So the school system is waiting for me to medicate my son before they'll really dive in and address his needs. (Such as getting his curriculum ON THE COMPUTER like they said they would in October.)
Our psychiatrist is targeting the fact that my son does well in a supportive environment with lots of trained people and proven behavior modification techniques. He does not want to medicate him until it can be shown that my son consistently exhibits explosive behavior in a supportive environment. For every episode of opposition and rages, there is a clear antecedent which the staff responded to poorly.
The school wants my son medicated because he'll be easier to manage if he is. They've given up on being creative with him because nothing works all day, every day. The last resort is to medicate and hope that it changes him enough to be compliant.
He psychiatrist wants the school to manage him before he'll medicate him, because the psychiatrist feels as if the behaviors my son is exhibiting are being triggered by the school. He doesn't believe that any medication will make my son compliant overnight. He wants to target only those behaviors that are truly out of my son's control, and he wants the rest of the mental health team to work with Saul in overcoming the rest.
The psychiatrist's view is that until the school is consistent in its approach to Saul before the medication, there is no guarantee that they will treat him appropriately after the medication begins.
OK then. Catch-22
The best option is really just to move him out of the school. And we're back to this merry-go-round. There are no programs for a fourth grader with these issues in my area. He is too articulate and sensitive for the programs for truly violent kids, and the programs for troubled gifted kids won't take anyone with a history of episodic rages. We can move him to another school in the same district and try to start over, but then we're back in the "He needs more support than we can provide" category. Everyone Verbally agrees that the District is going to have to build a program for young Asperger's children who act out, but no one will commit the funds. Also, to build a program takes about a year. Soooo, what do we do with him now?
We can't teach him until he's medicated, vs. There's no point in medicating him until they can demonstrate that they know how to teach him, because the medication isn't going to change who he is.
For all that I'm stuck back where I started, I really like this psychiatrist a LOT. He wants to start meeting with Saul's aide and anyone else who has daily contact with him. He's working well with the rest of the mental health team. He's ready to medicate, but he's also very interested in working out what makes this kid tick.
Did I mention that I have ANOTHER meeting regarding my son on Friday? Yeah.