To think if we can't get help, who can?

[drspouse]

DS (12) has ADHD and can be aggressive. We are seeing positive changes but he can still flip on the drop of a hat and last week threw something at me that made my head bleed, DH took him out to cool off, I had called the police and they had arrived meantime and this triggers social services to call which is why we do it.
Had a really patronising, I felt, call from social services today. They keep saying we've "refused services", throwing names around (names of people we may have met but we've met about 20 new people and some have actually rung DH or seen him not me, and names of services that we may or may not have been told about).

We have recently been awarded respite which is supposed to be a certain number of hours but none of the agencies can find us any workers and the SW acted surprised (despite there being a national care recruitment crisis). I contacted a mentoring agency - they charge £75/HR and we get minimum wage to pay the worker...

Both DH and I thought we were told we'd be getting a disability social worker. Apparently we should know he has the wrong sort of disability so no social worker.

We are fully aware that we don't always handle him well and the incident last week has also left me with bruises but it was the result of me telling him off for ignoring my instructions and he then pushed me against the metal radiator so I fell over and then he threw cutlery at me. I completely lost my cool as I was covered in blood and I wish I didn't because it just makes DS more wound up and more aggressive.

We've asked for help around staying calm and our mental health (because we are on edge wondering which day he will throw a kitchen knife or push someone down the stairs, and because we don't know how not to react when we are bleeding or bruised). We also want someone to help us with how we handle him and what to do when he's dysregulated. We were explicitly asked "what do you think you need" only to be told "we don't provide that" and then apparently we'd "refused services".

We've been told about 20 times to "call your GP". We've both been through their CBT course twice, me three times, and we're both on medication.

We are at risk of being seriously hurt. We are afraid for our lives and safety. But nobody can do anything about it. What are we supposed to do - wait till one of us is dead? Until he's in prison? Until he's old enough for us to say he has to move out and then he'll just be on the streets and on drugs but we might still be alive?

Just to add - I've had panic attacks myself, so I sympathise with your DH, and when I have both of mine have been upset and concerned. My teenager with AuDHD couldn't cope with it, but 'hilarious' was the opposite of how she found it. I appreciate that's only two children, but I really want to keep reiterating, as I have since I joined this thread many pages ago trying to help, that your son's issues are NOT just, or even mainly, due to ADHD.

I'm not sure why he would have CPTSD because, while not wishing to minimise the difficulty that being adopted caused he has no neglect, trauma or disrupted attachment.

One of My DD had in utero stress from birth mums lack of food, drug taking, alcohol and stress from her chaotic lifestyle, removal at birth would have been traumatic and a broken attachment, moving to foster care, being adopted in itself a traumatic attachment disruption. He is showing you he is very traumatised. Your denial of this is surprising.

School tried art therapy, he just draws the same cartoons he draws the rest of the time, he likes animals but walking around once a week with horses is not going to turn him into a calm child! Maybe it would be good for a calm anxious child but that isn't him. He will not talk to therapists.

That sounds like art therapy was going very well, that repetition was great and a good sign he was working through stuff in a rythmic way. Horses are highly attuned sensitive prey animals who communicate at a sophisticated level non verbally so perfect for children with trauma as they have a larger amygdala. Horse operate a lot from the amygdala and can be really in tune socially as they are herd animals. If you can communicate with ahorse that is a skill and hugely confidence building.

I can't find any controlled or systematic research showing any of the therapies that the ASF funds actually work, except CBT which is not suitable for a child that won't engage. DH was just recommended Therapeutic Parenting so I looked up controlled trials and systematic reviews like I always do and it doesn't work better than doing nothing. Why does the ASF waste money like this, honestly? There's so little to help and they are throwing money away.

A lot of parents have had huge success with therapeutic parenting and low demand parenting. Just because someone hasn't done a study it doesn't mean it doesn't work in practice. Children with damaged brains and nervous system and complex trauma cannot be parented in exactly the same way as NT children surely.

I'm finding your post a bit hard to read @ilovemoney but it sounds like you think we are trying to do exactly the same as with a birth/neurotypical child?
I am guessing you haven't read any of my posts.

I'm not going to link you to all the studies on how you tell if a child has an attachment disorder as I'm sure you can Google for yourself.

I'm going to make a really rude update here which is to say I'm going to ignore anyone who tries to make an additional diagnosis for DS, or who has obviously not read any of the previous posts or has obviously only read the OP.
Sorry. But not really.

Anyway an update:

DS is doing incredibly well at home and (if you read my other thread) is on much better epilepsy meds. We've hardly had any aggression and one incident was provoked by my DM full on shouting at him which frankly I don't blame him (she massively favours DD who can do no wrong even when she slapped me for moving her plate till she picked up her fork and stopped using her fingers.) He was quite confused over the summer and even got lost a couple of times but is more or less back to normal (for him).

However before the summer the schools said they were about to tell the LEA they couldn't meet need and the LEA would "have to find him another place" which shows they live in cloud cuckoo land.

