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TEEN REFUSAL
Suggestions of how to handle a situation when a teen refuses to have testing completed for IEP purposes. Has been tested previously and diagnosed with NVLD. Has a history of anxiety also, He also refuses to accept his previous diagnosis of NVLD. He says the psychologist is wrong.
Can a teen refuse testing?
What happens if he refuses testing?
He is already being seen by a psychologist, (individual and group therapy), pediatrician, psychiatrist. He also refuses to take any medication.
Thank you for your comments.
Can a teen refuse testing?
What happens if he refuses testing?
He is already being seen by a psychologist, (individual and group therapy), pediatrician, psychiatrist. He also refuses to take any medication.
Thank you for your comments.
You mention that your teen talks constantly (skype, etc. on the computer)......now we believe he is again far behind in his schoolwork .....
You do not say whether he goes out with friends or has any physical activity or any fun time. Although education is important, it is equally important for any age group to have quality "me time", and have interests away from school work. It seems to me that he is allowed to spend too much time on the computer - this in turn could be a contributory problem with regard to his headaches and nausea. Spending a lot of time glaring at a computer screen and not getting enough time away from the screen and not getting adequate sleep, can cause headaches and sometimes migrainal headaches with nausea.
Albeit he is a teen (you do not say what age he is), he still requires to have rules and boundaries at home. Of course, he will object. Most teenagers do and some get very anti establishment. I would consider limiting his time on the computer and remove any electronic gadgets like the computer and television from his bedroom. If he does not get to bed at a reasonable time, encourage this. A lot of teenagers will stay up late by getting engrossed with their computers and other electronic gadets and not get enough sleep.
Encourage him to take part in some type of physical activity - this could be swimming, taking him bowling, ice skating. Suggest some activities so that he can choose which one he would like to try. Perhaps organise a family outing, even for a day in the park or nature reserve, or take him and a friend of his to a recreational venue. If he does have any friends, suggest he has one to come over.
Be aware too, that nausea and headaches can stem not only from anxiety and stress, too much screen work and lack of sleep, some medications, but also from food allergies or food intolerance.
Keep a diary of everything that he consumes to monitor his condition, to see if there is a link to food and drink. Ensure that he has a good healthy and natural diet with lots of drinks, especially water. Dehydration can cause headaches too. Cut down on him consuming junk food, processed and sugary foods, like cakes, biscuits, chocolates, fizzy drinks. A lot of fizzy drinks and some foods, contain artificial sweetners and chemicals. Encourage him to eat more fruit and veg.
If he also complains of tiredness and doesn't feel like doing things, consider getting him checked out for iron and vitamin deficiencies especially Vitamin D and the Vitamin B group. Nausea and headaches can sometimes be caused by some infections - sinus problems or urinary.
Best of luck.
You do not say whether he goes out with friends or has any physical activity or any fun time. Although education is important, it is equally important for any age group to have quality "me time", and have interests away from school work. It seems to me that he is allowed to spend too much time on the computer - this in turn could be a contributory problem with regard to his headaches and nausea. Spending a lot of time glaring at a computer screen and not getting enough time away from the screen and not getting adequate sleep, can cause headaches and sometimes migrainal headaches with nausea.
Albeit he is a teen (you do not say what age he is), he still requires to have rules and boundaries at home. Of course, he will object. Most teenagers do and some get very anti establishment. I would consider limiting his time on the computer and remove any electronic gadgets like the computer and television from his bedroom. If he does not get to bed at a reasonable time, encourage this. A lot of teenagers will stay up late by getting engrossed with their computers and other electronic gadets and not get enough sleep.
Encourage him to take part in some type of physical activity - this could be swimming, taking him bowling, ice skating. Suggest some activities so that he can choose which one he would like to try. Perhaps organise a family outing, even for a day in the park or nature reserve, or take him and a friend of his to a recreational venue. If he does have any friends, suggest he has one to come over.
Be aware too, that nausea and headaches can stem not only from anxiety and stress, too much screen work and lack of sleep, some medications, but also from food allergies or food intolerance.
