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DS8's behavior has gotten markedly worse the past few months (while we were trying stimulant medication for his (supposed) ADHD) and culminated in Monday's 1hr long fit of rage. We ended the meds, and he seemed a bit happier, but still not "normal". He continued to exhibit the same behaviors in school - Tuesday the principal called and spoke with my husband on the phone and expressed her concern over his behavior and the things he was saying (about how he hates himself). Wed the teacher contacted me to schedule a parent-teacher conference, and then Thursday DS was so out of control my husband had to pick him up and bring him home!
My husband brought him into the psychiatrist we've been seeing and he agreed no more of the meds and that he was no longer sure it was ADHD, and he ended up recommending a place in town called 'The Excel Center'. It's a facility that allows for DS to be monitored the whole time he's there. In the morning he'll have a normal school experience, and in the afternoons either a meeting with the psychiatrist there, or group therapy (which is basically play therapy.) We are a bit overwhelmed/freakedout/stressed/etc, but hopeful that as a result of these folks being able to REALLY get to know DS they will be able to properly diagnose him and we can get rid of these tantrums!
(We still have the WJ-III scheduled for next week, and a full neuropsych eval scheduled for May.)
So, any prayers/good vibes anyone wants to send our way, we'll take 'em!
Thanks guys. The hubby and I are stressed, but DS was excited to go this morning. He told me yesterday he was excited because there "weren't as many kids there." He's never displayed or expressed any discomfort in large groups, so I'm not sure where that came from, but I was glad he was looking forward do it.
I'm so very sorry that your DS, and your family, is going through this. We had a similar reaction to the ADHD med Concerta. My DS11( then 9) was on it for about 2.5 months, and we saw our son become confrontational, aggressive, and downright unpleasant to be around. He told his principle that he felt angry and violent. It became dramatically worse when the Concerta wore off in the afternoon. He also developed a vocal tic, somewhere between a throat-clearing and a hum. When our doctor said that he needed to be on a higher dose, I reluctantly agreed, against every instinct in my body. He broke out in a full body rash that itched like mad. So much for Concerta.
I remember that he felt better when he went off of the medicine, but it took a while to get out of his system completely. I want to say it was a few weeks to a month. The vocal tic took 8 months to go away.
A year later, we tried to put him on Zoloft for social anxiety, and with the hope that it might also help with the ADHD symptoms. He was really struggling in school, both socially and academically. It was like he was just shutting down. However, he also had a very bad reaction to that medicine. Within a month, he was sleeping in his closet with a metal bar because he was convinced that someone was going to try to attack him. His anxiety levels went through the roof.
There is a happy ending to the story. Now at age 11.5, he is in a different school (one that is much more accepting of quirks and differences), with a second grade acceleration to 8th grade, and is doing well. He has a good group of like-minded friends, and that somehow makes the slow drudgery of school bearable. He still struggles with ADHD-like symptoms occasionally , but they seem to come and go. He has many food allergies, and when he gets into an allergen... then look out! His corn allergy makes him jittergy, impulsive, and if it is a large enough dose, then he becomes very argumentative. The only tantrums that he has ever had were after eating corn. I know that sounds strange, but I thought I would just pass it along. Most people don't think of food allergies as contributing to behavior issues.
The secret for us was to realize that in the summer, when he was away from the school and not being exposed to food allergens, he was a sweet, happy kid that we enjoyed being around. Within a week of being in a bad academic/social fit in school, then the angry, frustrated kid returned. He is a child that has very low tolerance for the boredom of school and for being in a socially stressful situation that included bullying. His old school was just plain toxic to him emotionally. He felt like a constant failure because he didn't fit in and because he was so different. He was being told on a daily basis that he was somehow "broken" because he didn't fit in. (his words) The stress of it was just eating away at him inside. (and yes, we heard the same refrain about how much he hated himself.) The new school is not perfect. He is still not being challenged academically. But we seem to be making do, mostly because he has found a solid group of friends who accept him, and the grade skip has helped. He now has some measure of self-worth again, and has regained his confidence in himself as a person. We are crossing our fingers and hoping that it lasts.
I hope that helps some. Each child is so different. They all have different levels of tolerance to different triggers. I know that having a kid who is having a rough time makes everyone's life difficult in the family. As a parent you can feel your heart just tearing apart as you watch your kid struggle. The worse part is not knowing what to do to help your child. I feel for you. Just know that, somewhere, somehow, there is a way out of this maze. I hope you find the answers you need with this new program. Just take a deep breath and trust your instincts.
