School needs a plan to help child be socially appropriate

[writergal]

We've been home schooling our son for the last year and he is returning to school on Feb. 1st. Today I met with part of his IEP team and gave them a print out on PANDAS and explained the various symptoms that are son is currently exhibiting. One of his symptoms is to slap his rear and make a funny high pitched noise several times a day. It's highly irritating, and unfortunately something that happens when he is anxious and agitated.

 

The school asked if we had any ideas on how they could talk with him, help him to be more socially appropriate. Obviously we'd love to see this happen. Formerly they had him on a point system, and we're trying to explain to them that he has brain inflammation.......does anyone have any ideas? Have you tried anything that has helped to minimize the unpleasant "behaviors", but not set your child up for failure?

 

I'm getting some blood work back on another of my children and going over the test results with Dr. T tomorrow, and will be asking him for ideas as well. I would really appreciate any thoughts or ideas on how to help our son. Our son is 9, in third grade and he thinks it's funny to slap his but and make funny noises. Basically he is extremely obstinate and will not listen. If he wants to do something he does it. We've talked to him numerous times about various behaviors, etc. and it just doesn't matter. If he wants to do something, he does it. Will ask him, is it appropriate to....ie, run outside without your shoes on in the snow? Is it appropriate to walk in the snowbank with your tennis shoes? Today I had some success. Instead of getting upset, I had him look at me, and reminded him that there was snow outside, we were getting out of the car and he did not have his boots on. He can only walk in the snowbank when he has boots on. Did he have his boots on? No. Was it ok to walk in the snowbank without boots?? NO.....and he actually listened.

 

Thanks!

 

Julie

[peglem]

Are you sure these behaviors are things that he just wants to do, rather than things he is compelled to do? It sounds more compulsive to me. If its just behavioral choices, then behavioral techniques should work. But if he's dealing with compulsions, its likely the anxiety that comes from not doing it is stronger than external rewards/punishments. It can be difficult to determine the difference between compulsions and voluntary behavior because the mind tries to make sense of it by providing reasons and/or the child is afraid to say what's going on.

So, if it's compulsive behavior, he'll need to be taught how to fight the compulsions and deal with the anxiety. Their are parents on here who are way more knowledgeable than me about how to do that. I hope they'll chime in here.

[LNN]

My son went thru a period last year where he was exhibiting highly inappropriate behaviors in school. he was in the midst of a herx that looked all the world like a Pandas episode. Got calls from the teacher, we had lots of talks, loss of privileges...nothing worked. So I started giving him 1/2 dose of Aleve in the mornings (works for 8 hrs). Two days later, I got an email from the teacher patting herself and me on the back because we'd finally 'gotten thru' to him. The behaviors stopped.

 

You're forunate to have teachers trying to understand and asking for input. But they also have to control the classroom and they won't always be able to accept the behaviors the way you might at home. Anything you can do to reduce inflammation "should" help and enhance the behavioral plans.

[bronxmom2]

I just want to concur that the behavior charts are not going to work and will probably just undermine your son's fragile self-esteem. My son exhibited lots of behaviors that seemed (like your son's) to fall between impulsive and compulsive. He is also 9.

 

Advil or Aleve in the morning to address the inflammation are a good idea. I also give my son fish oil every morning, though I'm not sure it does anything.

 

For us, adjusting his brain chemistry with a low dose of Strattera has been a magic bullet. BUT... we were pretty far along in the healing process (3 years of abx, PEX, multiple IVIGs) before I did this, so I did not do it when he was exhibiting his most maddening and inappropriate behaviors. He was better, but still struggling a little bit and I was confident that his remaining issues were not going to resolve without some additional help.

[beeskneesmommy]

Immediately upon reading your description, The behaviors struck me as compulsive - Just like light swtching, counting, insuring symmetry, etc. These behaviors can be very annoying, and I often have found myself addressing them with irritation and yes, even time outs in the past, until I saw that my little boy was unable to stop himself. Have you done any CBT?

[writergal]

No we haven't done any CBT. I think this is next on the list.

