Question about FASD

[Tinker35]

My hubby and I adopted his 2 grandsons. We've had custody since they were 31 months and 7 months old. They are now 9 and 7. They were exposed to prenatal drugs and alcohol, and both have issues from it. The youngest one was diagnosed with IED last year. He is taking Abilify and is in counseling, and is doing much better now.
The oldest one will be 10 in November, but is the size of a 5 yr old (47 inches and 49 pounds now). He was diagnosed 3 years ago with ADHD, and I agree with it. He takes Vyvanse which helps him stay seated at school. He is extremely immature and requires supervision for everything. He "forgets" to rinse shampoo out of his hair, "forgets" to stay in the yard when playing outside, etc. He talks to himself a lot, often gets way off topic when we chat, and sometimes seems like he's in his own little world. He has OCD tendencies. He is also overly emotional, easily frustrated, and cries a lot. At school, he bolts from the classroom or hides under his desk when he gets upset. He has a lot of trouble learning 3rd grade academics. He is a great reader, but cannot comprehend it. He is barely passing math and reading, even with the tutoring that the school is providing. Homework is a nightmare. He cries and runs to his room if he doesn't understand it.
The school just did an evaluation on him. He scored "low average" on his IQ test and his "atypical behaviors" were noted. They determined that he didn't qualify for an IEP, but the school is working on a 504 plan. Our local mental health center did an evaluation recently, and he started counseling. I was told that he "possibly" has FASD, but his diagnosis is "ADHD with anxiety/depressive disorder". He just started Zoloft.
I'm not sure if I'm looking for advice or just needing to vent. I'm at my wit's end, and feel so helpless. Maybe I'm missing something. Is there anything else that I can do to help him?

[courtney48]

Did the mental health program you are accessing review the school test results?  Do they agree?  Have they done any independent testing which would reveal more?  Do you know which tests were administered through the school?  I think you should pursue an IEP.  504 plans are courtesy plans at best and if not followed, you have absolutely no recourse.  Schools offer it to pacify parents.  You need an IEP.  He can be classified under "other health impairments", I'm not exactly sure how it is termed.  It's been awhile since I've had to deal with IEPs.  You might check out wrightslaw.com for more info on securing the best IEP.  You probably also have an advocacy group in your state that can help you sort through special ed.  You could call your state's department of education and ask for the name of an advocacy group.  Hope this is helpful.  Good luck.

[Kevin Kennedy, Ph.D.]

His presentation is very typical of children with FASD. His small stature is not unusual in such situations. I would pursue the school situation though, because it sounds like he needs more than the 504 Plan.

[Tinker35]

Thank you for the tip. After checking out the symptoms, I don't think he has Celiac Disease. He has no bowel issues at all. His eating habits are normal, he just can't eat much at one time. The ADHD medicine definitely affects his appetite, so I am constantly pushing extra calories into him after school when his medicine has worn off. He drinks nutritional supplement drinks regularly.
His pediatrician isn't concerned about his low weight, because his height is also way below average. The doctor told me that he may be a small adult, or he may hit a growth spurt and catch up.
I truly don't think it's a medical/physical problem.

[MLWTR]

Given his very small size, have you ruled out GI disorders that could cause malabsorption? In particular, I would think it would be important to rule out celiac disease because that sometimes presents with psychiatric symptoms.