11 year old DS already suspended from secondary

[HistoryT]

DS has ADHD diagnosed about a year ago. He takes 15mg of meds but I'm really not convinced they help. It's difficult because he only takes them on school days and while I do think that in the beginning they helped him stick at a piece of work for longer, I think they may also make him feel more agressive. I'm completely torn over whether to continue with them or stop.

He was bullied in his primary school. He annoys other kids, is immature and tries to get a reaction or 'stimulation' from interactions with other kids. He can also be kind, sweet, full of love and very thoughtful.

Secondary school was good for the first few weeks and now he seems to have got a reputation for being annoying and a bit of a clown and other children are dismissing him, saying derogatory things, putting him down etc. And so his behaviour has deteriorated, I think because he feels bad inside and it comes out as ager. He's extremely reactive and picks fights, hurts other kids. He crossed the line this week by head locking a girl and received a serious sanction, then he went on to do the same thing again a couple of days later. I don't know how to help him and scared he will have to leave his school. Current appraoch is to wrap him up in support and show him we're on his side, here to support, but at the same time his actions are so entirely unacceptable. He can't seem to take responsbilty or stop himself but is remorseful - but then he'll say things that show he believes the only way for him to respond is by being physical and showing others he is stronger than them. For context, he's average to small and defintely one of the shorter ones in his year.

What do we do to help him? Tried counselling but he tells them everything is fine and says he doesn't want to talk to anyone (he opens up to us a little bit but is mostly a ball of frustration and anger). He doesn't behave violently at home.

With love, the reason you probably dont see the aggression at home is because you all love him and make allowances for him. If he annoys the siblings, you probably give him some attention to distract him and interrupt the escalating behaviour. At school, kids are taught to ignore it and there arent enough staff around to give him the alternative timulation. So he continues until he gets a reaction from them.

If he was escalating to physical behaviour at home, how would you handle it? Can that be carried across to the school?

That poor girl. She must’ve been so frightened. And poor you.

What are the sanctions at home when this happens? Is his dad around?

@HistoryT were his adhd behaviours better controlled on the 20mg?
It’s totally normal to feel horrible as they wear off. What the clinician will normally do is offer a small top up dose eg 5mg/10mg of immediate release methylphenidate to take the edge off as the main meds run out. His conservative approach could be doing more harm than good.

Bless him? He put a girl in a headlock?

Medikinet & Equasym at both forms of methylphenidate - maybe lisdexamphetamine (Elvanse) would be a better option? The different layering the long release meds have also affects how they work for different people.

My son struggled with Concerta but fine on Equasym - he was only on 10mg for a very short time and had always been on at least 30mg as his stable dose - moving up to 40mg this summer after a growth spurt & drop off in function - he’s now functioning pretty optimally on Elvanse 40mg (also 11 and in Y7).

I think it’s worth bearing in mind that for your son to be behaving like this and having negative interactions with peers and teachers, he can’t be having a good time.

I think you may need to lean-in to the idea of medication and trialling different ones to get the right meds and dose. That’s not to say medication is everything, but it really sounds like he is very impaired by his need for stimulation and being disruptive as a consequence.

It is worth remembering that these people that he is using violence against are also children and if he is being annoying to them, they will be being annoying back.

It does amaze me that some of the responses are "bless" and knowing that their responses in a few years time will be 'violent man'.

He’s also going through a difficult transition without the correct treatment and support he needs to manage?

Firm boundaries are of course important, but it’s clear he needs some empathy and compassion until the situation stabilises. That’s what will help to reduce the chance of similar outbursts in the future.

He’s already under that approach and OP has said it hasn’t worked. I’m not saying he isn’t struggling he clearly is but ‘bless him’ for violently attacking a girl at school is hard to hear if I’m honest.

Bless him for attacking a young girl twice! oh my gosh.

Op you need to pull your head out the sand. How your meds affect you is you. Don’t base what he has on how you feel on yours. Change doctors for a start and he clearly needs to change what his on as it not working.

I’m surprised tbh that he hasn’t taken a beating from the boys for attacking a girl. Lucky him so far.

I can appreciate that. It’s not a nice situation for anyone involved by the sounds of it. I think OP posted in good faith to try and find a way past this behaviour, so no-one is condoning what happened. There are reasons for it though and treatment pathways that can be explored to make sure things get better going forwards. It sounds like OP is dealing with an unsympathetic/uninformed doctor while also having to get new support structures put in place in an entirely new school. It’s a lot to deal with.

