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helpful way to explain refusal and defiance

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ds7 - 2nd grade - started back to school 5 weeks ago after 1 yr of homeschooling. this is a new school. so far, they've been fabulous, never heard of PANDAS, interested to learn and help. on the 1st day spec ed was involved to help. next 2 days, very troublesome getting into school -- wild fight or flight tantrum, so they've seen that it's something not 'normal' school anxiety. we've been working an ERP-like plan that was good with me there at decreasing increments. i think he's generally the healthiest he's been in 3 yrs since onset. we've just gotten a new psych who seems to be the needle in the haystack we've been looking for after much frustration with useless psychs that really have no idea about anxiety. i believe it's separation anxiety and phobia vs. OCD but am hopeful this new psych can help sort it out. i am willing to see it could be OCD even though i have my thoughts. of course, there's still much to be worked on to discover roots of cause, plans etc. . .


we have a 504 plan meeting coming up, everyone seems on board. letter from psych will state severe separation anxiety and anxiety- NOS; i'm hopeful dr letter should say PANDAS -- neither letter will really list symtpoms.


last week was troublesome. Monday was monday and dh was out of town -- ds didn't go to class until ~2 hrs late with me sitting with him in an area of the library. tues, wed were good - went to class with me staying until after, then before announcements. thurs was very troublesome -- he went to class after lunch -- me with him until then. they sent up work for him to be done. he was eager to do it. fri, he stayed home b/c was coughing, tired and stuffy (staying home = the kiss of death for school anxiety!)


i think last week was a perfect storm for him -- he has a cold, dh was out of town in beginnig, this was the week we'd worked up to that i should just walk him to class, he saw the psych for the first time and talked with her about it (very productive session -- i was floored at how forthcoming he was). so -- his M.O. is avoidance and refusal -- so all this kicked in for refusal.


he has been doing wonderfully once in the classroom -- participating, following directions, rules, etc. in only the past week, he's been stating "i HATE school" and expressing troubles with the physical act of writing and coming up with ideas for writing and other discussions.


so, the unreasonable and unexplained severe anxiety of getting into the classroom has not been settled. it's now starting to meld with reasonable anxieties. i have actually made some progress with him in discussing this and working toward solutions. he's seemed to feel more at ease when i've said we'll talk with spec ed and develop solutions and plans. but of course, since his pattern is refusal and avoidance, that kicks in.


here's my biggest fear about him in school -- his anxiety presents with avoidance, refusal and defiance. i KNOW the medical and the psych behind it without a doubt, BUT i still find it challenging to keep in mind that it should be 'me and him against anxiety' and find it so easy to slip into 'me against his will'. so, for those with him at school, i fear it's easy for them to think they are battling his will and treat him as such.


so -- i'd love any advice on how to work with school personnel b/c i am beginning to fear that they don't understand b/c they see 'golden child' who CAN do all that he's supposed to but they are missing that when under the thumb of the anxiety, he just can't bring himself to do it, not that he's fighting just to get his own way. i think it's very easy to think 'he CAN do it, it's just a matter of if he WANTS to.' i cerrtainly believe that 3 years ago, i could have sort of understood but really also just shook my head and thought 'he's playing you to get his own way, you just don't see it' whereas now -- but only after living it -- do i get the stranglehold of anxiety and that plans need to work with that to defeat it rather than fight against it.


thoughts? help?

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I am going to play devil's advocate here a little bit-


I KNOW you KNOW your son, and know what you are doing- but so much of what is going on with him mirrors what we went through with my kids last year, so I only am saying this from someone who TOTALLY understands that you are pulling your hair out, and living every moment to get your son back to school and happy-




my daughter had major school refusal, anxiety and ocd. We tried and tried to get her back with baby steps, but we were not facing the underlying fear- so we got nowhere. This summer we went to USF (which BTW could be great for your son) and she faced the underlying fear- and we were able to get back to school without baby steps, without issue.


my other daughter also was having ocd, but frankly, a lot of defiance. We also dealt with this at USF. You know, after pandas ravaging our household for 2 plus years, me knowing it was caused by a medical/physical condition, us, as parents tired of seeing our babies suffer, had lowered the bar dramatically and let lots of things go. We learned that just because a child has anxiety (and ocd) does not except them from compliance, period. The anxiety and ocd needs to be adressed- but really before that can even be addressed, we needed to address the compliance. We had lowered the bar on a lot of simple age appropriate expectations, and we had to clearly state that the bar was being raised, and they would have age appropriate expectations. I can tell you that it was a rough go for a few weeks- but we are living in relative peace and normalcy now.


