Hi Dr,
I hope you are well.
I apologise for troubling you with this matter, but I was hoping to get your thoughts on this, that we could hopefully discuss on our next catch up with James.
As I mentioned at our last meeting, the difference we see with James on the 27mg doesn’t seem to be as noticeable in regards to school work, behaviour and homework as before. In fact, over the last month we’ve been seeing a lot of the ‘lash-out’ style behaviour from James and it seems to be an issue with his inability to focus or stay focused. Obviously when he isn’t on the medication we can see the significant hyperactive change in his behaviour, but essentially our reasons for medicating were to assist him with his education and socialisation with peers.
We had a major incident at school last week Tuesday when a lady who is new to teaching, got annoyed with James. An incident occurred on the playground where another boy was hitting and punching James in the head because he’d been caught out by James in a game of handball. James tried to ask this child to leave him alone, but after repeatedly having to deal with being hit, James’s frustration took over and he ended up kicking this other boy.
Of course when this other boy reported James for kicking him, James shut down (he doesn’t like or trust the teacher) She then proceeded to make a spectacle of James by sitting him up front of the class. James’s nervous ticks kicked in and he ended up tapping a ruler on the desk – this annoyed the teacher who then made him sit on the floor by the door of the classroom where he continued to take his finger against the door. 40 minutes later the teacher had had enough and sent him to the deputy principal’s office (whom he likes) where he managed to calm down and told her what had occurred.
In the phone call to discuss this incident, the teacher failed to mention that she had spent the better half of an hour yelling at James at the top of her voice (loud enough for children from the next classroom to peek through the windows to see what was going on)Several friends (parents of children in the class) also rang me to re0tell what their children had told them that evening. The part that particularly broke my heart was when he was telling me about the teacher making him sit on the floor by the door, his words were "then she made me sit on the floor by the door like a dog!"
The next morning I was in the school office at 8am wanting to speak with the principal who was unfortunately not in that day so I had to see the deputy principal. I was extremely angry that James had been treated in this manner and demanded some sort of action from the school. They then agreed that this new teacher does require some extra training on how to handle children with ADHD. We worked through a plan of action for the classroom and for James to cope at school – After a few hours, I felt satisfied that they now understood my view on the type of education they should have been offering my son.
The unfortunate issue here being is that the department of education does not identify ADHD as an Autism spectrum diagnosis for which the school can obtain the learning and teaching resources they would need to assist James. So I do have an ulterior motive to all this reading and research. James needs help and the only way he will get the kind of help he needs is if we can somehow fit him into a category that the DOE will recognise as needing assistance.
I’ve been doing a lot of reading, in the hopes of finding alternate ways to assist him with the issues that he is experiencing and a lot of what I’m reading about SPD and Aspergers is hitting home on several points.
In relation to the SPD and Aspergers, some of the traits that stood out for me include:
· Extra sensitive to touch – I’ve explained briefly below
· Sensitivity to sounds – Covers his eats very regularly when he feels overwhelmed – there may not even be excessive noise, but the sound contribution to the sensory overload seems to be the final straw
· Picky eaters –I’ve explained in detail below – not something he can really help though.
· Hyperactivity – mostly when off the meds / late afternoon and evenings
· Fear of crowds – our solution to this was to get him ‘wheelie’ shoes – he doesn’t seem to have this problem anymore, thankfully.
· Excessive risk taking – for example: a million reminders to check before crossing the road and he still walks out in front of cars – it’s not intentional, but happens every time and we are extremely fearful for his safety
· Avoidance of sensory stimulation – See above and below explanations
· Easily distracted – particularly by noise, movement, and touch.
· Struggles making and developing friendships – he finds it hard to talk to others and he has big issues with participating in large group activities
· Selective mutism – This is happening a lot more recently – he is shutting down and refuses to speak to teachers of peers at school – this in turn is making it difficult for teachers and school to determine his needs and assist
· Empathy – I think in James’s case its more about feeling remorseful than empathetic. He can put himself in others situations and understand how they are feeling, but he isn’t always remorseful if something has gone down that he feels wasn’t his fault or was the result of someone doing something to him first. I think the overriding response is fear of getting in trouble
· Eye contact – he will not do this unless prompted. At home we obviously make a point of doing this every time we speak to him or he to us, but the teachers are saying he struggles to make eye contact with them in class – I wonder if this is more of a lack of trust with his teachers than it is an inability to make eye contact?!