ADHD is a really difficult thing to live with and the secondary school years can be especially hard to navigate.

I agree with the couple of posters above. Not trying to create a pile-on but his suspension shows he is really out of his depth in impulse control and decision making.

Teenage boys are already a bit of a worry on the front, but protect your boy, and those around him, by seeking proper help before he gets into a really dangerous situation.

I think I would also say that regardless of your understandable concerns about medication he has been violent to a child. It cannot be accepted that this is just part of the struggle and the protection of other children has to feature heavily in your and the school's thinking.

Mainstream schools are hit and miss for making accomodations, usually due to lack of funding so they may not have the resources that OP has at home, which could just be as simple as his own space, more frequently.

SEN schools are also ridiculously hard to get into.

I agree with the other pp that school might not be for him but as a child over the age of 5 he is legally entitled to a full time education, and his disability should be measured as though he is not medicated for the purpose of not all medications work effectively all the time for every one.

It's likely that the OP sees less aggressive behaviour at home because of unconscious accomodations that are just naturally made at home, plus it's a different relationship dynamic with family than it is to teachers and other pupils.

I do think OP needs to dig her elbows in and get everything needed to start the EHCP process for accomodations at school.

You need to work with school to get to the bottom of why he is reacting like he is. What are the triggers to the behaviour? These things very very rarely come completely out of the blue.

can school meet his needs? Do you need to look at applying for an ehcp?

keep a diary of everything and ask school to. It will help paint the bigger picture

Look a longer acting methylphenidate like concerta or delmosart. My 11 year old takes 54mg

I wonder are you over identifying with his feelings.

He's not you.
He hasn't had your life history.
He doesn't have your feelings even if both of you have ADHD.

Isn't trialling the meds better than him getting worse at school?

CBT skills about expressing emotions might be useful.

There's a book called Think Good Feel Good by Paul Stallard. It's cognitive behavior skills for kids.

That might be more helpful to him, if you read it and see can you get him to understand it and approach it.

Reading Gabor Mate is good too but may not solve the immediate issue.

Your aim is to get him to notice and learn about his anger, and then take steps to pause before he reacts.

Both myself and my children have ADHD so I do get everything you talk about and its great you want to be supportive and help him. But I have been left wondering what you have done as a sanction for putting two kids in headlocks? These kids must have been frightened to death. Maybe you didn't do this but you implied your response was to surround him with support.
Its likely the kids at school will be frightened of him and stay away from him - I struggle to see how he is going to improve this vicious cycle of kids excluding him and him feeling bad about himself. I am wondering if you might need to look for a fresh start.

That's a low dose and there are better medications out there like Elvanse. My DD14 is on 40MG a day on school days and it really helps.

One thing though he really really needs to understand he cannot attack people especially girls. That is horrific.

Definitely get him coaching or counselling.

There must be some kind of impulse control as these posts are nearly always about attacks on girls, younger/smaller boys or teachers. I’m yet to read about them unable to control their impulse with a random bloke in the street or a much bigger/older boy, somebody able to really fight back basically. That doesn’t mean it isn’t ADHD related but indicates to me there is some kind of impulse control that can be worked with.

Spot on, Naptrappedmummy!!

This. My son was attacked in school by another child with ADHD, it's not OK. If an adult was attacked by another adult it would be a police matter, ADHD or not. I hate how it's just accepted that kids should put up with violence in school. I'm sorry but if a child puts others at risk for whatever reason they shouldn't be in school.

This is the looming issue. These boys need a long term view of what their life will look like if they carry on attacking people around them. In a few short years they will go from misunderstood schoolboy to a grown man who will simply be arrested and prosecuted every time this happens. Goodbye decent job and life chances. Presumably he wants a decent job and a girlfriend (or boyfriend!) at some point.

Like I said I do believe there is an element of self control because I bet OP’s son hasn’t attacked his sports coaches, friends dads or blokes on the street. Which is encouraging in a way as it shows it can be controlled to a degree.

But treating the issue with a radically different approach to the one he will face in 5+ years is setting him up for an enormous fall. As a mum of a daughter I’m really worried about the level of aggression it looks like there will be in boys/men when she is of dating age.

Bless him, I can relate to his struggles.
No one is excusing or accepting his behaviour and no one deserves to get hurt.

I think you need a new doctor. Are you seeing a GP or a autism specialist paediatrician?