The van picked up DS at 6:45, and like I mentioned, he was excited to go. The van had several other kids to pick up, so it was a long drive. Apparently, DS got car sick and threw up on himself. When they finally arrive at the facility, he's taken into the nurse's office to get cleaned up/changed. After that he was taken straight into the classroom. He was then asked to do some writing assignment he didn't like so he started to get upset. According to DS when he starting throwing a fit, he was told if he didn't calm down he was going to be taken to a hospital and not allowed to go home!! He then freaked out even harder. I was called at 10:45 to come get him. They were recommending he be admitted to the psych hospital!
I didnt even know what to say to that! We talked to the director of this place for over an hour on Friday about Ethan's issues and how they would be addressed here. We were told that today he'd see the Dr (psychiatrist) and be evaluated. We were told they'd be watching him so they could recommend a treatment/medication plan. And then this happens! They just drop him in a class, no Dr meeting, no intro/on boarding type thing. Just, have a seat, here's a writing assignment.
And of course it's lunch time so I can't get a hold of his regular psychiatrist right now, or the vp from his regular (public) school.
Epoh, I'm so sorry you guys are going through this! It sounds awful and I hope that you can get through to the other side to find the happy ending.
I wanted to say that our son was having terrible violent and emotional outbursts on a regular basis and it happened for at least a year? Maybe two - and he is only 6.5 now, so that is a pretty long time for such a short life and we kept blaming it on his allergies (like Ebeth said above with corn) or the meds he was on (for asthma) or sugar, or...??? and we could never get a hold of it. We went to a play therapist and she didn't think he had ADHD or bi-polar or anything treatable, really. We were frustrated and decided that we needed to try homeopathy again (we tried mostly unsuccessfully when he was a baby to treat his many allergies). Anyway, in addition to various diet changes (only have sugar with fiber or fat, more protein, etc.) she gave him some remedies and with in a number of days we noticed a difference. She said she was trying to 'calm his frayed nerves' or something along those lines. We had to tweak the remedies and we have been going for over 6 months, but it is well worth it. I just thought I would mention it, in case it hasn't been thought of and maybe it can work for others.
Good luck - my heart goes out to your son, I'm sending all my good thoughts your way.
Epoh, so sorry to hear all this. Know this: if this group cannot help your DS, you will find someone who will. It may take time, effort, patience, more effort. But you will get there.
Wishing you all speed in getting there, and some measure of peace ASAP-- DeeDee
This is unbelievable. It sounds like that program really doesn't have it together. My heart goes out to you all. I hope that you can get everything straightened out quickly.
@master of none: no, we do not believe he is a danger to anyone. He's smacked himself upside the head during his tantrums, and kicked walls, but never injured himself or anyone else, never broken/thrown anything, etc. prior to our foray into meds he'd never even directed anger towards anyone during a tantrum.
I am very disappointed in the program, to say the least. The director actually told me before I left "we just have to get him to stop having these out of control behaviors before we can assess and treat him" !! What on gods green earth was she doing the whole time we talked to her on Friday saying we needed help specifically WITH HIS TANTRUMS. Gah! If he wasn't throwing the tantrums we wouldn't freaking need their help. blows my mind.
We have an appointment tomorrow with the psychiatrist and I'm going to talk to him about trying a med for mood disorder without also doing a stimulant, which is what we had done before. I am also going to get him back into his school, as they clearly are better at this than this place we tried today! I spoke with the VP today and I just love her. We may go ahead and request an veal from school. I am not super hopeful about that, it takes 60 days (approx) to have him eval'd and, of course, there's the fact that he gets straight A's, in spite of everything. Then I need to call this place and get my freaking $$$ back!
As a foster parent, I've run the gauntlet with kids of every imaginable behavior issue. Something that we have had absolutely AMAZING success with doesn't require drugs or doctors....
Find a place in your area that offers Hippa therapy (equine)and get your ped to write you a referral. I've had kids that were born addicted, brain chemistry completely out of whack, explosive behaviors. Put them on the back of a horse a couple of times a weeks and literally within about two weeks their behavior completely changes.
I still don't completely understand how it works but the motion of the horse somehow sychronizes the nervous system and makes kids able to regulate their emotional overload. It is inexplicable but I have seen it change an 8 yo boy from a child getting thrown out of school 2-3 times a week to a child that NEVER misbehaves in school in a matter of a few weeks. The therapy goes between 6 months and a year and the results seem to be extremely long lasting. My adopted soon to be DS7 is a perfect example. He went for 7 months almost 18 months ago and we have had no repeat behaviors.
