School issues - ADHD - at my wits end! UPDATE: we changed schools!

[slk537]

Our DS has had a terrible first week in first grade at his private school. He had a good year for the most part in kindergarten, a decent summer in a VERY laidback atmosphere and now a horrible first week back to school. I met with his new teacher, she knows him from last year, we had some good plans in place and after seeing his pediatrician, we bumped up his Concerta dosage from the summer lower dose to a higher school dose.

This week he had issues with being very sensitive, a little paranoid, easier to anger, more obstinate, etc. I had many phone calls and he had to see the principal after having several meltdowns. Then yesterday he had a major meltdown and ended up hitting a child because he thought the child smiling at him was because he was making fun of him. This was at the end of a sprialling downward day. He has issues with impulsivity, but rarely meltdowns so this was a very uncharacteristic and unsettling week. I had already spoken with his teacher about the issues in the morning, but then received an incredibly awful phone call from the (new this year) principal after we were home.

She was terrible telling me about him hitting the little boy, how the other child's parents were "understandably very upset" said "as an administrator I..." several times and then ended up by saying "If this happens again on Monday you WILL get a phone call and you WILL come get him." I TOTALLY understand parents being upset if their child is hit and I know she is an administrator. But I have worked VERY hard and very closely and very positively with his teacher and I have spoken barely 5 words to the principal and all of them in this conversation and she was speaking to me as though I was being extremely defensive and unwilling to listen...almost as though I was a 7 year old myself. I did NOT appreciate this.

She handed the phone over to the teacher and we were able to have a good conversation. I did (politely) express my anger at how the principal was handling things and how I felt that there were some decisions to be made...how I knew she was working with DS, but I felt her hands were being tied. I told her I needed to come in and talk to her and the principal because if she (principal) feels she doesn't want DS in her school, we need to make that decision now because I won't put him through this anymore.

She handed the phone back to the principal, whose tone changed completely after I requested a meeting repeated the same thing about if she didn't want him in her school, we needed to make the change now. Suddenly she was willing to work with us, said obviously I am doing everything I can (call to pediatrician, appt with therapist, discussions with Special ed at the public school, working on changing meds, etc) and we can work together as he adjusts back to school. She then seemed to feel all was well and we really don't need to meet.

A few things that have come out of this however:

1. I talked to the pediatrician and we are scaling back the meds, as the high emotions/meltdowns can be a negative side effect of too high a dose

2. I am terrified that he may have naughty days this week and there will be no tolerance so I will have to leave work repeatedly to go get him and he will also be miserable.

3. I do not trust this woman who holds the place of authority in his school.

4. I will now worry constantly that each day will be the day they will give up on my child and we will have to start all over at the public school and disrupt him completely.

I'm venting - but if anyone has any advice I would really appreciate it! I am struggling with whether or not we should just pull him and go to the public school system where he would perhaps have a stronger and more understanding support system. I need to trust the people caring for my child and believe they want what is best for him on some level and I truly believe that while his teacher does care, this other woman does not.

 

[KirstenB]

It sounds like the principal is new to your school, is that right? So he/she doesn't know your child, or the child who got hit, very well yet. Our dd has ADD, and I know we've had a hard time with adjusting the level of her meds, and I'm guessing it'll be an ongoing thing.

I don't know what advice to give. Try to remember the principal has to protect the physical safety of everyone at the school, first. Obviously, unlike public schools, they don't have to provide a "free and appropriate education" to everyone. It sounds like the principal was trying to make you understand how serious these behavioral issues were. Unlike a lot of parents, you do get how serious they were, so you probably relieved a lot of the principal's anxiety about what kind of parent he/she was dealing with. It sounds like that's why he/she backed down. Hang in there.

 

[robin09]

As a mom of DD9 who has adhd, asd, ocd... what I can do is give you I have written quite a few posts similar to yours. You are doing the right thing in scaling down the meds. Our DD cannot take any of the adhd meds. She gets violent and nasty on it. It definitely is a wicked side effect. She has tried concerta and adderall with nasty effects. Strattera did absolutely nothing for her. Trust your instincts. If you think the principal is going to be a problem, make alternate plans now. Noone should have to live in fear of the phonecalls or being nervous about behavior issues.

