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Nvr2l8
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22 Jan 2008, 2:44 pm

I'm not sure where to go with this. My 9 yr old is the angriest kid that I've ever had to deal with. He's got a constant chip on his shoulder, has a hair trigger, gets nasty with anyone that crosses him and is wholistically a basically unhappy little bugger.

He's taking 54 mgs of Concerta & 25 of Strattera. He's in a day-treatment school (4th grade) that was pretty much the lesser of all evils when it came to NYC Board of Education options. :evil:

I just got a phone call today from the school that he was melting down, cursing, running, screaming and he had to be restrained. They've given him a 1 to 1 para, they try walking him, talking him down, having his therapist intervene, and nothing seems to work to avert a meltdown.

I have been told by others in the past that stims with some kids can cause problems with aggression, but he was somewhat aggressive and impulsive before he started the stims. He was almost 6 when he started on Concerta.

Any insights? Suggestions? etc. I've been doing the Explosive Child stuff, but can't get ANYONE else (including Dad) to embrace it.

HELP!

Beth


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ster
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22 Jan 2008, 3:01 pm

is it possible that his current meds aren't working to control the aggression ?

our son had terrible bouts of aggression pre-dx....once we knew what we were dealing with, and knew that he wasn't acting in certain ways to be purposely difficult or defiant, we were able to change our reactions towards him..........this went a long way to helping him get through the tough times. change in meds & a new therapist also helped the situation.



gbollard
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22 Jan 2008, 3:19 pm

Does his dad acknowledge that there are anger issues? Does he feel that there's an alternative way of dealing with them?

It's almost impossible to get any kind of therapy to stick unless all parties are using the same therapy.

He needs to be able to identify a meltdown coming on and take steps to avoid it. This is really, really difficult and possibly too difficult for a 9 year old. Self-control is definitely the eventual answer.

I'm inclined to think that he could probably benefit for more regular contact with therapists - and maybe classes designed specifically to work on the anger issues.



Tortuga
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22 Jan 2008, 3:35 pm

My son is the same age. He had very terrible anger issues when he was in public school. I started homeschooling when the county proposed the day program. He's gotten a lot better after a little over 1 year of homeschooling.

I figure that my son's anger issues were related to him feeling inadequate compared to other kids. Having privacy to work on his school work, has helped him a lot. Also, when he was in school, the other kid's issues used to set him off. Many of them were loud, rude or defiant. He picked up a lot of negatives from that and it took a while for me to turn it around.



KimJ
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22 Jan 2008, 4:04 pm

It sounds like he's in the absolutely wrong environment. He should not be restrained at all. He is probably dealing with anxiety issues on top of whatever makes him angry in the first place. I would go to his school to see what happens prior to these meltdowns. Is he ever happy or calm? Perhaps a mood disorder?

I can't comment on the drugs, never did them.

But last year my then-6 year old had similar issues. The school had no training in autism and we pulled him and "reset" him. He needs to trust the adults that are caring for him. It's good to see in a private, idyllic setting what sets him off.

I agree the other adults absolutely have to agree with using The Explosive Child together. You need to get his father (your husband) convinced that it's for the best to work together.



jaydog
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22 Jan 2008, 4:57 pm

well i'm an adult with Aspergers and co-morpid conditions such as anxiety and agoraphobia, PTSD, based on what you posted, i can totally relate, i never had any anger issues and only got in trouble once for fighting (and standing up against a bully) but it sure sounds like your child's meltdowns are cause of his school.

I remember when i was in school i was pissed of all the other students being rude and not caring about there education. (i went to a public school) and it was a disaster, I never had really bad meltdowns and never was violent, (but all though high school like 2-3 times a week i would have to go to the nurses office with severe migraines that turned into a flu) and by the time i was home i would just passout on my bed...

and was just totally out of it for 24-48 hours. But remember Autism is majorly Anxiety overload. Remember Autism is also sensory stimulation. The noise of people talking around him could also be a major trigger or hes just bored..

I would talk to the teacher and school and see if he can get a seat by the door, so if hes not feeling like being there, he can leave to the nurses office and or library or some place where he can be alone and reduce that anxiety. alot of people with autism have major depression, anxiety type disorders, and see if they have group activities or a presentation they have to do infront of class, have him go to the library like couple days before that is planned.



Nvr2l8
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22 Jan 2008, 9:45 pm

Thanks for all of the replies.

See, the school that he's in is for kids that are primarily there for conduct disorders - there are VERY few kids on the spectrum. There's a clear line drawn between the Academic and Psychiatric sides of the house. Then there's a less defined line within the Psychiatric house between parenting kids with Conduct disorders as opposed to handling kids within the spectrum.

Since Mr. 9 yr old has always been behavioral AND can't handle more than 10 kids in a classroom and SINY (where we are) doesn't have an autistic program for high functioning kids, nor do the General Ed schools, we're stuck with what we've got.