So I guess I say this because, if your son is dealing with anxiety (and/or ocd), it is still not okay for him to be defiant. I think you can be honest and tell him this, and give him acceptable ways to deal with the anxiety- but there should be consequences. We are using a very basic "time out" program (think back to when your child was 2).


I recommend finding a very tough psych, who sees through excuses, etc. We spent several years with different psychs- who couldn't hold a candle to the one we saw in FL- because he was knowledgeable and tough.


Good luck!

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You could be right - could be extreme anxiety. But it could also be OCD. My son's friend has defiance as a reaction to intense anxiety in school - and he recently confided that he constantly worries that something bad will happen to his family if he's not with them. So he always worries when he's away from them. It's an intrusive thought kind of OCD. The obsession is that some horrible harm will come to his parents and by not being there, it will be his fault. The compulsion is to do anything he has to to be with them. This includes having anxiety attacks at school that force his mom to come get him. It's not necessarily as manipulative as I make it sound. I truly think he's so overwhelmed with anxiety that he can't function until he sees his mom again. But it is driven by an OCD thought.


Regardless, I hear you when you said you feel like it should be an "us against anxiety" but instead it feels like "me against his will". One book that really helped me was John March's Talking Back To OCD. It talks about establishing roles. The parent is not the problem solver, the protector or the one who makes this hurt go away. The child is (the book is written with teens in mind but the concept hold true for younger kids with some minor minor accommodations IMO). The child is the only one who can control his own thoughts and fears. He is the only one who can boss back OCD. If the parent rescues, then OCD becomes afraid of the parent and never learns to listen to the child.


You've been at this a long time, you know about ERP and baby steps. But the shift from being fix-it parent to being coach helped me a lot. You need to tell your son that if he doesn't go into school on his own, OCD/anxiety wins. And you love him too much to let him lose this war. So you will coach him and root for him and support him. But he must be the one who fights like he means it, not just go through the motions to please you. he has to internally want to be the winner.


You can read excerpts here at Google Books:


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Smarty --


I'm leaning toward DCMom and LLM on this one, in general. My DS presents with plenty of avoidance, also, so I know that particular animal well.


But we were coached very early on, by our son's first therapist, that "refusal" was not an option; that if we lowered the bar to meet OCD's demands, the OCD would just continue to call for the bar to be lowered yet again, and again, and again until our DS was living OCD's life rather than his own.


Our problem in the schools has almost always been less in terms of explaining DS's behavior and more in terms of training the school personnel not to give into him when he tries to employ avoidance or refusal; they see his genuine distress, and so they tend to try to do things to "calm the waters," thereby aiding and abetting his avoidance, rather than supporting him while at the same time insisting that he move forward and accomplish the task, even when it means staring down a fear.


I'm also betting that, once you're entirely out of the picture and it's just your DS and the school personnel on a daily basis, he'll engage a lot less in refusal and defiance in the classroom itself; he might practice some masterful avoidance, dragging tasks out to the point where he runs out of time, for instance, but I think that with just the teacher and his classmates to answer to, his outright defiance will be reserved for you and your family, in the home environment. So I'm not sure you're going to be called upon, really, to explain refusal and/or defiance in the classroom. But maybe you're concerned about explaining it when it comes to how your DS responds to homework or other outside-of-the-classroom tasks?


That's a different issue and, in my opinion, a delicate balance. I'm fully on board with the ERP principals of facing the fears, not "feeding" the OCD, holding tight to certain immovable, non-negotiables, but I also know from experience that there can be, at times, a fine line between holding your child accountable for "bossing back the OCD," and pushing them too far, too fast, to the point where the stress feeds upon the stress and you thereby reach a point of diminishing returns. That's where accommodations like allowing your child to dictate some answers to homework questions, rather than insisting he write them down himself, come in handy.


So, long way of saying, explaining refusal and defiance to the school? I think that probably isn't really the issue. Like DCMom, I think you can sit your DS down and let him know that there are certain age-appropriate expectations that have to be met while, at the same time, encouraging him that he'll get support, kindness and understanding both at home and at school. But support isn't the same as avoidance or excuses, and he won't be asked to do anything he genuinely cannot do; rather, if you hit anything along those lines, you as his parent and advocate will work with him and the school to come up with the appropriate accommodation.