DD's teacher understands there are times that she needs time to unwind and to be left alone. It seems like you have a good teacher who is willing to work with you and a Dr. who listens to you...Listen to yourself and be prepared...

Our DS has had a terrible first week in first grade at his private school. He had a good year for the most part in kindergarten, a decent summer in a VERY laidback atmosphere and now a horrible first week back to school. I met with his new teacher, she knows him from last year, we had some good plans in place and after seeing his pediatrician, we bumped up his Concerta dosage from the summer lower dose to a higher school dose.

This week he had issues with being very sensitive, a little paranoid, easier to anger, more obstinate, etc. I had many phone calls and he had to see the principal after having several meltdowns. Then yesterday he had a major meltdown and ended up hitting a child because he thought the child smiling at him was because he was making fun of him. This was at the end of a sprialling downward day. He has issues with impulsivity, but rarely meltdowns so this was a very uncharacteristic and unsettling week. I had already spoken with his teacher about the issues in the morning, but then received an incredibly awful phone call from the (new this year) principal after we were home.

She was terrible telling me about him hitting the little boy, how the other child's parents were "understandably very upset" said "as an administrator I..." several times and then ended up by saying "If this happens again on Monday you WILL get a phone call and you WILL come get him." I TOTALLY understand parents being upset if their child is hit and I know she is an administrator. But I have worked VERY hard and very closely and very positively with his teacher and I have spoken barely 5 words to the principal and all of them in this conversation and she was speaking to me as though I was being extremely defensive and unwilling to listen...almost as though I was a 7 year old myself. I did NOT appreciate this.

She handed the phone over to the teacher and we were able to have a good conversation. I did (politely) express my anger at how the principal was handling things and how I felt that there were some decisions to be made...how I knew she was working with DS, but I felt her hands were being tied. I told her I needed to come in and talk to her and the principal because if she (principal) feels she doesn't want DS in her school, we need to make that decision now because I won't put him through this anymore.

She handed the phone back to the principal, whose tone changed completely after I requested a meeting repeated the same thing about if she didn't want him in her school, we needed to make the change now. Suddenly she was willing to work with us, said obviously I am doing everything I can (call to pediatrician, appt with therapist, discussions with Special ed at the public school, working on changing meds, etc) and we can work together as he adjusts back to school. She then seemed to feel all was well and we really don't need to meet.

A few things that have come out of this however:

1. I talked to the pediatrician and we are scaling back the meds, as the high emotions/meltdowns can be a negative side effect of too high a dose

2. I am terrified that he may have naughty days this week and there will be no tolerance so I will have to leave work repeatedly to go get him and he will also be miserable.

3. I do not trust this woman who holds the place of authority in his school.

4. I will now worry constantly that each day will be the day they will give up on my child and we will have to start all over at the public school and disrupt him completely.

I'm venting - but if anyone has any advice I would really appreciate it! I am struggling with whether or not we should just pull him and go to the public school system where he would perhaps have a stronger and more understanding support system. I need to trust the people caring for my child and believe they want what is best for him on some level and I truly believe that while his teacher does care, this other woman does not.

 

[slk537]

It sounds like the principal is new to your school, is that right? So he/she doesn't know your child, or the child who got hit, very well yet. Our dd has ADD, and I know we've had a hard time with adjusting the level of her meds, and I'm guessing it'll be an ongoing thing.

I don't know what advice to give. Try to remember the principal has to protect the physical safety of everyone at the school, first. Obviously, unlike public schools, they don't have to provide a "free and appropriate education" to everyone. It sounds like the principal was trying to make you understand how serious these behavioral issues were. Unlike a lot of parents, you do get how serious they were, so you probably relieved a lot of the principal's anxiety about what kind of parent he/she was dealing with. It sounds like that's why he/she backed down. Hang in there.

You are correct - she is new this year and doesn't know any of the children. Thank you for your perspective - I plan to talk to my SIL today as well. She is a teacher and has recently achieved her principal's license so I really need more perspective to determine where she is coming from.

