Angry underachieving son with executive function disorder. Advice?

Parent Cafe
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<p>I want to second and third what a number of people have said about school psychologists and school testing. Some are great, and really do want to help, some not so much. Unfortunately, you can’t always tell which one your student falls into. My guess is that in your case the school people may NOT have your son’s best interest at heart. Why? Because if they were serious about helping him, and really felt he had a diagnosis, they would write an IEP that clearly spelled out the accomodations and what the school would legally do to improve the situation. I am not sure where you live, but around here a 504 is not really enforceable, and basically a waste of time. An IEP is court enforceable, and has things in it like the school providing special assistance to help your son. That can include counselors for the exec. disorder, calendaring, providing a laptop/tablet and whatever else he may need. They do NOT have to do that with a 504 plan. That is usually for things like kids with asthma- that the student can leave class to get meds, sit out gym activities…that type of thing. </p>

<p>Seeking outside diagnosis and assistance is important. You can look online for ADD coaches- even though he does not currently have a diagnosis of ADD, he needs much of the same type of coaching as an ADD person. </p>

<p>And you need some assistance too. It is hard to stand up to this type of kid- he has gotten away with so much to this point that he knows EXACTLY how to behave to avoid having to do the right thing. He knows your buttons, and he knows that people in the house tip toe around him to prevent upsetting him. You will need help retraining the way you manage him. Or maybe I should say the way you manage your household and your family without letting him manage you. It is a difficult transition.</p>

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<p>Is he by any chance taking one of those protein powders with creatine for weight lifting? This stuff turned my S1 into a nasty, nasty boy!</p>

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<p>I may be naive, but I am hopeful that we can take small steps leading to a change. I do feel confident that the school counselor did everything she could do. It was the teachers who did not want to diagnose him as ADD, even though a few gave indications of behaviors that seem ADD to me (and to the counselor). Without the teacher’s input, the counselor could not record him as ADD. I believe that an outside counselor would have to do the same thing - request the teacher’s input on his behavior? </p>

<p>I think a huge first step has been accomplished in that he is willing to admit he has a problem and acknowledges that he will have to take steps to learn differently than his peers. My D2 went through a similar process and when she was finally able to gain self-confidence and figure out that it “wasn’t her fault” her ability and success rate changed 180 degrees and she is now a Dean’s List, 4.0 student at college. Meds were a tremendous help to her as well - although I resisted for a long time and tried a couple of different meds before we settled on Adderall. </p>

<p>Has anyone had a good experience with meds for symptoms like my Ss? Sadly, one of the WORST experiences we’ve had in dealing with LD issues was when we went to a specialist in LD for D2 who had a “patented” test (which was just basically an opportunity to charge us $75 per visit) and wanted to overmedicate D2 on Concerta that wasn’t working. The ped finally gave her Adderall and her world changed. Concerta could work for S though - so nothing against the particular med. Just a bad experience with a specialist that gave me a little pause. I’d be interested to hear others experiences with particular meds.</p>

<p>When I wrote the OP, I was at a low point with S. Outside of the house, he’s known as a very good kid and until recently, he was pretty easy for me to get along with and he and his sister consider each other to be best friends. I think this year’s failures have really brought him down and made him feel like he has no shot at the future he wanted (he’s always said he wanted to be a doctor). I do think we’ve breathed new hope into him and I’m hoping it will continue. I talk to his pediatrician tonight and the team of teachers on Monday. Any suggestions are welcome particularly because we have only a month left of school and any suggestions implemented now will have to come from me/the counselor since there will be no time to bring in an outside consultant.</p>

<p>No protein powders - he’s still in the midst of development which I think also has led to his confidence issues. I will look for an outside counselor to help us - when reading the 504 recommendations - they were almost laughable in the suggestions that he “pre-read” for every class. Ummmm if it were that easy, he’d do that. There were other suggestions like extra time as necessary, which will be helpful and has already been implemented in math. </p>

<p>H was raised by a single mom and I think sometimes has a hard time connecting to the kids on their level (he wants them to jump on board with whatever project interests him - which rarely interests the kids). He has a difficult time with the parenting thing - and I’ve unfortunately facilitated that by taking on most of the parenting myself. He would do things like ground S for two weeks for leaving a cup in the family room, but then do nothing when S talked back or refused to do something - a lot of mixed messages. H is on board with me for this and recognizes that as the only S, he needs to work harder on that connection. I think it’s hard for H. We really try the best we can to address everything, but at the same time to pick our battles. My Ds were a breeze compared to S, but I am hopeful it will get better.</p>

