Gifted Issues Discussion homepage Forums Twice Exceptional Progress? Kindergarten PM problems and Dr visit

Since my last visit
1) had many issues the week of the time change. Had two visits to the principal that week.
2) took ds to the doctor. Discovered iron deficiency and are now supplementing. Dr refused med increase after discussing problem behaviors at school. Ds pulled quite a stunt and the doctor said that ds is "smart and manipulative which can't be medicated". We were talking about shuffling cards and playing go fish and the doctor suggested ds start to learn black jack and become a professional poker player because he could count cards and make a lot of money...
3) we will write 504 after the first month of first grade. Counselor believes ds needs a challenge and says he is like Shledon Cooper from Big Bang Theory. Teacher and counselor feel he is too smart for his own good.
4) AM is going great. After lunch and recess everything gets bad. Ds eats very little lunch. He is irritating certain kids until they break which he finds funny. He is doing attention seeking behaviors. When ds is at home a nap helps these behaviors, but he also eats when hungry.
5) handwriting has drastically improved with teacher offering rewards and prism lenses. I'm in shock that he can form the letters now if he is willing.

So the problem behaviors - boredom? Hunger causing issues? Very possibly overstimulation by afternoon? Any thoughts? FWIW he knows all the reading/spelling objectives for the quarter. (He was reading this quarters sight words in 1st quarter). He knows the math objectives also, but isn't ahead on the addition/subtraction that he is bored. He gets to go to another class for math where the teachers team reach to work with the kids his speed.

Iron deficiency could cause some behaviors- the fatigue and mental fog could lead to poor judgement. It can take awhile for the supplements to do the work. My mother had an iron deficiency and she said she was exhausted and wasn't operating on 4 cylinders. It took a few months on iron supplements for her to feel better.

My oldest is an incredibly picky, slow eater who can't sit still... as a result with have experienced iron deficiency more than once. Do you know what his iron stores are? It's the stored iron that is really important! Depending on the number it can be 6 months before he is where he should be. How is it being treated?

Iron deficiency can have a HUGE impact on behaviour and how engaged he is overall.

We have been at a number of schools, all of which insured that small children eat their lunch... is that not happening at your school? My oldest even given a drink box of cold white/plain milk towards the end of day to keep him going (age 5 isn)... he would often lose it at the end of day without that snack.

Hope that helps!

I don't know your situation. Is him coming home for lunch or finishing at lunchtime an option - even short term?

They try to get the kids to eat by telling them to not talk. But there isn't much oversight. They aren't allowed to get up to throw away their trash if they bring lunch. So if they don't call him out he brings his trash and old food home everyday. Today we are sending snacks.

His iron level was 23 and it needs to be at 50. We are treating with a liquid supplement. Is causing constipation which we also have to add another supplement. He now has accidents in his pants sometimes at home.

I put a call in to the doctor hopefully he calls within a day or two.

Also they get maybe 20 minutes for lunch maybe 25 at most. He says he often isn't hungry. I have to hound him to eat at breakfast. That medicine seems to be as much a problem as a help.

If you can find a timed-release iron for kids, that could help with the constipation -- iron does that to me too, whenever my anemia flares up, but the timed-release helps because you don't get that one big whack all at once.

I have a terrible time with DS11 not eating his lunch. He continually says that he didn't have time, but I haven't found a solution. There *should* be time, with their schedule, but god knows what the kid is doing instead of eating.

Is there anyway you can have an adult at lunch encourage your ds to finish his lunch? Or perhaps you could visit during lunch for a few days and make sure he eats?

I'd give that a try just to see if it helps.

polarbear

ps - I'd also ask the school why wait until after the first month of first grade to write the 504. I totally understand a ton of reasons for that from the school's perspective - give him time in the classroom for the teacher to observe... put it off until the rush of school starting is over... other stuff. The thing is, I think you'd be off to a better start if you requested a 504 meeting *now* and get something in place for this year. Our experience with that whole "after the start of school" situation is that the start-of-the-year busy rush never really ends, instead the teachers are going to be finding other students to send in for testing/referrals etc so the wait can actually end up stretching out... or you might find your ds with a wonderful teacher who accommodates without having to think - which is great for first grade, but then you're left without a 504 and what happens when 2nd grade hits hard (if that happens) etc. JMO, but if a child needs a 504 plan, they need it now, not 6 months from now

We have had the 504 meeting and that is why the counselor is looking for the right teacher. We don't really know what to put in the 504. He doesn't need educational or testing accommodations. The counselor feels the teachers at the new building will be willing to do what helps him best.

