know. The only AD that has ever worked for my difficult child is Paxil, which is supposedly the least likely to do much of anything for most people, and is way down there on the list of ADs usually suggested for kids with BiPolar (BP). None the less, through trial and error, that has seemed to be the one.

As far as the schooling that is actually even harder to address in my opinion. For us private schools brought no more balance or help than public. In fact, the ones for mentally ill teens were horrible. Homeschooling really worked for awhile, because it caused him to be part of a community with the local social homeschoolers, and their classes, and for a couple of years he was successful with that.

My only other thoughts would be ~
To possibly find a mentor for him?
An outside class that he is really interested in, that also is a base for social opportunities?
Tae Kwon Do, or some other sport that makes him feel empowered?
Can your difficult child integrate back into a few mainstream classes at his HS?


I would focus the most on the social part at this point. That, in my opinion, is more of a red flag than the classwork. I did the opposite with my difficult child, and now he is suffering the ramifications of not knowing how to interface with friends or the world. School work can only do so much - in a couple of years - the most important part of this equation will be how he can socially interact with the world.
 

slsh

member since 1999
I've been thinking about this all day long. It's such a catch-22. I don't think you can wait until maturity hits and he is able to become self-invested in school work because by the time that happens he may well be long out of school (sorry - I don't mean to be negative but just from watching thank you and his continued lack of investment... if it's something that can be cultivated, I'm at a loss for how to go about it). I think the self-contained classroom in a HS setting sets up the kids who have the ability to be socially integrated, because by being one of "those" kids they're automatically ostracized (at least that's how it works in our HS). And I totally understand your son feeling like he's not like the other kids in his classroom.

I think ideally I would look outside the school for something to engage him. I love Fran's concept of her private school - connecting academics to real life activities so there's a concrete connection.

I think also a lot depends on what you see (or more importantly, what your son sees) as his life after HS. Is college a realistic option? I don't mean realistic in terms of cognitive ability but in terms of his goals and personal investment and realistic expectations of whether or not he would do more than just "show up". If not, would you (and he) consider a different kind of IEP - work/study, and not just flipping burgers at BK, but work as a way to explore avocations - what he likes, what he doesn't. Volunteering or apprenticeships or voc ed - something that he can have a more real connection to (I mean really, did any of us "connect" to biology or geometry???? :rofl: ).

If it has relevance in his frame of reference, I think there's a far better chance of getting him invested - especially if you can provide supports if anxiety/fear/depression sabotage him.

Hope you understand what I'm saying - I've probably overthought it by this point.

As far as the medications... gosh, I would be (and am) so leery of changing a combination that is holding moods in check. It sounds like he's doing so well at home, and school is just such a tough time all around for some of our kids - I don't know, I just would really hesitate to fix something that isn't broken (comparatively). But I am really conservative when it comes to medications so it's definitely just my opinion. ;)
 

jannie

trying to survive....
I don't have any specific advice, but I wanted to let you know that I'm sorry he's struggling right now.

You seem to know best about medications so I'd go with what you and the doctor decide together. I am a bit concerned that the zonegran may have been treating some depression and perhaps this is part of the reason he seems to be withdrawing. Lack of motivatin is often a sign of depression.

What type of social interactions did he have with his peers in his old school? Is it possible for you to contact one of his old friends and arrange that he comes over for a few hours. I know that typically at this age parents are NOT part of the social planning, but it may be helpful for J right now.

What is the school saying about his work refusal? Do they have any ideas or suggestions? Is there one class in which he feels connected to one of his teachers? If so, I do suggest you speak with that person. Perhaps they somehow have time to give him some extra attention. Unfortunately if he doesn't start completing more classwork he will not be able to maintain passing grades. Classwork has suddenly become a huge part of a child's grade.

Does he use a laptop, alphasmart or fusion to complete writing assignments? Would he be willing to work with a tutor after school for some support with geometry?

Hopefully things will improve.
 
F

flutterbee

Guest
I have struggled with school issues with both of my kids and still haven't figured it out. For easy child, it's been natural consequences and even then he needs hit over the head with them several times. My kids are nothing if not stubborn.

difficult child - it's still a daily struggle.

The only thing that came to mind - because he's not participating in class or making any friends - is maybe some anxiety.
 

gcvmom

Here we go again!
Do you think depression could be the reason he's not participating/cooperating?

I've heard Wellbutrin can be a good option for people with mood disorders (husband's sister has had good results with it and psychiatrist said it might be an option for husband in the future).

My 14yo difficult child 1 is also more interested in screen time than face time. His social life is essentially nil, except for the interactions he has at school. And now that soccer is done for the season, he has even fewer social opportunities. Part of this might be the age. I struggle knowing that this may be the way he is period. I can't change his personality.
 

smallworld

Moderator
Thank you all for your thoughts. I truly appreciate your sharing your experiences with me.

