Angry underachieving son with executive function disorder. Advice?

Parent Cafe
1

<p>We are so frustrated and in desperate need of advice. Our Ds seemed easy and were all hard workers who went through phases here and there, but were always reasonably respectful. Our son is angry, surly and currently has three Ds and two Cs and a B. His B is in honors biology, and a D is in honors geometry, the rest of his classes are all regular.</p>

<p>Our S is 15 and considered “old” in his class (summer birthday) and is just finishing 9th grade. We held him originally because his preschool teacher said he was immature and seemed to have no interest in learning basics like his ABCs. He has three older sisters, one with a ADD inattentive, and two that are super overachievers, including his next oldest sister who is currently a senior graduating first in her class and headed to an Ivy next year. </p>

<p>He’s known to have a great personality by some of his teachers, although others describe him as quiet or concerned with being cool. He has friends and people frequently describe him as funny. At home, most of the time he is very angry and rude to his us and his sister (the other two are in college). He regularly calls me names like “gay” or “frickin gay.” He hits his sister and his room is a disgusting disaster area. He rarely picks up after himself and when asked, he gets angry. He’s surly most of the time and rarely answers with more than one word which is barely audible. He has an iphone which he locks with a password. He frequently is not forthcoming, although I am not aware that he has done anything really wrong. He seems to regard himself as being a “good kid” and does not do a lot of things that would even make him suspect for “bad behavior” like drinking etc. I’ve taken away his phone, grounded him, rewarded him for his attitude/grades…I’m not sure what to do next. </p>

<p>He plays a sport one season, but doesn’t work very hard, although he scores frequently and his teammates seem to think highly of him. He’s just as happy to skip practice if we don’t insist. He sleeps a lot, and can sleep till 3pm on the weekends (after going to bed at 11pm) if we let him. He has a job and is a star at his job - known as the kid who will get there in minutes (rides his bike) and do whatever he can to be helpful without being asked. He’s very proud of his reputation at work.</p>

<p>So his success comes at his minimum wage job and somewhat through his sport. His wild anger and abysmal academic performance are frightening. I recently had him tested (which embarrassed him greatly) and due in large part to his teachers’ comments that although he gets distracted, they can get him back on task, he was not diagnosed with ADD but was diagnosed as having an executive function disorder. He has a difficult time focusing on homework and seems unable to sit still enough to study. I am meeting with his team of teachers next week (many of whom I’ve communicated with over missing homeworks, failing quizzes tests - all interspersed with intermittent high grades) His standardized test grades have been all over the place to very high, qualifying him for CTY, to very low.</p>

<p>Does anyone have experience with a child like this? A system of rewards/punishments that works doesn’t work? I feel like I’ve tried everything. We also work hard (and are working harder) to establish positive relationships with him (sports with H and food/shopping with me - he likes to dress well). I am losing sleep over this and feel like he is not succeeding on so many levels. He just doesnt seem to care about how we feel or understand about what it takes to do reasonably well in school. Help.</p>

2

<p>Executive function disorder is a learning disability. You and he both need help in understanding how this impacts him and what he needs to do to compensate for it. We found it a huge benefit to hire a tutor specializing in learning disorders for our very bright but similar issue S. He helped get him through the issues and learn to manage on his own. He worked with him for 3 years. But by college he managed on his own and has been successful. We also got him a 504 plan to force teachers to work with his. We found HS teachers less sympathetic to this type of disorder and needed the “stick” sometimes to get his accommodations enforced.</p>

<p>S was diagnosed end of 8th grade. It is not uncommon for a late id with bright kids. They hit the wall towards HS when juggling all the classes in their head becomes too hard. </p>

<p>So bottom line is get help. It will make a big difference. This is not something for which a rewards system works well. It’s not a simple obedience issue. It’s kind of like trying to drive without your glasses… All the rewards in the world won’t help if the right accommodation tools (in driving the glasses) are not provided.</p>

3

<p>There are colleges that have a one or two semester program for this. Examples are Landmark in VT and Mitchell in CT. I have a nephew with this disorder and he’s doing one of these programs. He doesn’t have the anger issue though and he seems to like the program that he is in. His mother pulled him from his public high school a few years ago because he was getting lost in the large classroom sizes and put him in a local private school with much better individual attention and it worked a lot better for him. He probably lost a few years in the regular classroom.</p>

<p>I don’t have any recommendations as I haven’t dealt with this personally - just know some thing second-hand but I do want to follow this thread to learn more about this issue. It sounds like a pretty difficult thing to deal with.</p>

4

<p>

</p>

<p>I am a little concerned with this statement, and hope that someone more “psych” will chime in. I am not doubting his executive function disorder at all, so don’t get me wrong. But just because a student can be redirected at age 15, does not rule out ADD- in my opinion. </p>