· Social awkwardness – he is now particularly struggling with friendships – if he makes a close friend he is struggling to understand that that friend may have other friends he wants to spend time with – James feels left out and angry in such situations despite us explaining it to him. Truthfully though he seems to ‘know’ a lot of peers but doesn’t really connect with them and form proper friendships. He often spends his time at school alone because as he sees it, he doesn’t have any friends to play with.
· Narrowed interests – this is very much James – once he finds something that interests him, nothing else seems to factor in for him and he can even get quite annoyed/angry/distressed when we encourage him to leave what he is doing to experience something else. Despite knowing this is his reaction, we absolutely make a point of limiting his time on the things he is so focused on and almost force him to do things he wouldn’t choose to do.
· Sticking to routine – if we don’t work on a routine, James will fall apart – he likes structure and order and absolutely needs to know where he stands with time – we have routine for almost everything at home and provide a running countdown on his activities so that he can mentally prepare himself for the next thing. He seems a lot more focused if he has a time limit on something that he can work towards achieving something.
· Literal interpretations – oh boy – this is a tough one – we find it so difficult to joke with him sometimes as he takes everything at face value. The difficulty arises at school often as other kids will say things to James in the heat of the moment that he will then obsess over and have a meltdown over. (A child last week told him to stop acting stupid at school – he was so distraught because he knows he isn’t stupid and why would this other child think that he was stupid)
James’s eyes hurt because he has to try to focus on what he is doing so much more because his brain isn’t always processing as it should. I guess he feels that if he sees it, then hopefully some part of his brain will remember it. His sense of smell is greatly heightened, which as you can imagine causes issues with food and going new places. He is extremely sensitive to sound, his brain is already working overtime to accommodate for the lack of attention and focus, loud noises – definitely a no-go. As you can imagine his taste buds are off the charts – bland food with minimal flavour must surely be a boring way to sustain yourself.
James doesn’t like anything runny/saucy; he refuses to touch red meat as he cannot digest it and being constipated is not pleasant, he doesn’t like certain textures or smells. We are super lucky that he doesn’t mind the colour of his food. He also doesn’t like pasta (slimy texture), potatoes (grainy texture), tomato (too wet/slimy), any dairy (too creamy and thick on his palate) and vegetables of any kind (each one has a texture he cannot handle). And what he can and can’t eat this week, will change next week, so every meal is trial and error.
I often find myself sitting on the floor next to his chair, simply rubbing his hands because he cannot stop the nervous movement that is preventing him from doing anything with his hands. He crushes his knuckles against the desk or chair as hard as he can as the pressure/pain response triggers more quickly with the brain than he himself can instigate and process, which relieves the symptoms. To take his mind off it, at home - we put on a video or something he can simply sit still and focus on, thus allowing his brain time to catch up and calm down, at school – they have only as recently as last week allowed me to send in a therapy pack containing a squishy ball and some stretchy snakes/lizards that he can fiddle with to assist.
I think one of the worst of all is the sense of touch. He doesn’t like to be touched by strangers because It’s too much stimulation for his brain to process and people smell different. I sit and rock him every night before bed while rubbing his back and arms and legs in the places and manner he can tolerate and finds acceptable. Over the years I’ve sung the same songs over and over again to build up his tolerance as I know how calming soft singing is to him.
I have to get down onto my knees to look him in the eyes to make sure that he hears me when I speak to him. I have to remind James several times every single day that he has his pants on backwards or his shirt on inside out. I have to make sure James wears underpants because society says it’s unacceptable for him not to wear underpants even though I know the constricted feeling of tight undies drives him insane. (I also do it because I know that other kids are cruel and will tease him for something so insignificant)
I have to brush his teeth for him because he gets distracted and forgets to do it properly. I still have to wash his hair every day in the shower because he hates water so much and even though the shower water is falling onto his body, it’s so much better than him submerging his little body into a bath of water. I have to remind him to wipe and flush every time he goes to the toilet because it has to be done despite him hating the feeling of wiping his skin and the sound of the flush. I have to buy him velcro shoes because despite him learning to tie his shoelaces at least once a week, he forgets. He has to sleep with the light on because being in the dark is too much sensory deprivation for him to cope with.
This has turned into a really long one and again I apologise but sometimes the 30 minute meetings just aren’t enough to discuss these things and they are valid concerns. I'm hoping we can perhaps set up a date to catch up and discuss the above email.
Again, I appreciate your time and assistance.
Chat soon
Colleen
No comments:
Post a Comment