My question is: should we remove her from the school (public) and put her in a specialized theraputic day school or quickly put and IEP/behavior plan in place and possibly switch her teacher?

She is getting ready to begin play therapy as well. Should we keep her home from school until we figure out what we are doing?

We want to what is best for her, but don't want to do to much too soon.

Ask her pdoc for a letter recommending homebound instruction (not homeschooling); Typically, when a doctor recommends homebound instruction, the school assigns a teacher to come to your home (or meet your daughter at a public place such as the library) for tutoring for an hour or two a day. Homebound instruction is a temporary means of keeping an ill child abreast of schoolwork. Your daughter might finish the school year in homebound instruction, or she might just need several weeks, then gradually reintroduce partial days.

Ordinarily, you might request a Functional Behavior Assessment (FBA) to figure out what is triggering your child's behavior; however, this behavior seems to be pretty recent and out of character, so I would chalk it up to illness. However, I do think you'll need to put an IEP in place to handle future on-again, off-again problems. I would put in a written request for an neuropsychological evaluation for special ed services. She does not have to have a learning disability to become eligible, but the school does need to prepare for a "next time" scenario, including ways to prevent meltdowns and ways to de-escalate meltdowns and keep everyone safe. There may be other needs uncovered in the evaluation.

As much as possible, analyze what kinds of situations triggered your daughter's meltdowns, from the school's perspective and your daughter's. I think you are right that some kind of frustration and/or anxiety has been grabbing hold of her. her behavior is not willful, it's just reactionary. If you can reconstruct the triggering events, you may gain some insight into what needs to change in future. For example, it could be difficulty in concentrating and making sense of math or writing assignments that are, during this acute period, overtaxing her brain. In such situations, she may need more 1;1 attention to help her stay on task and pull her ideas together. Or she may need more time to do things that she could previously do quickly. Or the teacher could be doing something that sets her off — something that wasn't problematic before but that is problematic now. Mostly, it sounds like your daughter doesn't have the cognitive energy and clarity to deal with schoolwork now; she may have trouble at home too, but with reduced work, some handholding and encouragement, and no time pressures, she may be able to stay apace academically.

Daunna Minnich
Moderator, JBRF Education Forum

One of our psychologists told me something one time in a counseling session that has really stuck with me, and I believe it to be very true:
A Large majority of the problems that Bipolar children experience are a direct result of how people react to them (namely adults). A Bipolar child frequently experiences the sudden onset of an extreme emotion and be it anger, anxiety, sadness, or elation they internally cannot justify why they are experiencing this emotion (as there is no event or situation that caused the emotion as is typical in non-bipolar people). Often (both in children and adults who have not fully come to understand their disorder) when they fail to be able to rationalize or justify the emotion they are suddenly feeling with great rigor they then will often attempt to create a situation which would justify or rationalize it. For instance a Bipolar child may feel the sudden onset of extreme anger (as is most common), they then will attmept to provoke a situation in which they can act out on that emotion, ie. Asking to do something they know they cannot do at the time (coloring when it's time to do math at school), when the adult tells then no, they can then argue and escalate the situation to the point that they can rage and express their extreme anger.

The suggestion that this particular doctor made to us, as parents dealing with a Bipolar child, was to always try to keep our responses very nuetral when dealing with her. We've learned to identify what is called the "rumbling stage" and learned how to try to avoid allowing our child to "engage" us in order to act out on her unexplained emotions. The rumbling stage is basically that point in where the child starts the feel the onset of the emotion. We have found that distraction techniques are very successfull is staving off and even taking her attention off the onset of these random moods. When we miss the rumbling stage, and she is already focused on it, it's very difficult (almost immpossible) to use those techniques at that point and this is where the nuetrality comes in. By not allowing the child to engage you you are refusing to awknowledge their attempt to act out the innappropriate behavior. For instance, during depressive states my daughter would often express feelings of helplessness and worthlessness (telling us she wasn't smart enough to do her homework and constantly saying "I can't do it", telling her "Sure you can you are so smart" would make it worse and only open up the floor with her for the debate on the issue, almost definitly leading to a melt-down/rage. We found that instead when she tries this approach with us we ignore it and try to redirect her (if her homework involves cutting and pasting asking her if she got her scissors out, do they cut well, are they too dull? ect) When my daughter is past the rumbling stage we (and it is VERY HARD) talk to her in a very calm voice with little (preferrably no) voice fluctuation and emotion. If she rages we provide her a safe place to do so but dont try to calm her down. For our daughter iliciting a response from us was a very important factor, so we found that when we gave her no emotion in our reponses, the intensisty and frequency of the rages dramatically decreased. Now when she does rage we dont awknowledge it, we dont respond to request from her durring these times and dont really even communicate with her (aside from telling her that she needs to go calm down and when she is calm we will talk).

We have SEEN AWESOME results at home, but as I said, school continues to be a problem and it took me a while to realize that it was because of the way that the teachers and staff were responding to her. Children with Bipolar disorder are very different creatures. You cannot take the same approach to them as a otherwise normal child and expect it to work.

Definitly get an IEP! Not only because it will ensure that the teachers provide the correct and appropriate accomodations but also because it will protect your child from the school taking corrective action against them for something they have done as a result of the disorder. I never thought it was a big deal before, since the teacher we had was providing some unofficial accomodations in the classroom, that was until my daughter got put in in-school suspension for 3 days and was at risk of getting expelled all in relation the her having a pretty bad melt-down at school. They cant' expect your child to function like all the others and they can't punish him for something he has no control over.

-Dani

P.S. Consider asking if your district offers a class for children who have behavioral problems that interfere with their education. Many districts provide this kind of class (often referred to as a BIC or Behavioral Intervention Class). They are usually much smaller class sizes (1:4 ratio) and the teachers a specially trained to deal with children with these issues and provide the students with coping skills to address their behavioral problems.