<p>I have an add child- it has manifested itself with anger, and when he was younger, this was a real issue. I will never forget the day I got a call from the principal telling me that my son growled at a teacher and held his breath until he turned red. He could always be re-directed, even on his worse days, that did not mean he stayed there when he was re-directed. But he is very bright, and his inability to remain on task is very frustrating to him. Boredom makes him irritable, and making him do repetitive/useless things makes him snarky and obstinate. Think stupid homework assignments or multiplication tables here. Especially busy work. </p>

<p>Honestly, we kept trying different things until we were able to find something that clicked with him and motivated him. That motivation is different for each child. </p>

<p>Are you going to keep working with a therapist or counselor to help you and him through this? This is as much of a you learning to manage and help him as a he learning to manage and help himself. </p>

<p>Good luck, I know that this is not fun at all!</p>

5

<p>

</p>

<p>Totally unacceptable. How does this get handled? </p>

<p>Frankly, I think you need professional help asap. Your daughter deserves to be safe in her own home. So do you.</p>

6

<p>

</p>

<p>This, I don’t think is executive function disorder. </p>

<p>I could be wrong.</p>

7

<p>I don’t know how much of his acting out is do to executive function issues, but the behavior you describe would not be tolerated in my house. Set clear limits with clear consequences for breaking each and every rule and always follow through with them.</p>

8

<p>He needs a strong father-figure role model. Not even joking.</p>

9

<p>There are just so many things going on. I thought he might have ADD - he literally flops around on a chair instead of studying - it’s like he can’t sit still. The teachers uniformly agreed that he was able to focus if he’s reminded to get back on task - so the school psychologist could not conclude ADD. The school psychologists report was very detailed and she clearly wanted to help him. She is recommending a 504 and that’s what we’re meeting about next week. I asked S to think about what might help him in each class (so far extra time with math tests quizzes is the idea that he suggested). I am hopeful the counselor will and teachers will provide guidance with what we can do. </p>

<p>The name calling is a part of his general anger - as is hitting his sister. He and his sister have always been very close and remain so, but I feel like he is so much stronger that he should not hit her, even if touches him first. Nothing scary here - I probably overstated - it’s just that he will push her if she hits him with a sock. Recently, when I “got in his face” about something I felt no fear of him hitting me. The name calling makes me feel bullied and i’ve talked to him about that - more so recently, so I am hopeful it will work. He has had every punishment and reward I can think of, and for extended periods of time. Bad acts do not go unnoticed. </p>

<p>Where would I find a tutor that specializes in executive function disorder? He is tutored weekly by a male math teacher he seems to like (he has had female tutors but seems to do much better and is much more positive - he actually asks for tutoring sessions).</p>

<p>I asked him about going to a counselor and he said he would refuse to go. Today we agreed on a contract with his self-imposed penalties for violations. I know it’s not enough; I feel like I need to be proactive. I do have a call into his doctor regarding treatment, including potential meds.</p>

10

<p>I have a similar but different situation with a child with add and executive function problems. We have a four-pronged approach:

  1. Tutor for organizational help once a week
  2. School support: we get a report once a week that includes what assignments are still missing, scores, and what important tests/projects are on the horizon. My kid won’t let me help her with organization, once we have this information, but she will let her tutor.</p>

<p>These two things alone were not enough, we also really have found it crucial to have</p>

<ol>
<li>A great therapist who my daughter trusts. This is the third one she’s had over the years, and finally we have a winner.</li>
<li>Medication, for ADD and anxiety. Also trial and error.</li>
</ol>

<p>It’s not cheap, but I see improvements. And slides, and improvements. And now my daughter is much nicer to be around, and is actually becoming a joy. </p>

<p>I feel for you! I wish you the best.</p>

11

<p>I have a sister and a brother with executive functioning disorders. In my sister, it manifested much differently, but my brother is very similar to your son. </p>

<p>He regularly has attacks of rage where he can’t control himself - he hits, punches, even has holes in his bedroom wall. At school, he’ll be getting A’s one day and F’s the next. He doesn’t seem to respond to the usual rules that a normal kid would abide by. </p>

<p>The answer? Get professional help. No one on an online message board will be able to offer significant advice, because every case is different. Start at your doctor, get referred to therapy, psychiatry, etc. Don’t be afraid to try more than one therapist if the first isn’t a match, and don’t he afraid of putting him on meds. </p>

<p>He will learn to cope with it and will be able to live a productive, successful life if you get him what he needs and are supportive. This also means tough love - take away his phone, etc. for bad grades, do not tolerate hitting, etc. you can discuss appropriate punishment and reward with a therapist.</p>

