This article is full of good advice for dealing with hormones + ADHD. We have a lot of both in our house. Meltdowns are a daily occurrence.
Tell yourself, "Stay calm, stay calm, stay calm!" You can do this!
Defuse the Drama: How to Handle ADHD Meltdowns
Thursday, June 25, 2015
Monday, June 22, 2015
She said the "B" Word!
It's not the first time I've heard it. Many people don't have any idea what it means.
Hearing that word from the psychiatrist's lips this morning was like being punched in the gut. Having grown up with a mother who had been diagnosed with Bipolar Disorder, I understood the ramifications of the "B" word. From the moment I knew I was expecting our first child, I have carried around the fear that one of our children would be diagnosed with bipolar disorder. My sister and I prayed we would not ever have to deal with mental illness ourselves or in our families, knowing that there was a chance that we or our children could inherit it from our mom.
Going back for a med recheck, I shared our son's IEP and the fact that he was now attending a therapeutic day school with our pediatric psychiatrist. She asked some questions about family history and read through the evaluation. Then she said the "B" word! She suspects that our son may be dealing both with ADHD and Bipolar Disorder and prescribed a mood stabilizer that was familiar to me because my mom took it.
For those who are not familiar with this term, bipolar disorder used to be called manic depression. It is a disorder affecting the neurotransmitters of the brain causing a person to shift from periods of extreme manic behavior to episodes of severe depression. These shifts can happen every few months. The person with bipolar disorder can have well periods in between or shift from a manic state directly into a depressive state.
According to The Bipolar Child by Demitri Papolos, M.D. and Janice Papolos,
"Bipolar disorder in children presents very differently from how it presents in adults. Children rarely fit the same recognizable pattern They may have a more chronic course of illness where they cycle back and forth with few discernible well periods in between. Some tend to cycle rapidly (more than four times a year); some cycle within the week or month...and many cycle so rapidly that they fit a pattern called ultra-ultrarapid cycling). They may have frequent spikes of highs and lows within a twenty-four-hour period.
Almost all bipolar children have certain temperamental and behavioral traits in common. They tend to be inflexible and oppositional, they tend to be extraordinarily irritable, and a large majority experience periods of explosive rage."
Now that you have a basic understanding of the disease, let me tell you why this word induces fear in me. ADHD seems pretty commonplace and accepted in our culture. There's an opportunity to appreciate and focus on the positive traits of ADHD. With a multimodal approach to treatment, a person can have a pretty normal life. However, Bipolar Disorder is labeled as a mental illness. It is considered a disease that requires medication. A person with bipolar disorder can lead a pretty normal life, but the mood swings can be extreme and come with life altering consequences. Medications are very important in treating it. Bipolar also comes with a stigma. When I was young, I remember my mom telling us not to tell anyone about her illness. She did not reach out for support because of her fear of being stigmatized. There was another man in our community that also had Bipolar Disorder who was nicknamed "Crazy Ed". He would wander the streets in our neighborhood and all the kids were afraid of him. Looking back, I am sad that even my parents didn't dispel the rumors about Ed.
Though it's not certain that BD is what my son is dealing with, I don't want him to carry the stigma of that label around with him. He's a wonderful kid with a colorful personality. Our approach to him won't change. We continue to focus on his strengths and work with him to recognize and deal with his emotions in a productive way. If he indeed has BD, I will grieve for him (and me) knowing the challenges ahead, but I am thankful we have gotten help when he is young, knowing that early intervention may save him from carrying negative coping mechanisms into his adult life. We proceed with much prayer and taking it a day at a time.
Bipolar!
Hearing that word from the psychiatrist's lips this morning was like being punched in the gut. Having grown up with a mother who had been diagnosed with Bipolar Disorder, I understood the ramifications of the "B" word. From the moment I knew I was expecting our first child, I have carried around the fear that one of our children would be diagnosed with bipolar disorder. My sister and I prayed we would not ever have to deal with mental illness ourselves or in our families, knowing that there was a chance that we or our children could inherit it from our mom.
Going back for a med recheck, I shared our son's IEP and the fact that he was now attending a therapeutic day school with our pediatric psychiatrist. She asked some questions about family history and read through the evaluation. Then she said the "B" word! She suspects that our son may be dealing both with ADHD and Bipolar Disorder and prescribed a mood stabilizer that was familiar to me because my mom took it.
For those who are not familiar with this term, bipolar disorder used to be called manic depression. It is a disorder affecting the neurotransmitters of the brain causing a person to shift from periods of extreme manic behavior to episodes of severe depression. These shifts can happen every few months. The person with bipolar disorder can have well periods in between or shift from a manic state directly into a depressive state.
