Hitting

[mrslookingforrightschool]

My son is 5 and in mainstream. He has severe ADHD and is currently awaiting an autism assessment (professionals think autism is possible, but he hasn’t been diagnosed).
The biggest issue is the hitting. It’s happening almost daily at school. Sometimes there are obvious triggers, but other times it appears completely unprovoked. Today he punched a girl, and when the PE teacher intervened to move him away, he kicked him too.
At home, he isn’t exposed to violence. We’ve never hit him, we don’t shout, and we have clear, consistent boundaries. He accepts boundaries at home reasonably well, but school is a completely different story. Once he’s dysregulated, it’s as though his brain goes offline and he acts before he can think.
He simply doesn’t seem able to cope in a mainstream environment. He has an EHCP, but despite support, the aggression is getting worse rather than better. We’ve been told there are no places available in specialist provision, so we’re stuck.
I’m heartbroken, exhausted and, if I’m honest, deeply embarrassed. I hate thinking that other children or staff are being hurt, and I feel like I’m failing him even though we’re doing everything we can.
If you had a neurodivergent child who was a hitter, what actually helped? Did anything reduce the aggression? Was it medication, a change of school, occupational therapy, different parenting strategies, age, or something else? I’m really looking for hope from parents who’ve been through this

Is DS diagnosed with ADHD (unusual but not unheard of at 5)? If so, is he on medication? If so, when was it last reviewed?

If DS has an EHCP, what support is in there and is it being provided? Does DS have SALT and OT input? How good was the EP advice? Has anyone mentioned up to date advice from the EP? If your area still has them, has the school asked the specialist teaching service for advice?

We’ve been told there are no places available in specialist provision, so we’re stuck.

Whoever has told you this has misled you. For schools who are not wholly independent, on its own, being full, which is not defined in law, is not enough of a reason to refuse to name your preference. The LA has to prove the school is so full admitting DS is incompatible. The bar for this is higher than LAs and many schools admit. It has to be something tangible and specific and is more than an “adverse effect”, “impact on” or “prejudicial to”. However, many parents have to appeal. When was your last review? Have you requested an early review.

Has the school kept a detailed diary, completed ABC charts or STAR analysis to spot triggers/patterns to try to help with those that appear unprovoked. Has the school had any support with deescalation strategies? To reduce the number of times DS gets to the point of no return.

Thank you, that’s really informative and helpful.
Yes, DS has been diagnosed with combined-type ADHD by the NHS. They won’t start medication until he turns 6. When he us 5 years 10 months old he needs to be referred to Mindworks for titration. I am not sure how long is the waiting but private services also said they wouldn’t start titration until he is 6.
He had his EHCP before he received his ADHD diagnosis, so I feel it probably needs to be reassessed. He also has social communication interaction difficulties but they said he is not autistic but they will reassess him for autism in the future. At the moment, it’s mainly based around social communication difficulties ,emotional dysregulation, impulsivity and not being able to sit, pay attention. He doesn’t currently have OT involvement, and his speech and language therapist sees him once a term. He can’t use his words in situations but during therapy sessions his language seems fine. Totally different in real life situations.
You’ve given me a lot to think about, particularly regarding the EHCP review and specialist placements. Thank you.

You definitely need an early review of the EHCP. DS needs far more support from it. He also needs OT input and more SALT input. Part of SALT input should be looking at generalising skills rather than only considering the SALT sessions as discrete stand alone time. If you want a move to SS, the early review is also the route to do that.

Thank you so much. I will definitely push for it.

”Has the school kept a detailed diary, completed ABC charts or STAR analysis to spot triggers/patterns to try to help with those that appear unprovoked. Has the school had any support with deescalation strategies? To reduce the number of times DS gets to the point of no return.”

We agreed on ABC however his teacher delivers it verbally and usually they say “unprovoked, impulsive” or I didn’t see what happened I wasn’t there, TA was busy helping another child”. I tried to make the Ehcp more specified and quantified but unfortunately it’s very vague and LA is determined not to change it. No de-escalation strategy.

Hitting is often a sensory need. Please seek OT advice and ask about retained reflexes.

When you next have the right of appeal, you should appeal to improve the EHCP.

It isn’t enough for the school to just verbally go through the ABC process. It needs to be written so that over time patterns can be spotted. It isn’t enough to just say unprovoked/impulsive. They need to look in more detail. Even if it is unprovoked &/or impulsive, there will be patterns to spot. Not just looking at triggers but spotting what works and what doesn’t in the management of the situation.

Thank you, yes I agree. I will have a private assessment, I asked LA but they said waiting is long etc

Where are you based?

Our DC also hit a lot at school - and would become completely dysregulated and lash out - mainly at teachers, very rarely at other children. I agree with PP that sensory overload was a huge trigger - they couldn't manage with the noise and hustle and bustle. The dinner hall was a nightmare. OT input helped, as did sensory circuits. But ultimately a specilasit school that was much quieter and calmer saved the day. Several years on and they are like a different child. Very calm and regulated and not an incident at school for over one year. Please do push for a SS - it was life changing for us all. I know exactly how you are feeling - DM if you want to chat more

Thank you so much. It’s really reassuring to hear that things improved so much for your DC.
I’ve been trying to get the right support in place, but from reading everyone’s replies I’m starting to think I really need to push for both OT input and a specialist setting/unit.
One difficulty we’ve had is that professionals have come to observe him at home or we’ve attended clinic appointments, and although he’s very hyper in those environments, he’s emotionally regulated. Because of that, their reports don’t really reflect what happens at school, where he becomes overwhelmed and dysregulated on a daily basis.
I think I also need to ask the school to provide detailed written evidence of his behaviour and the frequency of incidents, as that probably gives a much more accurate picture than clinic observations alone. Thank you again it’s really helpful to hear from someone who’s been through this.

It is common for DC to present differently in different settings. Some professionals will assess in school.