Fran, I always value your words of wisdom. I know that J feels out-of-place in his program -- finding it hard to fit in there, but definitely difficult to make inroads in the mainstream community.

klmno, we have told the program staff that they are only going to be able to break through his silence with frequent concerted efforts at relationship building. An attempt here or there isn't going to do it. Time will tell if they take this advice seriously.

J's psychiatrist is watching for depression closely. He saw J tonight and doesn't want us to make any medication changes over the winter break.

Susie, the state of Maryland doesn't accept online coursework to earn a high school diploma. I'm quite sure J doesn't have the motivation to follow through with this option anyway. And we'd probably kill each other with so much together time.

crazymama, thanks for all the info on Wellbutrin. We're keeping our medication options open at this point. I think J's psychiatrist wants to see how he does over winter break before he makes a decision.

jal, yikes about your aunt! I'll be sure to keep that in mind.

pepperidge, we've tried stimulants off and on for years. When J was in day treatment a year ago, his attending psychiatrist recommended that we not use stimulants any longer. So we just haven't gone back there.

The high school starts at 7:25 am. If he were at his home HS, we could consider a modified schedule. But his HS is a 30-minute drive away, and he's on a bus that picks him up at our door. Logistically, I couldn't drive him and get the girls to their schools on time. And Maryland doesn't accept online courses for credit, unfortunately.

I think I agree with your psychiatrist -- at some point, we need to detatch and let these kids make their own way in the world, as hard as it is for us warrior moms to accept. But I'm still hoping to stumble on something to make his way a little easier.

jen, thanks for your support.

toto, the one thing I've learned is that there's no such thing as a perfect school. But we all keep trying to find that best possible fit.

Sheila, J either won't answer our questions about school or changes the subject. It's maddening. I do know that he has never in his entire life liked school, but his happiest days were in 4th and 5th grades when he had a nice circle of friends with whom he socialized on a regular basis. I think those social connections at that time helped him become engaged in school more than anything else. The worsening of his mood disorder made it difficult for him to keep up with those friends.

Steely, thanks for all your ideas. We've tried most of them to no avail. I agree that the social aspect is something we really need to pour our efforts into.

Sue, I agree with you -- if we wait for maturity to set in, high school will be long over. J has not yet focused on his goals beyond HS. Cognitively, he's college material, but if he can't be invested in academics at any point soon, I'm surely not going to waste money on sending him to college right away. He has expressed some interest in doing community service this summer -- Habitat for Humanity kind of stuff -- which I'm in the process of exploring. I think engaging in some good old-fashioned manual labor may do him some good in more ways than one.

For the time being, our psychiatrist agrees with you about the medications. J is doing well at home -- so much better than when he entered day treatment a year ago -- that we certainly don't want to upset the apple cart.

jannie, J felt very flat while taking Zonegran, which is why we d/c'ed it. J told his psychiatrist tonight that he feels better off Zonegran -- he's experiencing highs and lows (but not too much in either direction), and he likes the way that feels. His psychiatrist suspects that J disliked school before, but now off Zonegran he's feeling (and expressing) his dislike more deeply.

His IEP allows word processing for written classwork. He refuses to work with a tutor (we've tried many times). He hasn't developed much of a relationship with any of his teachers, but I may email a few of them to see if they can invite J to participate in an extracurricular activity. He still gets together with one friend from our neighborhood -- he's lost touch with his other friends -- but they probably only see each other once a month or so.

Heather, anxiety is definitely part of J's makeup. And we certainly have noticed that when he's anxous, oppositional behavior surfaces. That certainly could be playing a role now.

gcvmom, J used to have a fairly social personality, which is what concerns us about how he's behaving now. We do think if he could just make one friend at his new school, he would actually look forward to going to school every day. That would be a huge improvement over what's happening now.

Thanks again, everyone.
 

pepperidge

New Member
Smallworld,

It is so hard to see them fail-at school, at friends, at life.

I think you are on the right track to think that a friend would make a world of difference. My oldest has now made a few buddies in his resource room and I think that is a large part of why he gets up and goes to school. It used to be such a huge struggle to get him there. His anxiety is much less--from medsom knowing the routine etc, and that helps, but friends are key.

Even so this year he has opted out of most of his general ed classes, which is disturbing to us.

All this to say, that it may take some time for your son to make friends. This is a school he has just started this fall, right? Maybe you need to give it a few more months and see what happens.

Do the staff report that he has any friends at all at school? could you do anything to foster the friendships?

Your thoughts about the summer are useful. I'm trying to think what type of programs might give him some sense of accomplishment but have enough supervision that he wouldn't be totally lost and would get something out of it. and also wouldn't involve too much anxiety. Is he good with younger children? could he be a CIT for a day camp? are there benign wilderness programs for depressed as distinct from troubled children?

While you may not be able to get credit for on=-line courses, the ERC may have computer based instruction that might be an alternative mode of delivery. Teachers would still give the credit; the learning however would take place with the computer.

You would think with all the resources in the area in which you live that there would be some school that would be appropriate for him. Sad how hard it is to help our kids.

Hugs for all you're coping with.
C.
 
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