 

[slk537]

As a mom of DD9 who has adhd, asd, ocd... what I can do is give you I have written quite a few posts similar to yours. You are doing the right thing in scaling down the meds. Our DD cannot take any of the adhd meds. She gets violent and nasty on it. It definitely is a wicked side effect. She has tried concerta and adderall with nasty effects. Strattera did absolutely nothing for her. Trust your instincts. If you think the principal is going to be a problem, make alternate plans now. Noone should have to live in fear of the phonecalls or being nervous about behavior issues.

DD's teacher understands there are times that she needs time to unwind and to be left alone. It seems like you have a good teacher who is willing to work with you and a Dr. who listens to you...Listen to yourself and be prepared...

Thank you so much! He does so well being calmed down on the lower Concerta but this higher dose just made him so oddly emotional. I haven't had the "that doesn't sound like my DS!" reaction to school feedback in 2 years so I knew there was something going on beyond the adjustment to school. We haven't had aggression issues since he was 4 so this just has really taken me aback. We pulled the dose back today and he is currently cuddled up next to me, watching a cartoon on TV - calm, happy and sweet and back to being my little guy.

DH is going to check into what we need to do to make the switch so we're ready if this week at this does doesn't help and as I posted above, I'm going to talk to my SIL today. I can't live like this, but I want him to get the Catholic education if possible. In the end, we'll do what is the best for him.

 

[bookwormde]

I would agree that looking at the meds and their level as a “cause” for the atypical behavior would be a good starting point.

Second It might be a good time to get an updated evaluation since this as the age that any additional/alternate diagnosis can often be made by highly qualified clinicians.

If your insurance does not cover it, call the public school district and see about getting them to have it done.

The idea that you are reevaluating the med protocols and having an updated evaluation done may help the “administration” to be more patient and understanding that there may be more going than is apparent on the surface.

bookwormde

 

[slk537]

I would agree that looking at the meds and their level as a “cause” for the atypical behavior would be a good starting point.

Second It might be a good time to get an updated evaluation since this as the age that any additional/alternate diagnosis can often be made by highly qualified clinicians.

If your insurance does not cover it, call the public school district and see about getting them to have it done.

The idea that you are reevaluating the med protocols and having an updated evaluation done may help the “administration” to be more patient and understanding that there may be more going than is apparent on the surface.

bookwormde

Thanks for the advice...! DS's pediatrician is consulting with a specialist in the behavioral health dept this week and we are going to meet with him in October. I'm glad to see that advised here - feels like we are on the right track.

 

[barkley]

just a thought-by any chance was your son sleeping later and therefore taking his meds a bit later during the day during the summer? reason i ask is when our ds was taking oral adhd meds it realy took some time for him to get readjusted to taking his meds early in the a.m. when school started back up. mornings were an absolute bear for him such that we were ending up having to wake him about an hour ahead of when he had to get up to just swallow the meds so it could have a chance to start activating while he was still sleeping. this seemed to help him wake up on a better note and handle the day overall allot better (he's now on the patch which is an absolute god-send, i can just apply it while he's still asleep so mornings and school in general is so far going pretty well).

p.s.-i noticed you say that your pediatrician is handling the meds issue, just want to suggest if your ds has'nt seen one, a pediatric neurologist or pediatric psychiatrist can be a tremendous assett for evaluations and medication/theraputic reccommendations (they tend to know the most up to date info. on adhd meds/treatments and can be of tremendous assistance).

 

[Selket]

I wonder if there is an "adjustment period" when you go to a higher dose of concerta? I noticed my son (when he first started it) was much more emotional and could be rude (he is ADD - not hyper and not oppositional) when he went to a higher dose. After a couple of weeks at the higher dose he was back to his old self except with a dramatic improvement with the attention.

I guess from that experience I'd want to talk to the doctor before reducing the dose - maybe they need to take the higher dose awhile in order to get used to it? I don't know - that seemed to happen with us.

