Where to from here?? Behaviour getting worse

[jogalong]

Ds is 7 ASD, mild ID in a special needs unit. Has had behavioural issues since he was little. Despite huge amounts of OT, sensory integration etc is behaviour is still awful.
Last resort and we put him on meds to try regulate him but twice already this week he's had to be put in the de-escalation room in school for hitting, kicking, spitting at his teacher, sna.
He is very clever, strong willed and stubborn and prob has odd. I feel meds are not working and really have no idea what we can try next. Any help appreciated.
Thanks

I would consider two options.

First taking him off the medication. It doesn't seem to be benefiting him and may possibly be making things worse (we had similar with ds2 where the side effects of the medication in terms of aggression were worse than the anxiety we were hoping to relieve). Of course do this in consultation with whoever prescribed it. Might also be an alternative one he could try.

Second, I would question whether the school placement is right for him. The ARP classroom at ds2's school was actually quite noisy and busy because although there were few children there were lots of adults and lots of coming and going. In our experience special schools presented a calmer environment sensory and routine wise but obviously will be considerable variation between schools. certainly we have found that when the environment at school is better the behaviour at home vastly improves.

Can I ask what the meds are? DS was put on sertraline last year for extreme anxiety and OCD. Relieved the anxiety fine but sent him out the window (almost literally) in terms of aggressive and impulsively risky behaviour.
Definitely worth a look which I realise is acutely depressing when you've been desperate enough to try medication in the first place

'Prob had odd' - this might be the key. If he has then there are different strategies which school can use to engage him, I would follow this up.

Interesting you had the same effect Bogburglar although the drug was different. ds2 was taking risperidone.

Yes indeed. You were very helpful when he was going off the rails on it and I was on here wondering what the bloody hell to do next.

If it helps the OP, behaviour is calm(er) but we have had to look at other ways of managing his stress levels. He's had a change of TA and what he can do is still very limited. Are just feeling our way back to a full time programme at school. It might be worth looking at a part time programme for a bit? DS has been able to manage his behaviour for a morning but not a whole day.

Best of luck.

PS am I teaching you to suck eggs if I recommend the Explosive Child by Ross Greene? We are also looking at a therapy called Non Violent Resistance for DS - it may be more appropriate for older kids (DS is 10) but appears to have some evidence going for it.

Thanks for all your replies. I was in contact with the psychologist and she's going to do another school visit.
An example of his behaviour is: Went for walk to shop today. Random stranger bumps into him. So he goes up and spits at them and runs away. Random stranger is obviously annoyed so I apologise and let them know I'll deal with it. I go up to ds and tell him its rude and not allowed spit. He proceeded to tell me to 'SHUT UP' and then spits at me and runs off. I give him a consequence which both of us know has no effect standing in the middle of the street. So we head home with the other 2 siblings in tow, me mortified and feeling deflated. And that is how every trip out and every day ends up. And I've no doubt the next time we're out it'll happen again.