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<p>From what i know: The teachers don’t diagnose and aren’t supposed to label. What they do is fill out a form about specific behaviors and rate them The psychiatrist does the diagnosis. Get someone unconnected with the school. I’ve found any testing done by school system has been questionable. </p>

<p>As for meds: my daughter went through a whole school year of trying different meds unti we found something that was ok. She had a terrible time with the stimulants, including concerta. They made her tic repetitively, for example, and we had lots of extra sleep issues. She finally did much better on a non-stimulant Strattera. Eventually it didnt seem like enough, so just recently we added a small dose of a stimulant (it’s been 4 years since we tried the first time) Focalin, as well as a low dose of Prozac for anxiety/depression. It seems to help her a lot.</p>

<p>Is sleep an issue at all for your son? My child has big sleep issues, common with ADD. Could that compound the issues?</p>

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<p>I have ADD inattentive and executive function problems. My experience is that the ADD meds don’t help with the executive function directly, however being able to focus and get down to business indirectly helps the executive function problems… I don’t need to be as much of an executive function superstar to get by if I am not wasting hours upon hours a day trying to beat my brain into submission. I can remember things more easily because I was paying better attention when I heard them, and time management becomes better because I waste less time wrestling with myself. I learned executive function skills with the help of a coach-- I was lucky that my college provided one. She was useful because she realized that if a certain organizational strategy didn’t work for me, it wasn’t a matter of growing up and learning to deal, it was a matter of finding another strategy… and another, and another, and another until one works. For me, both the coach and the meds are really necessary, one without the other isn’t quite enough. For what it’s worth, now that I am out of school my executive function issues have gotten a lot better… at least for me, it’s easier to be an adult than it was to be a student. I don’t need a coach anymore, and can manage without meds even though I’d be better with them.</p>

<p>As for meds, I have tried ritalin, adderall, focalin, and stratterra. All treated my symptoms except the strattera, which also gave me serious stomach trouble. Ritalin worked well but I had some jitters and some slight stomach issues, and I normally have no side effects at all from the right drug so I nixed ritalin. Adderall worked great for me, but I don’t take it because it reduces my appetite too much. Focalin is the wonder drug for me, works perfectly with zero side effects. Trial and error… it took a long time for me to find the right one but it is SO worth it.</p>

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<p>Many ADD behaviors are not the “classic” ones teachers seem to look for or care about – the student who is compliant in the classroom is a lot less likely to be accepted as having ADD because to many people, ADD just means bouncing off the walls. Executive function disorders are often seen as laziness or opposition. </p>

<p>There is some new (January, 2012) guidance on 504 plans that was issued by the US Department of Education; it is just now filtering down into schools, and is substantially more expansive than the old guidance. The associated Q&A might be helpful for you and might be helpful in terms of working with the school:
[Questions</a> and Answers on the ADA Amendments Act of 2008 for Students with Disabilities Attending Public Elementary and Secondary Schools](<a href=“http://www2.ed.gov/about/offices/list/ocr/docs/dcl-504faq-201109.html]Questions”>Questions and Answers on the ADA Amendments Act of 2008 for Students with Disabilities Attending Public Elementary and Secondary Schools)</p>

<p>I too would suggest outside evaluation.</p>

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<p>As someone who went through a very similar situation to your son, I hope I may be able to give you some insight into what he is going through. I have tested very high on several standardized tests, yet I feel very insecure about my own intellectual abilities. I have had a feeling of incompatibility with others (which sometimes makes me seem horrible when I am mad). I can sense this feeling in most aspects of my life. In my case it made me close out everyone I was suppose to love because my actions hurt would hurt them. I have a hard time understanding how someone can be angry with me and still love me. As I have gone through my rehabilitation and learning about my own learning process I have made some connections which are anecdotal, but they may be helpful. </p>

