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Working our way through one step at a time

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Morgan school plan 08-09 [May. 27th, 2008|11:44 am]
Working our way through one step at a time

[Current Mood |calmcalm]

School Planning for 08-09.
Brian, Susan, Sally
Amber, Holly
May 27. 2008

Thank you, Brian and Susan

I Should Morgan stay in the primes classroom next year? Is it even possible?
• Many kids do two years
• Catch up on classroom skills
• Catch up on social skills, tends to run a year behind anyway
• Confidence and positive feedback
• Teachers that understand him

• Boredom with curriculum
• Embarrassment this year and in coming years of being the oldest
• Feeling penalized
• Not getting a fresh start
• Not synching with the class for next year (Who is staying for a second year?)

II Summer Study/Efforts
• What needs to be worked on personally, socially and academically
• What should he have mastered?

III How can we be better GCS parents, either in or out of Primes.

• Daily communication
  o Easy for teachers
  o Clear and objective for parents
  o Private and positive for Morgan

• What we need
   o is resources to use,
   o support for current treatments
   o consistent feedback and suggestions for classroom management
• What Morgan needs
  o Privacy about ADHD, including medication talk
  o Positive encouragement of self, not of current treatment
  o Rewards, goals and charts, physical reminders of what he can feel good about
  o Freedom to be as wacky as other kids without it just being adhd or his meds not working.
  o Time and assistance in writing new behavior scripts, because now that he can focus he needs to learn a new way of acting and reacting.
  o Space to feel bad/mad/sad because this has been a lot for one little boy in a year and it is genuinely hard even when you do not see him trying anything.
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Weekly Update Af dum [May. 9th, 2008|11:36 am]
Working our way through one step at a time

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[Current Mood |anxiousanxious]

Week in brief:

Meds not showing same effects outside of the home as inside of the home. Grandma and school reports high emotionality, lack of control.

I think it is not that he cannot take control because at home he shows he can, but that he doesn’t know how else to act in these situations and so he acts like he used to, but know he is more attuned to what is going on around him and notices that people do not approve or include him in the same ways as other children and thus he reacts. If he has been attuned to the cues from others the whole of development he wouldn’t be so affected by them.

I am at a loss as to how to talk to the school about how what they are doing contributes to how he acts. I don’t want to press to have them do something if there is no plan and I still don’t have a plan. I wish school would end so I could really focus.

When to see the Behavioral Therapist and found out disturbing news that M scored very high, across all parents and teachers for depression, anxiety, and somatisation, in the 90th percentile of the clinical range for a seven year old. He is also in the 96-98 percentile for his ADHD in both the inattentive and hyperactive subtypes. While this all sounds dire to me she promises that prognosis is good because of two things. First, he does not show any conduct problems, defiance and other things that often come with ADHD,. Secondly, he is cognitively able to engage in imaginative play, which will be an asset in treatment.

She would like us to do Parent Training for behavioral therapy, because BT for ADHD can’t really be done in the office setting. He will also get CBT for the anxiety and depression. She says we can stagger these so one week he goes and the next week we go in, but if his appointments are at the same time as A’s we can have him go every week and then we can go every week/ every other week.

Our homework this week is ‘special time’ where we each spend one on one time with him for 15-30m each day. In this time we play a game he likes and chooses. We are not allowed to correct any behavior , give any directions, or ask him questions. We are merely to comment, continuously on what he does and what we like about it. Doug will do this on his days instead of every day.

Our other homework is to try to break down tasks so he cannot not comply, and praise him for each step. For example, in brushing teeth which is a fight, we should ask him to brush his teeth and then follow him to the bathroom, praise him for going into the bathroom, wait till he picks up the toothbrush and praise him for that, and then if he puts it in his mouth we are to praise him for that and if he swishes it around for a bit, praise. If he doesn’t do it properly, but makes a token effort we are to praise.

When behaviors happen that we don’t like we are to ignore them completely, unless they are somehow dangerous to himself or others.

***We need a med’s follow up and when we finally get a hold of the doctor we need to figure out what type of appointment we should be setting, because, since we aren’t bringing M to the office they want to schedule us for a parent conference, which only happen Monday at 8am and are an hour long, instead of just a recheck. Talk to Ped about sleep study – sleep disorder because of frequent waking, exhaustion even on meds.

***The food log has been a bust, partially. Need to reinvent it and go back to offering healthy foods instead of just whatever he will eat. Need to actually limit dairy to 2 servings a day. Need to actually add fiber each day. Need to push the fruits and veggies. Sadly the best way to handle keeping his nutrition up and the best way to handle his tummy issues are exactly opposite.

***Weight this week was 53.4

***We need to talk to the therapist about Biofeedback training and if it would work for him

***We need to set a meeting with the teachers this year, Sally, and the teachers for next year and start talking about making the transition to the next classroom.

***We need to schedule an appt with the therapist for Moo, as well as another for parent training. We need to talk to her about some key things we want addressed –like cues from other people, school, personal space, strangers. Social training would help him a lot. We also need to figure out how to talk to him about ADHD. Want to go to Borders and get him a book.

