Success with CBT for Separation Anxiety/ADHD & no meds?? - Mothering Forums

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#1 of 31 Old 05-11-2012, 08:23 PM - Thread Starter
 
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Hi,

 

My 6 yr. old son has severe separation anxiety and just recently diagnosed with ADHD. He did 3 months in public school before we took him out to home school him. His teacher and assistant principle seemed to have no knowledge of anxiety so without an IEP he didn't get much help at all. It was a bad experience for all of us. We hadn't realized the severity of his anxiety until Kindergarten started since he did well in a small preschool so we kept expecting him to just settle in which obviously did not happen and it only made it worse. He had panic attacks, threw up in class, refused to eat  and got really emotional, nervous, panicky even at home and even after we pulled him out.     

 

He seems much calmer now and is getting back to his old self since some time has passed since we pulled him out so we are now we are in the process of getting an IEP set up for next Sept and I was just wondering if anyone has had success or an improvement in their child once an IEP was in place? He has done play therapy before but we have started again with a new therapist that seems better suited to his needs. We will also do group therapy, dietary changes and work on behavior issues.  My husband is adamant about not doing the meds. at this age.  

 

I look forward to hearing any advice or similar experiences. 

Thank you.   

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#2 of 31 Old 05-12-2012, 05:03 AM
 
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My 4yo has a lot of separation anxiety too.  He won't play in his room by himself because 'he's scared'.  When he goes to the bathroom, he has to call out to me like every 30 seconds just to know I'm still around.  And he physically hangs on me and talks to me constantly because he needs the reassurance and approval.  He seems to do fine in his half day 4K.

 

I'm not sure what to do.  I've been telling him that I still love him, even when we're in different rooms.  I still love him if we are sitting on different couches.  I still love him when he's in school.  I'm hoping he will outgrow it. 

 

His teacher thinks he may have ADHD too.  But so far, we haven't had him tested. 


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#3 of 31 Old 05-12-2012, 05:50 AM - Thread Starter
 
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Yes, that sounds just like my son. It all really got bad in Kindergarten since it was just too big, too loud, too long and since he was diagnosed with ADHD he had trouble following the instructions and keeping up coupled with the anxiety he was a wreck. His teacher was not sensitive at all though so he did not feel safe. There were 26 students and only one teacher with an occasional assistant so it was not good for him.

 

I would say to you that if he your son is still like this when it is time to start kindergarten go with your gut instinct and either get him tested or what I should have done was put him in a small, private school. That was what my gut instinct told me to do and I really wish I had. I think if my son had gone to the local Montessori school we may not have had to pull him out of school.  It still would have been a struggle but I don't believe it would have gotten as severe or as stressful as it did.

 

Good luck!    

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#4 of 31 Old 05-12-2012, 09:46 AM
 
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Originally Posted by CleoS View Post

My husband is adamant about not doing the meds. at this age.

 

At this age? Why? Does he view medication as harmful? As a the "easy way out"? Is he in doubt of the ADHD diagnosis?-- I can see not turning to medication at this point if accommodations are sufficient, but not due to his age alone; the brain can malfunction like any other organ--ADHD results from a chemical imbalance in brain, the purpose of the medication is to correct the imbalance shrug.gif (ADHD Doctor About Attention Deficit Symptoms and Treatment for ...). Anxiety can be a manifestation of the ADHD and may improve with medication; non-stimulants may be the better choice if stimulants worsen the anxiety.

 

Under IDEA/IEP, if your child has a disability that adversely affects educational performance, your child is entitled to an education that is designed to meet the child's unique needs and from which your child receives educational benefit; the IEP is going to have annual goals, but it will also have an accomodations section. It is only as good as it is written and the persons implementing it; a compassionate, adaptable, and willing-to-learn teacher is important. It would probably help if her teacher has a resource to go to for questions, either your school counselor or her therapist; or, you can play intermediary and take questions from her teacher to the therapist. You may even want to have her therapist participate in the IEP meeting.

 

My ds had a very difficult Kindergarten experience as well. He began medication just prior to first grade; he was completely unable to participate/function in 1st grade without the medication. He has been on the second dosage of his second medication (Vyvanse) for over a year now and is doing very well on it.

 

 

[quote]ADHD Parent Medication Guide prepared by the American Academy of Child and Adolescent Psychiatry and American Psychiatric Association
http://www.parentsmedguide.org/ParentGuide_English.pdf

 

The Hows and Whys of ADHD Medication
http://www.additudemag.com/adhd/article/8673.html

 

ADHD Medication Chart: Compare Drugs for ADHD

A Full List of ADHD Medications


ADHD Stimulant Medications

ADHD Non-Stimulant Medications

Caffeine Content

Doctors Advice
http://www.drweil.com/drw/u/id/QAA400126

Preschool-Age ADHD Children: Too Young for Diagnosis? | ADDitude Magazine ...[/quote]


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#5 of 31 Old 05-12-2012, 10:47 AM
 
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Well, I'll be the other side of the coin. We did go the small private school route for our dd1 who had severe sep anxiety, too, and some ADD behaviors (inattentive). We have not done meds and don't intend to do so at this point. 

 

Her sep anxiety was definitely the worst the teachers had ever seen and remains the worst I have ever seen in any child. She didn't throw up, but she has anxiety about being sick and I can probably count on one hand the times she's thrown up in her whole life by age 11 now, so not sure it would ever manifest that way for her.

 

We knew she would be very anxious about K, though, since she had been anxious since birth and had a rough time in preschool, too. So we did seek out the private school. She loved her teacher and liked a lot of school, but really would have loved it if I could stay and go to school with her. Of course, that wasn't really an option, but since this was not public school we did have a lot more flexibility and I could stay for quite awhile in the morning. We worked out a little routine where I would hang out (with dd2 in tow), but just try to fade into the background, so I was a security blanket, but she was interacting with the other kids and the teachers rather than me. Then I would sit with her at circle time (about 45 min after school started) and then leave after circle time was over when they moved into the next part of the day. It was a struggle almost all year long. She refused to participate and do a lot of the activities, cried a the drop of a hat, etc. But she did get used to it and overall I think she really liked her K year. She loved her school and loved her teacher. 

