Auntie, I need you

J&A2008 · February 2013

I will never forget that you were an advocate for my child with ADHD before I knew how to be one. Thank you, again.

Do you have any experience with tics? Large movement tics? Any tips on how to deal with them?

I am in tears, and frustrated, and feeling betrayed by the school from an incident a few weeks ago. I just got an email from his teacher that he's been off-task all week and throwing paper wads, etc. He's been great at home, even working on a large social studies project and keeping on task, on schedule.

He was on a 5 mg dose of Adderall for his ADHD at the beginning of the school year. During state testing in the fall, his teacher noticed he was having difficulty concentrating and it was taking him an excessive amount of time to finish. We spoke to the pediatrician and his dosage was increased to 10 mg.

He had a marked increase in his arm flailing. We spoke to the pediatrician, but decided to keep the dosage as it was because he was improving academically.

At the beginning of last month, we decided to try reverting back to the lower dose. He seems on track academically, but the arm flailing seems to be getting continually worse. We got a new prescription for 5 mg.

In the middle of last month, he was written up for horseplay for "weird arm movements." He had been tackled to the ground by another student who said it was bothering him. Our son served a lunch detention for his "behavior." He is still on the 5 mg dosage.

I am calling the pedi in the morning and I am going to call our therapist to get an appointment. He has not seen the therapist in a while, as apart from the tic, things were going well. Now this tic issue seems to be getting larger, and I don't want it to keep him from getting the appropriate dosage.

If you have any thoughts or advice, I'd love to hear it.

RondackHiker · February 2013

Your kid was punished because another kid tackled him? The tick and special needs aside... Oh hell no. Who the eff cares if the other student was "bothered"? How is tackling okay?

I cannot get over that your son was punished for... What, being irritating in the eyes of another student? Talk about victim blaming.

LadyXaverian · February 2013

Say what?? The school knows about his existing tic? I've been a teacher for 10 years. This is crap. I'm so sorry.

dramamama2be · February 2013

RondackHiker:
Your kid was punished because another kid tackled him? The tick and special needs aside... Oh hell no. Who the eff cares if the other student was "bothered"? How is tackling okay?

I cannot get over that your son was punished for... What, being irritating in the eyes of another student? Talk about victim blaming.

This is my thoughts exactly. That's ridiculous that your child got punished for someone else tackling him.

ThePolishHammer · February 2013

RondackHiker:
Your kid was punished because another kid tackled him? The tick and special needs aside... Oh hell no. Who the eff cares if the other student was "bothered"? How is tackling okay? I cannot get over that your son was punished for... What, being irritating in the eyes of another student? Talk about victim blaming.

This!

That is just ridiculous.

RondackHiker · February 2013

I honestly feel ragey about this. Beyond the stuff I mentioned earlier, I echo PP. Does the school know about the tick? Who wrote him up, like was it a teacher who should know him?

"Weird arm movements" pisses me off a lot. Even without his tick, it's WRONG to call a kid weird. With his tick, it's cruel and unfair.

J&A2008 · February 2013

RondackHiker:
I honestly feel ragey about this. Beyond the stuff I mentioned earlier, I echo PP. Does the school know about the tick? Who wrote him up, like was it a teacher who should know him? "Weird arm movements" pisses me off a lot. Even without his tick, it's WRONG to call a kid weird. With his tick, it's cruel and unfair.

Ugh. Reading these are making me teary again.

No, it was a lunch lady, of all people, who sent him and the other boy to the office. It was the principal, who is not familiar enough with him to know his tic, who wrote up the "weird arm movements."

I pointed out to the principal that if his classroom teacher had been involved in the process, which is not their procedure, she would have been able to tell him that his arm movement is a part of his normal behavior, and not something aggressive or designed to irritate (though DH and I get annoyed by it too sometimes).

I feel like I should have been more aggressive with him, but at the time he had just transitioned to the lower dose, and I was hoping the tic would subside and life would go on.

FWIW, the write up did include some of his behavior in the classroom which was indefensible, BUT, that behavior was observed by his classroom teacher who did NOT write him up for it and instead dealt with it within the classroom, no detention given by her.

azzyberry · February 2013

You might try paging her on the special needs board. She is usually over there and is the mod for that board.

Also count me on team BS for your DS being punished for being tackled by another boy because your DS's tic annoyed him. I also don't like that it was written up as "weird". That term should not be used to describe any child for any reason.

Sorry your dealing with this.

J&A2008 · March 2013

-auntie-:

There are different kinds of tics, some are motor, some vocal, some a combination of the two. Some are fairly simple, like a jerk or blink while others are complex and can look almost ritualistic. They can morph over time, you might see a shrug for a while and then a twist or grunt might be added.
His is a pretty large movement, almost like a baseball pitcher's practice swing.