***Working with gasto still. X-ray showed clear, but many BM of unusual size after that, 5 the day of the xray (Monday) and 2-3 each day, since. Lesser complaint of bellyaches this week, post Monday. If bowels were clear where did all this come from? Called left message.

***need to note, post and backdate a ‘poop adventure’ post so it is somewhere.
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Concerta week 2ish [Apr. 28th, 2008|05:13 pm]
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Morgan was gone all last week, which was days 3-10 of his Concerta.

I still see the tiniest bit of emotionality, but what I don't see is incesant talking, needing constant companionship. He came home, built with legos for a while, then played with his mini's at the kitchen table, cleaned up both and is now making a ferret bed out of some towels and an empty box.

He is focused, happy and in control, but less Morgan than before --less wacky and silly, but I think it will even out. Last night he was just as wacky and silly as before.
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Mooo appt foo [Apr. 25th, 2008|11:50 am]
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I called UMass at 11:40 and left a few times for Donna, as well as phone numbers for her to call back to let us know if any fit. No Fridays, and since Wednesdays are taken for a few weeks, I gave our free afternoons after 4pm so that someone could just pick him up from school and take him over.

I also called Dr. Scwab's office, and spoke with Margaret at the front desk at 11:50am.

Bev had not yet sent over applicable paperwork -- Margaret said she'd get it right out, including faxing over a referral form, as Goode's office wants.

We need to take his insurance card in, and arrive 20 min early for paperwork.
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Change in meds [Apr. 18th, 2008|09:20 pm]
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Morgan changed meds from Adderall 5mg to Concerta 18mg.

We did not get to talk to the teachers Friday about the change and what they saw, but Friday night he was more focused and better able to even enjoy his sleepover. He had no arguements with his friend and was not at all over emotional.

Saturday we saw more focus and more independence, more thoughtful questions, a better recognition of social cues and more independence. He was such a big boy at the birthday party today. I didn't stay in a big effort to give him more independence. It was at the roller skating rink upstairs at the mall, so I went and got him all set up and then checked in every 30 minutes or so. He was so good and there has been no emotionality at all.
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First day results and second day [Apr. 9th, 2008|07:55 pm]
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Day one:
Morgan's first day of meds was a hard one. He was anxious when I left the school and wanted me to stay and then cried, by his report, five times through the day and had other heightened emotion things going as well. When we picked him up he was in a great mood, composed, talkative --not in his random way-- but happy to explain his day and how he felt. Which for those of you who don't know, never happens. Aikido went well, with a few reminders and then he was polite and reasonable and we went out for a late dinner, where he picked something new to eat *GASP* without fuss and was mostly composed while eating. At 8ish we started to see more craziness, which is to be expected, since it was 14 hours after the meds and also it was bedtime -- but he made it through and even went to bed well, but with a tummyache.

Teacher said he did semi acceptable work in time alloted, but had to rewrite due to messiness.

Day two:
Still high emotionality -- reportedly good at school, but was 1/2 class, 1/2 afterschool from 12:30 on. We picked him up at 4:30 and he fell to pieces because he was waiting to go outside and had been waiting and we showed up, just before the time came for him to go outside.

There were tears and tantrum the likes of which we seldom see anymore and it was frown worthy. This afternoon he has not been anyhow calmer or more composed or anything of the like. Swim happened -- getting changed with Dylan around was not calmer --Morgan was not more in control of himself and he was easily dissapointed when it was time to go and we couldn't wait for Dylan to get picked up --tears and all.
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Noho Peds Assessment [Apr. 7th, 2008|11:11 am]
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Read Nancy's eval.
Prescribed Adderall 5mg as a low dose, long acting med that should last 10-12 hours with slow come down.

He also recommended "A handbook for parents of ADHD" at AAP.org and "Help you child or teen get back on track" by Talan.

Follow up in twoish weeks.
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Morgan DXed with ADHD combined type [Mar. 20th, 2008|11:00 am]
Working our way through one step at a time

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At Haffey Center for Attention and Memory, by Nancy Haffey.

We were unimpressed with the idea that she doesn't endorse parent training and behavioral management --endorsing that books teach lessons and you learn in the moment.

Contacted Umass clinic for follow up in those areas.
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First day of Adderall 5mg. [Apr. 8th, 2008|10:24 am]
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Given today before school 6:30am. School notified with a list of side effects and warnings. The morning went smoothly and we had fun in the car listening to music and laughing. He seemed a little reserved in the car and then less wild at school, but he was nervous and upset about me leaving the school and it took a few tries for him to get into an activity, but even then he was not happy about me leaving.

I think the side effect of nervousness is going to be the hardest and I am worried about him not eating as much.

We are thinking of starting a food log for him, just to get a sense of what he is eating, but he is so picky.

We also put him on the waiting list for OT with Elizabeth McNolty. It is going to be a wait of six to eight months, so we called the peds back to see if we can get something else.
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