I've been thinking about a med change/getting rid of idea for a while, but want to see what alternatives there are.

Uhhhhh, my heart breaks for this kid!! !
B


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ster
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23 Jan 2008, 6:36 am

it was a bit difficult for us to switch the way we thought about our son. the way he acted, well, unfortunately we just felt that he was more of a conduct disorder kind of kid. we felt that he just needed to have more discipline.......it was difficult to make the leap of faith and try looking at him from a totally different angle. honestly, though, once we started seeing that much of his behavior was stemming from him misunderstanding/misinterpreting a situation~well, we were able to take a deep breath, stand back and actually help him through the situation.
it's quite a leap to go from believing your child is willfully defiant to believing your child is confused.
IMO, things would run smoother if you could get your husband to be "on the same page" as you. .....not really sure how you can do this......



katrine
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23 Jan 2008, 10:07 am

Your kid sounds a lot like my son (HFA, ADHD, epilepsy) a year ago. I really sympathize. The situation sounds really frustrating!

First: I've made it a point of telling people my son's behaviour issues were related to epilepsy. This may not be the case for you but as 1/3 of people on the spectrum develope epilepsy, it is worth a thought. Epilepsy can be subtle and cause explosive behaviour, both in the moment, directly related to a seizure, and generally, as it lowers frustration limits and confuses kids.

Second: I agree that you all should be using the same approach with your son.
Another thing I have found helpfull is a behaviour chart, which describes activities before an outburst, what the outburst was, how it was tackled ect.
I have also realized that the only way of dealing with my son is by dealing with his autism. His school day needs to be structured and visualized. I think I would choose to focus on the autism, rather than my son's intellectual capabilities, if I had to choose. That is, I would choose a school for autistic kids and not a school for kids with all kinds of problems, even if it meant he had to go to school with kids who functioned worse. (This may not be the right solution for other kids, but it may be for kids with the problems your's and mine have - aggressive meltdowns that end in restraint ect.) This is because so much of this negative behaviour is directly related to autism, and can be dealed with by providing an enviroment which is "autism friendly". It is also easier to cooperate with teachers who understand autism.

Is there any possibility of getting some "autism pros" on your team who can turn the situation around?

Is your son getting a lot of physical excercise? I found this helped my son. (hours and hours of excercise)

I hope this is helpfull to you. If it is any consolation, my son was really really bad a year ago, and is much better (and happier) now.



Tortuga
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23 Jan 2008, 3:41 pm

Nvr2l8 wrote:
Thanks for all of the replies.

See, the school that he's in is for kids that are primarily there for conduct disorders - there are VERY few kids on the spectrum. There's a clear line drawn between the Academic and Psychiatric sides of the house. Then there's a less defined line within the Psychiatric house between parenting kids with Conduct disorders as opposed to handling kids within the spectrum.

Since Mr. 9 yr old has always been behavioral AND can't handle more than 10 kids in a classroom and SINY (where we are) doesn't have an autistic program for high functioning kids, nor do the General Ed schools, we're stuck with what we've got.

I've been thinking about a med change/getting rid of idea for a while, but want to see what alternatives there are.

Uhhhhh, my heart breaks for this kid!! !
B


Your son's situation tracks very closely with what my son experienced. The day program was his last stop in the public school system. I was told that there was no classroom for HFA. The proposed day program in our area sounds like your son's current placement. I refused that placement because of their use of restraints. I think my son would have gotten worse and worse. They tried to sell me on it as if he could have earned his way out of that placement. I really saw it as a deadend. Behavior charts never worked for him because he couldn't handle being in a classroom with other kids....esp. other kids with conduct disorders.

I really feel for what you're going through.



Cori
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25 Jan 2008, 11:57 am

When my son took concerta, he was the most angriest kid I had ever seen. It just didn't work for him at all. But in your situation, I think I would call for an immediate meeting and demand an FBA be done, followed by a BIP. He needs positive reinforcements. He needs to learn self-calming techniques.

Good luck!



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26 Jan 2008, 9:34 pm

I'd see about a possible re-evaluation with the meds.

Both Concerta & Strattera have reports of causing aggressive behavior or the worsening of such in some individuals.


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26 Jan 2008, 10:34 pm

How does your son feel about the program/his school? What does he say to you? It's so important to get his feedback on what's going on.

It doesn't sound very good.

But, it sounds like his situation wasn't much better in public school, right? If you started him on concerta at age six, he must have had some serious issues prior to the day school. It's hard for me to believe that there aren't any Asperger schools in NYC.
http://nymag.com/news/features/23172/

I think they exist, according to this article. Is it that these particular schools are selective? Is it difficult to sue the city? It sounds feasible. Do what you have to do to make sure your son is in the BEST placement. I woudn't settle.

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