<p>I did well in school up until middle school. Throughout middle and high school I would struggle to follow the curriculum which would lead to bad grades. In classes that had less homework and more tests I did better. I was never diagnosed with anything by my teachers or parents. I believe this is due to a coping mechanism I developed from being the second to last of 7 kids in a devout Mormon family. I developed a mask for public. I knew my family was different, so I tried to learn from their social awkwardness. I would sit quietly trying to fit somewhere into the conversation, but always too hesitant to say much. I felt a need to conform to my culture, but resented every minute of it. I felt like I was two people: My public self and my private self. The point is, people with executive functioning disorder are not indecisive due to too little thinking. In fact, we think too much. It is unbelievably difficult to fit into the “normal” routine for very long because my thoughts are not naturally in sink with that sort of routine. When I am doing something like homework, and it is boring, if something more stimulating comes along I have little chance of forcing myself to stick with the boring task. This is not about will power either. When that more stimulating thing comes along it is like a black hole of thought. I use that analogy because the density of my thoughts about the interesting thing far surpass the thought I am putting into something boring. It is like trying to defy gravity to force myself to refocus on the boring task.</p>

<p>After graduating with a 2.5 GPA I convinced myself that I was better off pursuing other avenues. I decided to serve a mission for my church. While I am no longer a Mormon, I do look back on that experience as a having at least helped me learn to be self taught. I had to learn Spanish while living on the border of Mexico and the US. My father and brother both speak Spanish so I really wanted to learn as well. I was given a lot of free time to study on my own which helped me learn how to learn. My interest in learning Spanish gave me great focus eventually. At first it was difficult to stay focused while being away from home in a strange environment. After I got settled I found focus and started learning very quickly. This was my first experience in this new way of learning. </p>

<p>I went to a small business college in Salt Lake City later, which I dropped out of in within the first year. After that I bounced around from Job to Job, trying to keep my head above water. The whole time however, I was reading book after book about a long chain of interests from business to politics to history to Italian and Hebrew. I read Chernow’s biography on Alexander Hamilton. I got a lot of inspiration from Hamilton’s story of growing up in a poor family and becoming an orphan immigrant only to overcome the odds through his auto-didactic nature. He used his inner brilliance to find his way to founding the banking system of our country. I felt like I could attempt to follow his path. I found economics to be incredibly fascinating—Like one huge story/math equation. I found my way back to a community college in El Paso around age 25. I had several teachers that told me to transfer to a 4 year school as soon as possible. The community college was surprisingly easy, considering how hard high school was. The only problem was, I soon had my fill of economics and I wanted to do something else. </p>

<p>I am still undiagnosed at this point. I have lived in 9 different states since graduating high school. I joined the Navy shortly before going back to college. I was discharged at the end of boot camp because if anxiety. I was literally forcing myself to focus every waking moment for about two months. By the end I had a heart rate over 100 for a week straight. I went in to see the doctor for nausea, when the checked my blood pressure they forced me to drink two liters of water because they thought I was severely dehydrated. Instead it was the constant stress that eventually made me develop cognitive anxiety which has not left. I have had a constant pain in my chest since February of 2011. After I got out I hoped the issue would simply go away with time like it did when I was a child. Instead it has fundamentally shaped my life ever since. It is a wake-up call. It lead me to finally seeking a real diagnosis and it is my motivation for getting better. It is also the thing that makes me fantasize about suicide. </p>

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<p>I became angry, defiant. impulsive, overly sensitive, and constantly anxious. I have a really hard time keeping a job because of the anxiety. Eventually I somehow managed to get a girlfriend who was not Mormon. She helped me to see my way through my issues and eventually get therapy. The first therapist diagnosed me with Generalized Anxiety Disorder. I didn’t take any medication for it at that time. Later we moved to California together and I got health insurance through the state. This allowed me to see another therapist. During that time I used my intellect to learn about and meditate on my issue. I eventually came to the conclusion that I have had Inattentive ADD this whole time. I was not treated for it as a kid, and therefore left to learn coping methods on my own. It made me feel out of place most of my life. Part of the Issue is Executive Functioning Disorder. A therapist once told me this is like trying to grab the right thoughts out of a flood of ideas. The hard part is the right idea usually comes, but only after the fact. I am now attempting to focus my strengths on innovative photo stitching ideas. Basically, I am shaping panoramas to fit 3D frames or even sculptures. My brain has an OCD like obsession with fascinating creative ideas. </p>

