The school psychologist had cautioned us not to try ADHD meds unless one of three things happened: Steven was not learning to his potential, his self esteem crashed, or his relationships deteriorated. In four year old pre-school, all three happened at once and we fell into darkness.

Steven continued to become easily frustrated and melt down often. The teachers resorted to putting stickers on a daily paper to send home – giving him immediate feedback on his coping success. The many challenges, larger class, and more physical activities put Steven at greater risk of social mistakes. If a child bumped him in line or knocked down his block tower or told him what to do (and we know that rule conscious 4-year olds never tell each other what to do!) he reacted with anger.

Actually Steven’s meltdowns became more implosive than explosive. Bright red with tears in his eyes, he would clench his fists, grit his teeth, squint, and tense up like a coiled spring. It was the threat of violence that got attention. If no one touched him during that critical period, he’d calm down. But the perception of an imminent touch might provoke him to swing.

Then he got sad. The tearful apologies started. He was old enough that he understood his classmates didn’t react so violently, that he was different, that he didn’t fit in. He was just like the Sesame Street song “which of these things is not like the others”.

I don’t remember being invited to any birthday parties that year. I’m not sure if he noticed, but it broke my heart.

There was an interesting classroom dynamic that happened, though. Even as Steven started pulling away and isolating himself from the group, presumably with the goals of not to hurt anyone else and not to be hurt, the group started to gather around and protect him. If he got upset and lashed out, his classmates would be more concerned about him than themselves. Very maturely, they’d tell the teacher they were fine, everything was fine, how was Steven?
Steven was too wrapped up in his own emotional rollercoaster to recognize his classmates’ social cues. He had no idea that he was safely in a protective cocoon of watchful peers.

Oblivious to their quiet support, Steven felt isolated and alone, embarrassed about his outbursts and out of control of his emotional reactions.

Steven was showing two of the three indicators we’d been told to look out for: his self esteem was damaged and he wasn’t making friends.

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