 

Sep anxiety remained a struggle in 1st grade (same small private school) where her refusals took on the form of pretending to be a cat and only meowing and hiding in the corner under the tables, etc. I did the same thing and stayed through the morning circle and then left. Second grade was somewhat better (same teachers 1/2 mixed grade class), but she still had some anxieties especially if her routine was shaken up by a special event or substitute. Again, she really liked her teachers and they were very supportive of her. DH thinks they let her get away with being a cat too much, but I think it was really all they could do or else she would be crying in a puddle on the floor. She loved to observe and absorbed a lot by just listening even if it seemed like she wasn't participating.

 

In 3rd grade she really started to be more outgoing about participating in class and had a teacher she absolutely adored and still does. She still needed me to walk with her into the classroom in 3rd grade, however, although I didn't stay as long. It wasn't until mid-year in 4th grade that she didn't want me to come in the class any more. I had started asking by this time if she wanted me to come or not because I didn't want to embarrass her by coming if she didn't want Mom around. She really wanted me there, though, until about mid-year.

 

This year (5th grade) she's been in public school for the first time and is okay with the sep anxiety, but she does still have some school refusals. We just power through them if we can.

 

You know that anxiety is exacerbated by avoidance, too, right? Avoiding the source of the anxiety is as bad as throwing them in the deep end to see if they can swim so to speak. It's a tightrope walk. They need a gentle nudge, but don't push too hard or they'll dig in their heels. If you allow them to avoid an anxiety provoking situation that's like saying, "Yes, you need to stay far away from the water—it's very scary! Don't go near it! Good thing you stayed away. You be sure to stay away from now on because it's so scary!" Alternately, you can't just throw the water-phobic child in the deep end and expect them to swim. That's a good way to scar 'em for life. You've got to coax 'em to sit on the edge of the pool and put one big toe in and slowly ease them in until they're sitting on the first step. It's slow and tedious and fraught with tears, but eventually you have little victories you can celebrate ("yay, both your feet are in the water! You can do it!") and eventually you can get that kid swimming.

 

If you can get your child in that Montessori school or some other school environment that is willing to allow a lot of flexibility and will let you come and walk your ds to class and stay for the first part of the morning, etc, I think that's ideal. Unfortunately so many schools are not that flexible. I did not want to homeschool dd1 because I felt like that would be an avoidance behavior for her and would make her sep anxiety worse, but I thought she would implode in public school. Luckily we were able to find and afford this small private school until last year. I have a lot of friends in the homeschool community and could have easily gone that route, but I just didn't think it was the best thing for her.

 

She has grown so much these past 6 years. She will always have some anxious tendencies. I really think that's just the way she's wired (much like my MIL), but I think her successes working through her anxieties give her strength to tackle the new anxieties that come her way. 

 

We did not do CBT. We did get her eval'd in 3rd grade at the private school's request (they were concerned about accommodations that might be needed for EOGs). I had thought about getting her eval'd many times before, but I really thought she wouldn't participate and it would cause her more anxiety so I didn't do it until the school requested it. We had a private therapist (psychologist who specialized in educational testing) work with her. She did refuse a few tests, but did most of them. She denied having any anxieties, though, so that didn't even register. Crazy. 

 

The reason, though, that the school was concerned about the EOGs was because in 3rd grade her reading was very much below grade level and they needed some official documentation to be able to read the questions to her. They wanted her to do as well as she could on the science questions, for example, and not have her difficulties with reading cause her science scores to be low. The reason she had trouble with reading then, though, was anxiety! Reading was scary and she felt anxious about it and felt like she couldn't do it. She reads well above grade level now 2 yrs later (500+ page books) and it was just time and familiarity and maturity. There was no magic pill or technique that helped with the reading. We pushed a little bit and one day she discovered if she got out of her own way that she could read and have some flow to it (not halting, skipping words, etc) and she could do it fine! She just had to let go of the anxiety. 

 

As I said, she's been this way since birth. She was the same way about walking. My younger dd2 followed a typical pattern of pulling up around 9-10 months and holding on to furniture and fingers and cruising and falling down on her bum a lot, etc. She was walking shortly before her first b-day. Dd1, on the other hand, did the pulling up and holding on to your finger at about the same time, but she wasn't letting go of that finger at all. She held onto our fingers for a good solid 6-8 months and would not let go and try to walk on her own until she was 17 mo old and was confident she could do it w/o falling down. Same with reading. She wouldn't do it until she could do it w/o stumbling over words or having trouble. Lord knows we wanted her to do both. It really hurts your back to bend over like that for 6 months!

 

Anyway, I just wanted to say I've been there, done that, and come through on the other side somewhat. Try to find some way to let your ds dip his toes in the water w/o dunking his whole head under if you can. That might be a private school. It might be that an IEP can make that happen. 

 

Best of luck!

 

ETA: Wanted to add, that you know your child best! Listen to what the therapists and school personnel (and crazy people on the internet) have to say, but they don't necessarily always know what's will work the best. If what they suggest sounds right, then by all means give it a try, but if your intuition is telling you something else you should probably listen. I had a routine when dd2 was in the little private school, too, in K, and dd1 was in 3rd. We would walk dd1 to her class first and leave her there and then take dd2 to her class and then dd1 wanted me to come back and say goodbye a second time. So many people told me not to do this, but it was what worked for us. It provided a little mental security blanket for dd1 to know that I hadn't really gone yet and she could get a little bit into the groove and chat with her friends and settle in a little bit, but she was reassured that I would come back and check on her. The professionals felt like it was hard for her to say good bye twice, but they couldn't see it like dd1 and I could. I have no doubt for another child it would be worse and harder to say good bye twice, but because I know dd1 better I knew that was not the case here. Just remember, you know your child better than anyone else does.