<p>I know this was really long and if you have read this far, kudos to you. The point of all of this is to demonstrate how getting help ASAP is imperative. It is also to demonstrate how the EFD brain functions. I could have simply told you to get therapy without all of the extra stuff, but I added it to show how damaging it can be for a person to go through life with this disorder without getting help and understanding what is going on. For people with EFD context is everything. Context is what makes things interesting. When something is interesting to us, it is because of the context. The context will fire up the neurological engines and release a blast of brain activity. Our brain is not meant for precise decision making, it is meant for deep penetrating thought. The reason I do well on tests is because as I continue learning through my process, my thought chains begin to link with each other. I am able to make connections on a level that allows me to understand complexity rather than common sense. I understand common sense only after the fact because it has had a chance to fit into my thought process when I see the consequences first hand. Often this makes me angry. I think “why can’t people just think like me.” (I think this is another reason your son may be angry). As he learns more about himself he will begin to blossom. Please get him some REAL help. Don’t let it lead him down a path where panic attacks are the only thing that gets him to pay attention to who he is. There is incredible potential in people with EFD, however it does not come without hard work and intelligent direction. Make sure you get a therapist who connects with him and helps him to find interest in understanding what makes him who he is. </p>

<p>Again, thanks for reading this, I know it is LONG and without continuity.</p>

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<p>OP , you are getting some good advice from Ema and missypie, etc… I’ve been in your shoes and it is so hard, and frustrating. All I would add is don’t forget to have fun with him, don’t even think about gpa’s and colleges and how this will ruin his life — just stay in the present and don’t disasterize things. </p>

<p>I would emphasize the things he does right , the little victories of homeworks and pleasantness. Thank him for those. Be encouraging and supportive, verbally – guys sometimes need you to identify what exactly is going on, and validate their feelings. Assure him things will be okay, assure him you love him. Hug him. Even when he squirms. He will need time to digure out what all the plans mean. Expect two steps forward one step back! </p>

<p>Ignore people who second guess you. You sound like a good mom and that will steer you right. Feel free to pm me if you need to vent :)</p>

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<p>This thread is two years old, so I wouldn’t necessarily expect the OP to come back and respond.</p>

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<p>Ah, I was so hoping that the resurrection of the thread had been done by the OP popping in to tell us a fabulous success story!</p>

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<p>Time to lock the thread because it is so old. However, I would like to add to this mix that OP’s son reminds me of my oldest son, who is bipolar. I hope OP got a very good neuropsychological assessment. In my experience, the school assessments are often geared toward whether or not the district must spring for services. And the answer is often “no.” Having been that route, I will say that the information from the school assessment was not helpful, and we got the most help from the neuropsychologist.</p>

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<p>NO. Don’t lock the thread. I know the OP and she is still struggling. I will ask her to come back and post.</p>

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<p>If this thread is still open and the OP is around… I just wanted to say that there is hope.</p>

<p>Your S’s story reminds me a lot of my D. Her anger & defiance were breathtaking around age 15. What we did not know at that time was that she was becoming severely depressed. Things got incredibly bad for a while around her 16th birthday. Finally, she was diagnosed with ADD-inattentive and it all became clear. She had been an extremely bright, high-honors kid. In high school, her executive function weaknesses and caused her to struggle, which she had never had to deal with before. She felt stupid, a failure. Teachers and parents told her she just wasn’t trying hard enough, because no one knew what was really going on and she’d always been so high-achieving before. Downward spiral. Awful. It wasn’t until halfway through junior year this was all identified and treatment (therapy, medication) begun.</p>

<p>The real turning point was when SHE decided that her future (college) was important enough that she needed to work for it. It had to be HER decision, not mom and dad forcing her to do whatever (learn study skills, use a planner, go get extra help after school, etc.) She attended a 21-day Outward Bound wilderness program and says it changed her life, gave her focus and motivation. She turned herself around 180 degrees, worked incredibly hard, got great grades, got into great colleges. I’m simply amazed now looking back at the dark times when we didn’t even know if she would graduate high school, when our home was like a war zone and we were crying all the time. For a year and a half, my husband would break into a cold sweat every time his phone rang at work, because of all the crises with D.</p>