There's a new book out called "Reality is Broken," written by a think-tank gaming specialist. Her basic premise is that "reality is broken" because our academic and workplace experiences aren't properly modeled, and that's why so many people are drawn to escapism, like video games. And that the best, most successful video games emulate life principals, that if they were mirrored in schools and places of business, would make us all much better satisfied, fulfilled and productive. One key principal she talks about is "flow;" "flow" is when a gamer is kept just at the very edge of his capability, but neither challenged too much so that he becomes discouraged and disheartened and therefore decides to give up on the game, nor bored because things are too predictable or too easy. When you're adequately challenged, called upon to use all your best skills to move forward, but not so constantly and demoralizingly embattled to the point where you collapse and want to give up, that's when you're at your best.


My DS and I talk about "flow" a lot, and I feel as though my job as a parent is to help him maintain that level of function. And with PANDAS, that means my role and level of participation can vary widely, and his needs can vary broadly, also, depending on how healthy he is. So it's tricky, making sure that I'm supporting his "flow" but not expecting too much of him to the point where he's demoralized by his inability to push past some anxiety about something, while also not making it too easy for him to where he retreats and steps off an age-appropriate path because I've removed the challenge on his behalf entirely.


I like DCMom's idea of having an honest discussion with your DS; you could use that as an opportunity to engage in a "contract" with him about the non-negotiables (such as refusal and defiance), and what kind of support responses he can rely upon from you and the school as he stays in his "flow" and works toward being the boss of his life, rather than allowing the anxiety/OCD to call the shots.

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LLM- totally agreed. I am still working on moving away from being the fix-it parent, it is really helping, it is not easy (does not come naturally for me).


We found they DO have to become responsible, not only responsible to fight the ocd, be compliant to parents, but to do the work necessary. Really, bossing back the ocd is one thing, but what helped us was to really de sensitize them to the thought. So, in other words if the thought is something is going to happen to a parent- it is not enough to say- nothing is going to happen, and I am not going to listen to this thought- but the child has to do so much exposure to the thought of something happening to a parent, that when this thought comes up- it is boring, they are desensitized, they are not trying to not think about it or not listen to it. I am nowhere near as eloquent as our psych- but I hope this is making sense.


It is SO hard to see your baby, so scared, so emotional. It is my nature to rush in and make it better. But- being tougher on the ocd (while always maintaining compassion) has actually been the "kindest" thing we have done- because it has gotten them better, fast.


My older daughter's ocd comes out as defiance. Her only compulsion is avoidance, or to be with me. She is almost never defiant outside of ocd. It took us quite a while to figure this out, even though her sister was diagnosed with pandas already. Now, it is clear- as soon as I see that defiance- I KNOW there is something below. She has also gotten very good at sharing.


I do think there can be other causes of school anxiety (of course). I think that undiagnosed, or unadressed learning issues can be a major player- and wonder if there is any of that possibly?

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This is all fascinating to me. My son has always been fairly defiant, even though he is extremely worried about making everyone happy and getting a "good report". It was driving me crazy trying to understand how he could know what was expected, and feel so badly when he did not do what he was asked, yet none of that mattered in the moment. Our school director was finally the one who pointed out it was anxiety driven--that he wanted to comply, but could not do to his anxiety. It was such a revelation to me...It took me a long time to think through this, as it looks like defiance--but in reality, his "fight or flight" was surfacing as avoidance and refusal to engage at school. I still struggle to tell when it is an anxiety response or a compulsion (especially when he insists on continuing to do something after we have told him to stop), and when he is being naughty and defiant (he is 6). Would love to hear more from people on this issue...

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, yet none of that mattered in the moment. Our school director was finally the one who pointed out it was anxiety driven--that he wanted to comply, but could not do to his anxiety. It was such a revelation to me...It took me a long time to think through this, as it looks like defiance--but in reality, his "fight or flight" was surfacing as avoidance and refusal to engage at school....



so MMWG -- what did you do about this at school?