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#6 of 31 Old 05-12-2012, 11:36 AM - Thread Starter
 
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Thank you SOOO much Beanma! Also Emmaline :-) I will try to respond to both.

 

You have been through what we are going through and it really is so hard and I really appreciate you sharing. We have made some mistakes thinking that the school knew best so we did what they said...WRONG move! They really had no understanding or patience. We are hoping he will grow out of it a bit and be able to handle his anxiety better with help and as he gets older. Since he did do well in preschool and in places where he feels safe we wonder if that will happen since he sometimes CAN fight his fears and he feels proud and realizes that it wasn't so bad. Our first therapist actually seems to have done us a disservice. She came to the school and witnessed his clinging/crying/fear at the classroom door and just said "Homeschooling seems to be the only option, just take him home!" So, feeling as if there was no other choice that was what we did. I think the teacher was thrilled to see us go. I am not a natural home-schooler and we agree that avoidance is not good - I love you analogies btw :-)  But we felt there was no other choice at the time and it was heartbreaking to see him like that - we really did throw him in the deep end...with sharks!! He had nightmares and just looked sick from the whole experience. He now seems calmer and this is why we are ready to try again with a full understanding of anxiety and to stand up for our child's rights and knowing, like you said that we know our child best!

 

We got our own pyschological evaluation and this is why we are going ahead to try to get an IEP in place for Sept.  Our son will be 7 in Oct and his younger brother who turns 5 at the end of Aug. will be starting Kindergarten so hopefully he will see his younger brother attending and it will help him be more accepting school and separation. This is our hope anyway and our goal with lots of work of course.

 

As for the meds, our first therapist told us he had GAD and sent us to the psychiatrist who spoke to our son for about 10 mins then prescribed Zoloft. He was not in school by that time so we felt no rush to medicate.  After researching Zoloft we felt there were too many side effects and studies have only been on children 7 and older.  Even doctors and different psychologists we have spoken to seem split 50/50 on whether zoloft is appropriate or not. We decided it was not for us.  As for ADHD, it kind of blindsided us. The school doesn't seem to buy it. I am not sure. My husband believes it. So, we are now waiting to see if the school testing confirms the ADHD dx and also to see how he does with an IEP or private school with more support. This is the main reason hubby is adamant about not doing it at this age (zoloft) and I should have probably said "at this time" since he is not in school yet and we still have time to work with ds some more.

 

I really appreciate your input - both of you and I am glad to hear that both your kids are doing well. I am just starting this process so it seems daunting most of the time but glad it can be done without meds - the anxiety part anyway! As for ADHD, we will do what is best for him but want to take our time to make the best decision possible.

 

Last question, did anyone try eliminating red dyes and other dietary changes and actually see a difference? My son does not have allergies but I am doing a lot more organic foods, Omega 3, probiotics etc. but so far no noticeable difference.  

 

Thanks again!!

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#7 of 31 Old 05-12-2012, 01:22 PM
 
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My DD (age 15) has a diagnosis of an anxiety disorder in addition to ASD. CBT was very helpful for her. However, it was not the whole answer. For her, being in a school that didn't complete freak her out and push all her buttons was an important part of the equation, and she now attends a small private, alternative school.

 

They could not modify traditional school enough to make it work, and the really, really tried.


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#8 of 31 Old 05-12-2012, 03:03 PM
 
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CleoS, I can't type long this time, but wanted to pop back in after I read your response and say that my personal opinion is that anxiety can lead to some ADHD behaviors as a kind of avoidance mechanism. I think that's what we see in dd1. She doesn't have a big hyperactive component at all, but can get fidgety if she's anxious just like anybody else might, but she gets anxious much more frequently and about things that wouldn't bother other kids. Likewise I think she sometimes avoids dealing with whatever is making her anxious (reading, math) by not focusing on it. I will concede that she does have some organizational issues. Her room is usually a mess (clean at the moment, but I doubt it will last) and I don't see her ever being the type A kind of person with lots of lists and plans. She's more spontaneous and has a free-flowing artistic type temperament. She's more of a procrastinator rather than the person who has their paper done 2 weeks ahead of time. If the idea of an assignment makes her nervous she wants to avoid it and will find many other things to distract herself with. If it's an assignment she's excited about and feels confident about, however, she'll be ready to dive right in. So while she does have some ADHD (inattentive) behaviors I feel like the anxiety came first.

 

I think schools and therapists may disagree and feel like if she meets the evaluation criteria then she's ADHD. When the psychologist she saw in 3rd grade suggested that she met the criteria for ADHD she did say she didn't think medication was warranted, so we were able to avoid dealing with that. Also, ADHD does not have consistent diagnoses across the country and my state, NC, is the state with the highest diagnoses (http://neuropsychologyofhappiness.blogspot.com/2010/12/regional-variability-of-adhd-diagnosis.html , and http://www.cdc.gov/ncbddd/adhd/data.html ) so I took her diagnosis with a big grain of salt. Nobody in our local elementary has really had an issue with her behavior at all. She has had some struggles with math this year, but is performing at or above (mostly above) in all other subjects.

 

Like, Linda, we're looking at an alternative school for next year (middle school & high school combo charter school). I think she does better in a smaller environment.

 

Good luck!


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#9 of 31 Old 05-13-2012, 09:42 AM
 
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Originally Posted by CleoS View Post

We have made some mistakes thinking that the school knew best so we did what they said...WRONG move! They really had no understanding or patience.

 

We did that too; we're not at that school any longer. His Kindergarten year at that school was very stressful for him; my SIL saw him sitting in the hallway with his class one day and said that he was the saddest child she had ever seen.

 

With my ds, the ADHD diagnosis seemed obvious and the need for medication more urgent; also, the two evaluations he has had since the initial diagnosis confirmed it. I can see why your dh wants to hold off.

