Originally Posted by EdEd
Definitely a very tough situation. I think everyone has pointed out two courses/directions in strategy - 1) medication compliance, and 2) interventions when off meds.
In terms of the first, depending on where you are, some of it is the problem of how prescriptions are written - sometimes they don't write the prescription for a refill, so an appointment is necessary every single refill, and sometimes appointments aren't available until after the prescription runs out. I've never seen a situation where - if the family tries hard enough - they are unable to get refills in a timely manner. However, the way it's set up can make it difficult, especially if you have families with tough work schedules or transportation issues. All of this is to say that - even with support - you may still be stuck dealing with some of these issues.
In terms of when the child is not on meds - assuming it's a day or two - I would drop expectations, not enforce consequences/school rules strictly, and give alternative assignments that are enjoyable pleasant, all while trying to not make it seem like you are reinforcing the child (both so child doesn't think lack of meds is reinforced, and so other children don't detect a difference). None of those things are ideal, but better than the alternative of trying to run through consequences chain which will inevitably not work and lead to more frustration, more defiance, more paperwork, and a lot more negative interactions. The bottom line is that those are probably going to be lost days, so better to escape while enjoying each other than to try to have extremely negative experiences.
A more intensive solution would be to try to modify the IEP to allow for more intensive services on an "as needed" basis, basically opening you all up to changing placement for the day to a resource/self-contained room - provided that that was agreeable to all and a good option in terms of what those rooms/teachers look like.
Some of it also depends on how active/involved your social worker or support personnel are. For example, I've worked in locations where there are "drop-in" mental health department days where prescriptions can be refilled on the spot (e.g., every Thursday). You may come up with a system in which you called the social worker, who might then be willing to take the child to mental health to get the prescription refilled on the spot. Probably unlikely that all of that lines up, but thought it was worth a mention.
With some of the ADHD medications, it can be difficult to get them timely, depending on how the doctor writes the prescriptions.
With my seizure medications, I have to tell the pharmacy a week in advance of when I need a prescription so they can order the brand name pills (as my neurologist only wants me to take brand name pills, no generic)
Originally Posted by EdEd
And a response to those suggesting not to address the medication issue - I agree that, as a teacher, you shouldn't be the one directly communicating it, but it's important to understand that teachers are an important component of med compliance and feedback. Doctors often won't know how kids are responding to meds without teacher input, and teachers often are the only ones in a school that would know (or the first ones at least) that meds are running out or otherwise not working. Teachers working with appropriate support personnel such as social workers is an important element of meds working appropriately.
There is definitely an assumption with a lot of teachers that they shouldn't deal with anything related to medicine, but consider the example of meds related to some non-behavioral condition such as epilepsy, and the child starts having more seizures at the end of the month. Wouldn't it be extremely prudent that someone communicate that? What if there were no meds, and the child started experiencing extreme difficulty with breathing? Would someone at the school not recommend a physical eval? Again, it may not be the teacher, but compliance with appropriate medical procedures can be a critical ingredient in academic and behavioral success, and by no means should be ignored by the school.
Here's how I view the medication issue.
What a teacher shouldn't say: Johnny should try some ADHD meds, maybe he'll perform better in the class.
What should be said: Johnny has been doing great this week. or Johnny has been doing so well, then the past few days, he hasn't, has something changed?
The medication issue more comes up when it regards a disability such as ADHD and not something like epilepsy or asthma, in my opinion.
Originally Posted by EdEd
One other strategy I've seen - not implemented by schools, but by families. I should note that this isn't exactly permissible, and certainly not something a school could suggest, but still something I've seen families do. Essentially, the strategy is creating a "reserve" of unused medicine that can be used if meds run out. So, let's say a family forgets (or decides not) to give meds on a Saturday, leaving one extra. That extra pill might then be used at the end of the month if the child has run out. Often times, there is some overlap is prescription, and it is possible for families to accumulate a few extra pills if planned accordingly. Again, not something that's a realistic strategy that a school could implement or suggest, but nevertheless a possibility on the family end.
For meds like ADHD ones, I believe it is usually recommended that the patient take a continuous dose in order to maintain a theraputic dose in the system.
With other meds, this can or cannot be done, depending on what it is for, obviously.
Like I have a couple half pills of one of my anti seizure meds around the house, as I am to take a half pill immediately if I have a seizure and if it is within an hour of when I am to take my next dose, I am to take my normal dosage on top of the half pill.
With what some posters have said regarding a place for the student acting out needing a place to take a break. In the classroom I am observing in, a student who has an IEP (I believe for ED/BD) has been granted the right to have breaks recently and her place to go is either the nurse's office or the principals office and she can sit there for 10 minutes, or until she calms down.