He is back in school, has been in for most of 3 weeks except for 2 days after he was basically travel sick and vomited in school.
During that time he has done no academic work, hasn't been in the classroom, and has told us "they have said I don't have to do any work".
It is hard to tell if they have been ineffectually saying "oh DS do you want to come in the classroom now" and he refuses and they write down "not ready to learn" or if they have actively decided not to bother teaching him until we take him away.
He needs incentives to do anything hard. Obviously he does. He has no incentives to do anything even remotely challenging at school and he has every incentive to hurt staff (because when he does he goes off to a nice quiet room and gets to do colouring).
I called his case officer yesterday and emailed them again today, but if I don't hear back I will be talking to the head of her team.
I think my next step will be judicial review but it doesn't actually say "we will teach your child basic National Curriculum subjects" on his EHCP so I feel like a complaint that they aren't doing this might not go anywhere.

1. How do you know that what he has told you is true?
2. Let's say it is true. If he is aggressive when asked to do something then the staff have no choice but to reduce demands and provide an alternative. Staff won't accept getting hurt in order to show your ds that this behaviour won't work.
3. If they had an incentive that worked they would be using it.

It all kind of adds up to the school not being suited to your ds needs which is what the school have said.

There may not be anything better out there. I know you have said this yourself on other threads and I think you may have already tried to get other independent specialists and non specialists to take him.

You could try home education with tutors or eotas with tutors but you will likely have the same issues and again wont easily find people who are prepared to stand their ground with someone being aggressive. Students who are challenging with their behaviour often end up doing much less academic work while schools work on meeting their emotional and behavioural needs. My dd is accessing an alternative bespoke education service where tutors work individually with students. However it would again be trying to meet your ds emotional needs and working on his interests so not a traditional exam focused learning approach.

You are right, we don't know it's true.
But he thinks it's true, which is the important part.
We know they've said they can't teach him, as well.

At home, we have increased demands, ignored aggression, he's calmed more, tries harder, and helps around the house.

At school, they reward aggression, and refuse to listen to our ideas about incentives, and do everything for him. He doesn't do any learning and thinks he doesn't have to.

Hmm let me see, which one's working?

I've already answered the rest of what you've said.

OK. I think though that you are being unrealistic. I also remember you having to call for help when he has been aggressive on numerous occasions. You also do not have other children with similar needs to consider. I also think we are prepared to cope with things from our own kids at home that we cannot expect school staff to cope with. Ignoring aggression is your choice. Why should school staff do this? What happens if they do and someone is seriously hurt?

He has improved massively over the last few months, to the point where we have issues weekly or less whereas school seem to report issues daily.
Obviously we'd love him to be calm all the time but it's taken about a year from tearing our hair out to being proud of him for trying a new club yesterday with no fuss at all.
We have called the police, yes, but in some cases because we were told to report absolutely everything to get the help that was offered (though it hasn't been much).

It is obviously brilliant that things have improved so much for you at home and you may well be right that the line you took worked. Surely though you can see that the environment, peers and needs of other staff and pupils make the position at school very different? I can't see how a judicial review or any other legal action will be able to force his school to act in the way you think they should.

Glad things have improved at home!

Re school: they’re right though, they can’t meet his needs. Part of those needs are academic, so you agree. The school can’t teach him as doesn’t engage and gets aggressive.

In terms of the school “rewarding aggression”, what do you think they could do instead?

They’re putting him in a different room to separate him from children he could hurt or property he could damage. They could traumatise him by putting him in complete isolation or something he hated and you’d have every right to complain about that.

Basically I agree completely with @cansu

I was going to suggest this too. I work with similar children to your child.

Not sure I have advice but I will add my experience:

This does happen.

Students who show violent behaviour need to be risk assessed. Schools have a duty of care to their staff under the health and safety at work act and in order to stick to that they do risk assessments.

https://www.nasuwt.org.uk/advice/health-safety/risk-assessment-of-violent-and-abusive-behaviour.html

The current Dfe guidance on behaviour emphasises that keeping students and staff safe is a high priority and that child to child abuse is a major problem.

https://assets.publishing.service.gov.uk/media/65ce3721e1bdec001a3221fe/Behaviourinnschools--adviceforrheadteachersanddschoolstafffFeb2024.pdf

In most schools now if a student is being violent then they will be left in the classroom and the rest of the class will be evacuated. Obviously the teacher will try re-escalation strategies first.

In some schools student violence is a major problem and on occasion the unions have got involved after staff have been injured and the whole staff body have refused to teach the child.

I have personal experience that if a child has been supported and triggers identified etc, and has been through the process of support being offered but it makes no difference then they can end up just in a room pretty much on their own with a TA for support.

One of the children in question was routinely violent to multiple mainstream school staff. He had multiple diagnoses. He tried out a unit in another school but was violent there as well. He wound up back with us because no-one would take him. But his triggers were demand focused - he was basically demand avoidant - so classrooms would never work for him.

They did try to get him to learn things but ultimately it came down to the physical safety of other students and staff is more important.