 

[Kaler131]

I don't really have any advice because I am in the same boat as you....my DS8 who is in 3rd grade has a lot of the same issues and is perpetually in lunchtime detention We are just hangin on and taking it one day at a time. My DS11 had some of the same issues, but has outgrown them somewhat and is doing LOTS better now. Good luck! I just keep thinking of what my mom always says: "This too shall pass" and eventually it will. Now, if I can only keep up that mantra when dealing with my DD14 who is currently driving my CRAZY LOL!

 

[slk537]

just a thought-by any chance was your son sleeping later and therefore taking his meds a bit later during the day during the summer? reason i ask is when our ds was taking oral adhd meds it realy took some time for him to get readjusted to taking his meds early in the a.m. when school started back up. mornings were an absolute bear for him such that we were ending up having to wake him about an hour ahead of when he had to get up to just swallow the meds so it could have a chance to start activating while he was still sleeping. this seemed to help him wake up on a better note and handle the day overall allot better (he's now on the patch which is an absolute god-send, i can just apply it while he's still asleep so mornings and school in general is so far going pretty well).

p.s.-i noticed you say that your pediatrician is handling the meds issue, just want to suggest if your ds has'nt seen one, a pediatric neurologist or pediatric psychiatrist can be a tremendous assett for evaluations and medication/theraputic reccommendations (they tend to know the most up to date info. on adhd meds/treatments and can be of tremendous assistance).

It's actually the opposite for sleep right now - I work from 6-3 year round and DH works 4 ten hour days in the summer so he had to be at work at 6:30 then and 8:00 now so DS is getting a little more sleep. He is still taking his meds around the same time. I wake him up right before I leave and give him his meds so by the time he wakes up we don't have Hyperchild. Unfortunately he goes to a Montessori program during the summer so it is a LOT more laid back and he gets used to the lack of structure.

His teacher is being amazing about this situation and really is trying to work with him. We had a long chat last night and she has some good incentive ideas for him. I just have a true trust issue with the principal, but since his teacher is the key adult, I am choosing to have faith.

For your second point - DS's ped just started consulting with a pediatric psychiatrist last week regarding his does, and I am supposed to get a call today to set up an appt with him. There are so very many options out there that the ped wants to partner with an expert, which I am all for. We're also going to see a counselor next week to talk about behavior modification and I have high hopes for that, as we've seen her before and she's wonderful.

Is the patch a stimulant? The psychiatrist had brought up adding strattera to the concerta possibly and I am intrigued as to how these all work.

Thank you for your feedback - it means so much to me to talk to other parents of ADHD children and to see that we are on the right track...!

 

[slk537]

I wonder if there is an "adjustment period" when you go to a higher dose of concerta? I noticed my son (when he first started it) was much more emotional and could be rude (he is ADD - not hyper and not oppositional) when he went to a higher dose. After a couple of weeks at the higher dose he was back to his old self except with a dramatic improvement with the attention.

I guess from that experience I'd want to talk to the doctor before reducing the dose - maybe they need to take the higher dose awhile in order to get used to it? I don't know - that seemed to happen with us.

We talked to his pediatrician about the dose - he was the one who suggested dropping it. I think you are right though - it seems that 7-10 days is the "magic" adjustment period. I believe he wants to monitor this dose for a week and then talk about slowly adding in strattera, but we're going to meet with a psychiatrist who specializes in the meds to see what the best route is.

DS is definitely the "H" side of the ADD/ADHD but like your experience the rudeness and emotional sensitivity was just not like him. I think maybe we jumped too high too quickly on his school dose and just need to backtrack a little. I know today will be a squirrelly day for him, but as long as he is emotionally in check, it will be better.

 

[slk537]

I don't really have any advice because I am in the same boat as you....my DS8 who is in 3rd grade has a lot of the same issues and is perpetually in lunchtime detention We are just hangin on and taking it one day at a time. My DS11 had some of the same issues, but has outgrown them somewhat and is doing LOTS better now. Good luck! I just keep thinking of what my mom always says: "This too shall pass" and eventually it will. Now, if I can only keep up that mantra when dealing with my DD14 who is currently driving my CRAZY LOL!

Thank you for the support!!! It so helps me to know I'm not alone in this. And I see so many changes in him from last year so I know it will get better...I just can't wait for that to happen.