I wasn't dazzled by Tenex when we trialed it; it made DS tired and didn't do much for his impulsivity. We've not tried Strattera but I'm told it's supposed to also ramp down anxiety while improving attention. People I know who've done both claim the stimulants work better if the child can tolerate them. The other downsides to Strattera is that some people do well on it for 1-2 years and then it just seems to stop working for them and that it seems to cause GI issues in some kids.
We've already tried Strattera, and it didn't work well for him. I'll ask about the other.

About what happened at school. That's really ugly. Is your son served by an IEP or a Section 504? JMHO, not kid should be on a psychoactive medication without the school stepping up to provide the behavior mods and accommodations he needs. Meds are only 1 part of any tx plan for ADHD.

If your son has an IEP, and he was disciplined for a "manifestation of his disability", you need to jump on this. Any staff who has interaction with you son needs to be given training around his disability; training and itinerant support for staff should be included in his IEP. He is owed an apology. This was all kinds of wrong.
There is no IEP and no training.

I would be very concerned that he seems to be more able to behave at home than school. In most situations, kids reserve their more challenging behavior for home where they know they're loved unconditionally. These kids do best with clear and concise expectations, schedules and structure. Most decent teachers offer plenty of structure compared to home where things are more "on the fly" so this is sort of odd. My son was this way as well as a younger kid; teachers would talk about behavior I myself had never actually seen. He's always done best under teachers who were very organized themselves.
His classroom is very unstructured. He has a new teacher, and she herself has ADHD. She's been very good for him in that he has a teacher who gets him like no other teacher ever has, and his confidence has been very high this year. She has been overwhelmed with other 6th grade boy behavior, and for the whole rest of this year, SS has stayed out of it, but this month he has been joining in the pranks and rough housing. Kids are putting tape on each other, and there's a lot of distractions. He's been the one on track, trying to encourage other kids to settle down, but now he's joining in on the fun.

Is he an anxious kid by nature or upset about something? Increased tics and less than ideal behavior is sometimes a warning that something is going on that needs addressing. It could be an unkind teacher, trouble mastering material, a bully.
After posting last night I emailed his mother. His younger brother recently received an email from her. There has been no communication from her to them since Mother's day of last year. (They haven't seen her in five years.) I emailed her to ask her to also send an email to older SS. I don't know that contact between her and his brother (and not him) could cause more anxiety, but I can see that it might. Hopefully she'll send something to him, and then at least he doesn't have to feel left out, but, yes, he has always had a lot of anxiety stemming from abuse/neglect when he was in her home and then abandonment.

J&A2008 · March 2013

Thank you, Auntie. I really appreciate you taking the time to write all this information out and give me more to think about. It is very kind of you.

The classroom behavior and the write up are maybe two separate issues, but I can see that if he's mad at the school/principal/etc. he may feel less likely to follow the rules if he's getting in trouble for things that are not his fault. I will also talk to him about this.

AKbadwolf · March 2013

My DS is on Adderall and Intuniv.

We tried Strattera and for us it didn?t work. There was no change in behavior at all.

Intuniv helps DS's anxiety and sleep but it didn?t help for his ADHD so the Dr has us on both. The big issues with Intuniv is that it can cause weight gain (which can be a plus, my DS is underweight so we were hoping it would help balance him out) and it can mess with their blood pressure so you have to make sure you give it at the same time. It also can make them tired.

I think Auntie mentioned it but once you get the anxiety under control, tics can sometimes get smaller or disappear. My son has a tic where he picks at the skin on his hands. Seriously he always has scabs and scratches from picking at it but with the Intuniv it has lessened to the point he is not causing scars right now at least.

I would also push for a 504 or IEP. Both have been a lifesaver in dealing with problems like this.

PrideandJoy29 · March 2013

That's terrible!

J&A2008 · March 2013

AKbadwolf:
Intuniv helps DS's anxiety and sleep but it didn?t help for his ADHD so the Dr has us on both. The big issues with Intuniv is that it can cause weight gain (which can be a plus, my DS is underweight so we were hoping it would help balance him out) and it can mess with their blood pressure so you have to make sure you give it at the same time. It also can make them tired.
I think Auntie mentioned it but once you get the anxiety under control, tics can sometimes get smaller or disappear. My son has a tic where he picks at the skin on his hands. Seriously he always has scabs and scratches from picking at it but with the Intuniv it has lessened to the point he is not causing scars right now at least.

Thank you! We have been watching his weight since he is in the 17th percentile. Intuniv might be good for him. He also picks at and chews the skin around his nails. It's not as bad as it was, and he no longer chews/picks until it bleeds, thankfully, but it would be nice if there is something that would help him control this.

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