ADHD 6-year old crisis-level behavior... - CHADD's ADHD Pare...

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ADHD 6-year old crisis-level behavior in school

mrl12 profile image
mrl12

Hello folks. My 6-year old daughter in first grade has been having an extremely rough go of it since her school returned to "normal" (full-day schedule, five days a week.) She has been having major meltdowns in class. They seem to occur on the same days (Mondays and especially Fridays) and always at the same time of day. They get worse every time, resulting in her exhibiting aggression towards teachers and even other students, climbing on furniture, and throwing things. It's a major scene in front of her classmates and now she feels ostracized and completely alone with no friends. She's been suspended one day, and we can't get through a single day of school without being asked to come pick her up.

We just started her on long-acting ritalin, so she's been on that for five days with no noticeable differences yet. We're at a loss with how to help her. I know she's hurting and I just want for me and the school to be able to help her, but they're ineffective and, I think, unknowledgeable. They seem to think her behavior is attention-seeking and they reward her with the sensory room for good behavior, but they don't use it in any other way.

It's impacting my job now, as well, since I'm constantly distracted with my concerns for her and being pulled away to pick her up early. What a mess. Any advice?

22 Replies

Thanks for your message, many of us have been in your shoes. The 3 tools that help most are: educational plan ( IEP or 504 plan), thearpy and medication. Medication is really helpful when it works. We really saw a difference for.oir son when we saw a child psychiatrist. Type, dose and timing are all very important. We were told that the reason all 3 tools work best together is that medication only controls 60% of behavior and the school plan and therapy help with the rest of the behavior.

This journey has its ups and downs but these tools help the most.

Hope this helps, hang in there hope you can get it all dialed in ti help her.

Take care,

Does your daughter have an IEP or 504? With what you stated about her behaviors occurring at the same time and on same days, it does make you wonder about a triggering or reinforcing event happening at or after those times. Has the school conducted a functional behavioral assessment? (understood.org/en/school-le...) By law they are required to if behavior is impacting her ability to access the curriculum or results in a change of placement (arguably, having to go home) and they have reason to believe she is a person with a disability. If you live near a university, the special education department of their college of education might even be able to give you names of individuals trained in ABA who can conduct these. Your daughter’s pediatrician may also be a resource and advocate in this process.

Onthemove makes excellent points about the need for a holistic plan to turn things around. Regarding the school plan portion of these, it is helpful to know your rights and options in order to advocate effectively for the best plan. If you haven’t already, consider reaching out to your local parent resource center for more information. You can find your states center here: parentcenterhub.org/find-yo.... Each state also has a protection and advocacy center that consists of attorneys and advocates who educate and represent families and individuals in ensuring their rights under federal law are protected. You can find yours here: acl.gov/programs/aging-and-... by clicking the last bullet on that page.

I’m so sorry you and your daughter are going through this. My son had some similar problems in first grade. I think what helped us the most was him seeing a play therapist. She was so calm and steady and kind to him and to us. It was the total opposite of school! At first, his play was super aggressive with animals attacking each other and things like that. But as they went on things shifted to less violent, more creative and etc. It not like he was “cured” - he’s in 3rd grade now and still having challenges. But they are more manageable. I was told that it’s the relationship with the therapist that is so valuable for the kid’s self esteem, to have a non-parent adult who respects and accepts them.

The attention-seeking thing from the school really bugs me. Someone explained to me that with severe ADHD, self-regulation is so difficult that kids often need total stability around them to stay regulated. Eg, trusted adults, familiar home environment... when these are removed they just can’t keep it together, and not being able to control oneself is scary, so it’s a downward spiral -> meltdown. It’s why Mondays are bad, transitioning from the comforts of home ... and Fridays are often tough bc the poor kids are exhausted from trying to hold it together all week.

I feel you on the work thing. Getting those calls from school or camp when trying to work is one of the most gut-wrenching experiences I’ve had. It’s so hard.

Hugs to you and your sweet girl. Hang in there mama, you’re doing a great job.