Keep a diary of everything that he consumes to monitor his condition, to see if there is a link to food and drink. Ensure that he has a good healthy and natural diet with lots of drinks, especially water. Dehydration can cause headaches too. Cut down on him consuming junk food, processed and sugary foods, like cakes, biscuits, chocolates, fizzy drinks. A lot of fizzy drinks and some foods, contain artificial sweetners and chemicals. Encourage him to eat more fruit and veg.
If he also complains of tiredness and doesn't feel like doing things, consider getting him checked out for iron and vitamin deficiencies especially Vitamin D and the Vitamin B group. Nausea and headaches can sometimes be caused by some infections - sinus problems or urinary.
Best of luck.
COMMUNITY LEADER
Specialmom has some very good points. I would definitely like to point out the benefits of physical exercise. I have several studies that show it helps not only SPD, but ADHD, ADD, and certainly anxiety.
Speaking of the whole ADD thing. I asked my question because I am also the CL for the ADHD forum. And I now have over 40 years in the public school system as a teacher and administrator. I was pretty sure of your answer when I asked the question and I am not surprised at all.
I really wonder how the testing was done for ADHD/ADD and who did the testing. Following clinical standards, a questionnaire should have been sent out to his teachers. And since they asked for the testing, I am surprised by the result. Was the testing done by the parochial school system or a private psychologist?
Anyway, a lack of executive function is a key symptom of AD/HD. To me, he is now showing many of the symptoms of ADD or Predominantly Inattentive Type. Good link here on that -
http://www.help4adhd.org/about/what/WWK8
And if that is true, every thing I have read says that you cannot treat anxiety successfully without also treating the ADHD. In fact, as Dr. Charles Parker says in his book, New ADHD Medication Rules - " The antidepressant alone not only perpetuated the original symptoms, but also aggravation of the ADHD by the various multiple serotonin trials." (p88) In short, the SSRI's made things worse. The nausea, tiredness, headaches certainly could have been brought on by the meds.
I am surprised that his psychologist has not brought this up. Perhaps it is time to find a psychiatrist that specializes in AD/HD and get some more testing done. Obviously, things are not working very well now.
Remember that NVLD is actually not a single condition or leaning disability, but a cluster of conditions that make up a neurological syndrome. And it has some very specific symptoms that can show up early in life.
Of course, its always possible that the whole AD/HD thing has been examined. But if you need any more info, please post here or here - http://www.medhelp.org/forums/ADD---ADHD/show/175
Speaking of the whole ADD thing. I asked my question because I am also the CL for the ADHD forum. And I now have over 40 years in the public school system as a teacher and administrator. I was pretty sure of your answer when I asked the question and I am not surprised at all.
I really wonder how the testing was done for ADHD/ADD and who did the testing. Following clinical standards, a questionnaire should have been sent out to his teachers. And since they asked for the testing, I am surprised by the result. Was the testing done by the parochial school system or a private psychologist?
Anyway, a lack of executive function is a key symptom of AD/HD. To me, he is now showing many of the symptoms of ADD or Predominantly Inattentive Type. Good link here on that -
http://www.help4adhd.org/about/what/WWK8
And if that is true, every thing I have read says that you cannot treat anxiety successfully without also treating the ADHD. In fact, as Dr. Charles Parker says in his book, New ADHD Medication Rules - " The antidepressant alone not only perpetuated the original symptoms, but also aggravation of the ADHD by the various multiple serotonin trials." (p88) In short, the SSRI's made things worse. The nausea, tiredness, headaches certainly could have been brought on by the meds.
I am surprised that his psychologist has not brought this up. Perhaps it is time to find a psychiatrist that specializes in AD/HD and get some more testing done. Obviously, things are not working very well now.
Remember that NVLD is actually not a single condition or leaning disability, but a cluster of conditions that make up a neurological syndrome. And it has some very specific symptoms that can show up early in life.
