School Refusal

[LucyB]

I'm a long-time lurker looking for some help on school refusal. Son is 11 and in middle school. He was diagnosed several years ago with ADHD/ODD and takes Strattera. Strattera has caused some problems with acid reflux, so he is also treated for that.

Things have gotten very difficult the last few weeks. He has had a lot of minor physical complaints and wants to stay home from school. We did let him stay home a few times in case there were physical problems. We have changed the medication for acid reflux and upped the Strattera (he'd been on the same dose for a few years and he's grown a lot.) The situation has not gotten any better yet, but it's still too soon for the new Strattera dose to have any effect. We also started back with a psychologist who said we need to force him to go to school or it will get worse. We had to have a police officer escort him to school today.

Do you have any other suggestions? He insists nothing bad has happened at school. I am wondering if it could be anxiety. His dad has had anxiety/Obsessive Compulsive Disorder (OCD) problems in the past.

Thanks,
Lucy

 

[smallworld]

Lucy, welcome. I'm glad you decided to come out of lurkdom.

Strattera is an antidepressant used to treat ADHD symptoms. Some kids (like mine) have paradoxical reactions to antidepressants that include increased anxiety and depression (somatic complaints, as well as school refusal, are indicative of anxiety and depression). It's difficult to determine whether your son's current issues resulted from the Strattera dose becoming too low, or whether Strattera is the problem. For this reason, I encourage you to seek the help of a good board-certified child psychiatrist who has lots of experience with medication management. If the new dose kicks in and your son's symptoms persist or worsen, I'd be very suspicious it's the Strattera causing the problem.

Kids who have school refusal are typically anxious in general and are more fearful prior to going to school than once they are actually at school. It is unlikely anything bad happened at your son's school, although you should check this out with his teacher and the school counselor (bullying does come to mind). Your son definitely could be stressed by the new demands placed on him in middle school, which include many exectutive function challenges he never faced before and may have trouble with as a kid who suffers from ADHD. My son has a long history of school refusal (dating to kindergarten!), and we, too, were told he must go to school every day unless he is truly sick. Getting him to school last year at the height of his depression involved my husband carrying him to the car, some days in his underwear (with a bag of clothes in the car). As we've gotten a better combo of medications working for him this year, his school refusal is subsiding. We also decided he needed a smaller school environment where he gets a lot more individual attention.

Again, welcome. I hope you get some answers for your son soon.

 

[jannie]

My easy child had some negative side effects from Straterra-he stopped eating, was overly anxious and also started to really complain about school. He felt awful--he was unable to fully express what was really going on-however-we stopped the straterra and things improved--Basically for us, although the straterra was treating some of his sypmtoms of adhd and sustained attention, the negative side effects of the medication caused more problems. I wonder if the acid reflux would go away if you stopped the straterra. Has he been on any other medications?

Please talk to your doctor.

Welcome--glad to see you've posted.

 

[LucyB]

Thank you for the replies. We are working with multiple doctors right now to find out if the Strattera is part of the solution or part of the problem. We are fairly certain that it is the cause of the acid reflux, but don't know if it is related to the school refusal. He has been on adderall in the past, but it caused extreme weight loss and tics, so the neurologist (prescribing doctor) is reluctant to try another stimulant. He has been on Strattera since it first came on the market, but has never had the dosage changed until last week.

I should also mention that he has never had an IEP, but I am starting to think he may need one. School is being pretty helpful right now, but I may want something in writing to make sure they work with us on this.