6 year old aggression in school + Type of Therapy? NYC or Westchester

[missbonafide]

Hi Fellow Parents of ADHD kiddos -

my son is 6YO in 1st grade. He started guanfacine non-stimulant in spring 2022 to help with his impulsiveness & aggression that was impacting school setting. The teachers saw an improvement pretty quickly and he ended Kindergarten on a good note which was a relief. They also added a behavior para to support him around Feb 2022.

Now for 1st grade. He started this school year strongly. We didn’t get calls or incident reports for first 4-5 weeks of school. So we thought finally everything was in place. But in mid October those same behaviors from Kindergarten started up again:

Not engaged with his work

Not finishing work

Defiant / saying no to everything offered

Impulsive and taking items that don’t belong to him

When para corrects him he will be aggressive and has been hitting his para

*sigh*

We will be chatting w doctor to see if perhaps now is a good time to try a stimulant in addition to Guanfacine and see if it helps. We were going to wait until maybe 2nd grade when school was more demanding for the stimulant but looks like he may need more support now.

My question is since he’s still young what have you guys done in regards to therapy w that age group ? Have you found success w therapy? We are thinking therapy outside of school May help however I spoke with a NeuroPsych and she said therapy for him will not make a difference and the issue may be that the school needs to change or the setting needs more accommodations 😫.

For reference in school he gets OT and counseling plus SETTS teacher for writing support (he has dysgraphia). And he has a 1on1 para.

*he takes 1mg of guanfacine in morning and 1mg in evening - we use a pediatric neurologist for medication as we haven’t found a child psychiatrist yet that takes Cigna or that is taking new patients 😑

Looking for any insights or experience from those of you that now have older kids that could share advice when your child was this young of things that helped.

also any referrals of providers in NYC or Westchester if you live in this area would be appreciated— for therapy or medication management.

Thanks in advance.

[Onthemove1971]

It sounds like you know when things are working. Our son takes both a stimulant (Guanfacine) and Ritilin and it is an amazing combination when taken at the right dose and time. Since the medication he takes now doesn't help with his impulsive behavior, I hope if you try it you too and help him.

We have also, done private therapy with me and him together, so I can bring up things he needs to be worked on. I also then have someone to help guide me on how to handle situations wirh him, which changes as he matured.

It really sounds like you have had wonderful support in the school.

Hope you can make some medication to his program.

We are alway here for you.

[FrankenMummy]

You almost sound like you could be describing my son, who's also in first grade, on guanfacine ER 2mg, but he takes his at night all at once. We trialed concerta and adderall for him and stopped them both very quickly due to increased aggression, impulsivity, and sever emotional dysregulation. The only difference is the lack of support from the teachers at school. We're in Putnam county, and not sure where you are, but we've been having a terrible time finding a therapist as well. We did have success with the BOCES IDT program, but it seems like it wasn't enough support for him to transition back into school, specifically he went to the program at southern westchester boces which was amazing. Just a thought if he's having increased issues in school, you can always ask for other resources through the school system. Hopefully they're better than ours, we had to hire a child advocate to help us navigate it all all and we're still doing so now. Good luck, I hope that it all works out for you, I feel like everything with school seems to be an uphill battle for these amazing little humans who are forced to conform to a system not made for them.

[julieboolie]

Hi! I'm sorry to hear your update. I can definitely relate. My son is in Kindergarten and sounds similar. He's tried stimulants several times and all made him more aggressive. He just got his IEP a few weeks ago and they're working with him more now, but the special ed teacher had to resign (family emergency) and the new one isn't as good and is still getting to know him. 9I'm a bit envious of your 1:1 para!! :)) We currently have him on Clonidine and started Abilify a few weeks ago. They seem to be helping some. He's still challenging and angry and uncooperative, at school especially. Melt downs are a bit shorter now and he seems a bit less fragile. The newest medication takes weeks to reach full potency in his system, I'm told, so I'm hopefully it'll continue to help.

We have/had a behavior coach at home for him which was somewhat helpful. A lot of training for us as parents and coping skills for him, but what I'm learning is that until he's a bit more stable, which the medication is supposed to help accomplish, most of the tools can't really be implemented. He's too upset and out of control to apply it. Some has been helpful but most is beyond his ability at this stage. Therapy might be the same for your son?

Many here have talked about the right med at the right time. The addition of a stimulant is something I expect we'll try eventually. Once the anxiety part is more under control. Academically my son is struggling and is unwilling to do the work in class. It'll be interesting to see if they move him to 1st grade next year. Kindergarten is way more intense and less fun these days. How do they expect 5-6 yo to sit for 7 hours a day and then assign homework? My son melts down when I try to do work at home with him, and to be honest, I don't see what value it'll add. I don't make him do it. He needs some play time and to runaround and be outside.

Anyway, just wanted to share our experiences fwiw. Hope you can sort out what'll work best for your son.