P.S. sorry to assume you’re a mom vs dad.

Sorry I don’t have advice for you, but just wanted to send a virtual 🤗 hugs to you and your beautiful child.

My heart goes out to you. My son did this exact thing in kindergarten, though he also ended up wetting himself and stripping all his clothes off. I laugh in hindsight, but it was horrifying at the time, so I completely understand.

Mondays and Fridays are telling since they mark the beginning and end of the school week: pressure to start the week and pent up tension at the end. You may want to visit with the doctor about anxiety. This is something Ritalin doesn't address. And it's a major symptom for kids with ADHD (and ASD in my son's case). The other piece I want to second is an IEP and a Behavioral Intervention Plan. My husband and I also work with a special education advocate. She has been wonderful at helping us navigate the IEP process and advocate for my son's needs.

My son is now a relatively well adjusted soon to be 4th grader so there is light at the end of the tunnel.

Look up Pax Good Behavior Game. Mention to teacher. See these Pax Tools for parents for things you can do. Give the medication time to work but keep the psychiatrist informed. You are surrounded by people who have lived this on here. These tools are what I call the "bells and whistles" that go along with GBG. Each one has been researched, tested and refined. A doctor Dennis Embry combed through the behavior world finding things that worked and reducing them to their smallest components that are the nuggets that can't be misused or misunderstood. In 1999 at the Columbine Shooting Conference he met a Johns Hopkins professor Shep Kellum, who had used GBG in a study of Baltimore first graders in 1984 and followed the kids for 15 years. GBG was a brain changer and Embry tweaked it and improved it. These tools will make your life better and help improve your kids behaviors, but the GBG part actually changes the structure of the prefrontal cortex where decision making and self-control are developed. GBG actually exercises the brain in self-control by getting kids excited in class by winning team contests in which the prize is a physical activity e.g jumping jacks. and then having them get back to work. Done several times a day, the kids develop their own control instead of a teacher having to tell them to sit down. this then has tremendous effects on behavior all through their lives.

Pax Tools intro

youtube.com/watch?v=t952q7_...

Pax Breaks

youtu.be/0KgkB8LOgAg

Working from home

youtube.com/watch?v=DYsx5FB...

One reference of many you can google on Pax GBG:

NIDA Notes. “Behavior Game Played in Primary Grades Reduces Later Drug-Related Problems.” Volume 23, Number 1, April 2010. National Institute on Drug Abuse.

drugabuse.gov/news-events/n...

I relate to everything you are saying. My son was in first grade when things got really bad. He found success with broad spectrum micronutrients recommended by the psychiatrist. There are two companies, Hardy Nutritionals and True Hope. He has been on the Hardy DEN for two years and has had a complete turn around. They may be an option for your daughter that you want to explore.

Garden8871 profile image
Garden8871 in reply to Cjkchamp

Can I ask what dosage did you start out with? Did you use capsules or powder?

Cjkchamp profile image
Cjkchamp in reply to Garden8871

We use capsules. He started with one pill twice per day. Then it was increased to two capsules twice per day. Then two capsules three times per day. Current dose is four capsules in the morning, four in the afternoon, and three at night.

Garden8871 profile image
Garden8871 in reply to Cjkchamp

How long did it take to see a difference? Any change in appetite or sleep?

Cjkchamp profile image
Cjkchamp in reply to Garden8871

We saw slight changes after he began taking them, but noticed a real turn around when he reached the two pills three times per day. As he tapered off Focalin his sleep was what alerted us he needed a decreased dose of medications. Appetite is good and sleep good too.

I could have written this post word for word except for my son in 2nd grade. He exhibited the same exact behavior and roughly the same time of day. He has an IEP at school and I believe that is the only reason he wasn’t suspended or expelled. He was literally running out of class daily and I had to cut back my hours at work due to being called to pick him up every day. Ultimately the best decision for us (although reluctantly) was to try a SSRI for anxiety. I was extremely hesitant because I did not know what the long term affect would be neurologically. However, he (and we) had no quality of life and were just getting “through” one day to cycle into another. After a week of the SSRI , his aversive behaviors stopped and we were able to start seeing a counselor for coping skills when he is anxious. Of course medication is a decision between you and your doctor but I wanted to offer our experience.

