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Son Refuses to Be Tested
Q: My 14-year-old son has never been a great student. During the past two years (the latter part of seventh grade and all of eighth grade) things have gotten much worse. He was failing all of his classes. He wouldn't hand in any work. He is very smart, but has a real aversion to writing. I believe that his reading is also suspect. In the past, testing has not revealed any obvious learning disabilities. I requested more testing and Sean agreed to cooperate with this. Once the testing got under way, however, Sean decided that he did not want to participate after all. I am at a real loss as to what to do next. I have a hard time pushing the schools to do more when Sean refuses to participate. Initially the school wanted to just let Sean pass on to the high school and I objected and they have finally agreed. As much as I don't think he is ready for high school, I really don't have a good feeling about the results of him repeating the year in the same environment.
Over the years we have worked with two different psychologists, a psychiatrist, and different medical doctors. He's been diagnosed as ADHD and depressed. We have tried medications with no success. Any suggestions of what to do or where to find help would be greatly appreciated.
A: Since Sean has a history of not doing great in school, it's really important to find out why. He may have an underlying (and undiagnosed) learning disability that has made it hard for him to do well. An evaluation using appropriate tests would help to determine that, but right now, your son is not a willing participant.
You point out that he has been diagnosed as depressed and that he has ADHD, but that the medications have not worked. I would suggest that you take him to see a psychopharmacologist (a physician who knows about medications that affect mood and attention). Make sure it's someone who has had lots of experience treating adolescents. This way you can get a second opinion about the diagnosis and the appropriate medication (or combination of medications). If a doctor is able to find a medication that will help "lift" the depression, then Sean may be more willing (and more able) to take the tests that will help answer the LD question. He may have ADHD, but he could also be having difficulty focusing because he is depressed or distracted by worrisome thoughts. The consultation from a psychopharmacologist will help determine whether his difficulty with attention is a cause or a symptom of his problems.
It sounds as if there is a cycle of problems that needs to be broken in order for your son to improve in school. If the school has not done a thorough evaluation to determine the need for special education services, that should be done now. Unless something different happens in school, he's likely to continue to stay in neutral or regress. If he's interested in something right now, (like cars or electronics, etc.) try to find a school or program that will take advantage of this interest. Sean may be more motivated to learn if he's in a vocational program or a program that offers internships in the workplace. Moving up to a higher level or repeating the year aren't good solutions unless there's something different or special about his education.
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Jerome (Jerry) Schultz is the founding clinical director of the Learning Lab @ Lesley University, a program that provides assessment, tutoring, and case management services for children with learning challenges. Schultz holds a Ph.D. from Boston College, and has completed postdoctoral fellowships in both clinical psychology and pediatric neuropsychology.