Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Welcome to JA.com. Do you mind if I ask a few clarifying questions, before I provide my answer?
no at all
Thank you. I'll type them out..
Have you worked with any behaviorally trained therapists or consultants?
He sees a therapist once a month and they prescribed medication for him, but as far a any kind of therapy he is receving speech therapy at school aand has an aide that goes to classes with him.
What would you say are his top 3 problem behaviors? And have any specific strategies worked with him?
impulse control,gets bored easily,and when is denied something he has a melt down. He is good in science and math. He does not relate well in social situtions for example telling the teacher the reason he did not want to go to his class was because it was boring.
You mentioned that his parents are separated with shared living for him between them, and some staying at grandparents homes. Who is most in charge of discipline and are all adults involved, able to work and communicate effectively together if a plan was in place to manage the behaviors in question?
He lives in the same house with his other grandparents which where his adopted father lives and he just started going half time to his mom. As far as everybody in the same page I do not think it is happening. I live in Florida and they are in Ohio. I think that his Mom is more strict and the grandparents and Dad are more lenient and also very protective like they do not approve of his driving which he does when he is here in the summer.
always with one of us.
Ok. Thank you very much for the detailed information. I've got some ideas that I think will be quite helpful. I'm going to take a couple of hours to type out my response for you and I'll research and include some links to additional resources that I think will be helpful as well. You can check back at that time and decide if you will "accept" and thus pay for the answer or not. Does that make sense?
yes and that will be no problem.
I’d like to start my answer by complementing you on the tremendous love and dedication that you are showing your grandson Sam. It’s really wonderful to hear about such caring from a grandparent, even from such a distance. I’m also very sorry to hear about that incredible loss of money; - the program must not have been the best fit for Sam.
In the detailed information you provided during our chat session and in the body of your presenting question, you mentioned attempts at providing structure and discipline that were leading to explosive meltdowns. You also described problems relating socially at school. What I’d like to suggest is a comprehensive behavioral intervention that systematically explores what causing and what maintaining Sam’s problem behaviors. An intervention that will not only effectively explain specific behaviors but that will provide you, other family members and school staff with an integrated behavior change strategy to help Sam manage those behaviors that are getting in the way of his optimal academic performance levels.
One of the most practical and cost effective ways of helping XXXXX XXXXXe and improve his behavior is to work with a Board Certified Behavior Analyst. You may have heard about Applied Behavior Analysis in work with young children with autism. What most people don’t know is that the same scientific approach behind ABA interventions for autism can be applied to help a much higher functioning person like Sam. A certified behavior analyst or ABA specialist, can provide, you and Sam’s parents and other grandparents, tools for collecting very precise information and then to use that information in the design of very effective positive behavior change strategies, that can be applied in his home and school settings. The analyst can also do the needed behavioral observation him or herself depending on your budget.
Having a behavioral intervention of the quality that a board certified ABA specialist can enable you to effectively rule out or identify areas of treatment that are not going to work with an environmental intervention, and which may require other types of intervention, for example medical. An effective behavioral intervention can also sometimes lead to reductions in the requirement for certain medications related to behavior, mood and attention. An ABA intervention is also equally suited to effectively teach and reinforce social skills targets and academic learning strategies that may reduce Sam’s reports of boredom or difficulties relating to others and problems-solving together.
If you do decide to work with an ABA specialist I do recommend that you:
Interview a number of behavior analysts (they usually do not charge for a first telephone or e-mail consult) and ask them about their experience working with teens that fit Sam’s description. Most behavior analysts will ask very detailed questions. If they don’t have directly relevant experience, you can ask for referrals to behavior analysts who do have relevant experience working with kids like Sam.
Ask for free internet links and other free information sources to really help you learn about ABA and how it can best help Sam. I’d then share as much info as you can with the other adults in his life. The more they know and understand about ABA the more likely they are to feel stronger commitment to working with such an approach.
You may also ask if there are any advanced ABA graduate students who are in the process of becoming board certified, who may be willing to work with you and your family for free or at a reduced rate, in order to accumulate experience hours for their practicum towards certification.
It is also highly recommended if you do work with an ABA specialist that everyone living and working with Sam get on the “ same page”, as much as possible, in order to maximize the the benefit to Sam of the intervention that is developed.
Here are some links that provide more information about applied behavior analysis:
Here’s a page for locating a behavior analyst by area:
You may also wish to explore “Direct Instruction” as a remedial strategy to help Sam develop academically here are some links for you to learn more. It’s one of the best kept scientific secrets in the world of education for higher functioning spectrum, attention disordered, and neuro-typical kids, that there is (why is it kept secret? – I don’t know.) :
If you choose to work with a behavior analyst, you can suggest an interest in exploring a direct instruction strategy at home, if there is a parent or adult willing to work with Sam.
Please let me know what you think of my answer. If it’s satisfactory and helpful, please don’t forget to press the “Accept” button. Thank you.
How can I email this to my daughter in Ohio?
I will research the sites that you have provided and I just talked with my daughter and she is beside herself since Sam had a really bad day at school today.
Let me forward you're e-mail question to the site moderator. One simple solution may be to copy and pasted from your answer window here, directly into an e-mail. The moderator should get back to you shortly.....
Were you able to forward this answer to your daughter?