It is covered by most insurance companies and it works. Don't now how or why, but we refer to it as "the magic pony" because the changes are truly magical!
Shari Mom to DS 10, DS 11, DS 13 Ability doesn't make us, Choices do!
Psychiatric hospitalizations tend to be good for certain things, like schizophrenia where the patient went off his meds and out of control manic episodes. I think the program was just looking for an easy way to outsource a new problem rather than to provide any help.
As you are learning, a problem with psych medications (including stimulants) in general is that it's often a naturalistic science experiment to find something that works. And it's sometimes very frustrating and scary for all parties involved.
Shari - sadly, DS is terrified of horses. We couldn't even get him onto a little pony. (We have relatives who have a dozen or so horses and a couple of ponies.) We try again every time we go to visit them (about 2x a year.). Do any of these programs deal with fear of the animal? Living in Texas there are no shortages of horse places.
Jon - thank you, yes, it can be quite scary. I could see admitting him to a hospital of there was a risk of harm or if he were hallucinating or something, but all we've got are random, nonviolent tantrums a couple of times a day.
Hoping you can find answers fast on how to help your son so he feels more like himself. Sounds like the new school doesn't practice what they preach. Can't believe they threatened your son with hospitalization....sounds like they don't train their staff at all. Sounds like you trust son's Doctor but if you would like a second opinion you might want talk to Dr. Lusby at Cornerstone Assessment. She was very open when I talked to her on the phone about testing. Seems like a provider that your family would be able to connect with and trust.
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!
We have an appointment tomorrow with the psychiatrist and I'm going to talk to him about trying a med for mood disorder without also doing a stimulant, which is what we had done before.
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.
Originally Posted by epoh
We may go ahead and request an veal from school. I am not super hopeful about that, it takes 60 days (approx) to have him eval'd and, of course, there's the fact that he gets straight A's, in spite of everything.
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.
I could see admitting him to a hospital of there was a risk of harm or if he were hallucinating or something, but all we've got are random, nonviolent tantrums a couple of times a day.
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.
Just to be sure ...has he been evaluated for reactive hypoglycemia? Blood sugar drops can cause severe mood swings and out-of-control behaviors.
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.
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.
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.
Since your DS recently stopped the meds he was taking, if it were me I would give him a week or two break before starting another medication. My son is on Concerta, and when he went off it for 2 weeks over Christmas, the effects (which in our case are mostly positive, although he is less hungry) didn't seem to totally wear off for a week or so.
Could you stay home with him for a week, and just have a really low-stress time for a while before starting something new? It sounds like he has gone through a lot at school, with the meds and with this recent bad experience at the clinic.
Epoh - I am sorry you and your son are going through this.
I want to echo the concern about Risperdal. If your son is not in danger right now to himself or to others, I would really take more time to assess if it is the right decision to put him on a powerful antipsychotic. For me the use of antipsychotics is a much more serious decision than a trial of ADHD meds. These are drugs more often used for schizophrenia and children who are extremely violent and acting out.
Have they done an evaluation and given him a diagnosis?
Thanks guys. I totally get your concern regarding risperidol. That was my exact reaction at first as well!
The dose of risperidol DS is getting is 0.25mg, far far less than what is used to treat psychotic behaviors. And he will start out with half of that, actually. We are aware of what side effects to watch out for, and will stop the meds and contact his Dr immediately if they appear.
I feel like there isn't a magic bullet, no accepted treatment plan, not much literature, so we are playing by gut feel right now. He is also seeing a therapist. That will be weekly starting next week.
They deal with kids that are terrified of horses all of the time. It's part of what they do. I'm telling you it is sooo worth a try. It may take them a month to actually get him on a horse, but it works. We have used it over and over and over again. Kids with chemical disorders, SPD, bi-polar, depression, addiction related disorders, they've all lived with me and most of them have spent time on a magic pony.
Shari Mom to DS 10, DS 11, DS 13 Ability doesn't make us, Choices do!
Good to know Shari. There must be a place like that around here, there are so many ranches around here. I will def look into it. The therapist also recommended karate or some other martial arts.
So, DS apparently had a 'rough day' today, but no full-on tantrums. Unfortunately, because he didn't really do any work and wasn't hardly in his classroom, they are putting today down as an in-school suspension. I am hopeful that tomorrow (when he's on the full dose instead of half) he'll do even better.
In the mean time, I've been researching other schools in the area. Check out this place! http://hillschool.reachlocal.net/ I've already requested an info packet be sent to me. I'm sure the tuition cost will make my husband about pass out, but this place look amazing.