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Well, in preschool we were lucky enough to have a teacher who looked at the intent--why is the child refusing? So we made it through. Kindergarten this year we tried to explain and prepare, but he had been so healthy all summer that we were optimistic he would engage and participate. We were very wrong. The environment was so chaotic and he was so overwhelmed and anxious, we had never seen anything like it. This is when we realized his refusal was a by-product of anxiety, and by then he was over the edge anxious--nightmares, panic attacks, etc. It was a flexible school but he just would not engage, and if they tried to make him, he would meltdown. Fight or flight. There were other issues going on in the school, including some violence in the classroom (a little boy attacking him everyday, which did not help his anxiety either!).


So we pulled him out. If I thought time would have helped the situation, I would have left him there and helped him adjust. But I was there a few days to help with the transition and it was a mess. I honestly thought his issues were about 60% of the problem, and the school disorganization was 40%. His health was declining rapidly, so we decided this year to teach him at home.


But we are still fighting this battle--we want him to mind and to be respectful. I know his brain is telling him to do what he wants, not what we tell him to do, and we are working to break this pattern. Wish I could be more helpful.

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MMWG -- I agree completely about the "fight or flight" reaction and how it can read as defiance! Good point!


Smarty -- Would it be possible, if in the event your DS has this sort of reaction to a proposed task, that he be provided a "safe place," somewhere that he could go, away from the stimuli of the general classroom and the pressures of the teacher and other kids there, so he could calm down and sort out 1) what he's afraid of and 2) what other behavioral choices he might have at his disposal, rather than acting out? Maybe the school psychologist or social worker could offer him a "safe haven" in these instances?

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Smartyjones - your post sounds so much like my DS8 - avoidance, refusal, defiance, "I hate school", extreme difficulty with the physical act of writing. So many times I have fallen into the trap of my will against his will, and that never ends well. It's like I keep having to learn that lesson over and over again. And yet somewhere underneath all that anxiety there is a strong-willed boy, so finding a balance is like walking on a tightrope most days. I guess the thing is to decide what your non-negotiables are, discuss this clearly with him, stand your ground no matter how big the fight is, and be okay with letting the rest go. The other things will come as he heals. I never thought I would see the day, but it's happening for us now as DS is healing and the defiance is less and less.


Last year in grade 2 he had a very difficult time with his teacher. It became a constant battle of wills and very much her against him until he was no longer able to attend school. I'm not blaming it all on the teacher. Certainly my DS has major issues that are extremely challenging to deal with. In the past DS has been diagnosed with separation anxiety, selective mutism, social anxiety, general anxiety disorder, and OCD. The OCD was not obvious until part way through last year. We've been in therapy for anxiety since he was 3 - both for him, and for me helping him. The doctor's advice to the school is to have regular breaks, a safe place to go to, a safe person to go to, and occupational therapy. We tried everything and nothing worked. We tried play therapy, home therapy, school therapy. Nothing helped much. In meetings with the school the issue of "can't" versus "won't" came up again and again. The school staff kept saying that he is defiant and it's all behaviour. The therapist I brought to the meetings kept insisting that his behaviour is anxiety-driven and that he truly can't meet their expectation, so they have to change their approach to him. Things got worse and worse until finally I ended up homeschooling. I don't think I did a much better job than the school. I found myself wondering how much is can't and how much is won't. We were constantly in a battle of wills just to get a few minutes of basic academics accomplished for the day. I was so frustrated. He was so frustrated. And most of this centered around writing. Some days he refused to put anything at all on paper.


I was at a homeschool meeting on special education when I finally realized that his anxiety is just like a learning disability and I finally believed it really is an issue of ability. He can't function in the classroom the way he is expected to, and he can't put things on paper the way I want him to. And it's a vicious cycle reinforcing his anxiety since he knows he can't perform, but doesn't understand why. He knows that people are constantly putting impossible expectations on him and then getting angry or frustrated at him for failing. No wonder he refuses to even try anymore. Anyway, back to the LD presentation - the presenter talked about learning disabilities and how there is no motivation, positive or negative, that will make a LD kid learn the way the teacher wants them to. They just can't. Teachers try to motivate them with rewards, then get frustrated when they fail, then threaten them for not complying. Nothing works. He said the only way to educate these kids is through a qualified teacher who can teach them a whole new way to learn that fits the way their brains work. It was like a lightbulb went off for me. I realized we needed a different fit for him, and someone uniquely qualified to teach him in his own way. We finally found a program at a special school that we thought would fit, but at the same time discovered lyme and co-infections. Long story short, DS8 is 3 months into lyme treatment and healing. He is attending his regular grade 3 classroom (with accomodations) and is successful! He's engaged and thriving, catching up on academics, and we didn't end up needing the special program at all.


