9-Year Old Son Has Big Emotional and Learning Challenges

I have no experience with residential programs, but I do have experience with a defiant son. He would almost daily refuse to do things he had to do (go to school, go to an activity, do homework, whatever). I had to out-stubborn him every time and yes, he would rage, tantrum, say hurtful things and even fake illness/injury. He also would be very defiant and sometimes go into a rage when he didn't get his way. He would be truly awful for hours and hours afterwards...making all of us miserable. Finally in 4th grade I looked into child therapists who have an expertise in ADHD, Autism, ODD, Anger, Defiance. I found one near us and I talked to him beforehand about how bad and angry he feels when he has to do something he does not want and how there is this person who is really nice and might have some very helpful suggestions so we can all get along and be happy. He finally agreed to go with me to talk to her. He was insistent that none of his friends know about it. I had already had a couple very long talks with her all about him and our issues so she knew all about him. Well, she first focused on bonding with him and they just clicked. When we moved I again found a woman therapist and this one also focused first not on therapy but on bonding with him...she had teen sons and was very "cool" and would chat with him all about his favorite video games. He clicked with this woman too. Both years he actually enjoyed seeing these therapists and it was amazing the changes that were made...his maturity increased as did his ability to handle huge feelings and anger and he learned he has to take responsibility for his own actions in life. They would meet with me too and they taught me a lot about how to handle a kid like him and how to decrease all the bad interactions we were having. So...even though you say your 9 year old refuses to see someone, I think you should try very hard to get him to see an amazing therapist like the ones I found. I am so thankful at how much it helped. I wish you the best.

My post is very long (too long), but I really hope you find it helpful:

Your son sounds a lot like my 8 year old, though it sounds like you are having a rougher time and maybe not getting as much support.

Our son went to the dentist for a few years before the dentist recommended we take him to another dentist. Fortunately, he had a specific dentist in mind. This one specializes in working with kids with special needs. The staff is amazing! They have lots of experiences and lots of tools in dealing with different diagnoses and different behavior problems. I was shocked and impressed at what they were able to do with our son!

Talk to your dentist and your pediatrician and yoru psychologists. There really are experts int eh field who know how to work with your son. It is so easy to feel hopeless and overwhelmed and just completely discouraged. The right people for your son do exist! Keep looking for them!

Someone else mentioned finding another school. We are so thrilled that this was an option for our son. Our son had huge behavioral struggles at school. He was getting in trouble everyday, and the teachers didn't know what to do. The special ed teachers tried to help, but it just wasn't working. The special ed coordinator let us know about another school that specialized in behavior problem and special needs. They have a "Structured Teaching Program." My son is in a class of 8 to 10 kids, with 5 adults (1 teacher and 4 aides). He works with an adult one-on-one and then does independent work in his cubicle. They use a work, break, work, break schedule. Their PE class is very small, and they eat lunch in a lunch room with just one other class. Many of the kids have sensory issues, so these small numbers are a huge help. The school uses a "wait it out" approach to must behavior problems. If a child refuses to complete a task, an adult will simply wait for them to do it. My son refused to do something one day, and his teacher patiently waiting. He began yelling at her, and she just stood their waiting. He got frustrated and said, "Are you ear blind?" She told me she had to turn around because she couldn't stop laughing. But it was only a couple of minutes before he decided to go ahead and complete the task.

The principal of our son's new school told me, "I only have to wait one more minute than he does," and that gave me a whole new perspective on my son and his behavior. We were often told to just wait him out, but when you're trying to get out the door or when you're standing in someone's way or when you're at the grocery store, the idea of waiting them out can be terrifying. But hearing her say that helped me to see that I really could do this. I began trying to wait him out. I did my best to stay calm and prepared myself to have to wait for quite awhile. The first couple of times I dug my heals in and chose to wait were difficult and seemed to take forever. But the taught my son that I wasn't going to give in. It wasn't too long before his refusals started to decrease. He really started to understand that I wasn't going to give in and that maybe what he was being asked to do wasn't so bad.

I would definitely contact your principal and the special ed coordinator. Ask them about alternatives. There might be another school that would work better for your son. I know lots of kids have special needs and are able to receive accommodations and be in their regular classroom, but that was just not working for our son. Having him go to another school has been the answer to our prayers. They really know what they are doing, and it's a much, much better environment for him. I think it's something you need to explore.

