Friday, November 22, 2013

We all have special needs

This blog was founded on the philosophy that there is always something new to learn - we will never know everything, and our purpose is to continuously seek knowledge and understanding. Something I've learned through the years is that learning does not happen in a vacuum. Sure, there are times where you figure things out in the quiet of your own brain, but I can't imagine a scenario where there isn't some outside influence that sparks our thoughts and nags at our subconscious until ideas come alive. So today I pose this question to you: don't we all have special needs when it comes to learning? We all learn differently, and I am aware that there have been articles and discussions that indicate learning styles don't matter in the grand scheme of things, but how can this be true? Turn back time 100 years and consider the drop outs and 'dunce caps' - those students were ostracized because they weren't able to fit the norm and sit in rows with their hands folded reciting the three R's. I picture Willie Olson from Little House on the Prairie, constantly sitting in the corner, and wonder how his education might have improved if he was given alternatives to the standard learning methods that were available in that schoolhouse. I'm sure he absorbed some of the information that was discussed in that classroom, but how much understanding and processing came out of his experience?

We have come so far yet with every step forward there seems to be the proverbial two steps back. Study teams and case managers develop IEPs and behavior plans and classrooms can be adapted or have adaptations to meet the needs of the learners. Part of me wants to add 'to a point' and part of me wants to say 'to a fault'. The limitations I see are that there are still only so many resources and so many teachers available for too many students who have such varied needs, so while the school might be providing small class instruction, the academics are at a lower level because there is a limit to how many lessons can be taught simultaneously. So a child who is bright and actually needs a higher academic challenge is stuck because the small classroom setting that he needs is boring him because the subject and teaching are below his skill level. In the public schools, the assumption is that if there are special physical needs for learning to help students focus or process then the student must also need remedial studies. It is an unfortunate disservice either way.

Another part of the equation is the ongoing dilemma: to medicate or not to medicate? Some of my early classroom experiences as a teacher working with special needs students included personal witness to before and after medication examples. One student had an aide with her and her mother even was in the classroom volunteering a lot because she knew her daughter was a handful. After many months, the parents decided to try Ritalin, and the difference in this child was night and day. She was focused and engaged and finally had control over her impulses. A few years later, I was working in a transitional special needs classroom as an aide, and after a month or so working with the 9 students in this classroom, I came in one morning and saw one of the boys at his desk literally punching his forehead repeatedly. When I asked him why, he said, "I just took my Ritalin and it gives me such a headache until it kicks in". I felt so sad for him, that he had to hurt like that, but I also saw what a difference the medicine made, watching as it wore off midday and then took effect again with the lunchtime dose.

So now we come down to how you can help me through this blog - When it became apparent that my own son might fall into the category of ADHD or some sort of learning disability, I remembered that pain my student felt in that sixth grade class because of Ritalin and shared that concern with my husband and the pediatrician, and we really tried every other option over two years to try to help. I severely cut my hours at work. We modified his diet, sleep habits, even his environment (removed his carpet, organized his room).  Eventually, we tried a non-stimulant medication. The first day he had the pill, he sat at the table and completed his math worksheet without distraction all on his own. Then he drew me a very detailed pencil drawing of his favorite video game. That was the first drawing he had ever sat down and completed without any prompting - he just wanted to draw a picture, and he was able to get that detail out of his head and onto the paper for the first time. I cried. I cried a lot. It made me wonder what else was trapped inside his mind.

Since then, he has seen many doctors and psychiatrists and psychologists, and we have had to make adjustments as he has grown and gained weight (or not gained weight because of the medicines) and there has never been a perfect drug, but without anything things are not perfect either. In the past two months, my son has gained 7 pounds and grown 2 inches, and who knows when this growth spurt will reach its peak, and these past few months have been very difficult for all of us. Add to that a transition from middle school to high school, which is a huge campus sprawling over many acres and including multiple buildings and close to 1000 students in his freshman class. We have been assured that the school has excellent resources and that they are fully equipped to meet his needs. He is happy and has friends and is even getting involved in a club or two (which is a huge accomplishment). But there are weekly trips to the principal's office (sometimes daily) or the counselor. I worry daily about his activities in between classes and after school, since the campus is so large and they really have quite a bit of freedom. After school, they have 5th block, which is for tutorial (extra help) or clubs, or they are dismissed. My son has opted to ignore the bus and hang out, wander the surrounding town hanging out with friends, or if he goes to tutorial first or a club, he still disappears after and it is a big job for me to track him down and figure out how he will get home (which he never things about or plans for). I don't think he is aiming to be deviant or vindictive, he is just acting on impulse: it feels good to hang out with his friends, so he makes spontaneous choice and figures he'll deal with the consequences later.

When speaking with the study team in middle school, one of my concerns was the vast size of the school. I worried then that it might not be a good fit, and I researched options. There are schools that address the needs of students both behaviorally and academically. But the team encouraged us to give the public school a chance because they had many resources available. So here we are only three months in, and while there were no official disciplinary actions, there have been many concerns and conversations. Ultimately, we were required by the school to have him analyzed by a psychiatrist. We had also seen the same doctor back in 2010 upon suggestion of the middle school. This time, the doctor's solution was that our son just needed more medication for more (or all) of his day. While I agree that medication does help him to focus, and with the growth spurt we've seen in the past months, an adjustment to his medication was probably needed, but I also see that it causes him to not eat or sleep in healthy amounts so I am cautious about taking things too far. I wonder if it wouldn't be better to keep his medication at a minimal level and adjust his environment to one that is better suited to dealing with his impulsiveness and learning needs. My gut says that while he might be sad at being separated from his friends, he would be safer and his needs would be addressed more aptly in a different school setting. He wouldn't be isolated entirely from his friends, in fact, he would benefit because the one school I am leaning toward starts a little later in the day, and they don't give homework, so he would have the time to spend with his friends in the afternoon and evening without my having to harp on him to get his homework done.

So what do I want to learn today? I want to learn about Psychiatrists in the central NJ area. It has been a struggle to find anyone who really wants to help the kids. I need people to talk to and to evaluate my son and help us point him in the right direction, and find the best situation for his needs. Unfortunately, when I do find a doctor or a program I feel can make a difference (and seem to be genuinely interested) - they won't take our insurance.  Why? I am told time and again that it is because they feel it doesn't pay them enough - which to me it seems greedy and hypocritical when you are in a profession that suggests your passion is helping others. It also irritates me that the insurance company would be so stingy to deprive someone of payment they deserve, although I am more likely to believe that the doctors are really just taking advantage - they are greedy and won't accept the payment the insurance company offers, and they feel they can charge so much, which  makes them more exclusive and might even make it seem like they are better than they really are because they are able to command such a fee. My thought is that I make a 'realistic' paycheck and don't collect hundreds or thousands of dollars hourly in my paycheck, and we pay our insurance like everyone else, and the doctors should accept the paycheck the insurance company deems appropriate. My feeling is that these doctors are exploiting people in their time of need, but maybe I'm over thinking this. Unfortunately I have had a lot of time to think about it between waiting for appointments or waiting for doctors or insurance representatives to call back or waiting to hear from the school... I have had to adjust my schedule and managing these inquiries has taken over so much of my days! Which is why I felt it was time to seek more information, but not the promotional spin that one might find on the website from a practice itself, I need real feedback from real people....

Help me learn - Are there ANY good psychologists or psychiatrists out there who have made a difference in your child's life? What programs or adaptations or innovations have you found helpful in the classroom or school?  Thank you so much!