According to The Bipolar Child by Demitri Papolos, M.D. and Janice Papolos,
"Bipolar disorder in children presents very differently from how it presents in adults. Children rarely fit the same recognizable pattern They may have a more chronic course of illness where they cycle back and forth with few discernible well periods in between. Some tend to cycle rapidly (more than four times a year); some cycle within the week or month...and many cycle so rapidly that they fit a pattern called ultra-ultrarapid cycling). They may have frequent spikes of highs and lows within a twenty-four-hour period.
Almost all bipolar children have certain temperamental and behavioral traits in common. They tend to be inflexible and oppositional, they tend to be extraordinarily irritable, and a large majority experience periods of explosive rage."
Now that you have a basic understanding of the disease, let me tell you why this word induces fear in me. ADHD seems pretty commonplace and accepted in our culture. There's an opportunity to appreciate and focus on the positive traits of ADHD. With a multimodal approach to treatment, a person can have a pretty normal life. However, Bipolar Disorder is labeled as a mental illness. It is considered a disease that requires medication. A person with bipolar disorder can lead a pretty normal life, but the mood swings can be extreme and come with life altering consequences. Medications are very important in treating it. Bipolar also comes with a stigma. When I was young, I remember my mom telling us not to tell anyone about her illness. She did not reach out for support because of her fear of being stigmatized. There was another man in our community that also had Bipolar Disorder who was nicknamed "Crazy Ed". He would wander the streets in our neighborhood and all the kids were afraid of him. Looking back, I am sad that even my parents didn't dispel the rumors about Ed.
Though it's not certain that BD is what my son is dealing with, I don't want him to carry the stigma of that label around with him. He's a wonderful kid with a colorful personality. Our approach to him won't change. We continue to focus on his strengths and work with him to recognize and deal with his emotions in a productive way. If he indeed has BD, I will grieve for him (and me) knowing the challenges ahead, but I am thankful we have gotten help when he is young, knowing that early intervention may save him from carrying negative coping mechanisms into his adult life. We proceed with much prayer and taking it a day at a time.
Thursday, June 11, 2015
One Boy Speaks
I was touched by this well-written Letter to the Editor by Dylan Thompson. My heart goes out to ADHD kids who's self esteem is shaped by the words and opinions of others who don't understand how ADHD affects them. I see my own children struggling with feelings of inadequacy brought on by fall-out from their impulsive choices and uncontrolled emotions.
One Boy Speaks
One Boy Speaks
Wednesday, June 10, 2015
Navigating the Unfamiliar Rapids of an IEP
I had just returned home from the hospital the previous day from gallbladder surgery. That was quite unexpected! I had watched the boys board the bus and expected a quiet morning, resting while waiting for some friends to arrive in the afternoon who were staying for a few days. About mid-morning I hear the phone ring and my heart drops as I see that it's the grade school calling. As I answer I hear my son screaming in the background as the assistant principal tells me again that I must come immediately to pick him up.
This scenario went a little differently than in the past. There was a stand-off in progress in the principal's office while I was briefed on the events that led up to this moment. My son was on the far side of the conference table with batteries in his hand, ready to throw them at any one of the three adults trying to calm him down. As I enter, I also try to calm him to no avail. The principal and psychologist ask me to step into another room with them while someone else stayed with my son until I was ready to escort him out of the building.
This is when I hear something I never expected to hear. "We've tried everything we know of to help support your son, but we've done everything we can for him. We are recommending him for a case study so that he can receive more support." I agreed that the situation had gotten increasingly worse with his emotional outbursts and needing to be restrained. My eyes filled with tears of grief and frustration. I took him home along with a letter explaining his 2 day suspension.
Later that day, the school psychologist was to drop off a set of crutches my son had taken to school that were left in the classroom where testing had been in progress when he was removed. I was not surprised when a car pulled up in the driveway later that day. I was, however, surprised that the principal got out and walked up to the front door with the psychologist. As I invited them in, they joined me in the living room. The psychologist had a folder full of papers in his hands along with the returned crutches. As they sat down, he explained that they wanted to start the process for an IEP evaluation and needed my consent. They wanted to expedite the process since there was only 2 weeks of school left in order to schedule a meeting before summer. I agreed with their criteria as the documents were read to me. I only wished that they hadn't dropped in on me unexpectedly so that my husband could have been present.
I was generally acquainted with the IEP process, having taken a class addressing teaching kids with special needs when I first moved to Illinois to receive my Illinois teaching certification. I had also read a lot about IEP's and 504's as I educated myself about all the possible resources for my kids with ADHD as we navigated the public education system. I had always assumed that the parents initiated the process, though. I decided to read up on it more after our visitors headed home.