His main issues are irritating people and attention seeking behaviors. Dr is thinking a med increase? So why would a 12 hour time release med wear off at lunch? It would only be lasting, 5 hours? Doesn't make sense. That's why I wonder if its overstimulation/tired/hungry and boredom.

I mention a flipped classroom at the 504 meeting but they had never heard of it. They may allow extra time in the art room as a reward. They need a science lab as a reward. Lol.

I didn't realize you'd already had a 504 meeting. Did the team have any thoughts re observing behavior during lunch, thinking through possible issues that might be causing the change that occurs after lunch? It seems like something that someone could collect some observational data on I agree - it doesn't seem that a 12-hour med should be wearing off after 5 hours... and if that really is what's happening, I'd be a little wary of simply upping the dose... maybe trying a different med... but I'd also want to try other interventions first.

I think afternoons are tough in early elementary for a lot of kids - after being in school all morning, they rush through lunch (or at least it's a rush here - very little time to eat), then recess, which is exciting and fun and then bam - after all that activity, time to go back and sit down in class.

Have you thought about taking him out after the morning session for a week or so, feeding him lunch at home, and seeing how his afternoons go? Maybe have art and science lab at home

My experience with rewards at that age wasn't all that productive - they work well for situations our kids have control in, but sometimes the behaviors etc are a reaction to feeling out of control, and if that's the case - having a reward for avoiding the behavior may just add to frustration and not accomplish anything.

Just a few rambling thoughts - I hope you find something that works for your ds.

Best wishes,

polarbear

Polar bear - his teacher felt like a half daylight be a feasible option especially since he is ahead and not behind.
Counselor is afraid he will start to use it to his advantage.
Today I sent snacks and he will get a wind down time in the bean bag chair in the special Ed class.
I'm thinking of calling the principal and asking for a half day option. He could have a nap and still do a little work at home if necessary.

Teacher thought a half day would be a feasible plan. Especially since he is ahead and not behind.
I think it is a tired/hunger/overstimulation issue. Naps do amazing things for this kid. He is in kindergarten and they did allow naps back in more reasonable times. With the iron deficiency he may not be able to handle a full day. Add to that not eating well.
I put a call in to the principal to see if we can go to half a day. I REALLY wish we could so flipped classroom. We read at home and he is progressing right along. He likes goals like reading x number of stories to get a prize etc. I think partially he is ready for more. He is tired of handwriting and the sight words he knows. He needs to progress into being taught blends, the silent e at the end of words makes the vowel say its name, etc. I imagine its a long day when you have ADHD and are very bright and bored with the curriculum.

But it's totally possible. What med is he taking and where does the "12 hour release" come from? DD's "extended release" med lasted only about 5-6 hours when she was taking the lowest dosage. and about 9 hours at the next dosage. How long meds last will vary by individual, and by the strength of the dosage.

If you go to the Quilivant XR website it tells you it as a once a day med that continues working for 12 hours. However some medications don't dissolve properly in XR form so they often don't last as long. I'd rather give the med 30 minutes later and give him a MT Dew at lunch versus increasing the overall dosage. At the rate we are going he will need an increase 4 times a year. He hasn't gained any weight so we will continue to increase a dose that has diminishing returns. We feel the withdrawals are worse than his typical behaviors.
Medicine certainly isn't a miracle cure in this instance.

Is Kindergarten required where you are at? What happens if you pick him up at lunch time, feed him at home, give him a nap and do some after schooling as needed? IMO flipping a K classroom is a not an easy ask.

Where I am, children who still need to sleep (perhaps that best medicine!) are kept back... you find wide range of ages and abilities come K (this creates its own issues of course).

Regarding the iron, what I have found that works best is ‘Floradix'. The gluten free variety has the most iron per serve. I split the dose between two servings. Dairy has a big impact on absorption of iron. You should avoid serving milk (and apple juice!) within an hour or so of giving the Floradix. The vitamin B will also help with energy. Of course, discuss this all with your own doctor!!! For my DS11 we treated him with Floradix only, his levels were even worse that your DS’s at the time. You can buy it online at iherb.com for example, or at Wholefoods, etc. You can also take it yourself :-)

Certain dried fruit, e.g. raisins are a good source of iron as well pumpkin seeds -- keep these in mind for snack time.

I bet your little guy is super tired and uncooperative as a result of his iron counts, not to mention his age and activity levels. I don't have personal experience with ADHD but wonder how greatly his symptoms are impacted by the anaemia???