<p>There is light at the end of the tunnel! He will be okay. Best of luck.</p>

12

<p>If you haven’t taken him to a good psychiatrist to talk about the ADD you should right away. Do not necessarily trust the school psychologist’s diagnosis. Im sure most kids with ADD can be redirected! I have found so many people in those capacities to be clueless (while others are fine).</p>

<p>The other thing, please do not listen to judgemental folk who say the kid just needs limits. People in this situation get this all the time! I was just talking with a friend who’s son has aspbergers (still a little guy) who throws fits, and people who dont know cruelly judge her parenting. Those people do not know. They have never dealt with this situation. It’s not about limits, he has a condition that is crying out for treatment. </p>

<p>The psychiatrist and therapist should be able to help you find an organizational tutor if your school psychologist doesn’t know about these things.</p>

<p>What kind of area do you live in? I’m sure it’s so much easier if one lives in a city to find options for help.</p>

<p>PS: medication is a good thing. I’m not trying to diagnose your kid. Maybe you are against medication, maybe someone will hate me for suggesting it, but it can work wonders if it’s the right prescription. Talk to the psychiatrist now. Once he is 18 there is nothing you can do about it!</p>

13

<p>As a school psychologist, we cannot diagnose a student as being ADD based on our clinical judgement. We are required to collect information from parents and teacher using any one of a number of rating scales. It sounds like the responders were overly generous - and when that happens it is hard to make the case for an Attention Deficit. </p>

<p>As I read your post, it really sounds as though your son is depressed. Depression in males will often manifest itself as anger or defiance. Having a sister who is so incredibly successful must be difficult for him - and so often a kid like your son will decide he would rather appear disinterested than appear pathetic. </p>

<p>I agree he needs to work with someone. I would suggest that you try to approach this from a slightly different angle. I would wait until you have a lull and then try to talk to him about how you might work together to make his life happier. I wouldn’t talk about success or accomplishments - rather that you know him well enough to know that if he is being rude or unkind to his sister, he must be unhappy. What can we do? What are your thoughts? </p>

<p>Hang in there. I work with a lot of young adults and one thing I have learned is that they are so vulnerable and so easily embarrassed. You know if you don’t REALLY try (at schoolwork, sports), then you can tell yourself that you didn’t really care anyway.</p>

14

<p>Thank you so much for your responses. As usual, CC parents have given me so many different ideas. I think he is depressed - it frustrates him so much to not do well. With all of this momentum I think we have made game changing progress today. We worked on a contract where he made agreements regarding behavior and goals and created his own penalty. He will give me his phone each day and then will not get his phone back until his homework is done to my satisfaction (his idea). I will speak with his doctor about meds (I don’t like them - but with D2 meds changed her life after holding off for too long). Tonight when he came home from his sport he was kind and greeted me pursuant to the contract and with feeling. After all of the support from CC I did some research (this diagnosis is new) and came across this definition:</p>

<p>[About.com:</a> <a href=“http://www.ncld.org/ld-basics/ld-aamp-executive-functioning/basic-ef-facts/executive-skills-and-your-child-with-ld[/url]”>http://www.ncld.org/ld-basics/ld-aamp-executive-functioning/basic-ef-facts/executive-skills-and-your-child-with-ld](<a href=“http://learningdisabilities.about.com/gi/o.htm?zi=1/XJ&zTi=1&sdn=learningdisabilities&cdn=parenting&tm=105&f=20&su=p284.13.342.ip_p504.6.342.ip_&tt=2&bt=0&bts=0&zu=http%3A//www.ncld.org/ld-basics/ld-aamp-executive-functioning/basic-ef-facts/executive-skills-and-your-child-with-ld]About.com:”>http://learningdisabilities.about.com/gi/o.htm?zi=1/XJ&zTi=1&sdn=learningdisabilities&cdn=parenting&tm=105&f=20&su=p284.13.342.ip_p504.6.342.ip_&tt=2&bt=0&bts=0&zu=http%3A//www.ncld.org/ld-basics/ld-aamp-executive-functioning/basic-ef-facts/executive-skills-and-your-child-with-ld)</a> </p>

<p>I read it to my son and it was like a light bulb went off. He saw himself in every aspect of the definition and the weight seemed lifted off his shoulders with some recognition that maybe it’s not his fault that things seem so out of control. I also talked to my D2 and she said that her ipad made a huge difference in her ability to organize, particularly because of an app called ihomework. So…S’s birthday is coming up and since it’s a special birthday, an ipad will be a perfect present. He suddenly seems excited to work on a solution. Next year he will be the only child at home, so I am grateful that we will have a few more years to turn this around. He’ll be lucky to finish this year with a 3.0, but I don’t think we will get there, even with two weighted honors classes. </p>