Of course, its always possible that the whole AD/HD thing has been examined. But if you need any more info, please post here or here - http://www.medhelp.org/forums/ADD---ADHD/show/175
Ahh, I'm so sorry for your son and you as a mom. It is hard to see them struggle and then also so frustrating as you so want to help them and they are resistant.
Now, this is maybe off topic, but maybe not. My own son has sensory integration disorder. This includes what I've been told are executive function issues, symptoms that look like add/adhd, issues with social cues, inflexible, rigid, etc. Sound familiar? He's younger than your son, now in just the 5th grade. He's also a perfectionist with anxiety. He wants to do well so badly that he'll literally work himself into a frenzy. He puts a tremendous amount of pressure upon himself.
As I was told when he was young that it was sensory and not adhd==== and to never let them tell me otherwise, we worked the problem from a different angle. We did occupational therapy (six years worth). One of the key things we learned is that physical exercise and deep pressure have a calming, soothing and organizing effect on my son. Examples are exercises like swimming. This is muscle work accompanied by deep pressure. When my son is swimming, he can focus, think straight, his coordination is better, he is more regulated so has better peer interaction, better control of his emotions, more able to cope and blow things off, less nervous. It is a marked difference to where he, at 11, verbalizes it very well that if he doesn't have the physical activity, he feels like he is jumping out of his skin and can't think straight.
your son is clearly bright as is mine. I just have to wonder if anything like this is going on for him. Does he have any physical go to activities? Lifting light weights, doing planks, bike riding, climbing machine or actual climbing, running and slapping feet on pavement, swimming, rowing, pull ups, push ups?????? Karate? Anything like this?
Our occupational therapist told us that our son had in essence worked through many executive function issues because of his physical activity. There are studies that imply a direct link.
Guess what? I just told my son maybe a month ago the full extent to his disorder. we called therapy all those years just something fun to do to make our body feel good. He didn't really need to know much more because he was utilizing what he needed to in order to succeed and I didn't want him to feel different.
And the not feeling different is a HUGE deal to kids. My son wants to be like other kids. The school counselor at our school mentioned this to me and I always took it to heart . . that not making a child seem different while helping them is really key.
So, I would switch your tactic. Rather than convincing him he has a NVLD, talk to him about what he can do to help it. Try some new things in there. Talk about making him feel better, cope better, do better and there are some things that you can try. Not that he has X and won't succeed unless you fix it.
I don't know if that makes sense, it's a subtle difference.
My son has a 504 plan in place. the way I explained it to him is that it is a back up plan. That there are some things in place in case he needs them in order for him to do the best he can. My son is supposed to be allowed accommodations at school such as standing when he wants to in class, having an opportunity for movement, he can have a fidget and the teachers are not allowed to mention it to him in front of everyone. they may say to the class---- hey, everyone, if you have a hand fidget or want one of mine, pull it out! So my son isn't singled out.
and anxiety is such a beast. This is the big worry spot for my son right now. That and his being bullied. My son really grapples with standing up for himself. He's solid as a rock . . . the kid has been doing physical activity as I mentioned since he was 4 and swims 4 times a week for about 2 hours each time . . . he's physically imposing but a marshmallow. Boy, are some kids drawn to that and love to mess with him. I'm hoping he finds his inner voice that says "enough", turns into the incredible hulk and clocks them one of these days. Even if he gets in trouble. It would be so worth it after years of people thinking they could walk all over him and be cruel to him@!! (that is probably not the greatest mom statement there . . . sorry). But his anxiety is also something that we work on. I have books that I have read and then had conversations with him about info in the books without saying "hey, I read this about anxiety and you need to do this". It has just given me ways of talking to him and things to offer him to help. So far, it's worked but I watch this.
You say your on has done some talk therapy and is also resistant to that now?
Now, this is maybe off topic, but maybe not. My own son has sensory integration disorder. This includes what I've been told are executive function issues, symptoms that look like add/adhd, issues with social cues, inflexible, rigid, etc. Sound familiar? He's younger than your son, now in just the 5th grade. He's also a perfectionist with anxiety. He wants to do well so badly that he'll literally work himself into a frenzy. He puts a tremendous amount of pressure upon himself.