I don't know if any of that helps. I do know that if the school falls into the trap of battling his will then everyone will lose. And if you feed his anxiety then it increases. So you're on the tightrope. I hope and pray you find healing for him!

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I was at a homeschool meeting on special education when I finally realized that his anxiety is just like a learning disability and I finally believed it really is an issue of ability. He can't function in the classroom the way he is expected to, and he can't put things on paper the way I want him to. And it's a vicious cycle reinforcing his anxiety since he knows he can't perform, but doesn't understand why. He knows that people are constantly putting impossible expectations on him and then getting angry or frustrated at him for failing. No wonder he refuses to even try anymore. Anyway, back to the LD presentation - the presenter talked about learning disabilities and how there is no motivation, positive or negative, that will make a LD kid learn the way the teacher wants them to. They just can't. Teachers try to motivate them with rewards, then get frustrated when they fail, then threaten them for not complying. Nothing works.



momcap -- are you living my parallel life??!! i'm so happy to hear your son is doing well. so, you didn't need the special program or is he in that? -- is he at the same school where he had a troublesome 2nd grade? yes!! that's exactly it -- but i htink people get it when talking about learning disabilities but it's like that with him 'learning' about overcoming this phobia of getting into school -- he can't learn it with motivations, positive or negative. and yes, he's just in public school for the first time, i do believe he is a 2E kid but he hasn't been in such a system to determine that for their purposes and that takes some time. i do think that is some of the trouble. the other being unreasonable fear that drives the anxiety.



thank you all for your thoughts. i think -- and hope -- you know how much i appreciate comments and advice. i think i'll always remember when the first behavioral therapist, who diagnosed ds, said, 'what you're describing sounds like OCD" and i though, 'what in the world is she saying? that's not like any OCD i've ever heard of" -- so, i know to be open to all possibilities, even if they don't make sense to me.


laura -- thanks for the talking back to OCD book recommnedation -- i don't have that and it looks helpful.


i'm not trying to argue -- here's what i don't get -- it's all well and good to say that ds needs to comply with expectations -- the bottom line is that he's not.


if told he will have to go to school, i need to hand him off to someone who will take him, kicking, screaming and throwing shoes and have them take responsibility for him. i am willing to do that. i don't have anyone on the other end to do that. the 2nd day of school, the VP was telling me i had to take him home b/c he was not cooperative. in the meantime, they had given ds some books and he calmed. the next day was the same. so we developed this plan that i am involved. so -- without someone to take him on the other end -- what do i do with him?


at onset, if he didn't go to school with nice manners, he was required to go to his room and read or do activity books until school was over. he was 4.5 and half-day. he gladly did that -- 4.5 years old, in his room by himself for 3 hours. he does play baseball and is starting scouts. these are good experiences for him for social reasons that he needs. so -- if i hold that all that up as 'motivators' -- i've got a 7 yo with anxiety who is spending all his days with me in our house, reading - by himself. it's a matter of the lesser of two evils and he will pick the avoidance. it's not that i fear this will happen, it's his pattern.


he has a chart that he gets stickers for days he does the day's 'step'. the end result is a puzzle book he really wants. it's a good, fun reward system -- but means nothing in the heat of the moment.


so, it's fine to draw the line in the sand -- what do i do when he crosses it and the consequences are detrimental for all of us? me and him, here in our house, doing nothing.

Edited by smartyjones
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momcap -- i just reread your post -- so you didn't 'do' anything? do you think it was treatment of the lyme, etc that made the difference? ds is doing well fairly well medically but is still struggling with a virus that has been troublesome that he can't seem to fully kick. (we've treated for multiple infections)

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It can be really hard to 'enforce' the requirements like school attendance. Especially if you have no one on the other side to hand off to.


The first step I think would be to take the "coach" concept in Talking Back to OCD and explain to your son that he has to be the boss. That there are lots of times in the day you won't be around, so he has to teach OCD to be afraid of him, not afraid of you. That you understand this is scary, but there's really no other option. And then reassure him that you'll be there to coach him, just not do it for him.


