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OK at school Not OK at home?
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<blockquote data-quote="rlsnights" data-source="post: 407998" data-attributes="member: 7948"><p>Jean - I wrote a tome and decided not to post it. It runs 3 pages in word. <img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite3" alt=":(" title="Frown :(" loading="lazy" data-shortname=":(" /> I might pm you with it but really, I can summarize it if I have to. It just won't answer some of your questions/observations in any detail.</p><p></p><p>Bottom line is there are not good alternative schooling options available in our district. He was on H/H last fall and he got worse not better. We've had 3 psychiatric hospitalizations in the past 9 months with major medication changes at 2 of them. Except for possibly adding an AD (which his psychiatrist and I are both rather afraid of trying for fear of mania and/or full blown psychosis) we think his medication cocktail is doing a pretty good job, believe it or not.</p><p></p><p>What's going on is an ugly confluence of bipolar depression/mixed moods and disordered thinking. During his hospitalization last April/May he was diagnosed with thought disorder - specifically "ideas of reference". The partial program staff felt he was actually delusional but the psychiatrist didn't agree. When that diagnosis was really explained to me it was one of those "ah ha" moments. It explained sooo much about his behavior, all the way back to kindergarten. </p><p></p><p>Given his life experiences and our family milieu of illness and disability (all nuclear and 5 of 7 extended family members we see regularly are living with with chronic and/or serious (1 terminal) health problems including MS, end stage renal disease and severe short bowel syndrome that requires TPN) the disordered thinking is manifesting rather predictably as a web of maladaptive beliefs centered on his physical health.</p><p></p><p>He has come to believe that there is 1) something physically wrong with him that is causing his fatigue and disordered sleep that the doctors haven't discovered yet 2) that he has absolutely no control over when he goes to sleep, when he wakes up and how he feels during the day 3) that nothing he does will change these things 4) that he is unable to go to school or perform any "difficult" tasks if he feels tired/bad/didn't sleep well 5) that it is wrong for anyone to expect him to go to school when he feels tired/bad and 6)expecting him to keep up academically is not just unreasonable but punitive.</p><p></p><p>This is really very helpful to me. Having to summarize this for you all has helped me really get a handle on the things he believes about himself and what's happening in his life. Maybe there is some hope of getting the school psychiatric to see this after all. When you put it all together like that it really does sound delusional don't you think?</p><p></p><p>My plan at this point (the psychiatrist is on board with it 100%) is to ask for support for getting him to school from the same system that helps parents of kids who are truant. I am going to ask for a truancy officer to come to our house to get him up and to transport him to school. I'm going to tell the school that he isn't "truant" in the traditional sense but he has developed maladaptive behaviors because of having been sick so much and those are causing school refusal. He's a strong young man and we are unable to physically force him to get up and go to school. So we need someone else to come in and help with that piece.</p><p></p><p>The psychiatrist and I both expect that, once truancy is involved, it will quickly become clear to everyone that he is in fact mentally ill and suffering from both depression and disordered thinking. I suspect that this will provoke a crisis and he may have to be hospitalized but maybe not.It is criminal but this seems to be the only way of getting the school district to recognize that his mental illness is substantially limiting his ability to benefit from his education.</p><p></p><p>Patricia</p></blockquote><p></p>
[QUOTE="rlsnights, post: 407998, member: 7948"] Jean - I wrote a tome and decided not to post it. It runs 3 pages in word. :( I might pm you with it but really, I can summarize it if I have to. It just won't answer some of your questions/observations in any detail. Bottom line is there are not good alternative schooling options available in our district. He was on H/H last fall and he got worse not better. We've had 3 psychiatric hospitalizations in the past 9 months with major medication changes at 2 of them. Except for possibly adding an AD (which his psychiatrist and I are both rather afraid of trying for fear of mania and/or full blown psychosis) we think his medication cocktail is doing a pretty good job, believe it or not. What's going on is an ugly confluence of bipolar depression/mixed moods and disordered thinking. During his hospitalization last April/May he was diagnosed with thought disorder - specifically "ideas of reference". The partial program staff felt he was actually delusional but the psychiatrist didn't agree. When that diagnosis was really explained to me it was one of those "ah ha" moments. It explained sooo much about his behavior, all the way back to kindergarten. Given his life experiences and our family milieu of illness and disability (all nuclear and 5 of 7 extended family members we see regularly are living with with chronic and/or serious (1 terminal) health problems including MS, end stage renal disease and severe short bowel syndrome that requires TPN) the disordered thinking is manifesting rather predictably as a web of maladaptive beliefs centered on his physical health. He has come to believe that there is 1) something physically wrong with him that is causing his fatigue and disordered sleep that the doctors haven't discovered yet 2) that he has absolutely no control over when he goes to sleep, when he wakes up and how he feels during the day 3) that nothing he does will change these things 4) that he is unable to go to school or perform any "difficult" tasks if he feels tired/bad/didn't sleep well 5) that it is wrong for anyone to expect him to go to school when he feels tired/bad and 6)expecting him to keep up academically is not just unreasonable but punitive. This is really very helpful to me. Having to summarize this for you all has helped me really get a handle on the things he believes about himself and what's happening in his life. Maybe there is some hope of getting the school psychiatric to see this after all. When you put it all together like that it really does sound delusional don't you think? My plan at this point (the psychiatrist is on board with it 100%) is to ask for support for getting him to school from the same system that helps parents of kids who are truant. I am going to ask for a truancy officer to come to our house to get him up and to transport him to school. I'm going to tell the school that he isn't "truant" in the traditional sense but he has developed maladaptive behaviors because of having been sick so much and those are causing school refusal. He's a strong young man and we are unable to physically force him to get up and go to school. So we need someone else to come in and help with that piece. The psychiatrist and I both expect that, once truancy is involved, it will quickly become clear to everyone that he is in fact mentally ill and suffering from both depression and disordered thinking. I suspect that this will provoke a crisis and he may have to be hospitalized but maybe not.It is criminal but this seems to be the only way of getting the school district to recognize that his mental illness is substantially limiting his ability to benefit from his education. Patricia [/QUOTE]
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