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Old 12-03-2008, 07:45 PM
 
Location: Woodlawn, Bronx
54 posts, read 162,872 times
Reputation: 35

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My four year old son has always been tempermental: difficulty with transitioning, inclined to say no first, quick to temper tantrum, terrified of failure, and frequently reluctant to try new things. His day care is a special needs pre-k, and he transitioned to the special ed side of it a year ago (getting play therapy, occupational therapy). I agreed to have him in a self-contained room for this year, and he's been making a lot of progress. We also are trying to be consistent with behavioral charts at home (from Kazdin method for parenting the defiant child). They have diagnosed him with Oppositional Defiant Disorder, and think there may be a mood disorder also (wouldn't be that strange - anxiety and depression are rampant on both sides of the family).

I now need to make decisions regarding his kindergarten placement. They are recommending finding him a 12:1:1 class (I think this is the structure - 12 is definitely correct) - they think the 8 class would be too behavioral. I am concerned with the labels, as in NYC, the only thing I think he would possibly qualify under would be "emotionally disturbed", which seems like it should be a label of last resort for me, and this has also been said to me by a psychologist friend who actually makes these recommendations. They have said to me that I could decline the labels and services, but then the kindergarten could say that they can't cope with his behaviors, and he would be stuck with what ever was available, rather than the ideal setting.

He has a late birthday (Oct 1), and in some areas wouldn't even qualify for Kindergarten next year. There's a part of me that wants to hold him back, and find a private day care/pre-k for him to give him one more year to mature, while privately taking him to therapy, and working on his behavior via behavioral strategies, and even medication for the mood disorder if necessary.

Has anyone done this? Would I be doing him a huge disservice? I worry that I'm so concerned about labels that I might be making the wrong choices. He's a bright kid, and I worry that he'll get stuck in special ed forever, and never learn the strategies he needs to succeed. I have no intention of leaving that completely up to the department of education - I fully intent to have him in cognitive behavior therapy as soon as he's able for it, and family therapy asap in order to structure our responses to him (which admitted do not always model the behavior we hope to see in him ).

I'm sorry for the length of this post- brevity is not my strong suit. Any information regarding the NYC system, or just your own experiences with what worked for you would be fantastic.
Teresa
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Old 12-03-2008, 07:55 PM
 
Location: Colorado
546 posts, read 1,495,051 times
Reputation: 702
Hi Teresa--

Just curious--isn't 4 years old kind of young to be diagnosed with Oppositional Defiance Disorder? How did they come to that determination? It seems like there have already been a lot of labels placed on your son and he seems so young to already have these labels attached to him. Is it your school giving you this information?
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Old 12-03-2008, 09:42 PM
 
Location: Woodlawn, Bronx
54 posts, read 162,872 times
Reputation: 35
Four years old seems way too young for me too, although when you look it up online they do have things to look out for at 2 to 3 years of age, although that might be the benefit of hindsight for parents whose children were diagnosed later. I've argued from the beginning that there's no tolerance for any difference anymore, and issues of temperment are being dealt with as disorders, but if that's what he needs right now in order to lead a happier life in the future, should I be arguing?

He has an incredibly difficult time dealing with frustration, and I think the transistion issues tie into that (frustration with dealing with leaving a favored activity, place). He also doesn't have great models (or genetic material maybe) in Daddy, and occasionally Mommy . We are trying our best, but are definitely not perfect.

I realized tonight in writing this stuff up that the school is inadvertently reinforcing the prolonged tantrums too - they said the other day that one of the teachers has to spend extended amounts of time with him when he's lost it, and it's his favorite teacher. And as we all know, any attention can be reinforcing. I left a message on the treatment coordinator/therapist's voicemail to say my thoughts on it (teacher with him it help him calm, but if he doesn't, walk away and call the support staff to come take him out of the room for a walk - with as little interaction as possible).

I want to do what right for him. The big issue is the tantrums. He is learning at home that he doesn't get anything for certain tones of voice, and we work very hard at ignoring anything inappropriate that isn't dangerous, and being systematic at reinforcing the good (I have to be more methodical about that). He is very bright, and very reinforcable. We no longer have issues around getting dressed and out of the house in the morning (although I think wearing something other than sweatpants is going to have to go on the chart!). It's just that the behaviors we're trying to address now are more nebulous, and more difficult to chart as distinct entities. Much easier when it was just "get a reinforcer for getting dressed nicely". A specific moment in time. We practice the skills we want him to demonstrate, and do a lot of role playing, and reading stories and nice books about anger and more appropriate outlets. Now we just have to remember to have fun and enjoy each other.

Teresa
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Old 12-04-2008, 01:48 PM
 
Location: Colorado
546 posts, read 1,495,051 times
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I also have a 4 year old boy and we have many, many struggles (getting dressed, brushing teeth, using proper language) however I would be very weary of anyone who tried to label my son just because he has some behavioral issues here and there and he tests the boundaries. I would be more worried if he was perfectly compliant and easy all the time. We are trying Magic 123 now for STOP behaviors and it really seems to be working well. He goes to Preschool 3 days per week and we have had no issues at school. He seems to comply and behave for others better than me.
Just be careful about labels and reading too much into what "therapists" and "professionals" are telling you. There are good ones and bad ones out there. You are mom & you probably know best.
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Old 12-06-2008, 04:27 PM
 