 

I would consider carefully what/how the school evaluates for ADHD. A favorite evaluation of schools seems to be Connor's, which is primarily a measure of hyperactivity and isn't useful in identifying ADHD-PI. Ds' first school said that "they" did not consider ADHD before second or third grade, treated him like a behavior problem, and seemed baffled that their little behavior charts didn't work--though they didn't do any evaluations other than "observing" him.


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#10 of 31 Old 05-13-2012, 03:43 PM - Thread Starter
 
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Thanks again ladies. I am also not sure if it is the anxiety causing the attention/focus issues. He is not really hyperactive in my opinion but has a really hard time with school work - avoidance possibly since it is hard for him and he is anxious about it. He scored extremely low for "working memory" and the psychologist said his scores could indicate a learning disability which would obviously cause him more anxiety.

 

I hope the IEP he receives places him in another school and hopefully a smaller self contained class with 5 or 6 students.  I think he could handle a small class setting with help.  The anxiety is the main thing though and like you Emmeline my Mom who visited from overseas at Xmas said "Where is the little boy I saw last summer!?" She said he just seemed ill and sad. This was after 3 months of school. The teacher also said that in her 20+ years of teaching she has never seen anything like it. This of course didn't help us or her to better understand.  An alternative school seems ideal in the future. I will keep in mind what you have all advised about the ADHD too. 

 

Hope you all had a Happy Mothers Day!! 

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#11 of 31 Old 05-14-2012, 01:38 PM
 
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This is our experience:

 

DD, 6, has HFA, severe separation anxiety (from birth), SPD and RLS (restless leg syndrome).

 

I have been struggling with the separation anxiety all her life. Like all here, we could never leave the room, she'd call out if she went to the bathroom (often she'd ask us to come), she still gets worried when we go to the garage, etc., she has never been able to play off by herself and so on. We tried CBT through her support team in the clinic we use for her HFA. Did one-on-one CBT, group-based CBT, and more. Tried every approach and angle. She understands it completely when she's rational and not consumed by fear. She can tell me all the things (tools) she can use. Knows it backwards and forwards. It doesn't help her one bit when she's starting to panic. She loses the connection to her rational brain completely and is instantly consumed by her fear. CONSUMED by it. Her eyes go glassy, she can't make eye contact, can't respond. She becomes a wild animal in flight mode. To feel like she had any control in her life, she was a complete tyrant at home. Controlling everything we did, every aspect of "play" with her little brother, having huge scary violent tantrums when she didn't get to keep control. It was damaging the family dynamic. Exhausting us parents and frightening her brother (he's nearly 3).

 

Finally, out of desperation after trying years of CBT and PBS and AP approaches, we turned to Zoloft. I agonized over it. I blamed myself. I questioned the ethics of it, wondered if I was taking the easy way out. All of that and more. Much more. BUT. The change has been night and day. I can't begin to tell you how different a child she is from that frightened creature we had in our lives before. Now she can concentrate at school, talk to other kids, play with them a bit, let things slide that she used to obsess about, use those tools I spoke about above when she does start to feel some worry. She's in control of her emotions for the first time ever and she's amazing now. AMAZING.

 

I won't say meds are for everyone. But I will say this: Don't discount them. Try - yes, do try - every other alternative you can find. Work hard at teaching your little guy the tools that may be able to help him through CBT. If it works for him, HOORAY!!! But if it doesn't, consider what HE is experiencing. Is his life a happy one? Is he interacting with other kids. Is he able to function and feel like he's doing well in what he does? If he's not, then look to EVERY option you have available.


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#12 of 31 Old 05-15-2012, 07:06 PM - Thread Starter
 
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I have been struggling with the separation anxiety all her life. Like all here, we could never leave the room, she'd call out if she went to the bathroom (often she'd ask us to come), she still gets worried when we go to the garage, etc., she has never been able to play off by herself and so on. We tried CBT through her support team in the clinic we use for her HFA. Did one-on-one CBT, group-based CBT, and more. Tried every approach and angle. She understands it completely when she's rational and not consumed by fear. She can tell me all the things (tools) she can use. Knows it backwards and forwards. It doesn't help her one bit when she's starting to panic. She loses the connection to her rational brain completely and is instantly consumed by her fear. CONSUMED by it. Her eyes go glassy, she can't make eye contact, can't respond. She becomes a wild animal in flight mode. To feel like she had any control in her life, she was a complete tyrant at home. Controlling everything we did, every aspect of "play" with her little brother, having huge scary violent tantrums when she didn't get to keep control. It was damaging the family dynamic. Exhausting us parents and frightening her brother (he's nearly 3).

 

 

This sounds like my son when he was at school for those few months. It truly is/was exhausting and what made me think about Zoloft however, since he wasn't in school any longer when we got prescribed Zoloft we figured we would wait and try to get him back to where he was before school which was still anxious but not out of control. He now still calls out and wants us on the same floor of the house when he goes in a bathroom occasionally but he interacts well with the neighborhood kids, goes outside alone with friends etc. so he is manageable now mostly because he has had no real stressors. We will see how it progresses. If he can't function or live happily then of course we will do everything we can to help him succeed and live a happy life. It will be hard decision even though I know it could be a possibility in the future. I am glad it worked for you. It must be such a relief to have your daughter and a calmer family life back!  She must feel so much better too!  Thanks for sharing :-) 

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#13 of 31 Old 05-15-2012, 07:07 PM - Thread Starter
 
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I have been struggling with the separation anxiety all her life. Like all here, we could never leave the room, she'd call out if she went to the bathroom (often she'd ask us to come), she still gets worried when we go to the garage, etc., she has never been able to play off by herself and so on. We tried CBT through her support team in the clinic we use for her HFA. Did one-on-one CBT, group-based CBT, and more. Tried every approach and angle. She understands it completely when she's rational and not consumed by fear. She can tell me all the things (tools) she can use. Knows it backwards and forwards. It doesn't help her one bit when she's starting to panic. She loses the connection to her rational brain completely and is instantly consumed by her fear. CONSUMED by it. Her eyes go glassy, she can't make eye contact, can't respond. She becomes a wild animal in flight mode. To feel like she had any control in her life, she was a complete tyrant at home. Controlling everything we did, every aspect of "play" with her little brother, having huge scary violent tantrums when she didn't get to keep control. It was damaging the family dynamic. Exhausting us parents and frightening her brother (he's nearly 3).

