Gifted Issues Discussion homepage Forums Twice Exceptional No regular school for the next 4 weeks...

I would love to see Dr. Lusby, but I don't think we can afford her right now. Even though my insurance would refun some of the cost, we'd probably have to come up with around a grand up front. Something to keep in mind if this doesn't get better in the next few weeks though!

Have you ever tried medications for anxiety with him (SSRI)? This can be life-changing for an anxious child. Something to talk to the psychiatrist about; whether it's appropriate depends on whether there's a family history of bipolar, among other things.


Definitely request the eval! If he were to get an IEP, it would assure certain legal protections and ideally get the right mix of accommodations and services into place. If he's tantrumming several times a day I don't think anyone in their right minds would try to tell you there's nothing going on with him. They desperately need a plan if they are going to educate him, and only by evaluating will you get a plan in place. Put everything in the request letter that has ever been a problem for him, and while you are at it, request a Functional Behavior Analysis (get them to take data on what precedes a tantrum, what happens during it, and what follows it) done by a qualified expert.

Yes, it's slow to get this process going, but consider doing it in tandem with the private eval (which I hope is still in the works, you were on a waitlist somewhere, right?), so that you can get everyone on one page ASAP. The school cannot use a private eval alone-- they have to do their own "educational eval" to establish IEP services.

DeeDee

Just to be sure ...has he been evaluated for reactive hypoglycemia? Blood sugar drops can cause severe mood swings and out-of-control behaviors.

This may not be helpful, but I just want to say that I'm fairly shocked and confused that they have suggested this for a child whose problem behaviors are those you describe. It seems really extreme. DD8 tantrums probably once or twice a week (no harm to objects, self, or others--but she screams and is hysterical) and while I am concerned and seeking a referral, I would never consider her behavior worthy of hospitalization even for a second, even if it were daily.

He has not - his behavior doesn't seem dependent on much of anything. He's had tantrums before mealtime, during and after. Any time of the day is a good time, apparently.

Could this be from medications? There is alot of medical literature that ADHD medications can provoke mental illnesses including manic-depression. Maybe getting off medications could ultimately end this cycle?

I know that some people find great improvement from medications. Each child is so very different that it is hard to know.

Our personal experience was horrific, from both Concerta and from Zoloft (which is an SSRI for anxiety). The personality changes that occurred with these medicines were frightening. My brother-in-law, who has a PhD. in psychology, also tried Concerta for his son for ADHD symptoms. He was alarmed enough to stop the medicine after just 3 days.

Epoh: You are the best person to know if your son is worse or better when on the Concerta or the mood stabilizer. I'm assuming that you tried the meds because of some issue that you were having. But did the tantrums get worse on the meds?

The question that I have is when is your son calm and happy? That was easy for us to find because it all centered around a bad fit for school. If your son feels a lack of power or respect in one aspect of his life, it will start affecting his interactions with everyone, particular in a safe environment like home. My DS could hold it together, mostly, at school, but we were his safety valve at home where everything began to blow. Power struggles and tantrums can often be a call for help that he feels powerless in some aspect of his life.

Can you find a way to get him out of meltdown mode when he is in it? For us, the overly authoritarian approach, which unfortunately they tried with threatening him, always backfired and made things escalate. We always found that when our DS was getting upset and very anxious, that we could get him to "think" his way out of the state. I remember him getting very upset about something being unfair when he was about 8, and we started a long discussion about life being unfair, which for some reason lead to the election between Al Gore and George Bush of all things. I think I was trying to show him that even adults who have power and authority can sometime feel that life is unfair. Somehow engaging his brain about the Electoral College and its role in electing a President completely defused his emotions. Within a few minutes, he was completely calm, and we had an hour long discussion about politics. We still laugh about that today. When he was undergoing allergy testing and was completely phobic of needles, we had him find the prime numbers to 100.

I don't know if any of this help? It is so hard when each child is so different!!

Thanks guys - we started the meds due to tantrums in school, at home and in other environments (soccer, at grandparents', etc). I do think he had a bad reaction to the stimulants, which caused to back off all the meds. When he has a tantrum he typically just has to calm himself down gradually. Nothing really seems to help, but I know plenty of things that make it worse! I have heard from his teacher that allowing him to do math work calms him down sometimes, so we can try that.

We saw the psychiatrist today and we are going to try just a med for the mood disorder (risperidol). I am very interested in looking at other school options for next year, but first we have to make it out of 2nd grade!

I'm going to offer my 2 cents which is going to come across kind of strong and for that I apologize in advance as I know you are just wanting things to improve for your son: if it was my kid I would quit my job and stay home with them, move, totally alter expectations for their and my future -- whatever it took to decrease their stress level, before putting them on risperdal to control behavior that is not life threatening.

Risperdal is an antipsychotic, it is a fantastic medication for people with schizophrenia who can't control themselves, and people with behaviors that are life threatening to themselves or others. On balance in those cases it can be better to substantially alter the person than to have them remain a danger. Yes it is used a lot in people who aren't a danger but there are risks. In rare cases it can have permanent side effects that simply don't go away when the medication wears off, look up tardive dyskinesia on youtube and see if you are willing to risk that to avoid this year's tantrums.

It sounds as if this is a hard situation for everyone and I hope you find a safe way through it.

Polly

This is pretty much my point about psych meds being a naturalistic science experiment. I don't have any opinion about this particular drug, however.