<p>Now, our home has laughter and joy. D is helpful and loving. She’s doing amazing things and going to a great college this fall. IT CAN GET BETTER.</p>

<p>I sincerely hope OP is doing okay. One bright thing is that she identified a problem and is trying to find help early. I hope she’s found a good therapist and an executive function coach (search ADD coach, they are the same thing.) I hope she’s not relying solely on the school. If we had done so our D would not have made the incredible progress she did.</p>

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<p>I’m here! (Thanks Toledo!) PhotoWeaver - what kind of help do you suggest? Staceyneil - what an impressive recovery. Did your D make the decision before outward bound, or did you feel like outward bound prompted her decision to focus on herself? Did she go willingly to outward bound? </p>

<p>I wish I could say that everything quickly got better, but instead it was the opposite. My S did get involved with a girl who was depressed and self-harming, and that brought him to a new low. She clearly had issues and my S jumped in, heart first. This went on for about a year, and in December of last year, after he decided to break up with her, he spiraled downwards as he refused to move on with his life or let her move on with her life. What was most disturbing was how he dealt with it. S has been on medication, which does help. His PCP thought he was depressed and gave him medication, but he refused to take it. He’s been for counseling, numerous times. He’s about to turn 18 and is definitely still struggling. His grades this year were abysmal, but in light of his depression, the school is considering waiving his midterms, which could give him a “pass” in one class, 2Cs and the rest Bs and As. I’m hoping his GPA will be above 3.0, weighted. He’s refused to look at colleges and won’t allow us to talk about college with him. I’ve told him that he doesn’t have to go, but he says “of course I’m going”. I’m afraid we’ll end up paying $$$ for him to go to a college and fail out. </p>

<p>We are looking into summer programs. We initially planned to send him to GLA Thailand, but with the unrest in Thailand, I’m not sure if that’s a good idea. I will look into outward bound. For the last few months, my focus has been on keeping him safe and maintaing communication. I’ve succeeded there. Maybe this thread revived itself at exactly the right time - I will look into a summer program and commit. Thank you! </p>

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<p>Wow…my heart is out to you. My son started becoming this way when he turned 15, also. He wasn’t “angry” just for angers sake…but at us for getting on him all the time. We thought he was depressed, had him evaluated and came back ADHD-NOS (not otherwise specified). Which mean, not enough to give an inattentive diagnosis, but we could put him on meds. So frustrating, because he isn’t classic ADD. I think he has two things: low sluggish cognitive tempo and executive dysfunction. I found these all by myself…you would think after $3,000 of testing, and psychologist and psychiatrists and ADHD coaching, someone would have given me more info. None of them worked…he went, but never engaged. What worked was that<em>I</em> made an appt. with his psychologist and talked to him about things. He gave me some great insight and skills to use at home. We went thru a really rocky stage at about 16-17 when he started smoking pot, which added such tension and anger (mostly from me). There were holes in his bedroom walls that I found he kicked after we’d have a row. Believe me…we came down on him hard, did negative and positive reinforcements. Once he walked out and we didn’t know where he was. I finally texted him at 10:00 and told him to get home, he was making matter worse. I really feel we did everything loving paretns could think of to help our son. No learning disabilities normal (but high normal) IQ. Our life with him in H.S. wasn’t pretty and I was glad for him to leave, and it grieves me to feel that way. We knew he wasn’t ready for college (2012 grad). We knew it, but didn’t know what to do with him…and he WAS on academic probation after the 1st semester. 2 withdrawals, 1 F, 1D and 1C. 1.0 GPA. OMG. We were beside ourselves, getting ready to pull him out, but he begged and begged. We decided we still couldn’t live with him and we’d give him another chance. Better the Univ kick him out, then he could never blame us. He ended up taking 12 hours, Withdrew from one and got a 3.0 with the other 3 classes.</p>