We're using private swim lessons at the Y as something for him to "work towards". his teacher has set up a sticker system, so he has 4 chances to get 4 stickers throughout the day. If he gets at least 12/20 in a week, she'll let him pick a "prize" on Friday. He is really excited about this. We're adding the swimming lessons as an extra incentive because Michael Phelps is his new hero/role model ever since DS found out that he also has ADHD.

What do you find works for you with your boys?

 

[melafive]

Before I write anything I just want to say that I know this does not pertain to all children with difficulties. I just want to get my son's story across because I think it can go undiagnosed.

My son was always moody and emotional. He was a very crabby child. His emotions went from happy to sad, mad and angry, quickly. Things were difficult for him. He could barely hold a pencil. Towards the end of ktgn there was a question as to whether or not to hold him back. Around the same time he also developed a tic. I researched and researched and found a connection between food allergies/intolerance's and learning problems. I also found that food allergies/intolerance's can increase tics as well. I decided it would not hurt to eliminate different common food allergens. My son improved but he still had issues. I soon narrowed his reactions down to corn and eliminated all that I could. I had him tested for corn and indeed he was allergic. Recently I had him blood tested and his is no longer allergic to corn but has a very low reaction to dairy products.

My son is now in third grade and he generally does not have any problems now. He still has a hard time with spelling but that is about the only concern. He has come so far.

Now I am not saying that this is the case for you OP but it is something to think about if you have not already.

 

[Kaler131]

We're using private swim lessons at the Y as something for him to "work towards". his teacher has set up a sticker system, so he has 4 chances to get 4 stickers throughout the day. If he gets at least 12/20 in a week, she'll let him pick a "prize" on Friday. He is really excited about this. We're adding the swimming lessons as an extra incentive because Michael Phelps is his new hero/role model ever since DS found out that he also has ADHD.

What do you find works for you with your boys?

That is so awesome! That is a really great reward for him to look foward to!!
With my son (and previously with my older son), we have been working with his teacher on a reward system. His teacher gives him a sheet of paper at the beginning of the week with the days listed and if he has a "good day" he gets a check, if he has a "somewhat good day" he gets a check minus, and if he has a "not very good" day, he gets a minus. At the end of the week he gets a reward from the "Treasure Box" that she has in her room that is filled with goodies that are donated by parents and others. He LOVES the "treasure box" and has been working hard to get his checks!
With my older son, he was obsessed at the time with Yugio and Pokemon, so my DH & I bought a bunch of packs of the trading/game cards and sent them into his teacher to give to him when he had good days. It worked most days) like a charm! Of course, after a while we had to switch it up a bit when he began to change his interests or got a little bored with the rewards.

 

[barkley]

Before I write anything I just want to say that I know this does not pertain to all children with difficulties. I just want to get my son's story across because I think it can go undiagnosed.

My son was always moody and emotional. He was a very crabby child. His emotions went from happy to sad, mad and angry, quickly. Things were difficult for him. He could barely hold a pencil. Towards the end of ktgn there was a question as to whether or not to hold him back. Around the same time he also developed a tic. I researched and researched and found a connection between food allergies/intolerance's and learning problems. I also found that food allergies/intolerance's can increase tics as well. I decided it would not hurt to eliminate different common food allergens. My son improved but he still had issues. I soon narrowed his reactions down to corn and eliminated all that I could. I had him tested for corn and indeed he was allergic. Recently I had him blood tested and his is no longer allergic to corn but has a very low reaction to dairy products.

My son is now in third grade and he generally does not have any problems now. He still has a hard time with spelling but that is about the only concern. He has come so far.

Now I am not saying that this is the case for you OP but it is something to think about if you have not already.

i am so glad you went with allergy testing. i am always saddened when i hear of kids that have been diagnosed with add or adhd whose doctors don't do testing to rule out other possible factors. with our ds before adhd was even explored we had allergy, hearing and vision tests-something i would reccommend as a minimum elimination screening.

 

[barkley]

It's actually the opposite for sleep right now - I work from 6-3 year round and DH works 4 ten hour days in the summer so he had to be at work at 6:30 then and 8:00 now so DS is getting a little more sleep. He is still taking his meds around the same time. I wake him up right before I leave and give him his meds so by the time he wakes up we don't have Hyperchild. Unfortunately he goes to a Montessori program during the summer so it is a LOT more laid back and he gets used to the lack of structure.