What I did with my DD was explain this in a calm moment and get her psyched. But then as the moment of truth approached and she started to freak, I'd reassure her that I'd never ever ask her do anything dangerous. That if I asked her to go to school without me, it was only because I knew she'd be safe. That her fears were a trick, OCD trying to steal all of her energy and attention. Because OCD is mean and selfish and wants her all to itself. So the best thing she could do would be to make OCD mad and starve it of her attention. If she starved it, it would go away. I'd go on and on about how proud she'd be when she kicked OCD's butt. And we'd make huge deals out of every little success. I'd also tell her that if she couldn't find the courage to be brave at drop off time, then I'd have to stop dropping her off and she'd have to take the bus instead. this usually motivated her to try really hard - the fear of an abrupt goodbye was worse in her mind than the ability to say goodbye in the lobby. It took lots of bribery and pumping up. it was exhausting and I'd cry on the way home. I don't think I ever would've forced the issue to allow someone to drag her into the building, kicking and screaming. That would've felt so wrong. But we got to school early to give her lots of time for pep talks and getting acclimated to the flow of things. That helped. Ultimately, it came down to framing the problem in a way that allowed us to be on the same team, us against OCD, with me as coach and cheerleader, her as ultimate warrior and winner. Thankfully, success on one day helps for the next. But it's still incredibly hard. Until abx kicked in, every day was a huge struggle to do all sorts of things, big and small.


For us, the key has been to make her own the battle, because really, she's the only one who can do what needs to be done. The "punishment" has come from her experiencing natural consequences - the feeling of self-disappointment and loss of doing things she enjoys when OCD wins. It's a ton of work, but she does finally internalize it and now says "will you help me fight it" instead of expecting me to make it go away. The change in mindset/ownership is what made the difference.

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I was there with my daughter last year. I could NOT physically make her go to school. She was 10 at the time, and would physically NOT go, and I could NOT physically force her. So- we switched to homeschooling, and going to therapy and working on essentially response prevention (getting her back to school a bit at a time). So sounds like, on the surface- exactly what you are going through.


It was SO hard- my daughter is an excellent student and she always loved school. I was so sad for her. We followed our psych's advice (someone who has written many books on kids with anxiety and ocd).


In the end, we were going about it all the wrong way :(


If this happened again- the first thing I would do is get on a plane to FL for intense therapy at USF. We did it this summer, and I wish we hadn't waited so long. We would/will be back again, if we find ourselves in a rough spot like that again.


So- here is what I think the psych would tell you-


you need to get to the bottom of what is bothering him. You cannot move forward without this.


Compliance is necessary. But you can balance it with what you think he can do (but be brutally honest).


Can he function at a playground, at the movies, at a playdate? Where is he on this other stuff? Is it just school?


So- you have a talk with him, lay it out. Tell him these are age appropriate expectations: he will go to school, be respectful, work on his ocd/anxiety, be compliant at home, do age appropritate chores etc. You will hold him to these behaviors, support him, and reward him. You will work together, but the big work is on him.


So- you can say, I know this is hard, so we won't expect everything right away. But- if you are not at school, we will spend that entire time working on getting to school. This would mean doing exposures, practicing, etc.


If he will not comply there are consequences.


My psych told us: parents need to give their kids shelter, safety and food. EVERYTHING else is negotiable- meaning if you have a non compliant child, you can take everything else away. We did not have to go there. We were able to regain compliance with the time out method- which I will detail later. (this is assuming that you don't get complete compliance with everything else at home).


So, totally- I get, and I think a psych would get- that you cannot force him to school. BUT- you can set up expectations that he will work his hardest (and do give him a safe place to go to, or a safe way to deal with the anxiety at school), and if not, everything is on the table (TV, Video games, playdates, all of his toys, etc.) He does not have to get back to school full day, immediately- but he does need to work with you on getting there.


I would think a really tough and qualified psych would be hugely helpful.


Do you have any gut feelings as to why he is not attending? If it is sensory stuff- then he would have problems other places- right? Does he have a learning disability that is not being addressed properly? Do you have issues with defiance at home? Does he do age appropriate things like, cleaning his room, putting away his toys, helping around the house, etc?


Believe me- I know how much this stinks, and how much it takes out of you. My 11 year old missed almost 5 mos of school last year. It drained me, and it drained her. I never want to go through that again.....

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