Monday came and so did an appointment with a new doctor who we hoped would be able to fine tune my son's medication. We were hopeful that this was the solution to the emotional outbursts that had escalated at school and at home. The doctor prescribed Intuniv to be taken along with the Focalin XR. I was able to fill the prescription as soon as we returned home and give it to my son that evening. In my mind, once his meds were regulated, that would take care of the problems he was having in school.
That afternoon, the psychologist called. He proceeded to drop a bomb that sent me reeling. He told me that the IEP meeting was set for the following Monday at 11:30. Could I make it? There was no finding a common time that was convenient for all parties. Then he said that he would be recommending that my son be transferred to a therapeutic day school where he could receive the support he needed. He wanted me to find a time to meet him there to tour the school in the next 2-3 days. My mind was swimming at this point with emotion, panic. What was happening?! I called my husband who, too, was concerned at the pace this process was proceeding. We had never been through this before. We didn't understand what was going on.
I decided to get some counsel from people who could inform us about what was occurring. I called a social worker I knew in the district. She felt that the recommended school was a good one. I called and asked the psychologist who had diagnosed our son if we could meet as soon as possible to discuss our options. I also called a dear friend who had taught in the district for many years and was intimately familiar with the IEP process. Both she and our psychologist were concerned about the pace of the process. Having everything happen in the span of less than two weeks was uncharacteristic of the norm. It was suggested that we put a hold on the process and wait until the beginning of next school year to have our son evaluated, after his med issues had been dealt with.
With our busy schedules, my husband and I had very little time to process all that was happening. I researched our rights and shared all the information I was collecting and all of the advise I was given. We decided to draft a letter requesting that the process be suspended and rescinded our consent for the evaluation until next school year. This was sent to the school personnel and to the director of special education for the district. We felt a little relief about slowing up the process instead of being carried by the current down a river we felt out of control to navigate.
The next day, the principal left a message that we should meet so she could explain "the repercussions related to our request." That sounded so negative, thus putting us on the defensive. We were already so fearful we were being coerced to send our son away. Later that day, we received an e-mail from the director of special education who invited us in a more amicable tone to meet with her. We made arrangements to meet the following afternoon, which was the Friday before the Monday scheduled meeting.
The meeting with the director was preceded by prayer and preparation. We went forward with it with much fear and trepidation. Being from the homeschool community which generally does not trust the public schools and having heard horror stories about negative encounters with the powers that be in public education, we put our trust in God to protect our son and make us the best advocates for his best interest. I prayed for courage.
The meeting was the best thing about this whole situation. The director empathetically listened to our fears, our concerns for our son's best interests and our emotional reaction to some things that had happened. She addressed each of the issues in a way that put our minds at ease with going forward with the meeting the next Monday. I appreciated that she expressed going through a very similar process as a parent with her own son having similar needs to ours. She sincerely apologized for the manner in which things were handled. It was a matter of the IEP team being so familiar with the process taking for granted that we were starting from the same knowledge base as they were. Also, she filled in the blanks of some background information that would have reassured us if it had been communicated when the process was initiated by the school.
We needed to again give consent for the process to continue and attend the meeting. We also asked our teacher friend from the district to attend with us as our advocate since she had sat through so many IEP meetings in her 25 years of teaching. Our psychologist also agreed to be connected by phone to contribute his input. We were at peace. The director also attended in the role of LEA (local education agency) representative. We felt our concerns would be represented and we were able to be contributing members of our son's team.
The meeting was like a whirlwind. Though it lasted about 1 1/2 hrs., it seemed to rush by. For the most part, the psychologist read the evaluation at lightning speed. There was so much to cover. It went so quickly that though I was prepared to contribute (as briefed by a parents' rights website) by sharing our son's strengths and asking some questions, I didn't see opportunity to do so. Although, all of my concerns were addressed and those who were there from the school were very familiar with my son's relational and academic strengths. The piece that surprised me was the sighting of 10 major disciplinary infractions during the first few months of school. It was stated that there have been behavioral concerns since the beginning of the year. I didn't realize that the notes that came home at that time were serious issues or out of the ordinary. They were all infractions that took place at recess or lunch or on the bus - unstructured times during the day. That made sense to me.
The two parts of the meeting were first to determine if he was eligible for special services and then second to set measurable goals for him to work toward achieving with resources recommended to help him reach those goals in good time. Three placement options were suggested, but the special school was really the only viable option with his extreme physical responses. When I visited the school the previous week, I actually felt like it was a good fit for our son. It had small class sizes, lots of positive reinforcement and structure and an intervention office that was trained and equipped to handle those emotional meltdowns that had led to the suspensions at his regular school. I also liked that the evaluation system that was used to determine his readiness to transition back to the least restrictive environment meant that as soon as he was ready, he would be brought back to the district and probably the regular classroom setting as soon as was possible.
