Short background, DS8 was grade skipped last year and started 3rd grade this year at a HG school in a neighboring school district. About 3 weeks into the year, we got an email from his teacher with behavior concerns some of which he had in the past but we chalked up to poor placement and lack of mental stimulation at school. The first several weeks at the new school they were doing assessments that were extremely writing focused. He cannot sit at a desk and write for long periods. After we got the email about his behavior, I started giving him Omega 3s, I started using the Nurtured Heart Approach and we started a daily behavior chart that focuses on eliminating the problem behaviors but also includes one thing about his day that we could celebrate at home that night. We also decided to go ahead and have further neuropsychological assessments and he did get an ADHD diagnosis - the neuropsych believes that the physical act of writing is extremely tedious for him (did I mention that his VCI is 42 points higher than his PSI).
This week was his parent teacher conference. He is working well above grade level in all subjects � even writing. His behavior is markedly improved - he even got an A in citizenship. He has gotten a week of all greats on his daily behavior sheet. We talked with the teacher about how difficult the transition was for him and now how he seems more comfortable at school. It was nice because the teacher seems to see him as the kid he is (creative, funny, curious, exuberant) not as the frustrated, overwhelmed boy he was less than a few months ago. We also talked about keyboarding and she said that when he is proficient at keyboarding, she always has one laptop in the room, so that will not be a problem with him using it if that helps him. We have been working on keyboarding at home.
I have also been working diligently on EF skills with him at home. I have provided some stronger organizational structure and set up systems that help him succeed in accomplishing things like initiating homework, cleaning his room, getting ready in the morning, packing his backpack, etc. I am striving to acknowledge all the good behavior I see (which actually is a lot). He is getting more mature and the impulse control issues while still there are diminishing as he gets older. In short, I have been trying very hard to help him ramp up his compensation strategies.
Nevertheless, I still see issues that I can�t help but think that medication could possibly help him with. Like I said, the impulse control still needs work. His written work, while good, is sometimes poorly organized and visually inconsistent and his ability to initiate tasks or focus on difficult or boring tasks will need work for some time. I feel medication will make it easier to work on behavior therapy for impulse control and EF skills and we can address those skills more successfully with meds.
Alternatively, I think we have some good strategies in place now and that we may be able to make some more headway (therapy, accommodations at school, work on EF at home/school, etc.) and delay medication for a few years until having stronger EF skills becomes more crucial and see how he is doing at that point.
I would be interested in any thoughts, especially from those who have grappled with this and decided one way or another and how that worked out.