As I was told when he was young that it was sensory and not adhd==== and to never let them tell me otherwise, we worked the problem from a different angle. We did occupational therapy (six years worth). One of the key things we learned is that physical exercise and deep pressure have a calming, soothing and organizing effect on my son. Examples are exercises like swimming. This is muscle work accompanied by deep pressure. When my son is swimming, he can focus, think straight, his coordination is better, he is more regulated so has better peer interaction, better control of his emotions, more able to cope and blow things off, less nervous. It is a marked difference to where he, at 11, verbalizes it very well that if he doesn't have the physical activity, he feels like he is jumping out of his skin and can't think straight.
your son is clearly bright as is mine. I just have to wonder if anything like this is going on for him. Does he have any physical go to activities? Lifting light weights, doing planks, bike riding, climbing machine or actual climbing, running and slapping feet on pavement, swimming, rowing, pull ups, push ups?????? Karate? Anything like this?
Our occupational therapist told us that our son had in essence worked through many executive function issues because of his physical activity. There are studies that imply a direct link.
Guess what? I just told my son maybe a month ago the full extent to his disorder. we called therapy all those years just something fun to do to make our body feel good. He didn't really need to know much more because he was utilizing what he needed to in order to succeed and I didn't want him to feel different.
And the not feeling different is a HUGE deal to kids. My son wants to be like other kids. The school counselor at our school mentioned this to me and I always took it to heart . . that not making a child seem different while helping them is really key.
So, I would switch your tactic. Rather than convincing him he has a NVLD, talk to him about what he can do to help it. Try some new things in there. Talk about making him feel better, cope better, do better and there are some things that you can try. Not that he has X and won't succeed unless you fix it.
I don't know if that makes sense, it's a subtle difference.
My son has a 504 plan in place. the way I explained it to him is that it is a back up plan. That there are some things in place in case he needs them in order for him to do the best he can. My son is supposed to be allowed accommodations at school such as standing when he wants to in class, having an opportunity for movement, he can have a fidget and the teachers are not allowed to mention it to him in front of everyone. they may say to the class---- hey, everyone, if you have a hand fidget or want one of mine, pull it out! So my son isn't singled out.
and anxiety is such a beast. This is the big worry spot for my son right now. That and his being bullied. My son really grapples with standing up for himself. He's solid as a rock . . . the kid has been doing physical activity as I mentioned since he was 4 and swims 4 times a week for about 2 hours each time . . . he's physically imposing but a marshmallow. Boy, are some kids drawn to that and love to mess with him. I'm hoping he finds his inner voice that says "enough", turns into the incredible hulk and clocks them one of these days. Even if he gets in trouble. It would be so worth it after years of people thinking they could walk all over him and be cruel to him@!! (that is probably not the greatest mom statement there . . . sorry). But his anxiety is also something that we work on. I have books that I have read and then had conversations with him about info in the books without saying "hey, I read this about anxiety and you need to do this". It has just given me ways of talking to him and things to offer him to help. So far, it's worked but I watch this.
You say your on has done some talk therapy and is also resistant to that now?
Hello Again,
Yes, he was an "A" student in elementary school. Won Science Fairs, History Fairs, etc. He began with concerns in 7th grade. Executive function issues, very rigid, did not pick up on social cues. His teachers said he should be tested.....hence the testing. They said he did not have ADD or ADHD. He tested very high for a high school entrance exam and was placed in all "AP" classes. He could not organize himself, would do the wrong homework, or do the homework and forget in at home or in his locker. He then would not write his homework down in his agenda book in 9th grade. We tried to help keep him organized, however he was beginning his teen years and as most teens......did not want our help. The school was not much help......it was a parochial school. We did have a 504 plan put in place......but this was not very helpful......plus the school did not implement it very well. He also hated having a 504, he felt like he was being judged and that he was too smart and should not have a 504. He wanted to stay at the school sooo much. We tried to get him into College Prep classes, but the school said no. Then when it was very obvious he could not make it in AP classes....they said it was too late to change in the year. Consequently, he passed to 10th grade, but just barely.