Location: Woodlawn, Bronx
54 posts, read 162,872 times
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I feel like I've read every discipline book out there! I really like "The Kazdin Method for Parenting the Defiant Child" (I don't love the title though!). It requires a lot of structure and discipline, which I could use a little work in myself He's gotten much better in things that we have specifically targeted (getting dressed in the morning, leaving the house, etc). It's more difficult with the less tangible moments in time - like not losing temper when frustrated by toys, playmates, etc. I worry that the only thing the school can do is treat a behavioral issue like a mental health issue, and keep recommending him for these special classes. And I have to say that he would have a hard time even if he was one to one with a teacher, unfortunately. The size of the class is really just more realistic for a teacher to be able to cope with helping him, not to help him cope better. He needs to learn skills to calm his body, but because his first response when upset is to say no, he doesn't learn the methods when they are needed. And I feel like they spend a lot of time trying to eliminate behaviors while not substituting more suitable ones (scribbling angrily on paper, pulling on stretchy putty/stretch armstrong type of thing, etc.). I really have to write all my ideas down, present them, and try to figure out if there's a way to meet his needs - academically he should be in a regular classroom, and I'm wondering if there's a possibility of some sort of para who would be there to help him when needed, but that might be expecting too much.

I also wonder if I can find a private pre-school he can attend who will be able to help him, and won't put me in the poor house in the process. I think he's way too young, and immature to be attending kindergarten at four going on five.

Teresa
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Old 12-07-2008, 05:40 AM
 
Location: The Poconos
910 posts, read 2,679,935 times
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I'm in the same boat for my 4 year old as to his placement for next year. Right now he's in a daycare/preschool setting and is really flourishing there. I think we are going to put him in half day preschool next year. I'd rather ease in and see how he does, rather than throw him into something I'm not sure he's ready for and then have to back away and transition him all over again, which is difficult on a good day!

Only you as the mom can make that choice, and sometimes we dont even know if it's the right choice until we try! If he's doing well where he is, consider something similar. He can always switch next January to the next level up rather than September. Good luck, keep us posted!
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Old 12-07-2008, 08:26 PM
 
Location: Chicago
2,467 posts, read 11,308,946 times
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Quote:
Originally Posted by Winter01 View Post
I also have a 4 year old boy and we have many, many struggles (getting dressed, brushing teeth, using proper language) however I would be very weary of anyone who tried to label my son just because he has some behavioral issues here and there and he tests the boundaries. I would be more worried if he was perfectly compliant and easy all the time. We are trying Magic 123 now for STOP behaviors and it really seems to be working well. He goes to Preschool 3 days per week and we have had no issues at school. He seems to comply and behave for others better than me.
Just be careful about labels and reading too much into what "therapists" and "professionals" are telling you. There are good ones and bad ones out there. You are mom & you probably know best.
As a "therapist" and "professional" I would be HIGHLY concerned by ANY professional who diagnoses a 4 year old with ODD. I would definitely go to a specialist, preferably a child clinical psychologist who works in an interdisciplinary team that can also access peds issues/OT issues (sensory) (as well as behavioral) immediately for an accurate diagnosis (you need a full assessment) and help with individualized educational planning. I know you say that this has been going on for years but I have NEVER diagnosed a 4 year old with ODD (and I've worked with really severe children, as young as 2). And since they say "and probably mood" it seems like they don't know what the heck is going on. Plus, any reputable professional would know that oftentimes symptoms of mood look exactly like ODD in younger children. Again, this is IMHO and I guess he could have ODD, but I would be SHOCKED as 4 is way to young to state that
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Old 12-07-2008, 08:28 PM
 
Location: Chicago
2,467 posts, read 11,308,946 times
Reputation: 864
Quote:
Originally Posted by TeresaMike View Post

I also wonder if I can find a private pre-school he can attend who will be able to help him, and won't put me in the poor house in the process. ITeresa

Surprisingly enough, you'll find that public schools generally provide more services than private (and private schools aren't required to provide any services). Again, you need to get a thorough assessment that can help you out with figuring out what is going on and an appropriate plan for his behavior/education.
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Old 12-12-2008, 12:54 PM
 
910 posts, read 2,925,290 times
Reputation: 666
Default My 2 cents

I would not--no way start a boy--academically normal or not--at 5. Boys do better starting at 6. They have so many delays compared to girls. Schools have becomed feminized and many if not most public schools are better suited for girls. Here's an article worth reading.

Boys in School . Raising Boys . PBS Parents | PBS
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Old 12-14-2008, 06:27 PM
 
Location: Woodlawn, Bronx
54 posts, read 162,872 times
Reputation: 35
"Surprisingly enough, you'll find that public schools generally provide more services than private (and private schools aren't required to provide any services). Again, you need to get a thorough assessment that can help you out with figuring out what is going on and an appropriate plan for his behavior/education."

I guess that's my concern - I think he's way too young to start Kindergarten next year, and should have another year of preschool, even if I have to pay for it myself (in NYC he would not be entitled to attend another year of publicly funded preschool, as he is eligible to go to kindergarten). However, if he still needs services, I really HAVE to have him go to special ed kindergarten. The plan so far if that I will get him independently evaluated (maybe there's something else going on), start family therapy this month to help support and structure my husband's and my response to him (we tend to get anxious and stressed around this issue, and overreact to him when he gets out of hand), try to find a montessori preschool in the area that has room and will take him, and let the preschool he is currently in go for what they feel is the right thing for him, based on how he is currently functioning. We will try to get his behaviors under control (at least the ones that are interfering so much with school - temper tantrums, throwing toys, etc). If his behaviors have calmed down, then I'll put him in the montessori preschool. If they haven't, I'll go with the kindergarten class. I'm just hoping that he calms down, as I don't know how much it will screw with his further education, even if we move states, to have special education and behavioral issues on his IEP.

Teresa
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