His teacher is being amazing about this situation and really is trying to work with him. We had a long chat last night and she has some good incentive ideas for him. I just have a true trust issue with the principal, but since his teacher is the key adult, I am choosing to have faith.

For your second point - DS's ped just started consulting with a pediatric psychiatrist last week regarding his does, and I am supposed to get a call today to set up an appt with him. There are so very many options out there that the ped wants to partner with an expert, which I am all for. We're also going to see a counselor next week to talk about behavior modification and I have high hopes for that, as we've seen her before and she's wonderful.

Is the patch a stimulant? The psychiatrist had brought up adding strattera to the concerta possibly and I am intrigued as to how these all work.

Thank you for your feedback - it means so much to me to talk to other parents of ADHD children and to see that we are on the right track...!

daytrana patch is a stimulent (as was dextrostat which was the oral med ds was on for several years)-and our experience with it has been fantastic.

the thing that has made a huge difference for ds is he no longer has that 'crash' when his meds would wear off (always seemed to happen right towards the point in the afternoon when we were sitting down to do homework )-with the patch it can work up to 12 hours but it stops working about 2 hours after it's removed. we time it out so it's wearing off as he's dozing off it's also made a big difference appetite wise. ds has never been a big eater but the meds would kill his appetite totaly. with the patch it's much improved.

 

[kirbydog48]

My ds9 has ADHD. His first medication was Concerta, which made him extremely emotional with daily meltdowns and inability to handle frustration. Then we switched to Adderall, which was horrible; he became this angry rage-filled little person-scarey. He's been on Focalin XR(long-acting) for a year and it's worked the best with the least amount of side effects. Some times you have to try a few before you find the right one. I would definitely try to find a good pediatric psychopharmacologist-they tend to know a lot more than regular pediatricians about the drugs. That principal sounds rough!

 

[kaffinito]

Hang in there with your son's principal. If you continue being calm and proactive eventually the two of you might reach an accord.

My DS (16) is ADHD among other things and has been on Adderall for a long time. He first started on Ritalin, which made him very violent and emotional. It took a while to get him switched over to Adderall, and then a while longer to adjust the dosage up to a level that worked. We started with the lowest dosage, and then increased it once a month until we were comfortable with the dosage. I also had my son allergy tested, and he had an eeg, and hearing and vision tests.

He would still periodically break out in emotional phases, which is how I found out he was bi polar as well. He was diagnosed with that when he was 12.

It's a tough road to go down, but hang in there, you sound like a very caring parent!

 

[Hasil72]

slk537, your way because we've been there. First grade for our DS was a nightmare.

For what it's worth I apologize in advance to anyone who feels I should be flamed for doing this. I know for some that meds are a very unpopular option. DS (9) is has been on the Daytrana patch AND Strattera for two years now. Surprisingly, it works out for him. We held off on meds until it reached a point where is wasn't fair to at least give them a try. Started on adderall. Like another poster, it was ugly and turned DS into a demon. I suggested Strattera, which was somewhat new at the time, and it worked great for DS. The only thing was that we needed to give it to him at night because it made him tired during the day. It was great. When we switched neurologists, the impulsivity was increasing so he suggested adding the patch. I was extremely hesitant and apprehensive but eventually tried it. I was concerned that they would either counteract each other or over medicate DS. Turns out neither happened. Love it! I can choose when to put it on and for how long.

A few side notes about both...
Strattera takes a few weeks to build up in your system so it may take a while to see the results. Also, I think it put weight on DS. His eating and activity habits were the same but he put on some weight. May cause drowsiness.

Daytrana is almost immediate. For DS it kicks in about 30 minutes after you put it on and wears off about 45 minutes after you take it off. It decreases appetite like any other stimulant. DS lost all the weight he gained. It can cause skin irritation. We resolve this with olive butter cream (Palmers-$5 at Target) and hydrocortisone if needed.

Good luck! If I can answer any specific questions, let me know.

Lisa