Too Smart for Special Ed, but Struggling in School

I was charmed the first time I met 9-year-old Tyler, a darling red-haired, freckle-faced fourth grader with High Functioning Autism (HFA). In spite of the troublesome complaints his parents had led me to expect–"He's rigid and controlling, has outbursts at school, picks at his arms until they bleed, has to have things his way..."–I couldn't help liking him right from the start.

I'm not surprised that his parents were frustrated. Tyler didn't click with siblings or teachers or anyone else.  He had many of the classic signs of HFA:   sensory issues, emotional meltdowns, poor organizational skills, trouble going with the flow...

In spite of his above-average intelligence, Tyler struggled in school. Though he had been screened for special education, he hadn't qualified for any extra help. Life was filled with conflict, both at home and on the playground. His parents, Amy and Tim, were concerned that Tyler's problems were only getting worse, and that there seemed to be so little support available for him.

Though Tyler had significant problems with reading comprehension, he's always been a whiz at math. His head seems filled with numbers, and he's obsessed with the stock market. Every morning he gets up before anyone else in the family and devours the stock market quotes. He follows business trends and possesses an encyclopedic knowledge of the New York Stock Exchange. He goes wild if his pretend-investments take a plunge in the market.

"He's so smart, and yet he doesn't get the simplest things, like treating others the way he wants to be treated. It's those little things that throw our whole household into chaos," his father explained the first time I met the parents.   Tim and Amy were frustrated with his rigidity, the frequent calls of complaint from the school, and what they termed his self-centered behavior.

After visiting with Amy and Tim, I met Tyler, then eight. For the first ten minutes, he gave me non-stop sage advice on how I should invest my money. When I was finally able to steer him into a conversation about school, he began spouting off about the teachers. The trouble was all their fault, he shouted. "They're stupid and they have favorites." It was clear that Tyler was not one of the favorites. "It just isn't fair!" he yelled, tears threatening to spill out of his wide-set blue eyes. He reached for his arm and began scratching. It was then that I noticed the scabs and marks on his arms that his parents had described.

There was no doubt that Tyler was smart, and he knew it. But he felt profoundly unsuccessful in every area of his life.

Amy and Tim dearly loved Tyler, but every time the school called, they felt like failures. And the strain was beginning to show in their marriage. Tim believed that Tyler needed more discipline to change his behavior and was resentful of Amy for not backing him up; Amy felt that Tim was too harsh with Tyler, only creating more stress on him without resolving the problem, and she attempted to compensate by leaning more in the permissive direction.   

I spent some time appreciating their best attempts to resolve these difficult issues, then we set about designing a treatment plan.

First I referred them to a private neuropsychologist for thorough testing. Her assessment showed deficits in executive functioning (inability to plan ahead and organize) and fine motor delays (he could not write fast enough to record assignments). He lacked social skills, and he definitely had sensory problems–he couldn't tune out background noise, and he had unusually strong reactions to certain noises. He had trouble performing well on tests because of his tendency to over-focus on certain parts of a test. His reading comprehension scores, together with some other findings, were enough to qualify him for special education services.

My next step was to advocate for Tyler with the educational system. I accompanied Amy and Tim to school, where we talked with his teachers about some of the reasons for Tyler's problematic behavior. Once they understood that his acting out usually stemmed from anxiety and his inability to understand social expectations or grasp assignments, school personnel were willing to make accommodations. Eventually an appropriate IEP (individual educational plan) was developed, that included goals to address skill building in areas of social development, organizing and planning, fine motor, and reading.  

Tyler's teachers were willing to make some accommodations.   When they realized that his worst class–music–was physically uncomfortable for him, due to super-sensitive hearing, the teacher allowed him to choose a seat near the back and to slip in earplugs. The music teacher was also willing to modify the amount of participation she expected of Tyler, once she understood the problem.

Because recess was often the most uncomfortable time of the day, due to its lack of structure and Tyler's social difficulties, the special education teacher formed a small game club for Tyler and a few other carefully selected peers, who could also benefit. This relieved some of the anxiety Tyler typically anticipated for this part of the day.

Tyler received remedial help in reading, his most challenging subject area. Then, when these changes were set into motion, I referred him to a psychiatrist to be evaluated and further treated for his anxiety and compulsive skin picking problem. Even though his anxiety was greatly reduced by the measures taken at school, Tyler was able to benefit from appropriate medication, and this is when his parents and teachers began to notice the greatest improvements in his confidence socially. Tyler began to engage more comfortably with his peers, and overall, appeared more relaxed and confident.

One adjustment that seems to have been particularly helpful has been the resource room teacher's willingness to do a brief preview with Tyler at the beginning of the day. This helps Tyler know what to expect and gives him a chance to talk about anything that could be anxiety-producing. At the end of the day, his teacher does a review, talking with him about his successes and reviewing the things that went well. This allows Tyler to go home feeling positively about his day.

Tyler now feels more relaxed and better able to cope, both at home and at school. After years of disliking school, he actually looks forward to going, his mother now says.

As the anxiety has lessened, Tyler's tendency to pick at his skin and chew on his sleeves has become less evident.

Amy and Tim have worked at helping Tyler to become more flexible and less rigid in his demands. Their treatment plan at home has focused specifically on goals to improve Tyler's relationships with family members and build self-responsibility skills. "It's made a huge difference in our home," Amy says. "We now have a much happier kid–and that makes all of us happier!"