We wanted him to attend a different school, but he begged to stay there, so we tried tutors, it helped a little for his second year in high school. At that time he was in all college prep classes, but then he became depressed and anxious.....nausea, headaches, lots of doctor appts......pediatricians, psychologists. He ended up having to repeat his second year in high school.
He also attended a Special program ....this helped him with his executive function issues.
He is now at a different school, but lots of nausea, headaches, could not get up for school in time. We would be late for work trying to wait for him to get to school. If he is sick, we call the pediatrician, if it is an emotional
issue we contact the psychologist. He blamed the nausea, headaches and tiredness on the meds. This is why he wanted to get off them. He is now off the meds, but still having issues. He talks constantly (skype, etc. on the computer)......now we believe he is again far behind in his schoolwork, and I wonder if he is so overwhelmed that he may be school phobic......however, he continues to deny this and deny he has NVLD, ......
Yes, he was an "A" student in elementary school. Won Science Fairs, History Fairs, etc. He began with concerns in 7th grade. Executive function issues, very rigid, did not pick up on social cues. His teachers said he should be tested.....hence the testing. They said he did not have ADD or ADHD. He tested very high for a high school entrance exam and was placed in all "AP" classes. He could not organize himself, would do the wrong homework, or do the homework and forget in at home or in his locker. He then would not write his homework down in his agenda book in 9th grade. We tried to help keep him organized, however he was beginning his teen years and as most teens......did not want our help. The school was not much help......it was a parochial school. We did have a 504 plan put in place......but this was not very helpful......plus the school did not implement it very well. He also hated having a 504, he felt like he was being judged and that he was too smart and should not have a 504. He wanted to stay at the school sooo much. We tried to get him into College Prep classes, but the school said no. Then when it was very obvious he could not make it in AP classes....they said it was too late to change in the year. Consequently, he passed to 10th grade, but just barely.
We wanted him to attend a different school, but he begged to stay there, so we tried tutors, it helped a little for his second year in high school. At that time he was in all college prep classes, but then he became depressed and anxious.....nausea, headaches, lots of doctor appts......pediatricians, psychologists. He ended up having to repeat his second year in high school.
He also attended a Special program ....this helped him with his executive function issues.
He is now at a different school, but lots of nausea, headaches, could not get up for school in time. We would be late for work trying to wait for him to get to school. If he is sick, we call the pediatrician, if it is an emotional
issue we contact the psychologist. He blamed the nausea, headaches and tiredness on the meds. This is why he wanted to get off them. He is now off the meds, but still having issues. He talks constantly (skype, etc. on the computer)......now we believe he is again far behind in his schoolwork, and I wonder if he is so overwhelmed that he may be school phobic......however, he continues to deny this and deny he has NVLD, ......
I find it rather interesting that the child did not experience any nausea and no headaches when he was away from school on his break.
This suggests to me that there is a issue at school that is making him anxious. Do you ask him how he is getting on at school, if he is happy there, any subjects that he hates to do, or any one (students or teachers) that may be bullying him. It may be worth speaking with his class tutor to see how things are at school and whether he has any friends at school.
At the age of 12 my son would be extremely ill with severe migraines and vomiting once a week and it took me a while to find that this was a regular weekly thing so I started to question him about what happens on that day at school. It transpired that he hated rugby and once I wrote a letter to the school so that he would not take part in the sport, he was fine.
This situation with your teen does need to be tackled carefully and it is important to ask questions in a way that he does not suspect that you are trying to find out what is going on. A good psychologist and councillor would have been able to get him to "open up" if there is a problem at school. You do not say the outcome of the psychologist's findings. May be he was not referred to the right type of counselling therapy. There are different types of counselling.
I do not blame the teen for refusing to take his medications given then fact that he did experience side effects from them.
