Where the HELL do we go from here?

[HosannaInExcelsis]

I am so desperate for help. I hope someone has some ideas, as I am clean out of them

DS (7) has Asperger's Syndrome and some quite severe behavioural difficulties as a result. He has a diagnosis and a Statement, and attends a specialist unit within a mainstream school. This is his second year there, after a horrendous couple of years in a mainstream primary class, where he was repeatedly excluded for being unable to obey the rules (he wouldnt listen to teachers at all or sit still or do as he was told ever; he regularly tried to escape the classroom, lashed out at children and teachers, tried to escape the school grounds etc - horrendous times, basically).

His current school are generally lovely and very understanding. He is in a small class with a high adult-child ratio, so the environment has seemed to suit him better than a big, noisy mainstream class of 30 kids. We have a good relationship with his teacher and the Head, and DS seems reasonably happy there. However, his explosive temper is not improving and as he gets bigger and stronger (he is a very big lad for his age) the results of his outbursts are getting worse.

This week alone he has physically and verbally abused the escort on his bus (he has recently picked up swearing from a boy with Tourettes who travels on the same school bus, so that is a charming addition to his already terrible behaviour ), kicked a door at school and broken a pane of glass in the door, and today he has been excluded (one of the few times the school have ever excluded a child from the SEN unit ) for punching a teaching assistant in the eye when she tried to break up a scuffle between him and another boy over a toy in the playground.

I am mortified . Just so, so distressed about it, really, and worn out with the endless worry about DS. I feel so angry with him - for hurting other people, for hurting himself with this awful, awful behaviour.

I just don't know where to go from here. The school are having an emergency risk assessment meeting tomorrow and the unit is closed half day because of what happened with DS today. I am gutted. How can I help my DS? How can we stop him lashing out constantly? If anyone has any ideas or experience of this, please, please let me know

so sorry you are going through this. Have you had any assessment by child psychiatrist? Ds (classically ASD) who became quite aggressive some years ago has been helped massively by medication. I don't know if this is a possibility for your ds?

Thanks for your reply, cansu.

He was diagnosed by the Community Paediatrician, who is also a Psychiatrist, who offered Ritalin and/or some other anti-psychotic drug at the time. He was 5 at the time and the thought terrified me . I am still loathe to go down that route.

He saw psychotherapist at CAMHS for a year or so. It didn't help at all. I just don't know where to go for help now? CAMHS have been pretty ineffectual and I actually have no idea what sort of professional we need

ABA? Usually LAs loathe to pay for ABA but where no alternative may consider it.
Do you have a behaviour support outreach team who would come in?
Personally I would look to an ABA consultant
For eg Treehouse ABA school in London is very expensive but keeps many children out of even more expensive residential provision. Advantage of ABA is they will come home and go into mainstream because being very consistent is going to be key.
If out of school more than 5 days you are entitled to home tuition (See IPSEA website for info on exclusions) and recent LGO report 'out of sight out of mind' stating minimum levels of education eg 25 hours a week
For support that ABA approach is suitable look at Royal College of Psych guidance here and here. So you need someone qualified to do functional analysis.

It seems to me on reading this that the school is not the right place or they have nto got the right support available to them.

If he is to to be excluded then they will need to demonstrate very high levels of support and no other support would be availbe to them.
If they have done what they have done here what more is reasonable for a unit to do?

I think you need to re look at the support package and intereventions. Look at the SALT and OT intereventions as it seems that he is overly stimulated throughout the day. How many of the frictions are due to his lack of semantic/ pragmatic language.

I am so sorry. I can guess how you feel, but this happened at school and so school should be trying to work out why it happened and then how to avoid it happening again. Hopefully they will call on specialist advise if needed.
I would think knowing what triggers potentially harmful behaviour might help so that triggers can be avoided or worked around, or anger defused before it overflows. My son with autism and ADHD helpfully had a full blown meltdown in front of the visiting specialist school doctor (sn school) who fortunately for us recognised the underlying anxiety that triggered the meltdown. As part of the management ds was put on a very low dose of a blood pressure medication which seems to just take the edge off that explosive panic.

I would ask for a referral to a Clinical Psychologist as they are trained in adressing challenging behaviour. (I see your son saw a psychotherapist and I don't know what their background was but psychotherapists are not usually trained to adress challenging behaviour with clients with special needs).

A clinical psychologist would assess your son, and the reasons for his behaviour, and then draw up a program and strategies for the school and for yourselves at home, aimed at preventing him getting to the point where he acts like this, reducing the difficult behaviours, teaching him other coping strategies etc.

It sounds as if that might be the type of approach needed.