 

 

This sounds like my son when he was at school for those few months. It truly is/was exhausting and what made me think about Zoloft however, since he wasn't in school any longer when we got prescribed Zoloft we figured we would wait and try to get him back to where he was before school which was still anxious but not out of control. He now still calls out and wants us on the same floor of the house when he goes in a bathroom occasionally but he interacts well with the neighborhood kids, goes outside alone with friends etc. so he is manageable now mostly because he has had no real stressors. We will see how it progresses. If he can't function or live happily then of course we will do everything we can to help him succeed and live a happy life. It will be hard decision even though I know it could be a possibility in the future. I am glad it worked for you. It must be such a relief to have your daughter and a calmer family life back!  She must feel so much better too!  Thanks for sharing :-) 

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#14 of 31 Old 05-16-2012, 08:24 AM
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My 11 year old DS1 has experienced severe separation anxiety since birth, but it has improved dramatically since he was about 5 years old.  I'm almost crying here, because I've never seen this type of separation anxiety discussed so openly before - everyone, even most doctors and psychologists, act like they've never seen anything like this before, and the implication is always that I cause it somehow.  I feel a strong sense of camaraderie with everyone who has posted on this thread.

 

DS1 has never been prescribed meds for anxiety or attention.  His attention issues diminished greatly when he learned how to manage his anxiety.  His dx is ASD, and his primary issue right now is cognitive delay.  I've been told repeatedly over the years that medication will not alleviate DS1's combination of symptoms.  We did not pursue CBT formally, but I read a book on it and applied the principles at home successfully.  Here's the blog I wrote about  panic attacks & CBT.  We used play therapy at home to teach self-regulation, which is the key to managing anxiety without meds.

 

He is mainstreamed in a regular 5th grade class with 30 students, he's on the school safety patrol, he's an altar boy at church, he plays basketball in an inclusion league, he rides roller coasters all summer long.  We didn't think that he'd ever be able to attend school because of the severity of his anxiety.  We thought that he would never be able to participate in group activities.  He relies on a tight schedule, he knows exactly when he will see me, when he will have meals, when he will do chores, etc.  I know people still say that you just have to let your child cry and scream - those people are full of excrement. The child must be a full, consenting participant in the separation process if there is going to be long-term success.


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#15 of 31 Old 05-16-2012, 06:59 PM - Thread Starter
 
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I'm almost crying here, because I've never seen this type of separation anxiety discussed so openly before - everyone, even most doctors and psychologists, act like they've never seen anything like this before, and the implication is always that I cause it somehow.  I feel a strong sense of camaraderie with everyone who has posted on this thread.

 

I know people still say that you just have to let your child cry and scream - those people are full of excrement. The child must be a full, consenting participant in the separation process if there is going to be long-term success.

 

Yes, they seemed to blame us for his issues too. Bad parenting was easy for them to wrap their heads around.  They even asked us "Who is the parent and who is the child?" when he refused to get on the bus. They told us to tell him he would get on and that was that! Then if he did not we should send him straight to his room when he got home (for the night), put on his favorite show loud enough for him to hear it then taunt him with it! Makes me cringe just thinking of that exchange with the teacher and assistant principle.

 

And, yes, yes, yes to your second comment. I have been told to simply "Just separate" Ha! Seems so easy to some. And yes again that the child must be willing and able to do it for it to work long term. I am so glad to have had so many responses. I had a quick look at your blog and will go back frequently I am sure!    

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One more thing -  we got our report back from the psychologist today and it says "At this time, the testing results do not support the diagnosis of Pervasive Developmental Disorder, however it is recommended that he be monitored for Autism Spectrum Disorders"  

 

So, wouldn't this possibility make medicating him tricky since generally Autistic kids are not medicated, correct? Or no?  I am just confused a bit since in the next paragraph she recommends having him evaluated for possible medication to alleviate the anxiety, hyperactivity (not unusually so IMO), and impulsivity!  This is in order for him "to increase his ability to succeed within academic environments" 

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So, wouldn't this possibility make medicating him tricky since generally Autistic kids are not medicated, correct? Or no?  I am just confused a bit since in the next paragraph she recommends having him evaluated for possible medication to alleviate the anxiety, hyperactivity (not unusually so IMO), and impulsivity!  This is in order for him "to increase his ability to succeed within academic environments" 

 

well, autistic people aren't generally medicated for having autism. There isn't a drug that has been developed that has been proven to be effective for the treatment of autism.

 

But people with autism can take medication for other things. My ASD just took a round of antibiotics because she had strep.

 

People with autism can take medication for anxiety, just like other people can take medication for anxiety. It's not treating the autism per say, it's treating a symptom related to autism that makes life difficult, and it's treating that symptom the same way that it could be treated if it occurred without autism.

 

In one of her books, Temple Grandin talkes about meds. She takes something .... I can't remember what right now... I think it was from an older class of anti depressants. But she finds them helpful and they work for her. She is a big fan of people with autism trying different things to figure out what works for them.


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#18 of 31 Old 05-17-2012, 05:07 AM - Thread Starter
 
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well, autistic people aren't generally medicated for having autism. There isn't a drug that has been developed that has been proven to be effective for the treatment of autism.

 

But people with autism can take medication for other things. My ASD just took a round of antibiotics because she had strep.