I also wonder whether the anaemia and/or the iron supplement effect the absorption of the ADHD meds.

I don't know about iron and ADHD meds interacting. His teacher says he isn't mature enough for a full day. I've been anemic before and it was exhausting.

Sleep works magic for him. Mid day when he gets hyper, it's a symptom of being tired and overstimulated. He awakes calm and focused. I've often heard that kids with sensory issues need a lot of sleep due to overstimulation. I've read that gifted kids can often be overstimulated also. And his class has. Lot of commotion. Lots of centers as switching. Kids in and out, two teachers etc. it would drive me crazy. I need structure and quiet to have that inner calm. It doesn't distract me, it irritates me.

I am asking the principal to move to a half day. He doesn't need the day for academics. If they would test him today he would pass all the 4th quarter requirements with flying colors. But if he was at home we would work on reading his little stories, new words, and maybe things he is interested in like geography and science.

I just wonder if he will be able to survive 1st grade. I hate all this. That's why I need this group. It's killing me to see this kid always in trouble when he is tired and bored. He wants to learn. He loves to learn but he hates school. What a conundrum.

The last time my DS was anaemic, I serious thought something was wrong with him. He played football/soccer at the time and the team manager was a school psychologist serving several high end privates near me, and we discussed in detail the possibility of ODD on a number of occasions. We also heard 'I am bored' constantly!!! I can not tell you how often, he would tell you nothing interested him.

We went to heaps of appts with different types of doctor's... they didn't find anything other than anaemia.

He is not an easy kid, has never been. That didn't change. We did work to get him more appropriate work at school as a result of testing we did trying to get to the bottom of his issues. This took a bit longer to come about, but our situation improved greatly when the anaemia was solved (before the changes occurred at school). Hyper and tired... not a good combination.

Most of your issues *could* clear up when the anaemia is solved. Like I said before, it could take a good 6 months.

Have they checked for celiac, as well (this test can take a bit longer to come back)?

We haven't check for celiac. What type of doc tests for this? Thanks for the kind words. Sometimes I just want to give up.
We will keep working on the iron. We are also staring juice plus which may help with some nutrition issues also. Guess we will see.

There are different blood tests to check for celiac. I would think your GP or ped could help you. Do they have an idea was caused the anaemia in the first place? Our doctor checked to see if DS had a 'the gene', which he did not. He if had it a second test would have been required to see if he celiac at that point in time. I don't know a whole lot about this, but there is more than one way to test for it. They were checking to see if celiac was causing the anaemia. Obviously, it helps to know what caused it to try and prevent a recurrence.

Did they check other vitamin / mineral levels... B-12, zinc, D for example? (Blood test.)

Apple juice (maybe their are other juices or juice plus???) and dairy will interfere with iron absorption. Ideally, you need to be really, really careful about his diet and the timing of the supplements (iron or Floradix, juice plus) for the next 6 months and then retest. You can continue the Floradix after the anaemia has disappeared.

You can't give up :-) Just get really organised! Maybe a nutritionist could provide you additional support?

Best of luck.

I don't have any advice for your situation but I just wanted to say hang in there. JK was a disaster with my DS and it was only half days. Our drop offs were horrific spectacles just about everyday. He's now in grade 2 and life in general is much better.

Hope you're able to figure out something for your little guy.

I also strongly recommend getting a celiac test. Here is some info:

For most people, the serum anti-tissue transglutaminase (tTG-IgA) is the best antibody blood test for screening for celiac disease; however, it is important to also get a total serum IgA. Having this total serum test will help bolster the reliability of the tTG test. The reason for this is that while the tTG test is very reliable, its reliability is dependent on the premise that the person being tested adequately produces IgA. If the individual does not produce sufficient amounts of IgA and is instead IgA deficient, then tTG-IgG should be tested instead.

I was tested just 3 years ago with a variety of symptoms, one of which was anemia. I also know someone whose Kindergartener was having multiple health/behavior problems and we suggested they test for celiac. It is a simple, noninvasive blood test. He tested positive. After a few months of a strict gluten free diet they have a new kid. He was having ADHD type of behaviors that are now better. Speaking for myself, I never realized I had sort of a "brain fog" as they call it from reacting to gluten. If anything it's worth a try to rule it out!

Good luck!

Thanks all. Just talked to principal and she said no to half days. We are going to have another 504 meeting within the week. (Sigh) I feel like I'm on a merry-go round!