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(Long) Emotionally Impaired? What to do?
Old 01-31-2012, 11:38 AM
 
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I work with a child 4 days a week who is not diagnosed with any sort of EI, but shows strong signs of something. Mom is puzzled - she's had many tests done and has a great doctor. She recently started on an anti-anxiety patch due to her tendency to be very finicky and uncomfortable with changes in schedules, loud environments, etc. She is a self-proclaimed vegetarian who only eats a few different things - very reluctant to try anything new. These are some observations that I have noticed, and I would not mind input if you are able to read it all.

Behavior:

When frustrated or upset, she has difficulty seeing things right in front of her own eyes - for example: if she is very upset, and you tell her to put something on the table, she cannot find the table. She wanders around the room several times and cannot seem to remember everyday objects
Enjoys being competitive, however, will manipulate/cheat/or change rules to avoid losing
Getting dressed in the morning (according to mom) is very difficult for her due to her particularity on clothing, and can only wear certain things
Very "quirky" and unique
LOVES science
Requires work to be done in a certain way
Argumentative about facts, even when told by an adult
Gets frustrated about insignificant things, and can work herself up into a meltdown
Cannot do a short/simple assignment without constant praise
Needs to turn every task into a game with very particular, non-sensical rules
Very inconsistent behavior - will write all 4 spelling sentences by herself quickly one day but the next day will have a temper tantrum and it will take almost a half an hour
Says, "I can't" constantly - believes she is not smart
Low self-esteem when working - when she writes the wrong letter, she will erase very harshly while saying, "I always ALWAYS mess up that word! I'm not smart!" and then when she rewrites it, she will push so hard into the paper that the pencil breaks - sending her into another tantrum
When we arrive to the answer, she usually disputes it/disagrees with it, and will write the answer very lightly on the paper to where you cannot even see it. When I ignore it and say, "okay, good job! Let's go to the next question!" only then will she write the answer darker
When she is frustrated/having a tantrum she states that everyone hates her and is always yelling at her, even if she is being softly spoken to the entire time
Is very quick to make overgeneralizations, such as: You never help me when I need it

Reading:
Gets upset when the text is "too small" when it is really not - but has no trouble reading tiny font and special fonts (like curly letters, etc.) when she is in high spirits
Very poor decoding skills
Can read larger words, like "hippopotamus" or "evaporation" but fails to recognize many high-freq. words (especially the "wh" words)
Can read a word on one page, but forgets it on the next
Mixes up letters within the word when reading "stop" becomes "spot"
Quick to guess on words and does not usually get concerned if the word makes no sense in that sentence
Sees a small word that she does not recognize, and adds letters that aren't there to create a word that has the same initial sound
Has difficultly with within word spelling
Struggles with word families
When sounding a word out, she will remember the initial sound, but forgets it by the time we're at the 3rd or 4th letter
Choppy fluency/very robotic reader
When reading word problems, she confuses the W's - What, when, where, why, and how many. "How many Tuesdays are on the calendar" - will answer with, "Yes"

Math:
Subtraction skills are very low
Does not know concepts of subtraction/adding - so when given manipulatives, she is not able to figure out when to show total and take away, or combine groups to add.
Low number sense - seen very strongly when counting money (Quarter + Nickel ... She knows their value, but cannot skip count 5 from 25)

Writing:
Very lazy/large/messy penmanship (writes better on college rule - wide open blanks or spaces cause her writing to become large and preschool-ish

... as for my own reaction to these peculiarities, I am attentive to her needs AS NEEDED. That is to say, I do not try to "buy in" to some of the empty complaints that she uses, and I avoid arguing with her. Most importantly, I ignore attention-getting behavior, so that she is able to understand that there will be no acknowledgment of this type of behavior choice and that it is just wasting her time. When she is genuinely upset/worked-up, I offer her breaks (though she argues with every suggestion), she is very stubborn. I also give her several choices for even the smallest things, like, "Do you want to cut your spelling words out while standing, or in a chair? Or -- "do you want to use pink, or purple scissors today?" She enjoys the control. I try to keep my questions/statements close-ended so that she is not confused with them. I have worked with Asperger's in the past, and I see slight similarities in her behavior with that of AS. I also know that AS in girls is much different than in boys. After reading on it, I see some things - but she is only in 1st grade and sometimes we have to just say, "she's only 7..." so as not to overanalyze things and set expectations that are way too high, or too intense.

It just seems like no matter what I do - how consistent I am - or how sure I am of something, she finds a new outlet for these behaviors! Her mood changes every day and I never know what I'm walking into! Yesterday, we read a book that she has read before. The words were easy and the story was very fun, but she began to argue with the spelling of the words! "Walked shouldn't have an 'e' in it! Now it says "walk-ED" even though I told her that there is not much we can do about the book that has already been printed, she continued this for several pages (20 minutes of this!!) and then she read the last half of the book fluently with no problem. (?!?!?!) *sigh* I am deeply worried about her success in school in the upcoming years - despite all of the support she gets at home and in school.