OK. I went through the past posts and I am both confused and worried about your case history.
Your child acts up in the classroom and has issues with transitions, perfectionism (?), some ADD syndroms and some anxiety. He scores very high on academic tests, had a 99th percentile score on the COGAT, and similarly high scores on one standardized attention test.
He is clearly (past post on self advocacy in math, IIRC) bored out of his mind at school.
You have read Misdiagnosis/Dual Diagnosis of Gifted Children, right? What's your feeling?
Because from what I have read Asperger's might be an issue, along with a bunch of other possibilities, and what you are getting instead of a referral to a good neuropsych is treatment from a psychiatrist who "doesn't like labels", is willing to prescribe very powerful drugs in non-standard dosages, even after one trial resulted into disaster, and before -- although I am working from memory, darn those timestamps -- anybody could be sure that the drug that sent him into that manic (?) episode at school was completely out of his system. Oh, and referred you to a program which dropped the ball in a rather frightening way.
I don't know what your relationship with the psych is like. Me, there are so many red flags in your past posts, I would get a second opinion before giving anything more to my child.
Also call the people you have that evaluation scheduled with for the Spring (and I really hope they get 2E), ask them if they have had any openings show up in their calendar, state that your son has been kicked out of school and your need for answers is getting very urgent, and do any begging/pleading/screaming needed to get you those appointments STAT! Ask to be put on their list in case anything gets canceled, explain that you are willing to drop everything, grab your son and get into their office within 10mn/30mn/1hr, whatever it takes.
From here it looks like a bad educational fit (I didn't check all 201 of your past posts looking for hints about what your child's pre-elementary life was like) for a gifted child with maybe 2E issues. So looking for a new school would help. But make sure about the 2E issues too.
I don't know what your relationship with the psych is like. Me, there are so many red flags in your past posts, I would get a second opinion before giving anything more to my child.
Also call the people you have that evaluation scheduled with for the Spring (and I really hope they get 2E), ask them if they have had any openings show up in their calendar, state that your son has been kicked out of school and your need for answers is getting very urgent, and do any begging/pleading/screaming needed to get you those appointments STAT! Ask to be put on their list in case anything gets canceled, explain that you are willing to drop everything, grab your son and get into their office within 10mn/30mn/1hr, whatever it takes.
From here it looks like a bad educational fit (I didn't check all 201 of your past posts looking for hints about what your child's pre-elementary life was like) for a gifted child with maybe 2E issues. So looking for a new school would help. But make sure about the 2E issues too.
I agree with SiaSL - and would add one thing - let your pediatrician know what's been going on this week if you haven't already and ask him/her to call the neuropsych you are scheduled to meet with and see if they can't get you in asap. Our 2e ds was having an incredibly stressful year at school two years ago, and it coincided with the time frame we'd been requested to bring him in for a neuropsych update. When I called to make the appointment, I was told we'd have to wait 6 months. When I took ds in to see our ped, explained about the stress he was under and the concerns we had, the ped was able to make a call to the same neuropsych and we were able to get an appointment within just a few weeks.
I don't know your work situation, but the other thing I'd look into is taking him out of school all together for awhile, until you have a better understanding of what's going on. If he misses even a full year of school and does nothing but sit home and have a chance to relax, he's still very young and he'll be able to get back on track at school later on.
You have read Misdiagnosis/Dual Diagnosis of Gifted Children, right? What's your feeling?
Because from what I have read Asperger's might be an issue, along with a bunch of other possibilities, and what you are getting instead of a referral to a good neuropsych is treatment from a psychiatrist who "doesn't like labels",...Also call the people you have that evaluation scheduled with for the Spring (and I really hope they get 2E), ask them if they have had any openings show up in their calendar, state that your son has been kicked out of school and your need for answers is getting very urgent, and do any begging/pleading/screaming needed to get you those appointments STAT! Ask to be put on their list in case anything gets canceled, explain that you are willing to drop everything, grab your son and get into their office within 10mn/30mn/1hr, whatever it takes.
LIKE Here's the link to Misdiagnosis and Duel Diagnosis -
It's ok to ask everyone who is dealing with your child to view it (assuming that you like what you see)
I wish I could hug you all through the internet. You are all so amazingly caring! I feel like I have done a poor job of explaining things along the way, and that is all my fault.