 

And I agree - I believe that this is compulsive- the sudden "need" to slap his rear and make loud noises. His last compulsion was to tell everyone multiple times a day that he was going to kill them and poke their eyes out...fortunately he cycled through that one.

 

I understand that the school wants to have some type of plan in place, but their current process is not taking into account that we are dealing with a compulsion and we need to handle it that way. And yes, I'm concerned that putting a plan in place will further harm his already fragile self esteem.

 

I'm wondering if he can just have a card, or something that he gives to the para that indicates he's having a problem and then he can leave the classroom and go to the bathroom and go through his compulsion.

[writergal]

Thanks for the idea to give him Motrim in the morning before school. It would be awesome if this would help.

 

We've also talked to the school about scheduling an AVE session with our unit in the middle of the day to help calm him as well.

[LNN]

You can also get a doctor's note (our school has a form they need a doctor to sign) that allows your son to take motrin while at school. We tried that but it was cumbersome. They wouldn't take my son's word for it when he asked, so I either had to send in a note that morning - it was confusing for the school, as they don't like to do "as needed" or be in a position of interpreting things. They want things spelled out. So we ditched the motrin and went with the aleve once he weighed enough (@55 pounds I think).

 

Yes, you should be able to get him a pass to leave the room when he has the urge. Then it will be a matter of training your son to recognize the building premonition/need to do the compulsion while there's still time to ask for the pass. Like someone potty training, there may be times he's "too late" and does the compulsion without thinking about the consequences. It's a tough thing for someone who's brain isnt' all there. So I would ask for it, but prepare them for failures early on or see if you can get him a pass that's always kept at his desk - something he can grab quickly without having to get called on or explain himself.

 

As for CBT - it is a very powerful tool. ERP is harder (IMO) but is also worth looking into. CBT can be made to be very intuitive,even for younger kids. We use it in our house every day. It's just "normal" to us now and is a big help.

[smartyjones]

I understand that the school wants to have some type of plan in place, but their current process is not taking into account that we are dealing with a compulsion and we need to handle it that way. And yes, I'm concerned that putting a plan in place will further harm his already fragile self esteem.

 

I'm wondering if he can just have a card, or something that he gives to the para that indicates he's having a problem and then he can leave the classroom and go to the bathroom and go through his compulsion.

 

i am a big believer of dr ross greene -- you can google his name or collaborative problem solving. you can see if you think it might be helpful do a type of problem solving with your son to see what he thinks may be helpful for when he feels the urge. since it's likely something he can't control, he may feel powerless and have no ideas what to do. you can then discuss your and the school's concern that it can be disruptive to the class - and the subsequent cascade of events between him and the teacher may make trouble for him - and then together brainstorm some ideas about what to do -- like having a pass to go out of the room. does he actually have the before-hand knowledge that he could do that or is it a surprise to him? we don't really deal with tics, so i don't know much -- could he have a substitute thing to do in the class instead of the slap the rear - like punch a bean bag or something?

 

it's likely the school's plan will include some sort of 'consequence' for when he does it. perhpas some type practice for when he feels the urge but doesn't make it out of the room -- like practicing using the card or punching the bag when he doesn't actually have the urge so he'll be bettter prepared next time is better than something liek losing recess, that just makes him feel bad and doesn't address the issue. something in the same vein of when someone needs practice, they just need to practice -- like when ds9 isn't batting so well, he just needs to go to the batting cages -- he's not bad, he's not trying to gain something, he's not looking for attention, he's not trying to bug people -- he's just needs a little more practice gaining more skills. -- your son is trying to gain a skill in controlling/diverting a tic in a social setting -- something much harder than most of us ever have to learn.

 

we're working now with ds7 on 'what do you think other people might think and say if you say that in that manner?' the end result being their attitude will likely cause him upset -- so, if you don't want to feel upset when someone corrects you, perhaps, you can say what you think in a different way. maybe you can adapt that -- i know you can't help the slap, and - what do you think the teacher will do/say/act when you do it? since none of us really wants that , what can we do so it maybe won't be so difficult for you?