<p>Suggestions for actual practices that worked for executive function disorders are very welcome. Years ago, I got advice about my D2 from CC parents and she still uses many of those techniques today!</p>

15

<p>Laurenthemom: what type of testing did they do? Executive function issues can have a number of causes; my oldest D has NVLD (non verbal learning disorder) and ADHD-inattentive. The NVLD was diagnosed in 8th grade after testing (specifically subtest scatter within her WISC testing) but the ADHD wasn’t addressed until 9th grade. She’s also gifted so she was able to function at a high level until the higher order math & foreign language classes required too much effort for her to sustain things. </p>

<p>Suggestions:

  1. Your son has to buy into the diagnosis. Sounds like you’ve made a big leap of progress by him reacting so well to the definition. For kids who’ve been successful in the past, I think it’s really a relief to know why things are so much harder now.
  2. Find a tutor to help him with the EF issues. We contacted a local private school that specialized in LDs and asked for a teacher to recommend for tutoring. One mistake we made: DH, the GT teacher at school, the tutor and myself were all coming up with wonderful suggestions to help D organize herself. She got so frustrated after a week of this and said “I have to figure out what works for me!” So two of us backed off & she found what worked.
  3. When she started addressing the ADHD issues with meds, she was able to better focus on the EF issues. Did they do a TOVA test? (Test of Variables of Attention.) </p>

<p>His anger is understandable although his actions are inappropriate. One thing I remember the therapist telling us right after D was diagnosed: “If you knew how hard she is working to just keep herself afloat, you would just cry.” I felt so bad. I did sit down and apologize to her for missing what was going on for so long, and for some of my words & behaviors when she was at her worst & I was frustrated. The good news: she’s was a National Merit Finalist & is finishing up her second year of college. Sophomore-Senior year of high school were much more manageable than Freshman year of HS. Based on his positive response today I think you’re going to have a happy ending as well.</p>

<p>Best of luck & feel free to PM me if you have any questions.</p>

16

<p>Does he have an outlet for stress or anger? </p>

<p>While i don’t have what your son has, I have been diagnosed with ADHD and aspergers. I have bad days to the point where there is nothing i can do. My good days often go great, however if i am distracted by one little thing, it falls apart completely. I have found though, however, that if i direct my irritation/anger/stress towards an outlet of some sort, it helps a bit.</p>

17

<p>Mostly dropping in to say hello to others touched by executive function disorder. </p>

<p>Besides looking for a therapist/psych to deal with the anger issues, it would be great if you could find an executive function coach. </p>

<p>Have you ever traveled abroad? I like to travel, but there’s always that point of arrival in the foreign country…it’s 8 am, you’re exhausted, everyone is speaking a language you don’t understand and you don’t know your way around. There’s always a moment at that point when I think “why in the world did I think this would be fun?” I sort of think that is how people with executive function disorder feel all the time. They observe everyone else going about their business knowingly and calmly, but through their eyes, the world is chaotic, doesn’t make sense. </p>

<p>Is it correct that your son’s testing and diagnosis was done through the school? I don’t want to be critical of school psychologists or diagnositians, but public schools are strapped for cash and they have a great motivation to diagnose as few kids as possible; special services are expensive.</p>

18

<p>

</p>

<p>The wrong person is in control.</p>

<p>Before I would reward him with more nice clothing and an ipad, I would make those things conditional on getting into counseling. You have more power than you think.</p>

19

<p>I am concerned that at his age, he even pushes his sister (you backed off from the earlier characterization of his behavior as “hitting”). As he gets older, he needs to control any urges toward physical aggression, especially toward females, or he is going to end up in front of a judge. This is not something to be brushed off.</p>

<p>He seems to have contempt for you and for your authority. How does his father handle him? Sometimes boys respond better to male authority. You need allies.</p>

20

<p>I think it’s great that he’s agreed to your new plan. Getting him on board with that is huge, and it’s nice that he was receptive. But-- I just read the article you cited, and this stands out for me, and reflects my own experience: under impulsivity
the child might be “very inconsistent, following the rules one day and not the next”</p>

<p>The nature of the problem is inconsistency, so expecting it is paradoxical. (I’m not saying its not worth working on though, it is important). This is why it is crucial to have a therapist and a psychiatrist. All the good intentions in the world, set up with structures, won’t work against impulsivity. Impulsivity won’t change without therapy and probably more importantly medication. For us, ADD meds were not enough, but the Prozac really changed the game. </p>

<p>Authority, rigidity, and rules have an important place, but can lead to disaster and rebellion–they can make it worse–if not combined with therapy and medication.</p>