I was disappointed with the psychiatrist at first, and was upset with the term 'mood disorder' and assumed he was using that as some sort of catch all instead of telling us what he really thought it might be. However, I have since learned that mood disorder really is the label for his type of behavior. I've read a lot lately (hah! there's an understatement) and the accounts I've read from other parents of children with mood disorders so very closely matches what we've gone through. My son's behavior isn't as severe as some accounts I've read, and he's not aggressive/violent, so I am hopeful that he might grow out of this, and that it won't turn into full on bi-polar disorder. (Bi-polar disorder does run in my family, however, so I feel like we'll always be on the look-out for it.)
Once I began to accept the mood disorder diagnosis this particular med choice became more palatable. There really doesn't appear to be a whole lot of consensus on what meds are best for treating mood disorder in young kids, but low dose of respiradal appears to have a fairly low incidence of side-effects, and we are watching out for them!
The neuropsych already has us on the list to call if there is any cancellation/no-show. (I was told it's very rare for people to do either.)
If I had the ability to take any amount of time off of work and stay home with him for a while, I would do it in a heartbeat. As it is, though, I am the primary breadwinner, and I've pretty much used up all my paid time off (though my boss has been very understanding about letting me go for all of DS's Dr appts and such) and I won't get more until July 1st. We are actively looking for a different school situation for DS for next year. I really think he's at a point where he can't really take this anymore, but I don't know what I can do between now and the end of the school year. All these private schools I've come across have a fairly lengthy enrollment/screening process, so even if we manage to narrow it down to one or two of these places and begin the paperwork, it's highly unlikely he could get into one this school year. We can't just take him out of school and have him do nothing - who would watch him? All our family works, and school is compulsory.
I just ordered Misdiagnosis/Dual Diagnosis from amazon. I had figured I'd look around in local bookstores and pick it up when I found it, but I decided to just go ahead and order it. I do think if we can get him into a better school situation a lot of his behaviors will improve, BUT, he's had behavior problems since he was a toddler. He has these issues even during activities he enjoys. We actually first sought out counseling and parenting help when he was only 4yrs old. So I don't think I can blame the school for everything we are seeing.
Again, thank you guys so much. I can't tell you how amazing you all are and how much I appreciate all the help/direction/links/advice/compassion.
It's so much tougher with a school age child than a preschooler in so many ways... so much higher expectations by the school, and if school isn't working there are so few other options for child care. All of this sounds so stressful and like I said before it's clear you just want him to have an easier time.
I think I remember from a while back that he was on Trileptal, an anti-epileptic, what happened with that? Is he still on it or did that get stopped? And did the Concerta help at all? Usually when there is a diagnosis of adhd it seems like a psychiatrist usually tries a few different meds for it before giving up on that class of treatment. This more seems like they have tried one medication from each of three classes and then decided that what it treats must not be the root issue. I guess I get the sense the psychiatrist really isn't sure what is going on with him and is kind of doing medication trials to see if that will help narrow down what is going on, do you feel like that? Better than asserting a exact diagnosis of course if they are in the dark, but makes it really confusing.
For the immediate future, what about a babysitter that could pick him up from school at lunch each day, just reduce the amount of time at school, too expensive? Or maybe a family style daycare would take him full time for some respite from school? Just seems hard to imagine him getting through the rest of the year at school while adjusting to these medication changes.
I second the idea to call your pediatrician and get their input also.
I second the idea to call your pediatrician and get their input also.
It depends on the level of knowledge of pediatricians with respect to psychiatric/psychological issues.
I don't think pediatricians generally focus much time in the more exotic psychological/psychiatric issues. Some even have a problem with the more standard ones.
We actually started with the ped, they refer out issues like this through either the children's hospital's behavioral program or through a local place called the Child Study Center. Neither place is covered by our insurance, and to have him assessed there would cost well over $1500, not to mention any treatment they recommended. We did get this psychiatrists name from them and he is highly recommended. I had never been to a psychiatrist before, and at first I was kind put off by him. My husband has been to several over the years (because of his ADHD) and he really likes this psychiatrist.
My husband picked up DS right when school got out today, instead of having him go to after school care like normal. I think we are going to try to do that when we can. I am going to get the paperwork tomorrow from the VP to have DS evaluated by the school, but she says that will likely take about 60 days. I also requested info from the private school I mentioned, so we'll see how that goes and if it's possible to get him there (or elsewhere) this school year.
It's been good. Since he started the risperadol he's been CALM. Not any different personality-wise, just calmer. I asked him if he felt any different yesterday and he responded "No. I am just calmer now." Friday he had no incidents at school and I am hoping Monday goes as well.
I am hopeful that tomorrow (when he's on the full dose instead of half) he'll do even better. 
Friday he had no incidents at school and I am hoping Monday goes as well.