This is such a difficult situation, and I completely empathize with you. The phone calls from the school and sadness on my daughter's face were overwhelming and heartbreaking. After trying three different stimulants without success, our pediatrician recommended genetic testing to find out what type of medication would work best for her. We found that her body doesn't use dopamine, so all we did was add extra dopamine which potentially made her symptoms worse. She is now on Guanfacine, and it has been great. Her pediatrician explained that Guanfacine is for kids that really struggle with impulse control (i.e. climbing on furniture, throwing chairs, biting peers etc.). It doesn't help as much with the attention part of ADHD, but we found once her behavior was more under control she didn't struggle as much with the attention part. I hope this helps, and best of luck!

Thank you for sharing your experiences. My son is also in 2nd grade and has been running out of the classroom since Kindergarten. I transferred schools because despite having an IEP and BIP it just wasn't a good fit. It was much better in his current school but once the pandemic hit virtual school has been better but still pretty difficult on me trying to teach, parent, and work full time. I have been trying to get him in to see a psychiatrist but between waitlist and seeing one who I am not sure is right for us, has been another very difficult task. His pediatrician gave him what I learned is a pretty low dose of Adderall which helps some but I am fairly certain that he has an anxiety disorder as well. The psychiatrist he saw once basically said he doesn't really believe in medicines or labels; which I don't believe a diagnosis is really a label. This is such a difficult path, particularly when the misconception is ADHD is just hyperactivity. It is reassuring to have a place to vent, share experiences, and know that there are others who have been in your shoes.

I hire a professional educational advocate and it has been worth every penny. She has gotten the school to provide more testing and services than they otherwise would have. And she acts as my advocate by attending IEP meetings. I recommend asking around wherever you are located for advocate recommendations and giving a couple of them a call.

Hi , I experienced similar situations with my son , now 13 and doing much better .. He was also “suspended “ in kindergarten and I’ve been told by an school education lawyer that no child that young should ever be suspended.

We were asked to leave multiple schools and only until we found a specialized learning disability school did we start to see some positive changes . Not sure if your child is in a regular public school but we finally realized that “normal “ schools are not equipped or trained to handle our child’s multiple challenges. Unfortunately even special Ed teachers are not trained to handle more severe cases .

I would search for schools geared for learning/ behavioral disabilities,. Well trained staff that don’t see our kids as “bad” along with cognitive behavioral therapy and possibly medication( and a lot of prayer :) will greatly help ..I’ve hit that “ desperation point many times but know that it does get better over time .....just hang in there .

Finding the right medication/s may take time. It can be a long process but don’t give up :)

As a teacher, we really are not trained to help when a child is having extreme behavior issues. As a mom of an ADHD ODD kiddo, I now know how to handle things. I definitely would keep trying medication, we tried 9 things before getting the right fit. Also, go to the school and demand help…504 if the behavior is not impacting academics or ask for educational testing. They will try and hold an SST, but put a request in writing for educational testing, they have 50 days…no silly meetings without any actual help. Lastly, play therapy. It took forever, but we finally found an inperson therapist. With all that, I know from September to January I was a hot mess trying to help my kiddo. It will get better ❤️‍🩹

Thanks for all of your advice and support and for sharing your experiences. It means a lot.

This is definitely the hardest it's ever been for us, and I foolishly never imagined it possibly getting this bad. Things were better (not perfect, but significantly better) during the pandemic, even. When we were in our homeschooling routine, she was even starting to thrive and her mood was steady and positive. I'm not sure what exactly is triggering her at school, but common sense is just that she's been through a lot and was expecting to get "back to normal." But back to normal for her meant what she was doing when the pandemic interrupted things--which was kindergarten. Back to normal most certainly did not mean end-of-year full-on first-grade academia, which she was not even close to being prepared for. I feel like her school made a lot of errors during the pandemic--several schedule changes throughout the year (many times we only had 12-hour notice of a schedule change), and zero addressing the students social-emotional or trauma-informed education since returning. No consideration of where the students are academically or emotionally, they're just following the standard curriculum.

