Okay, I am admittedly ignorant re: the bump's set up, so I am sure I'm missing your reply in some obvious way, but I'm not seeing anything in my inbox. Please feel free to C&P your response here, or I can PM you my email address.
LOL-- not stellar is putting it mildly. My PM was actually asking you if you or anyone you knew had any recommendations for a top-notch psychiatrist in FL, preferably Orlando or south, but we're willing to go anywhere if it's someone who's worth the trip.
For background, DS was dxed with autism at 3.5. We have always dealt with tantrums and aggression, but we have seen a dramatic increase in severity since school started, and both his behavior team (which includes a BCBA and two BCaBAs) and DH and I are no longer convinced that his behaviors are attributable solely to ASD. He will go from fine one minute to completely out of control the next, and there is a deliberate nature to the rages-- he'll flat out tell me that he wants to hurt me/his teachers, he's started seriously upping the risk-taking nature of his actions (climbing on furniture and jumping off, licking his fingers and reaching for outlets, etc-- things that he knows can't be ignored), and the episodes go on for hours at a time. His current psychiatrist just started him on risperdal, but is reluctant to explore beyond his ASD dx at this point. We're wanting to get a fresh set of eyes on the situation, and obviously would prefer to get an expert's opinion. If you have any suggestions, I would greatly appreciate them!
The way I read the post was that you have a MIA mod on that board and wanted someone to delate a meanspirited post. LOL. It's been a rough couple of days at Chez Auntie. Sounds like things have been tough for your family, too. I think you're wise to have him re-evaluated; can you start this process through your district as well since this behaviors have a new, escalated feel to them. I would think an FBA might help get a handle on why he's melting down. It's great that he's getting ABA, but an expert outside the situation would be better for this. The whole fresh set of eyes thing.
Part of the current situation is that we switched him to a private program this year. We could go back through our district if this continues to deteriorate, but the entire ESE dept has been decimated over the last two years, and the worthwhile resources/professionals/teachers are stretched thin at best. We moved him to this new program for several reasons, but mostly because it offers a much lower student:staff ratio, and caps the class size at 12, two issues that we had a lot of trouble with at his previous elem. The entire staff is trained in behavior techniques, his teacher is a BCaBA, and the educational director is a BCaBA. We have brought in our own BCaBA to observe, and the former director of our local CARD office (we're just north of Palm Beach, so the FAU office) who is a BCBA has been in to observe as well. All agree that the major function of the behavior is to gain control and avoid tasks, but the strategies that have been implemented have not been successful on a consistent basis. There is a sense of this being an extended extinction burst, but what dissuades me from accepting that as the full answer is that the episodes extend beyond the individual moment. For example, if he's behaving like this to avoid school, then it would stand to reason that the meltdown would end once he was home, but it almost always continues at home.
-auntie-:
I don't know anyone on the ground in the MCO area. Have you contacted CARD at University of Central Florida? There should be a support group associated with this location that can probably fill you in on who is good in addition to the staff.
Good idea, and I have tapped into the former director of the local CARD satellite office, but I will check into the other CARD offices as well.
-auntie-:
How long has he been on the Risperdal? That typically helps kids settle; they often start with a tiny dose to control for side effects. A lot of kids start at once daily 0.25mg, some need it twice to get any effect.
He started 0.25mg Risperdal on Wednesday afternoon, took the same dose about 45 minutes before school started on Thursday morning and had a full scale meltdown an hour into school. Continued to have smaller episodes over the course of the morning and afternoon at home, despite getting a second dose following lunch. Per his psych, we upped his dose to 0.5mg 2x daily starting today, and things do seem to be better, but he didn't have school today, so we haven't had a true test yet, as school is most definitely more of a trigger than home.
-auntie-:
It may be that what you are seeing is all ASD. Sometimes kids' behavior gets worse before it gets better. It's like the raised behavioral expectations at home and school meetingand increased maturity/bandwidth in sustaining tantrums creating a perfect storm of unregulated behavior. Most do settle as they approach puberty, but you need help sooner.
Agreed.
-auntie-:
Have they done any social thinking or self regulation programs in his class. Something like Superflex or The Alert Program?
We utitlize the principles of both at home, but to my knowledge they don't use either program at school. The thing with DS is that when he is calm, he takes everything in, and can readily tell you exactly what he should do in any hypothetical situation, but when he is in the moment, he is completely incapable of pulling any of that info up. He shows remorse after the fact, and again, can tell you what mistakes he made and what he should have done differently, but if you were to drop him into that situation again, 9 times out of 10 he'd make the same mistakes.
Karalyn44
member
Re: -auntie- YGPM
LOL-- not stellar is putting it mildly. My PM was actually asking you if you or anyone you knew had any recommendations for a top-notch psychiatrist in FL, preferably Orlando or south, but we're willing to go anywhere if it's someone who's worth the trip.
For background, DS was dxed with autism at 3.5. We have always dealt with tantrums and aggression, but we have seen a dramatic increase in severity since school started, and both his behavior team (which includes a BCBA and two BCaBAs) and DH and I are no longer convinced that his behaviors are attributable solely to ASD. He will go from fine one minute to completely out of control the next, and there is a deliberate nature to the rages-- he'll flat out tell me that he wants to hurt me/his teachers, he's started seriously upping the risk-taking nature of his actions (climbing on furniture and jumping off, licking his fingers and reaching for outlets, etc-- things that he knows can't be ignored), and the episodes go on for hours at a time. His current psychiatrist just started him on risperdal, but is reluctant to explore beyond his ASD dx at this point. We're wanting to get a fresh set of eyes on the situation, and obviously would prefer to get an expert's opinion. If you have any suggestions, I would greatly appreciate them!
Part of the current situation is that we switched him to a private program this year. We could go back through our district if this continues to deteriorate, but the entire ESE dept has been decimated over the last two years, and the worthwhile resources/professionals/teachers are stretched thin at best. We moved him to this new program for several reasons, but mostly because it offers a much lower student:staff ratio, and caps the class size at 12, two issues that we had a lot of trouble with at his previous elem. The entire staff is trained in behavior techniques, his teacher is a BCaBA, and the educational director is a BCaBA. We have brought in our own BCaBA to observe, and the former director of our local CARD office (we're just north of Palm Beach, so the FAU office) who is a BCBA has been in to observe as well. All agree that the major function of the behavior is to gain control and avoid tasks, but the strategies that have been implemented have not been successful on a consistent basis. There is a sense of this being an extended extinction burst, but what dissuades me from accepting that as the full answer is that the episodes extend beyond the individual moment. For example, if he's behaving like this to avoid school, then it would stand to reason that the meltdown would end once he was home, but it almost always continues at home.
Good idea, and I have tapped into the former director of the local CARD satellite office, but I will check into the other CARD offices as well.
He started 0.25mg Risperdal on Wednesday afternoon, took the same dose about 45 minutes before school started on Thursday morning and had a full scale meltdown an hour into school. Continued to have smaller episodes over the course of the morning and afternoon at home, despite getting a second dose following lunch. Per his psych, we upped his dose to 0.5mg 2x daily starting today, and things do seem to be better, but he didn't have school today, so we haven't had a true test yet, as school is most definitely more of a trigger than home.
Agreed.
We utitlize the principles of both at home, but to my knowledge they don't use either program at school. The thing with DS is that when he is calm, he takes everything in, and can readily tell you exactly what he should do in any hypothetical situation, but when he is in the moment, he is completely incapable of pulling any of that info up. He shows remorse after the fact, and again, can tell you what mistakes he made and what he should have done differently, but if you were to drop him into that situation again, 9 times out of 10 he'd make the same mistakes.