With all of that said, my husband and I consented to the recommendations. The assistant principal of the therapeutic day school was present in the meeting and our signed consent put in motion all the processing needed to set up transportation and admission into the school by Friday (3 days hence)! So, he was able to start attending about 1 1/2 weeks before the close of the school year. He could use this time to adjust to his new situation with minimal academic requirements. He also qualified for the extended year program which includes 5 weeks of attendance for half days, four days a week starting in mid-June. In the summer they focus less on academics and more on social development and therapy. They have 6 social workers on staff and each student receives 1 hour of one-on-one therapy each week. They also offer services to the families of the students attending so the parents can consult with a psychiatrist or social worker regarding issues at home.
I hope that my description of events communicates the emotional journey I experienced during this fast-paced process. I know that I am one of innumerable parents who has had to navigate the waters of the IEP process for one of her children. Our experience was not typical as far as pace and timing, but I hope that it can give parents who have yet to embark on this daunting adventure a glimpse of the waters ahead. Though we felt some tension in relationship to the school personnel, we were able to communicate our concerns and resolve any issues we had. We bear no ill will toward the grade school staff and look forward to continued communication at the time that our son transitions back into his home school.
This scenario went a little differently than in the past. There was a stand-off in progress in the principal's office while I was briefed on the events that led up to this moment. My son was on the far side of the conference table with batteries in his hand, ready to throw them at any one of the three adults trying to calm him down. As I enter, I also try to calm him to no avail. The principal and psychologist ask me to step into another room with them while someone else stayed with my son until I was ready to escort him out of the building.
This is when I hear something I never expected to hear. "We've tried everything we know of to help support your son, but we've done everything we can for him. We are recommending him for a case study so that he can receive more support." I agreed that the situation had gotten increasingly worse with his emotional outbursts and needing to be restrained. My eyes filled with tears of grief and frustration. I took him home along with a letter explaining his 2 day suspension.
Later that day, the school psychologist was to drop off a set of crutches my son had taken to school that were left in the classroom where testing had been in progress when he was removed. I was not surprised when a car pulled up in the driveway later that day. I was, however, surprised that the principal got out and walked up to the front door with the psychologist. As I invited them in, they joined me in the living room. The psychologist had a folder full of papers in his hands along with the returned crutches. As they sat down, he explained that they wanted to start the process for an IEP evaluation and needed my consent. They wanted to expedite the process since there was only 2 weeks of school left in order to schedule a meeting before summer. I agreed with their criteria as the documents were read to me. I only wished that they hadn't dropped in on me unexpectedly so that my husband could have been present.
I was generally acquainted with the IEP process, having taken a class addressing teaching kids with special needs when I first moved to Illinois to receive my Illinois teaching certification. I had also read a lot about IEP's and 504's as I educated myself about all the possible resources for my kids with ADHD as we navigated the public education system. I had always assumed that the parents initiated the process, though. I decided to read up on it more after our visitors headed home.
Monday came and so did an appointment with a new doctor who we hoped would be able to fine tune my son's medication. We were hopeful that this was the solution to the emotional outbursts that had escalated at school and at home. The doctor prescribed Intuniv to be taken along with the Focalin XR. I was able to fill the prescription as soon as we returned home and give it to my son that evening. In my mind, once his meds were regulated, that would take care of the problems he was having in school.
That afternoon, the psychologist called. He proceeded to drop a bomb that sent me reeling. He told me that the IEP meeting was set for the following Monday at 11:30. Could I make it? There was no finding a common time that was convenient for all parties. Then he said that he would be recommending that my son be transferred to a therapeutic day school where he could receive the support he needed. He wanted me to find a time to meet him there to tour the school in the next 2-3 days. My mind was swimming at this point with emotion, panic. What was happening?! I called my husband who, too, was concerned at the pace this process was proceeding. We had never been through this before. We didn't understand what was going on.
I decided to get some counsel from people who could inform us about what was occurring. I called a social worker I knew in the district. She felt that the recommended school was a good one. I called and asked the psychologist who had diagnosed our son if we could meet as soon as possible to discuss our options. I also called a dear friend who had taught in the district for many years and was intimately familiar with the IEP process. Both she and our psychologist were concerned about the pace of the process. Having everything happen in the span of less than two weeks was uncharacteristic of the norm. It was suggested that we put a hold on the process and wait until the beginning of next school year to have our son evaluated, after his med issues had been dealt with.