She has a 504 that we put in place during the homeschooling, but we never revisited it for the return to the classroom--I should have initiated that We've had meetings, but obviously nothing has worked. I've been trying to get them to do learning and OT evaluations. I have suspicions of possible dyslexia and sensory processing issues. And now I'm also wondering if she has ODD. She has exhibited defiance at home for years, but not usually with other people or at school. I requested these other evaluations and hand-delivered to the child study team. I've also contacted a child advocacy lawyer to try to push them to expedite this considering the severity of the situation.

Yesterday was the last straw for me. She had been out for four days (due to the holiday and a day of suspension) and she was so anxious about her behavior upon returning that she was up until 1:30 in the morning. I was called twice yesterday, and the second time they asked me to pick her up. At that point, mama bear came out and I reminded them that she is 6 years old and has just been through a year of hell, told them we were all failing her, that we were the grownups and it's our job to support her and help her succeed and this is on us, not her. Then I told them I was taking her home and not bringing her back until there was a plan that could support her. I got a note from her doctor to school her remotely for the remainder of the year. So far she's resisting more than before, but at least we're not suffering the stress and anxiety of these daily outbursts and distractions.

I'm honestly not sure what we're going to do for the rest of this year, this summer, or next year, but damn I have never felt this hopeless and miserable. I'm close to tears nearly all the time, and it's so hard when you have to keep your game-face on for your kids, yet you're dying inside. Just hanging on to the knot at the end of my rope.

Thanks for listening and being there. Nobody else ever understands how hard this is unless they live or lived it.

Hi mama,My 5 year old son sounds very much like your daughter. My best advice to you is to educate yourself as best you can about disability laws related to education, have her evaluated for a private in home OT, try to get as much time for yourself as possible to help destress, and get FMLA to protect your position at work!! I went through the same thing and lost my job because I didn't have FMLA. I wish you the best.

Michele

My son acts out in the same ways so I'm doing virtual school until I get his IEP in place but it's still hard so I sympathize with you especially with worrying about the well being of your child and having to be at work with it always on your mind, I'm disabled so I am able to be with my son and it's still stressful. Luckily my son has good Drs that actually listen to me and we work together since I know my child better than anyone so the best advice I have is that if your child acts out especially at the same time and days generally, then find out what is triggering her to behave the way she is and keep asking questions about it and reassuring her that you just want her to have good days and be happy and you love her and build a strong foundation of trust with her because alot of it can be attention seeking but there's still something that is making her act out. My son is the sweetest boy but he can get very violent when he is triggered and his triggers are usually hunger or wanting to feel independent but it can be millions of things so it's just trying to find the trigger so that it can be fixed or avoided and that helps drastically. Also, I've never tried Ritalin, but my son takes Adderall but was still too aggressive and high-strung so his Drs added a colonidine with it in the morning ( because he usually just takes 2 at night to go to sleep) but adding the one in the morning has shown to be helping quite a bit. It's also a matter of finding what strength and combination works best for her specifically though and that is where you have to have trust between you and her Drs because everyone is different and my son's Dr's and I talked and I adjusted until we got a working combo and hopefully you can do the same. Also, ADHD may be part of another problem as well though because from ages 3-6 my son has been diagnosed as severe ADHD and Disruptive Behavior Disorder and now at age 6 and just finished kindergarten we are going through the process to test for Asperger's and it's definitely what he has because he is extremely intelligent and can read entire books knows his math and has since before he started school but he doesn't understand emotional issues and how to wait his turn or not Interrupt and it's all me, me , me in his world so if she is attention seeking then you might ask your Drs about that also. I wish you the best and I hope she finds the right course of action so she can enjoy being a kid and not have to go through all this anymore. I'll be praying for her!!

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