 

People with autism can take medication for anxiety, just like other people can take medication for anxiety. It's not treating the autism per say, it's treating a symptom related to autism that makes life difficult, and it's treating that symptom the same way that it could be treated if it occurred without autism.

 

In one of her books, Temple Grandin talkes about meds. She takes something .... I can't remember what right now... I think it was from an older class of anti depressants. But she finds them helpful and they work for her. She is a big fan of people with autism trying different things to figure out what works for them.

I think I was too tired to think straight, I did know they can take medications but when it is a combo of symptoms( I guess like most kids have) I just wasn't sure about the antidepressants/ADHD effect. But, "Beachcomber" did say Zoloft worked well for her HFA daughter.  Like I said I think I was just exhausted!  I know a Mom whose son has Aspergers and I guess her words keep ringing in my ears about how her son can not be medicated.   I have to get one of Temple Grandin's books - I saw the movie with Clare Danes just by chance a few months ago and it was a real eye opener. Fantastic movie.

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#19 of 31 Old 05-17-2012, 06:40 AM
 
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Cleo, if you want him to go back to school I'd seriously look at your options for a different school. Would you be able to afford a private school? Many offer tuition assistance programs. Is there a smaller charter school nearby? Could you transfer to a different school in your school system?

 

Since he did well in preschool (my anxiety kid did not) I really think it's that particular school environment that is pushing his buttons. Personally, for my anxious kid I feel like she gets a lot out of  school and is able to stretch and grow through her anxieties in a way that she couldn't in a homeschooling environment, but homeschooling for a few years might be a good option for your ds and you. If you do go that route I would be sure to remind him that all school is not bad. Don't let homeschooling become an avoidance behavior for school in general, but just an avoidance of throwing him in the deep end with those unsympathetic teachers and administrators at that particular school. Remind him that he liked preschool and let him know that his first grade teacher just wasn't a good fit for him. Kids understand about fit. They can understand that Dad's shoes fit his feet, but not theirs and they can understand that one teacher might be a good fit for their friend and classmates and a bad fit for them. It takes the blame out of it—not that I don't blame the mean, unsympathetic teachers, but kids can blame themselves for not being strong enough to be able to hang where they see their peers and that can lead to thinking that they'll never be strong enough to separate and go to school by themselves and build up more anxiety about school. So, if you make it about the fit with that teacher, or that school, you're allowing your child room to see themselves as someone who could fit in at a different classroom/school. Then when/if you're ready to try school again down the road he can view himself as potentially successful and not as someone who couldn't handle it before and now it's going to be horrible all over again.

 

"I am just confused a bit since in the next paragraph she recommends having him evaluated for possible medication to alleviate the anxiety, hyperactivity (not unusually so IMO), and impulsivity!  This is in order for him 'to increase his ability to succeed within academic environments' "

 

I think if he's not having problems succeeding in his current academic environment (homeschool) then you could sit on this. If he's got issues at home too (many or most? ADHD kids do) and you can't accomplish your goals then it wouldn't be a bad idea to pursue the medical eval. What I'm getting from your other posts, though, is he's fine now that he's out of that school. 

 

What are your options for next year?


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#20 of 31 Old 05-17-2012, 01:39 PM
 
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Ah ha, another like minded child here! I have a 9 year DD1 who has struggled with anxiety her entire life. She did not attend K, she was unable to function in life then. I say it that way because she basically spent her K year at home refusing to sleep and crying hysterically if I should walk to the bathroom alone. She did enter school in 1st grade, we choose a tiny, private school that accommodated her. She started off hiding under her desk refusing to speak and eventually progressing to a class leader. The anxiety while it has improved, has NEVER gone away. We have good months and bad months. After X-Mas, it dawned on me that that the bad months greatly out number the good ones and she was getting old enough that she started vocalizing that she did not want to feel this way, she said she wanted to be a normal kid. She is now on Zoloft and now for the first time in her life, she seems like a regular kid. 

 

So what I am saying is maybe you are not to the medication point right now, and believe me when I say that I truly do understand, but always don't always discount it either. What is not right right now, may be right on down the road. 


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#21 of 31 Old 05-17-2012, 03:09 PM
 
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Oh, hey, something you said Peony lit a little spark in my synapses. DD1's troubles often seemed to be seasonal. For years she's had a harder time in winter and been much better in summer (even in school in the warm months). We see this pattern both at home and at school, but more so at school because she's generally happier and given more freedom at home. Anyway, a few years ago I started researching Vitamin D and subsequently started all of us on vitamin D supplements. I do think it has helped and I think fish oil helps, too. I also take both of those and I think it definitely helps with my mood. I am self-diagnosed with Seasonal Affective Disorder. Basically I'm solar powered and if the sun isn't shining I'm on half-power. I'm in the South so you'd think I'd get plenty of D, but my levels were low at the dr a few years ago and I'm a big proponent of it. Rainbow Light makes a couple of great-tasting gumdrop type supplements (lemon and orange). There's very little risk with it and it could help so you might give it a try. Most kids love them. We do Nordic Naturals chewable fish oil supplements, too (strawberry flavored). 

 

Neither one are a cure-all, but I do think they might help dd1's mood/anxiety and they don't hurt. Plus they're good for brain function and the immune system and bone health and lots of other stuff.


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#22 of 31 Old 05-18-2012, 11:14 AM - Thread Starter
 
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He does still struggle mainly with focus/attention with his homeschooling. One on one he is ok but it still takes effort to keep him with me and focused. He does learn when he wants to and despite his anxiety at school he did learn to read and progress just not as fast as everyone else. His anxiety is also still there but he is not frantic and sick looking with it like he was while in school. I think it is still on the more severe side though.

 

We are also looking at a Montessori School nearby which is still an option. We just thought we will see what the public school system has to offer. I believe if he is in a self contained small class then it will be in another school which is what I want.  He is scared of his old school. But, if we are not comfortable with the IEP then we will send him to Montessori or try to at least.  

