Wednesday, May 9, 2012

13 year's angry outbusts in school

I came across your blog yesterday after being called in to our son's school to face angry and upset teachers - again.

After "fighting" for years against the ADHD label and putting our son on medication, our 13-year-old has now been on Ritalin and then Concerta for three years. It has helped with his concentration. However, recently he has been having anger outbursts and his school has run out of patience with him. He seems to react whenever he feels "picked on" although he is actually being reprimanded for bad behaviour and disrespect. It's as though he cannot actually stop with his verbal backchat and he has shouted out at his teachers on several occasions. In hindsight he has reacted to this "picked on" feeling throughout school and has had to change schools because of it. Is this feeling of being picked on possibly related to something we are not seeing? At the moment his teachers feel it is purely bad behaviour and our concern is that he will face suspension and expulsion from school. I hope you can help.

Many thanks and kind regards.

Hi, Sometimes kids with ADHD feel "picked on" because they are often impulsive and distracted, so that adults have to remind them to use appropriate language and to concentrate on their work.  What starts the reprimands at school?  You say he was disrespectful--did that start after he was told to do something (focus or not talk so much) because of the ADHD, or was he being disciplined for something else?  It sounds like when reprimanded he has trouble keeping his reaction to himself.  Could the teachers cue him without a critical tone if he is just off task, and would he then get back to work, or would he still react angrily?  

Once he is angry, will he take a time out to slow down  or can teachers re-direct him and give any consequence (if he used inappropriate language) later on when he is calmer and may be able to accept a consequence.   

I'm not sure if I got the sequence right (what starts the interaction with the teacher?), so the first step is to chart the sequence: what is said by each party.  Look for patterns and try to change the sequence in one way or the other.  I talk about this (changing the sequence)  in more detail in my parent's manual on anger overload.  The idea is to intervene early before the stage of anger overload.  But you have to know what the early signs of anger are, which is sometimes difficult to pick up on if the child hits the overload phase in a matter of seconds.

Other suggestions include working with your son at night or (at school with the social worker or counselor) to look at the pattern and help him later that day (the day of an outburst while it is still fresh in his mind but after he has calmed down) to see what the other person was thinking (your child feels picked on, but you explain maybe the teacher is just reacting to certain words or behaviors and if he could change these somewhat the teacher may not give him severe consequences.  You try to help him see what the teacher is responding to and how he could avoid severe consequences.) The idea is to help him not feel picked on, but to see that adults may look at his behavior differently than he does.  Then he can be encouraged to think of alternatives he could use in the future if he is upset.  This process would take place over several months to help him see the patterns and the alternatives.  Eventually he will then likely understand better other points of view and begin to use alternative words before he says the wrong things.  Another suggestion I make in my parent's manual is to use catch phrases at the time he feels angry to help him remember to think it over. 

If he is in the overload phase (extreme anger lasting several minutes to an hour or more) he will not be thinking rationally so this is not the time to discuss his behavior.  It would be best to remove your child from the room and have him sit somewhere quietly until he calms down.  

Please refer to other posts in the blog or to my book for other suggestions.  Hope this helps, Dr. Gottlieb

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