This suggests to me that there is a issue at school that is making him anxious. Do you ask him how he is getting on at school, if he is happy there, any subjects that he hates to do, or any one (students or teachers) that may be bullying him. It may be worth speaking with his class tutor to see how things are at school and whether he has any friends at school.
At the age of 12 my son would be extremely ill with severe migraines and vomiting once a week and it took me a while to find that this was a regular weekly thing so I started to question him about what happens on that day at school. It transpired that he hated rugby and once I wrote a letter to the school so that he would not take part in the sport, he was fine.
This situation with your teen does need to be tackled carefully and it is important to ask questions in a way that he does not suspect that you are trying to find out what is going on. A good psychologist and councillor would have been able to get him to "open up" if there is a problem at school. You do not say the outcome of the psychologist's findings. May be he was not referred to the right type of counselling therapy. There are different types of counselling.
I do not blame the teen for refusing to take his medications given then fact that he did experience side effects from them.
COMMUNITY LEADER
I can see why he was not happy with his meds. The Abilify probably had a lot to do with that. This link is one of the few that specifically mentions the gastric reflux problem -http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Abilify
Hopefully, that will get better once he has been off it for awhile (if that was what was causing the problem).
Did you know that anxiety is a very common co-disorder of ADD or ADHD? Has he been evaluated for ADD? And if school is one of the major causes of anxiety, there are things that can be done for that (besides either ADD or a lighter anxiety med).
Did he do pretty well in elementary school, and then as he hit middle school or high school did his grades begin to slip and the anxiety worsen?
Hopefully, that will get better once he has been off it for awhile (if that was what was causing the problem).
Did you know that anxiety is a very common co-disorder of ADD or ADHD? Has he been evaluated for ADD? And if school is one of the major causes of anxiety, there are things that can be done for that (besides either ADD or a lighter anxiety med).
Did he do pretty well in elementary school, and then as he hit middle school or high school did his grades begin to slip and the anxiety worsen?
Hello,
Thank you for your input. The meds that were taken are the following:
Zoloft, Abilify, and Cogentin (for the side effects of Abilify).
He went off Zoloft first, then off of Cogentin because the dosage of Abilify was lowered. Then he stopped taking the Abilify.
He would complain of being tired all the time. Also, of nausea and headaches.
Since he was off of the meds..........he still complained of the nausea and headaches.
Consequently,............................
He was seen by a G.I. specialist and they prescribed Pepcid as needed.
He was also seen by a Neurologist, they do not believe it is organic in nature........because since he was on school break he had no nausea and no headaches.
~~~~~~~GLLR
Thank you for your input. The meds that were taken are the following:
Zoloft, Abilify, and Cogentin (for the side effects of Abilify).
He went off Zoloft first, then off of Cogentin because the dosage of Abilify was lowered. Then he stopped taking the Abilify.
He would complain of being tired all the time. Also, of nausea and headaches.
Since he was off of the meds..........he still complained of the nausea and headaches.
Consequently,............................
He was seen by a G.I. specialist and they prescribed Pepcid as needed.
He was also seen by a Neurologist, they do not believe it is organic in nature........because since he was on school break he had no nausea and no headaches.
~~~~~~~GLLR
COMMUNITY LEADER
Given the prior testing, there should be no need for further testing. In fact, his refusal to test and take meds is as important as any test might be. I can't tell from your post if he is on the autistic spectrum or the ADHD. But, his refusal to take meds would suggest that he does not like the side effects. If the meds are properly prescribed, the side effects should not be an issue. Kinda of wonder what he was prescribed?
Well, since it isn't like a blood or urine test that you can compel by force, yes, he can refuse to participate in the testing process. He can just sit there silently.
I don't know if you're his teacher or parent, or other, but it sounds like you need to find someone he really respects and trusts who can lead you through this process. It's key to find a psychiatrist/counselor/teacher/other who he wants to please.
Best wishes. This is really hard.
I don't know if you're his teacher or parent, or other, but it sounds like you need to find someone he really respects and trusts who can lead you through this process. It's key to find a psychiatrist/counselor/teacher/other who he wants to please.
Best wishes. This is really hard.
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