 

You are right that if he has the right teacher in the right environment I think it will really help. His Kindergarten teacher was not a right fit at all and sadly made it worse IMO.

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My DS was diagnosed with anxiety at age 4.  He does not have ADHD, but does have sensory issues and some other OT issues.  

 

He was already going to OT to deal with the sensory stuff, fine motor skills, etc.  For the anxiety, we took him to a child psychologist who did CBT with him, and it made all the difference.  His anxiety related behaviors were really ramping up to the point of him not wanting to participate in activities he had done since he was really little and previously been totally comfortable with, having panic attacks at school, etc.  I wasn't willing to let him slip away from the life I knew he had enjoyed because of the anxiety.  So, we began a lot of work with the therapist - sometimes just my son, sometimes just me and my husband and sometimes all three of us together.  It actually did not take very long to start seeing a significant change in him (although the work during that time was pretty intense for us).  He was so much happier, able to participate, relax and not worry as much.  

 

A few things we learned from our therapist (and I know this is just one person's professional opinion, and others may have a different take, but it rang true for us) -

 

- genuine anxiety is generally not something a person outgrows - it is kind of a life long thing that you need to learn to manage.  My son still has anxiety.  We all now know how to deal with it much better so it doesn't impact his life the way it used to.

 

- we have to be careful about the kind of school setting we choose for our son.  He went to an alternative public school for 1st grade and went backwards in a lot of ways.  It was too big, too chaotic and the teachers weren't willing to implement any suggestions we had or even really recognize that the anxiety was causing the behaviors.  We never even got as far an an IEP.  He is back in a small private Montessori this year (second grade) and doing great again. 

 

- someone else mentioned the anxiety getting worse in certain seasons.  This has certainly been a pattern for us.  My son's anxiety was triggered by my cancer diagnosis when he was 2.5 yo - and it was spring time.  Our lives were turned upside down pretty quickly as we dealt with it.  So, spring time is when we see the anxiety really flare.  Our therapist said that young children who don't have as many verbal skills to process traumatic events, often really take in their surroundings at the time of the event - which, when they experience them later, can become triggers for anxious times.  

 

- Anxiety in kids is often misdiagnosed because a lot of the behaviors associated with anxiety can also be associated with other things.  For some reason, many professionals are quicker to label a child as having ADHD or even autism than anxiety.  

 

We were pretty opposed to medication for our son, and wanted to try everything else before we went down that road.  Luckily, we were able to avoid it with the help of a great therapist.  

 

I hope you are your little guy are able to get some good help.  I remember feeling so sad for my son as I watched him struggle.  I also remember feeling like I had no idea what to do to help him.  Things are so much better now - but we had to make some changes for sure.  

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#24 of 31 Old 05-18-2012, 02:27 PM
 
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mamadebug, if you feel like sharing some of the CBT techniques you used I'd love to hear them. 

 

When we had dd1 evaluated at the school's request we mentioned the anxiety to the psychologist and she did evaluate for that as well, but because dd1 doesn't carry her anxiety around with her — she's just anxious when confronted with a situation — she answered the eval in such a way that it did not indicate that she had anxiety. I really liked the pyschologist and dd1 did too, but I thought that kind of missed the mark. She was not objective enough about herself at that age (9) to see herself as anxious. However when confronted with an anxiety-provoking situation (say, being asked to read by the teacher, or going by herself to the fridge in the garage, or going down a slide when she was little) she would have a huge anxiety reaction.

 

She is 11 now, reading easily and above grade level, and seems to be coping much better in general. I do think she will always have an anxious personality. She will never be a huge risk taker.

 

I feel like we've done pretty well by her. I'm sure there are things we could have done differently and better, but with age and maturity she seems to be coping fairly well. I read a lot of books about anxiety, too. I never found one that matched up with her type of situational anxiety (and there are many, many situations which cause her anxiety) because most were oriented toward the always worried/anxious. I have some anxious tendencies as does my mom, but ours is more the low-level worry that you carry around with you all the time (especially my mom — I'm usually able to tamp mine down or bulldoze my way through it). Dd1 seems to be totally carefree and happy but can go from 0 to freakout in nothing flat. I think she takes more after MIL who seems to have more of that almost panic-attack anxiety. She is much better than she used to be, though, according to DH. She discovered yoga in her 30s/40s and went on to be a yoga teacher and I think that must have helped her. 

 

Anyway, I'd be interested in reading about any CBT type tips and techniques that have worked for y'all.

 

Best of luck to everyone!


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I'm sure there are things we could have done differently and better, but with age and maturity she seems to be coping fairly well. I read a lot of books about anxiety, too. I never found one that matched up with her type of situational anxiety (and there are many, many situations which cause her anxiety) because most were oriented toward the always worried/anxious. ...

 

Anyway, I'd be interested in reading about any CBT type tips and techniques that have worked for y'all.

 

 

 

Not to sound overly negative, but it may be that your DD's anxiety will go through the roof at some point in the next few years. Puberty is rough for most girls, but for girls with anxiety to start with the hormonal swings of puberty can cause massive, massive upheaval. I think it's too early in the game for you to say "with age and maturity."  It's possible you are in a calm before the storm.

 

I highly recommend working with a therapist. My DD's worked on teaching her specific skills, and then when they meet they reviewed how they week had gone and which kind of techniques were appropriate for which situations she was experiencing anxiety in. They talked through what happened when she tried different techniques, how to switch from one to a different one. There's really no way from reading books or talking to other parents that I could have provided that level of help to my DD. 

 

Some of my DD's stresses are around social situations, and she also did a social skills class. Although they mostly worked on skills like carrying on a conversation, they also worked on dealing with social stress. This was also helpful for my DD.

 

I'm a yoga teacher -- some of what I do in a yoga class is similar to CBT techniques to relieve stress. But it really wasn't much help in getting my DD through this.