I really encourage you to talk to all your doctors again. They need to realize that you are feeling quite desperate and possibly hopeless. They need to help you find better resources. There are behavioral specialists out there who can make a difference. Family counseling might help. We've gotten some great tips from family counselors over the years. If your son is really refusing, you might look into ABA therapy. Oftentimes they will come out to your house to work with your son in his environment. Our son was initially turned down for ABA by our insurance company because he didn't have an Autism diagnosis. He does now, but at the moment we are happy with his current therapies. We might look into it again at another time.

I don't know anything about residential programs, but that might be something you do need to consider. Please do talk to your doctors. They need to help you find resources to help your son.

You say that your son is not willing to see professionals in the community. How about you? Have you gone to professionals, explained your son's diagnoses, and asked them for parenting help? Learning ongoing strategies that are likely to work for your special-needs child is crucial. That same therapist can also give you insight into the question that you asked - how effective are residential programs for kids with your son's diagnosis.

I have not been through this but I'm glad you're considering the option. I was going to suggest that you look into it before I got to your question. Perhaps even a short-term inpatient treatment (say, 30 days) could be enough time for him to get the services he needs to get started on a path to wellness and balance and then would be able to continue treatment from home?

Before getting to the topic of residential treatment, another option, and one that will probably be a longer fight but a better long term solution, would be to work to have him out placed for school. If his needs are such that he cannot meet his educational goals in your district, then your district has to pay for him to be transported to and educated at a school that is a correct fit for him and has the services that he needs to learn. They won't be able to provide everything he needs there, but in a more therapeutic learning environment, many therapies can be given as part of his school day, in that school setting. Getting this isn't easy, but it can be done.

Regarding residential treatment, I have a friend whose 14-year-old daughter has been in residential treatment for years. It's a hard road, and not for the faint of heart. Her daughter had to be placed because she was a danger to herself and to her family. She has a severe behavioral and mood disregulation disorder and her violent outbursts required police intervention. While it is absolutely the right choice for her, quality facilities are few and far between. She spent 3 weeks in the ER waiting for a bed a couple of years ago. Her mother has pulled her out of programs where she was being abused by other patients and staff. Programs have been shut down abruptly due to findings of negligence, or worse. She is looking for a new program because at her current one, her daughter loses a lot of the time she's supposed to spend in the classroom strapped to a chair, because that's really the only tool the facility uses to deal with outbursts.

So high-quality, long-term care is a tremendous challenge to qualify for, find, and maintain. That said, there seem to be more shorter-term programs available. If I were you, I would talk to whomever leads his treatment team (psychiatrist?) and see what they say. It may be that he doesn't qualify for this kind of care at all and never would - there is a tremendous lack of mental health providers for children and care goes to those who are desperate cases first. Hopefully, though, there may be a local facility that would be a good fit for your son where he could get intensive, round-the-clock care for a short period., then you could work with your school district on getting him placed into the right educational setting where services can be delivered long-term.

A 9 yr old is unwilling?
A 9 yr old doesn't get a choice.
I'm not sure where he got the idea he has a choice.
I'm not sure where you got the idea he has a choice either.
I'd start off by realizing that you are his parent and guardian and you are responsible for him for 9 more years - until he is an adult and can make decisions for himself.
Until then - you call the shots - and you don't apologize for it.

Putting him in a resident/boarding school situation might give him the structure he needs but he's going to have to listen to authority - the school will be standing in for you.
With significant emotional, behavioral, and educational needs - I assume he's been diagnosed and you are working with doctors and counselors.
What do they say?

These are my thoughts - take from it what you can use and discard the rest.
If you feel attacked/defensive, well keep working with a counselor so communicating with people comes a little easier to you.

I'm wondering how, if he is unwilling to see a doctor (or counselor I assume) he was able to get medication? Who is prescribing this without seeing him and monitoring the effects? I find that troubling in and of itself.
As far as a residential school, I don't know, and the person I would suggest you speak to is his therapist or psychiatrist, because they would be the most qualified to assist knowing your son's specific diagnosis and needs.
I'm not trying to be negative, and I know ODD kids are very, very, difficult and mentally and emotionally draining (I'm assuming that's his diagnosis, because you didn't say.) I'm just trying to get my head around the idea of a kid being able to attend public school, and function, and yet not be able to function at home...?

I hope that you have a qualified and competent psychiatrist. Can you enlist the help of this type of doctor? Is the psychiatrist aware of the extent of your son's issues?

What kind of medication is he on? My daughter takes many medications and we're careful to only use one pharmacy to keep things in order. You might ask your pharmacist about whether any of the meds your son takes can cause some of his behavioral problems, and whether he's taking the meds the right way.