With our busy schedules, my husband and I had very little time to process all that was happening. I researched our rights and shared all the information I was collecting and all of the advise I was given. We decided to draft a letter requesting that the process be suspended and rescinded our consent for the evaluation until next school year. This was sent to the school personnel and to the director of special education for the district. We felt a little relief about slowing up the process instead of being carried by the current down a river we felt out of control to navigate.
The next day, the principal left a message that we should meet so she could explain "the repercussions related to our request." That sounded so negative, thus putting us on the defensive. We were already so fearful we were being coerced to send our son away. Later that day, we received an e-mail from the director of special education who invited us in a more amicable tone to meet with her. We made arrangements to meet the following afternoon, which was the Friday before the Monday scheduled meeting.
The meeting with the director was preceded by prayer and preparation. We went forward with it with much fear and trepidation. Being from the homeschool community which generally does not trust the public schools and having heard horror stories about negative encounters with the powers that be in public education, we put our trust in God to protect our son and make us the best advocates for his best interest. I prayed for courage.
The meeting was the best thing about this whole situation. The director empathetically listened to our fears, our concerns for our son's best interests and our emotional reaction to some things that had happened. She addressed each of the issues in a way that put our minds at ease with going forward with the meeting the next Monday. I appreciated that she expressed going through a very similar process as a parent with her own son having similar needs to ours. She sincerely apologized for the manner in which things were handled. It was a matter of the IEP team being so familiar with the process taking for granted that we were starting from the same knowledge base as they were. Also, she filled in the blanks of some background information that would have reassured us if it had been communicated when the process was initiated by the school.
We needed to again give consent for the process to continue and attend the meeting. We also asked our teacher friend from the district to attend with us as our advocate since she had sat through so many IEP meetings in her 25 years of teaching. Our psychologist also agreed to be connected by phone to contribute his input. We were at peace. The director also attended in the role of LEA (local education agency) representative. We felt our concerns would be represented and we were able to be contributing members of our son's team.
The meeting was like a whirlwind. Though it lasted about 1 1/2 hrs., it seemed to rush by. For the most part, the psychologist read the evaluation at lightning speed. There was so much to cover. It went so quickly that though I was prepared to contribute (as briefed by a parents' rights website) by sharing our son's strengths and asking some questions, I didn't see opportunity to do so. Although, all of my concerns were addressed and those who were there from the school were very familiar with my son's relational and academic strengths. The piece that surprised me was the sighting of 10 major disciplinary infractions during the first few months of school. It was stated that there have been behavioral concerns since the beginning of the year. I didn't realize that the notes that came home at that time were serious issues or out of the ordinary. They were all infractions that took place at recess or lunch or on the bus - unstructured times during the day. That made sense to me.
The two parts of the meeting were first to determine if he was eligible for special services and then second to set measurable goals for him to work toward achieving with resources recommended to help him reach those goals in good time. Three placement options were suggested, but the special school was really the only viable option with his extreme physical responses. When I visited the school the previous week, I actually felt like it was a good fit for our son. It had small class sizes, lots of positive reinforcement and structure and an intervention office that was trained and equipped to handle those emotional meltdowns that had led to the suspensions at his regular school. I also liked that the evaluation system that was used to determine his readiness to transition back to the least restrictive environment meant that as soon as he was ready, he would be brought back to the district and probably the regular classroom setting as soon as was possible.
With all of that said, my husband and I consented to the recommendations. The assistant principal of the therapeutic day school was present in the meeting and our signed consent put in motion all the processing needed to set up transportation and admission into the school by Friday (3 days hence)! So, he was able to start attending about 1 1/2 weeks before the close of the school year. He could use this time to adjust to his new situation with minimal academic requirements. He also qualified for the extended year program which includes 5 weeks of attendance for half days, four days a week starting in mid-June. In the summer they focus less on academics and more on social development and therapy. They have 6 social workers on staff and each student receives 1 hour of one-on-one therapy each week. They also offer services to the families of the students attending so the parents can consult with a psychiatrist or social worker regarding issues at home.
I hope that my description of events communicates the emotional journey I experienced during this fast-paced process. I know that I am one of innumerable parents who has had to navigate the waters of the IEP process for one of her children. Our experience was not typical as far as pace and timing, but I hope that it can give parents who have yet to embark on this daunting adventure a glimpse of the waters ahead. Though we felt some tension in relationship to the school personnel, we were able to communicate our concerns and resolve any issues we had. We bear no ill will toward the grade school staff and look forward to continued communication at the time that our son transitions back into his home school.
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