 

For her, 12 was the worst. 13 was still rough. By 14 she was doing OK. She's now 15 1/2 and doing really, really well.


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#26 of 31 Old 05-18-2012, 07:07 PM
 
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Well she's 11 and has improved so much from when she was little. I think her track and her issues may be more unique than is typical with anxiety. Her trajectory is oh so much better than it was. She is able to do fairly well this year in public school. She's had some issues, but overall is much better than 2 years ago when she was in private school (and that year would have been a disaster in public school).

 

As I mentioned the psychologist could not give her an anxiety diagnosis based on her evaluation although that's clear to DH and I that she has had anxiety issues since birth. My sister is also a psychologist and I've spoken to her about dd1 a bit and she has offered some resources. She indicated that dd1 might be termed emotionally over-reactive. 

 

I appreciate the intent in offering the advice and I didn't mean to imply that she was out of the woods yet. I did say that I think she will always have an anxious personality. However, based on my knowledge of my kid and my experience with her I can say with age and maturity she is doing much better than she was as a young child when she hid in the corner and meowed like a cat. She can integrate into a classroom and enjoy participating at this point. I don't see her backtracking to the "cat"-atonic (ha!) stage of earlier years. She may have more rough times ahead. Personally 13 was the worst for me — I hated 8th grade — but I think she will do okay. It won't all be golden for her, but I think she will do all right. 


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#27 of 31 Old 05-24-2012, 06:53 AM
 
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i haven't read all the replies, but i just want to let you know i am in a similar boat. my son who is 9.5 has been dx with SPD, OCD, anxiety and ADHD. he refuses any meds (we tried one). he says he doesn't want his "brain edited."  okay, i have to respect that. but holy *&^% he is sometimes hard to deal with... whew! anyway, we are still searching for a CBT who can take him. seems all the good T's in the area have no space in their schedules. meanwhile, i deal with him as best i can... i've been dealing with him since he was born... he's always had special/high needs. so i have a pretty good idea of what he needs. problem is, he refuses to do a lot of what might be helpful to him. shrug.gif and now that he is almost 10, he's coming into his own. he's growing up and the pre-teen hormones are starting to appear. so, he changes sometimes from day to day! duck.gif

 

he's a good kid, but he's gonna need lots of coaching to be a successful adult! he;s got one AS parent and one ADHD parent, so he was behind the 8 ball to begin with!

 

i take ADHD meds as an adult, but i don't think all kids need them if agree they can do other things to help themselves. (have you read "disconnected kids?" or "last child in the woods?")


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#28 of 31 Old 05-24-2012, 12:13 PM - Thread Starter
 
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i haven't read all the replies, but i just want to let you know i am in a similar boat. my son who is 9.5 has been dx with SPD, OCD, anxiety and ADHD. he refuses any meds (we tried one). he says he doesn't want his "brain edited."  okay, i have to respect that. but holy *&^% he is sometimes hard to deal with... whew! anyway, we are still searching for a CBT who can take him. seems all the good T's in the area have no space in their schedules. meanwhile, i deal with him as best i can... i've been dealing with him since he was born... he's always had special/high needs. so i have a pretty good idea of what he needs. problem is, he refuses to do a lot of what might be helpful to him. shrug.gif and now that he is almost 10, he's coming into his own. he's growing up and the pre-teen hormones are starting to appear. so, he changes sometimes from day to day! duck.gif

 

he's a good kid, but he's gonna need lots of coaching to be a successful adult! he;s got one AS parent and one ADHD parent, so he was behind the 8 ball to begin with!

 

i take ADHD meds as an adult, but i don't think all kids need them if agree they can do other things to help themselves. (have you read "disconnected kids?" or "last child in the woods?")

No, I haven't read those books but I will add it to my list. I have a stack next to my bed I need to get through. Sounds like my son also although we didn't try meds. as of yet.  Is anyone else's child almost constantly negative, grumpy, complaining, bored? He is happiest and seems like he has no issues when he is running free with friends outdoors - with a parent nearby though. We can now be inside but he will come in to check every now and then. 

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#29 of 31 Old 05-24-2012, 03:11 PM
 
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Hi so sorry to hear about your son. The effectiveness of an IEP really does depend on what is put in the plan. Some of my sons teachers basically use a generic type one just to fill up space and didn't really address the main issues. They tended to put down more academic stuff and not behavioural stuff which is where the main problem was. You really need an input to the IEP and ask for regular feedback of what is accomplished and where they currently are! As for meds, we suffered worse side effects with some meds whcih were cumulative and didn't really start initially so we didnt realise it was the meds causing a problem. Now it wasn't for ADHD, it was for another medical condition but if you go down that road, monitor, monitor and monitor!

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#30 of 31 Old 08-18-2012, 09:02 PM - Thread Starter
 
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Just wanted to update here that we got an IEP and we are going to try it out.  This summer my son has made leaps and bounds with his anxiety. I can't pinpoint exactly what it is or a combination of everything but he is a happy child now for the most part with much reduced anxiety.  Some things we have done are: continued with a new therapist one-on-one, started a small social skills group once a week, elimated food dyes and cut out many processed foods, buy more organic food, upped his omega-3 dose and the big one.....he did his first extra-curriclar activity! He managed to separate and accomplish approx 10 swim lessons. It was a small group and we were in view but that is big for him! I think swimming really helped and it was a great starter activity which he will continue.  

 

So, now with his IEP in place we are hoping things won't spiral down again since he is going back to the same school as last year. It seems good though since they have him 48% of the time in a small class setting (3 kids) which will take care of all his academics since the rest of the time is pretty much recess, lunch, music, PE, etc. But, when he is in his general ed. class they will give him preferential seating and be aware that things like fire alarms, tornado drills etc. could throw him into a tizzy. We will visit the school a few times before day 1 and his special ed. teacher is even meeting us there with her new puppy for him to play with and to get comfortable with the school. So, fingers crossed all continues to go well!

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