A child who refuses to go to the doctor may need intervention that is involuntary. That would be a careful discussion with his doctor and his psychiatrist and you.

And just be aware, not all residential programs accept all children. Sometimes the child has to be willing to go, and willing to comply. A psychiatrist may have suggestions. You also might request a thorough neuro-psych evaluation. Or perhaps he needs to be admitted to an inpatient psych facility for a period of time.

Is he learning in school, and how is his behavior at school? Is it different from his behavior at home?

This sounds like a really tough situation. Don't give up!

What is his diagnosis? What professionals have worked with him? What do you mean, he refuses? He's 9, not 19. How can we give you our opinions when we know so little about this child?

I have over 15 years in developmental disabilities. I worked with kids and adult both in their home, residences, group homes, supported living, and shared living.

What you're describing is heart breaking. There are places he can go but I would really like to hear that you've gone outside of your area and done everything you can, making sure he's seen the best in the fields for behavioral meds and therapy before you take that step.

I do understand though, our grandson was a terror and it wasn't healthy for any of us. We had to let him go live with his mom. She is doing a great job with him. He's straightened out a lot. But it broke him. He was devastated for several years and cried for me every day. We'd had him since he was a few days old. My daughter had him on a Thursday and went back to work the next Tuesday. We'd had him ever since. He was 7.

I cried for him every day too but I knew I had failed to be what he needed. Sending your son away could be the absolute best thing for you. The guilt you will feel is overpowering and awful and consuming. I would first look at longer term inpatient treatment so that the goal would be for him to come home and live with you again. Then if he doesn't respond to that place it might end up being a transitional place where they find him a place to go.

The only thing I would recommend for you is to call your state social services offices and ask them if they have a developmental disabilities division that you can have the direct number for. Then talk to the workers in that office and see what other resources you might have. If all else fails they would also know any facilities that can take him.

As you can see from some replies below, and mine too - we have no idea what you mean when you say that your son is unusual because of, for example, being "unwilling to go to the dentist". I mean, how many 9-year-olds would you describe as being totally willing to go to the dentist...? Do you think other parents have children like that?

Not being judgmental, just hoping that you can clarify your question/situation. Because right now he just sounds like a "normal" defiant pre-teen, who calls his mother bad words and hates going to tutoring and dentist appointments.

We, too, have a child who has significant issue. So significant that after providing 24 hour awake care for him for years, we could no longer provide the necessary care for him in our home. He is currently in his 3rd residential treatment facility in 3 years - at this point (he is 16), he needs a team of people to manage his daily life, not just "mom and dad." Our son has FAS, EOBPD, Mod-DD, Anxiety, PDD-NOS, the list goes on and on. He does take medication, but goes through periods of med refusal on top of all of the other daily issues and struggles.

My advise is

1. Contact your county children's mental health services - they can connect you with services, many of which can be in your home or during the school day at school, as well as attend IEP meetings with you. They can also offer financial assistance in some instances (depending on the county you live in).

2. Meet with your school now and rework his IEP - it should be EXTREMELY SPECIFIC. Our son's IEP is nearly 50 pages long and addresses every possible second of the day, including bathroom visits, how lunch is structured, etc. Kids with extreme issues often can manipulate their environment and if one person/teacher/para isn't on the same page as everyone else, it can lead to HUGE meltdowns (because one person says yes, and then next person says no, etc.).

3. Find out what other schools are in your school district that can address your child's needs. Here, they are called "Level ___" schools. A Level 5 might be a locked school with typically more staff than students. A Level 4 usually is SED/Behavior. A Level 3 is usually Mod DD with some Behavior. These "schools" are not advertised and usually you find out about them long after you need them (and then it is hard to come back from those behaviors even in a new setting). Find out what your schools are, how they work, who are they for, etc.

Remember, just because a child has "issues" doesn't mean that they can't be held responsible for when they break socially acceptable norms. Yes, his swearing might be "related" to his disability, but that doesn't mean that he cannot have consequences. Especially for swearing - which I firmly believe is a choice since it is used to get a reaction out of people in most cases. Don't confuse "consequences" with "punishment." If one of our kiddos is swearing in public let's say (we have two kids with serious issues - one is still at home with us), that child has to leave and go home. It isn't socially acceptable anywhere to use those words. We don't call it a punishment, but it isn't ok to act like that in public so home it is until we can get our mouth under control.

Good luck.