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Sounds liek a spectrum child
Old 01-31-2012, 12:16 PM
 
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I am a regular poster, but don't want to sign-in since I am on prep at school!


From your description, this child sounds like she is most likely on the autism spectrum and not emotionally impaired. I'm not sure what testing mom has had done, but a neuropsych test seems in order at the very least to rule out autism.

I'm sure she's getting a ton of support, but if it's not the right support, it won't help. An occupational therapist that can help her regulate her sensory system nay be helpful.
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Old 01-31-2012, 05:22 PM
 
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I agree with the pp. Some things that have helped me teach students like this are using visual cues as well as verbal directives. Make sure that your directions are short, one step and give time for the student to process. Visual picture schedules work good so that she will know what to expect during the day and can check off tasks as she completes them. Look for social stories to help with school and home life situations. She sounds like she will need sensory breaks during the day, your OT can help you figure out what types would work best for her and then you can build in these breaks during her day. It sounds like you know how not to get into that power struggle with her- I know that I've waited out students for a long time, just to complete a 5 minute time out/chill out! Good luck! Your school psychiatrist should be able to help with getting the diagnosis of autism, or aspergher's.
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Old 01-31-2012, 07:22 PM
 
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I soooo see a spectrum child too.
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Old 02-01-2012, 12:49 AM
 
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She sounds spectrum to me, too. She sounds a lot like my son, who is on the spectrum. Is this something her doctor has considered? What kind of a school psychologist do you have? In our state, a school psych can give an educational diagnosis of ASD for educational planning and placement. Spectrum can look different with different people.

I agree with getting the OT involved to help meet some of her sensory needs. That should help regulate her so she can function better in the classroom. I would also try to work regular breaks into the schedule so you don't have to wait for her to be really upset before you give her one. I also completely agree that a visual schedule can be really helpful. Make sure you are very explicit with directions. Most importantly, remember (which you probably already know) that her actions and reactions are not personal, they are most likely a result of her trying to cope with and interact with her environment. Don't assume she has the same perspective on or understanding of any situation.

Good luck, I hope you get some answers!


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Old 02-01-2012, 01:11 AM
 
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Sorry, the nighttime "glitch" was going on when I posted this, so when I refreshed when it came back up, it posted again. Nothing to see here....
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Thank you
Old 02-01-2012, 08:49 AM
 
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For all of your advice and insight! I am her tutor - so I do not have school support. She does receive support at school though, from what I hear. She goes to a private school, and her class size is very, very small so she benefits from 1-on-1 help at school, and there are extra people that do work with her. Tonight is spelling sentence night *dreaded* - but sometimes she surprises me and says, "I don't want ANY help tonight!" I give her these "really special" cones from the dollar store that have positive sayings on them when she is self-sufficient while working. We call it "happy working" and I try to show her every day what happy working looks like. If we smile, laugh, and we try our best she gets a cone. She has been denied them before, so she knows the consequence. It really irritates her when she doesn't earn all 6 of them each night.

Again - thank you for the advice!
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Could Be Autism Spectrum Behavior
Old 02-01-2012, 10:10 AM
 
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...that being said, try a token economy system. Be sure to also have pictorial expectations for behaviors. You can start with a certain number of tokens on a Velcro board and tell her that a set number need to be remaining at the end of the lesson. One could be removed for each negative behavior. If the number of tokens remaining is equal to or higher than the predetermined goal, then she could earn the reward of her choice from a pictorial menu of options.
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Old 02-02-2012, 07:49 PM
 
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It sounds like she also has some sensory-intergration disorder. I once had a student that displayed some of the same behaviors ( can't find the desk, very quirky too) I am starting to believe that some of the odd behavior that is so often thought of as autism has something to do with chemical/vitamin/mineral imabalances naturally found in the body. I believe that these people who claim that their autistic child was cured after certain foods were added or taken away were actually seeing a difference because their child was able to process information correctly. There are some places that take stool/urine/hair/blood samples and then can decipher what is missing or overloaded in the body. It's worth a shot.
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Sensory Processing Disorder - interesting
Old 02-04-2012, 05:15 PM
 
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Hiker - that is a very interesting point. I honestly hadn't thought of that, but now I am seeing the similarities. Cafe - I might suggest looking into the book "The Out-of-Sync Child," about sensory processing disorders. I bought a copy cheap on Amazon years ago, I bet it could shed some light on the situation and help you determine whether your situation sounds like those in the books. If you feel that it is the same disorder, I am sure that mom would be very grateful to have something else to look into!


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