Staff in special schools and PRUs are generally better at dealing with violence as they get so much of it, but even they have limits and the academic curriculum there is generally not as good as mainstream

What we think school should be doing is more or less what happened at the PRU where he was very successful.
Ignore everything they can.
Tell him once and don't keep on telling him.
Give him rewards that work (mainly screen time, but they need to be in control).
Sit with him but don't talk to him when he isn't doing what he's supposed to be doing.
Don't try and ask him to tell you why he's upset.
No rewards till he's done what he is supposed to be doing.
If he's nervous or refusing to do something I sit and read a book or tidy up and don't talk. That would be extremely easy for his 1:1 to do and we've explained how we work it but they won't have any of it.
We let him get bored with nothing much to do until he does what he's supposed to be doing.
Some of the things that are theoretically "low demand" work with him - not going on at him, not appearing to care if he does something, giving him choices (but if he doesn't choose we choose for him).
Removing the actual demands just means his world gets smaller and the things that set him off become less and less easy to control. This is not speculation, it's what actually happens.
Adding them slowly but without appearing like we care has made him able to do more things.
We know he's not able to cope with a large class but we also know he is able to cope with a small group most of the time.
School seems to do the opposite: they talk too much, keep trying to persuade him, and talk when he's dysregulated.

Forgot to reply to the self defense: it's on the list, but things have calmed down a lot at home and our home priority now is teaching DD to ignore him. But he's getting better with her too, for example he used to do everything he could to get to her in the morning to pull her hair or push her because she reacted so well. We had to stick to each of them separately to keep them apart.

This morning he said "oh there's DD I'll pinch her" but wasn't anywhere near her. She growled at him (which is her go to reaction) but he said "only joking, do you want cornflakes?" Which to my mind is a perfectly normal sibling interaction and is a huge step forward.
We also need to teach my mum how to ignore him, she's like one of those reactive yappy dogs when he puts a foot wrong!

Some of those things you list do sound like things the school should be able to do.

But a few of those things sound unrealistic.

I think you need to bear in mind though that children, even those without SEND, can behave very differently in different settings. Your son had a series of enforced school moves so at this stage, a school setting is likely to automatically be a bit triggering for him.

Is there an option for the school to do a managed move to a PRU, or some other form of alternative provision? I appreciate that might be temporary but it might be better than nothing. Although he’d be at a secondary PRU when the one he was presumably at before was a primary one, so a PRU might not work as well for him now as it did before.

There's a secondary PRU but we've been advised it's a lot more triggering for a lot of children. We looked into the medical AP but were told it's for children who don't have an EHCP and are medically incapable of attending their mainstream school. There are no other AP options.

We don't feel it's the actual environment that upsets him - he's generally good with the other children, always to be seen on the field at break - the only occasions he's been aggressive to another child is where that child has bullied him first. I'm not really sure what learning would look like in a non school setting but if an adult is trying to persuade him to learn that's the kiss of death whereas if something is happening around him and there's a chance to put his hand up and look clever he's all over it. So a tutor or similar at home would work less well than school does if that's possible!

If he was the kind of child who did the hard work of practicing writing/complex reading/maths on his own and needed inspiration in a group setting then something like riding/sports/art group/museum visits might work but he needs competition in the basics - being first to say the answer, praise for coming up with a good description, that kind of thing. You have to make him forget it's hard work and think it's a game, but he needs lots of practice in some of the things other children don't need.

"he needs competition in the basics - being first to say the answer, praise for coming up with a good description, that kind of thing. You have to make him forget it's hard work and think it's a game"

I do understand this but won't this either have been plan A at school and it's already failed, or if it wasn't Plan A there was a really good reason why not, eg his peers are not able to cope/do not thrive with this approach. In either case perhaps school are not going to be able to meet need.

I wonder if it might be possible to introduce this game element with a one to one teacher. I compete with my teen all the time, and adults can regulate their responses better than SEMH needs peers. If DS is motivated by being the "winner" among peers then that implies someone has to be the "loser" - and that he must take his fair turn at losing himself. Neither of which sounds very realistic or stable to me in a group of presumably quite reactive and high needs kids. I just wonder if a tutor could work and be more realistic than trying to get a whole peer group set up perfect for him. A tutor with the right classroom experience, who's understood and digested your most recent insights and can "buffer" the winning/losing, mop up enough of the losses while still maintaining their position, and gameify the learning.

My son's got a different profile but he has massively struggled to engage. A.N.Other tutor has not worked out but the right tutor should be able to provide the "Goldilocks lesson" - not too challenging, not too easy, just right to press DS's engagement buttons. You can't keep moving him from peer group to peer group until one fits, and school probably have no other groups he could slot into anyway, but you can try different tutors and they vary massively in skillset and how much they'd click with your son.

I know you want/need him to be in school and therefore you want/need school to provide the learning in the peer group. But it's a long game. We've divided it up. Engagement with amazing tutor first, and he's gone from outright school refusal to asking to see mainstream classrooms. Would it be worth maybe seeing if they could teach him one to one at school for a few weeks in one subject? Please don't bite my head off if you've covered this. I have read the thread but I can't claim to retain every single sentence you've written.

I've just read all through your thread and it sounds so difficult. How are you/him doing now? (I've got no advice just support from the sidelines really - adhd/autistic kids so some understanding but we aren't facing anything as near complex or difficult. My heart goes out to you.)