In the fall of 2013, for better or worse, Monkey Boy started fourth grade. I always start out the year with a letter to his teacher explaining his history and his problems, and they seem to appreciate the insight. We both really liked his teacher, and she started the year on top of things with him. We had an IEP meeting in the fall to discuss his OT (Occupational Therapy) evaluation from Children’s Hospital, but because it wasn’t blatantly affecting his school work, he didn’t qualify for any services from his elementary school.
In the meantime, we were also trying different ADHD medications. In the fall, we tried two different doses of Vyvanse, but even the lowest dose sedated him. It also really bothered his stomach. The pediatrician was still dispensing his medicine, so I decided to take him to the psychiatrist when we felt he needed another change. We then tried two different doses of Focalin, but it either sedated him or didn’t last long enough.
We talked to the psychiatrist about Monkey Boy’s anxiety and the long waiting list for occupational therapy. She referred me to a psychologist in her office for his anxiety and to Helping Hands for occupational therapy. The psychologist was another total failure, but Helping Hands has been wonderful, and he was able to get in immediately.
In January, we tried anxiety medicine and no ADHD medicine. The anxiety medicine worked wonders. I have never medicated Monkey Boy lightly, but after talking with many other people as well as various healthcare providers, I decided this was the best thing for him. Suddenly, his bug phobia was much less pronounced, he participated more in class, and he would stay in a room by himself. The only downside was that his behavior in school (which had NEVER been an issue) went downhill. I wasn’t sure if it was because Stafford County schools were having so many snow days, he was no longer anxious about getting into trouble, or the lack of ADHD medicine. I do know it was an issue on and off for the remainder of the fourth grade.
Because he seemed to be less attentive, we put him back on ADHD medicine in February and this time we tried Metadate. He did fairly well, but it wasn’t lasting quite long enough (only about five hours), and math, a topic he really needs to focus on, was at the end of the day. We didn’t want to increase to the next dose because it would have doubled it. Finally, I asked about Quillivant. It is the only liquid extended release ADHD medicine on the market. Because it is a liquid, it’s easier to fine tune the dosage. Since swallowing capsules had also been an issue for Monkey Boy, I thought it might be worth a try. The psychiatrist agreed, and this is what he used, at the lowest dose, for the rest of fourth grade. The only drawback is that it usually isn’t in stock at the pharmacy and needs to be ordered. And apparently,my kids’ insurance company prefers an alternate because I got a letter saying if I chose the generic form of methylphenidate, it would be free. The thing is Ritalin, Concerta, Focalin, and Metadate are all methylphenidate medicines, and they all work differently for Monkey Boy, so it really made no sense. My cost is so low that it wasn’t enough to persuade me to change.
We were now into the spring of fourth grade. Monkey Boy had made some progress in math and reading, but was still way behind his peers. I had a psychologist retest him for learning disabilities, but the results were consistent with previous testing, and we really didn’t learn anything new. He had weekly visits to the OT and continued to work on his IEP goals. What confounds me the most is that he has these goals for math, but then he is also expected to keep up with the class. Granted he has some one-on-one help, but that’s no good when he still doesn’t have the foundation. He managed to meet all his IEP goals by the end of the year, but he also fell further behind in the classroom. Now he despises math, he refuses to try, and he doesn’t stay focused.
He was invited to do weekly after-school tutoring for reading in April and May, but we chose not to participate. It interfered with other appointments, and he was just “done” by the time the school day ended. There is only so much you can “stuff” into a child’s head in a day.
Because I was still concerned about language and articulation, I got a referral to a speech pathologist. Monkey Boy has speech once a week in school, and he loves the teacher and the group, but I thought he might benefit from additional therapy over the summer. He had an evaluation in the spring, and qualified for services, but then we had to wait for authorization from the insurance company. This took longer than usual because there was some confusion as to whether speech therapy was covered by the policy…unfortunately, it isn’t, but at that point we chose to proceed with therapy anyway.
In May, the special education team and I met for Monkey Boy’s final IEP meeting of the year to set goals for fifth grade. For the most part I was satisfied with the outcome. The only thing that required any discussion was the addition of a typing accommodation. Monkey Boy still has trouble differentiating capital from lower case letters in his writing. They say this isn’t too much of a concern per se; however, it’s a big problem when it comes to proper capitalization in sentences. The special education teacher suggested allowing him to type, but the team decided it would give him an unfair advantage. I agree that he does need to learn proper capitalization on paper, but it’s kind of a joke to say Monkey Boy would ever have an unfair advantage in anything related to academics. Especially, since he has physical limitations that make handwriting difficult for him, but I learned about that after school ended, so it’s something new to discuss.
He ended the school marginally ahead of where he started, and he managed to fail all of his SOL tests. Sometimes, I just wish time would stop to allow him to do some catching up.
In my next post, I’ll share with you how I set out to “ruin” Monkey Boy’s most recent summer vacation and we’ll take a glimpse into the beginning of fifth grade as we enter the unknown that is the 2014-2015 academic year.