Need BIP advice

[claymama]

I've got something of a dilemma that applies both at home and (more critically right now) at school.

difficult child tends to have very unpredictable spurts of aggression or meltdowns. Sometimes, the teachers (or I) can spot warning signs or impending triggers and (sometimes) head off the unwanted behavior, but often difficult child will simply be in the zone where he'll be completely uncontrollable ... throwing pencils, or even chairs, screaming, running amok, running out of class, etc.

This has happened three times this term. The first time, when difficult child threw a chair at a teacher, he got a 2 day suspension. The next time, when he was really really wound up and noncompliant, he picked up a chair (twice) but didn't throw it, but wouldn't settle or accept intervention (go for a walk, do some activity of his chosing, go to the swings, etc). Teacher called me, worried that things would escalate and difficult child would engage in harmful behavior, and asked me to pick him up (non-suspension, just early release). I called the Vice Principal (school psychiatric was not available) and told him I didn't believe this was the best solution because difficult child would then learn that misbehavior = going home, and no matter how miserable I make home (no tv, no games, no snacks/lunch except when he'd have them at school, etc), he'd rather be home than school some days. VP agreed, as did teacher, so we left him at school and eventually (after aid convinced him to go to the swings for 45 minutes!) he had a decent afternoon. The very next day, he threw a pencil at a teacher's face. He had an in-school suspension, spending the rest of the day in the VP's office doing work.

Teacher, psychiatric, VP and I agree we need to meet to try to come up with a BIP. I just don't know what kinds of things we should put into it ... I've looked at samples, but most of them just address preventative measures, rather than coping-with-behavior-in-progress options. I don't want this to lead to an alternative placement, if at all possible. We are just now starting to try different medications, and I'd like to have time to find one that works before we decide to take such a drastic measure.

Any suggestions would be greatly appreciated!

 

[Sheila]

It's encouraging that the teacher, psychiatric, and VP want to address the problem with a BIP.

I'd request a Functional Behavioral Assessment (FBA) be performed. It's difficult to design an effective BIP unless the trigger for the behavior(s) is identified. There's a thread or two in the Special Education Archives regarding FBAs.

If there's not an individual in the school district that's qualified to perform a FBA, they will need to contract with someone, e.g., behavioral specialist.

A couple of things came to mind when reading about the Pervasive Developmental Disorder (PDD)-not otherwise specified diagnosis and "swings for 45 minutes." Running, throwing chairs,.... I may be missing the mark here, but I'd request that the school district's occupational therapist (or your private Occupational Therapist (OT)) become involved for consultation and recommendations. If an Occupational Therapist (OT) evaluation (including an evaluation for Sensory Integration Disorder) has not been performed, it needs to be done in my opinion. [The school district is obligated to provide Occupational Therapist (OT) if difficult child needs it.]

Kids with a Pervasive Developmental Disorder (PDD) often have sensory issues and fine/gross motor skill delays that are somehow connected with vestibular and another term I can't recall at this moment. Swinging, twirling, deep pressure, heavy exercise, etc., is something these kids "need" in order calm themselves and/or organize their thinking. Ironically, "the playground" is where a lot these "needs" are fullfilled. It could be that something like a trip to the playground every 2 hours for 15 minutes would help difficult child control his behavior. If so, it needs to be written into the BIP.

Pervasive Developmental Disorder (PDD) kids also often get easily overstimulated. If difficult child's classroom has too much activity going on, gets too noisy, is too cluttered, the fluorescent lights are buzzing, etc. -- these could be triggers.

Is transitioning from one task to another problematic? Are the transitions triggers?

If difficult child can feel when he's about to loose control, the BIP should include his ability to immediately notify the teacher so that he can be taken to a safe place (school counselor's office) -- not for punishment, but to calm down.

I'd want it written into the BIP that in the event restraints are required, the provider has appropriate training.

Your signature indicates he may have bipolar, but he is not yet stabilized. For his safety and others, he may temporarily need to be in a self-contained classroom or theraputic day treatment center.

Another good resource for you and/or the IEP team may be to consult with professionals at a theraputic day treatment center regarding handling particular behaviors. Schools will sometimes tell parents that the school district doesn't have a theraputic day center, and that may be true. However, rest assured they know of a provider and can contract with entities outside the district when it's necessary.

 

[claymama]

Hi Sheila,

Thanks for your thoughtful response.

difficult child is in a self-contained ED classroom and has mostly 1:1 support (there are 5 children in the class, one head teacher and three aids). The classroom is low-stimulant, designed by a brain-based learning specialist.

He receives Occupational Therapist (OT) services 2x/week.

His diagnosis is very much in flux right now because he has so many crossover symptoms. We are trying to narrow it down by seeing which medication works. Right now his psychiatrist is leaning away from the Pervasive Developmental Disorder (PDD)-not otherwise specified (which actually came from the evaluation done by our old school district, not difficult children psychiatrist or neuro-psychologist) and leaning towards the BiPolar (BP) diagnosis, with ADHD as a comorbid condition (based on family history and difficult child's reaction to stimulant medications). We started Abilify yesterday evening, so we'll see how that goes.

He has many, many triggers and sometimes there is no easily discernible or preventable trigger. For instance, he can be triggered by remembering something that happened 6 months ago. So, while prevention can sometimes be accomplished, some of the acting out comes from way out in left field, landing us in the midst of a meltdown or defiant episode with no warning.

It's frustrating, but at least I'm pretty confident that the school is willing to work with us for difficult child's best interests.

Thanks again!