Advice needed couple different issues

ToBeMrsT

DS was diagnosed back in September with ASD and ADHD.  He is in kinder and just turned 6 in January.  He's high functioning, in a regular classroom with pull out for speech twice a week.  Privately we do speech and OT once a week.  He's under an IEP which has the speech and some accommodations-  like sitting by the teacher ect.  

The year started out really bad-  suspended twice in the first month, but settled down in October and has been fine since then.  Although I feel like we are walking on eggshells and things go could downhill so easily since the school is so quick to suspend. 

1.  First issue-  he's potty trained and has been for a few years, BUT when he poops he doesn't know how to wipe himself.  We've tried to teach him, but so far it's still really messy. We've just been hoping he would never poop at school and up until today he hadn't.  Today he did and he did not wipe well.  It was a mess all of his underwear and pants.  It happened 15-20 minutes before the end of the day and he did not tell anyone so his teacher didn't even know.  I found out when we got home.  What do I do?  We've never talked to the school about this because our district tolerance level is so low.   We learned that pretty quickly at the beginning of the year with his suspensions.  advice?

2. He's medicated because he used to get very angry and act out.  He's so much better now and has learned to cope so well.  He's doing well in class and is getting good marks daily. A few times a month he still struggles in PE-  just being wild-  spinning, running around, not listening.  

He's taking Kapvay and Risperidone twice a day.  On the weekends our doc said it was fine to skip the morning meds if we felt like it so we've been doing that for the past few months.  I was pretty convinced that he was in such a good routine at school that I felt like we could skip the morning dose before school as well (still getting his nightly dose).  So today we did and he did well in class, but got in trouble in PE (spinning, pushing, running).   I don't like that he's acting out in PE, but I also feel like it might be time for them to learn a different way to handle him if he's doing well in class. Advice?  thoughts?  

ToBeMrsT

Ok so don't tell them them about the wiping and just cross our fingers that it doesn't become an issue.  Thank you.  

When he takes his regular dose in the mornings he usually does fine all day including the 45 minutes in PE (PE is at 1:45pm).  

You're right he's not on a med specifically for the adhd and it might be time for that.  Back in August/Sept we started with Focalin which either made him really emotional (lower dose) or zombie (higher dose) so we stopped that.  After that we tried Vyvanse and it was the same as Focalin.  He was still pretty angry when getting upset so we tried the Kapvay and we saw a huge change at home, but at school it wasn't enough so the doc added in the Risperidone.  The two together worked well.  

It's just hard to medicate him for this one thing when he's doing well in everything else. 

d.f

1). My DS refused to wipe his own butt up until about a month into Kindergarten (this year). I pushed ,incentivized, and rewarded him for it and it finally worked. He still takes forever and he still gets a sticker for it but he does FINALLY wipe his own bum. My kiddo had a rough transition to K too. He's in the mainstream classroom 91% of the time with pull outs. He pulled it together pretty much as the ink dried on the form giving permission to do the evals for a Functional Behavioral Assessment. We still haven't met and implemented the behavioral plan yet but since he's been doing well for a while we haven't pushed very hard. I don't have med experience at this point.

ToBeMrsT

Poor motor skills.  He just can't do it without making a mess on himself and his hands.    sometimes the toilet too. 

If I medicate for PE it has to be every day.  They have it for 45 minutes every afternoon.  It's all they have-  they don't have art or music.  

We have a doc appt on Monday.  I'll talk to her about trying something else for the hyperactivity. Maybe he can take it at lunch time since PE is in the afternoon.    

He does fine at recess and lunch - and no music class.  

An aide would definitely work.  I don't think they would give him one though.  When he was suspended twice in that first month they finally gave him an aide part time in the class just to get him through the day.  As soon as he started improving they took the aide away.  

APE class might work if the school has one, but that would mean less time with his class since it would probably be at a different time of day.  I don't really mind that, but I know the goal is to keep them with their peers as much as possible.  

ToBeMrsT

d.f said:

1). My DS refused to wipe his own butt up until about a month into Kindergarten (this year). I pushed ,incentivized, and rewarded him for it and it finally worked. He still takes forever and he still gets a sticker for it but he does FINALLY wipe his own bum. My kiddo had a rough transition to K too. He's in the mainstream classroom 91% of the time with pull outs. He pulled it together pretty much as the ink dried on the form giving permission to do the evals for a Functional Behavioral Assessment. We still haven't met and implemented the behavioral plan yet but since he's been doing well for a while we haven't pushed very hard. I don't have med experience at this point.

I need to work harder.  Thanks for suggestions. 

joshsmandy

My son was having issues with not cleaning well, I bought him flush able wipes and problem solved. I think it may be the difference in texture, toilet paper is a little more rough then the wipes are. Good luck

d.f

It's gross and we have to take the bathroom trash out daily but my kid isn't allowed to flush his toilet paper anymore. He gets himself clean. He's very detail oriented in that way. I don't know that it's a matter of working harder. It took forever with my DS. He poop trained almost a year after pee training and. NOTHING I did got him there faster. Then it was over a year later before he'd wipe his own butt. I only pushed because I knew there would be social liability in K. Then it was a matter of finding what would work. A lot if things didn't and just increased hi anxiety around it.

ToBeMrsT

Thanks for all the suggestions.  I think getting some flushable wipes in the bathroom could help and I'm going to work really hard with him.  

Auntie, if PE does become an issue where do I start?  Do I talk to the coaches first, principal?  Or call an ARD meeting first?  

I think I'll talk to our doc about something to help with his ADHD symptoms since I'm trying to back off the other meds.  His anger is so much more controlled now which is such a great thing.