<p>Fast forward to now. Things have gotten MUCH better maturity wise. He’s calm and we actually have normal, adult type conversations. He helps around the house and his room is picked up!! Such a change. There doesn’t seem to be any more teenage angst…he seems to be more where his peers were 2 years ago. Kids with these disabilities are ofter 2-4 years behind their peers, and he definitely was. His grades are not stellar by any means. The are all over the place, but he’s not on probation. He seems to be only able to manage 9 - 12 hours a semester. But there is progress. Since we can check his grades, he was skipping tons…and I means probably most of them the first year. This past semester (his 4th), he went to almost all of them. He made this decision on his own…it was internal. He did have to withdraw from one class. Things are better…far from perfect. But in two years time he has come along. I wish I could give you a great success story right now, but I can’t. He has a FT summer job, and will be getting an apt. at his Univ next year, trying to do 15 hours. Life is a marathon, not a sprint.</p>

<p>Your son will mature. Of course, we wish it will happen faster but it will happen. Just keep remembering that he is probably more of a 16 year old…not an 18 year old. That is why you are still getting so much immaturity and angst. What I would do is point out drop dead admission dates for colleges (is he a Sr.?) Tell him that you will help him do whatever, but he will have to come to you. Don’t expect him to do the research, you’ll have to do that for him, and even keep reminding him. “Do you know next week is the deadline?” Anything you need me to help you with. Normal kids can handle these things on their own. Our can’t. No kid WANTS to be like this…keep remembering that. Oh, before I forget. Your son might have some Oppositional Defiant Disorder, from the calling names and hitting. Many of these disabilities are co-morbid. Have you looked that up?</p>

<p>Same with Outward Bound…look into it, research it, tell him what you found out and the dates. </p>

<p>Good luck…you are not the only one. It DOES get better as they age, but it takes such a toll on us. I always say that I have a blackbelt in parenting. </p>

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<p>My 23 year year old (Asperger’s, executive function disorder, ADD, depression…) is transfering in the fall to a 4 year college. He has enough hours to be a senior but will need more than one year to complete his major. Very bright guy, but it took until last fall semester (a semester when the HS class of '09 “should” have graduated) to get his academic confidence back, to study, etc. </p>

<p>I agree about the being behind peers. I felt like I was sending a 3rd grader to middle school, a 6th grader to HS, and a 9th grader to college. It took until he was 22 years old before started acting like a college freshman should. </p>

<p>But with that knowledge, I really don’t know what my advice to other parents would be. Full time jobs are hard to come by. If you send them to community college and they aren’t engaged, they can just as likely to fail out of that. Son went to school at a cc part time and always worked 15-20 hours a week. I guess just keep them doing something. There are two young men on our block who have “issues” and both are around 20 doing nothing…no work and no school. </p>

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<p>Hi Lauren,
I also replied (lengthily, I am afraid!) to your PM, but I’ll answer your question above:</p>

<p>My D was initially somewhat ambivalent about Outward Bound. In fact I was worried she;d reject it out of hand when I brought it up. But I think that she was just starting to feel the benefits of the intensive therapy and antidepressants and starting to come out of her funk and realize that she needed to do SOMETHING to change her path. Her dad had done an Outward Bound trip when he was a teen and told her it was life-changing, so she agreed to give it a try. I was surprised at how she embraced it actually. She knew it was going to be really really hard, and as a kid who’d recently always taken the easy way out of things, I wondered how she’d manage. But I think she took it on as a personal challenge, and then was super proud of herself for finishing the course.</p>

<p>She made “the decision” to work hard to figure out how to succeed academically -I think that’s what you’re asking- when she got back from Outward Bound. I don’t think she could really process more than one challenge before that. So the initial thing was deciding to go on Outward Bound (and, I think, hoping it would unlock some answers for her) and then when she got back she felt really motivated and powerful and was able to do the hard work she needed. September found her working hard with her ADD coach, figuring out how to get extra help at school when needed, seeing her therapist once a week, AND going on lots of college trips and doing interviews.</p>

<p>She would say that Outward Bound was the turning point for her.</p>

<p>Good luck.</p>

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<p>Also- regarding testing to help clarify things… sometimes a regular IQ test (which our school did when D started struggling badly) will give some clues. For example, of the 4 sub-sections, D was in the 96-99% percentile (or something ridiculous like that) for three of them, but only 50% for Working Memory. Since working memory is like a basis for executive functioning, that explained a lot about her struggles… even before we had the ADD-PI diagnosis.</p>

<p>For us, it was really helpful to see these things with actual names. It took us a long time, I’m sorry to say, to get over thinking, “she just needs to try harder” and realize that it just wasn’t that simple.</p>