Right, Wrong, and Children with Psychiatric Illness

September 27, 2011 Angela McClanahan

Last week was certainly eventful. After Monday's outburst that led to a call from school, Bob was under strict orders to...well, just try to get through the day without any drama. He did relatively well, presumably because a school skate night at the roller rink was at stake. Or so it seemed.

By Thursday evening, he had earned clearance to attend the skate night, and we headed to the rink after dinner. His teacher was also there, chaperoning her kindergartener. Eventually we were talking, and I tried to keep the conversation light, not wanting her to feel like every parent encounter in has to be a conference. So her comment about how Bob had done remarkably well in her class that day--even though he received an incident report in PE--was completely unsolicited.

"An incident report," I mused. "I'll have to ask him about that. I didn't notice one in his backpack."

Lo and behold, within minutes of getting in the car to go home, Bob was pulling said incident report from his pocket.

Okay, so, it was PE, and the boys were grabbing balls out of each other's hands in a very unsportsman-like manner. Fair enough. Of course, Bob upped the ante by dropping an "f-bomb" within earshot of the teacher. Not what I would prefer him to do, but still preferable to launching an assault on a classmate. I'm not saying I would have ignored it, but I might have been willing to still allow him to skate.
My concern was his obvious concealment of the evidence against him, knowing it would backfire. The PE teacher is a stickler about getting those reports back with a parent signature, and he knows this. After closer inspection (at a traffic light) I noticed he'd tried to forge my signature.

Oh, boy.

I expected this act of deception to be attempted at some point, but not 4th grade. Even I waited until high school to pull that stunt.

The real concern is his lack of remorse for his behavior. Indeed, he seemed to feel entirely justified in his actions. If he brought the incident report to my attention, he might not be allowed to attend the skate night. Right or wrong seemed to hold no weight in his decision-making.

It's a pressing issue for me, now and in the future. Bob still doesn't seem able to connect his actions with consequences. Consequences, to him, are merely "bad things other people are doing to me." If he never makes the connection, I don't know how he'll avoid serious problems in his adolescent and adult life.

No one else seems to know how we, the parents, can help him make that connection, either. All I've ever been told is to "keep doing what you're doing." All well and good, but not wholly effective. At least not thus far.

More and more I'm at a loss as to how to help him grow as a person. Higher medication doses are all the "professionals" appear willing to offer. More and more, I'm doubtful that's the best answer.

APA Reference
McClanahan, A. (2011, September 27). Right, Wrong, and Children with Psychiatric Illness, HealthyPlace. Retrieved on 2024, June 17 from

Author: Angela McClanahan

samantha roby
April, 28 2012 at 12:36 pm

Angela and other readers,
I cannot believe what you wrote! My son does excactly the same thing! I thought i was the only one whose child at age 10 cannot connect action with consequences, he thinks and explains frequently others do bad things to him. Rather than he didnt make a good choice and there is consequences. How do you discipline a child who does not understand this comprehension?
He has been diagnosed adhd thus far but i think it goes deeper than that. I was so afraid he had anti social disorder, one of the signs of course is lack of remorse for actions, which my father had. I am not sure what your take on this is. He also lies frequently to cover up getting in trouble. Like bob he is also socially below his peers although academically he does farely well when his behavior does not hinder him.
Like your recent post about the child who was arrested and the comments others made, parenting a child with a mental illness is so more complicated. Trying to get him to behave is near to impossible when he is in his own world. Sometimes he can be wonderful, then he can be the worst brattiest child you ever met all in the same day.
I have used spanking, time outs, grounding, losing priveledges, day to day disipline (he only loses said privaledges for that same day, we will say he can have a fresh start the next day to make better choices). The day to day disciplining seems to work the best. One being after a day of being grounded he pretty much forgets why he was in trouble in the first place and finds other ways to misbehave or have fun distegarding his earlier punishment.
The reward system seems to backfire as well, if i say,"if you do your chores without a problem (or whatever it is) you can earn 'this or that'. Once he hears 'he can have' he expects it regardless of his behavior, even if he does do what he asks and earns the reward he expects even more after that, you give him an inch he takes a mile!
Parents say the boy needs a good whoopin, well ive been there done that, it doesnt do a bit of good, and i dont paticularly like scaring my kids into submission, but i did try. I am extremely consistent. Routines and schedules are a must. I have tried everything and have realized that i honestly cannot control him. His behavior has embarresed me so many times and i am constantly speaking with his teachers, principle, baby sitter, all day. He was on meds but they made him comatose, very bad.
One more comment i have two other children ane they are very well behaved, when they are disciplined they tend to get the undersyanding not to do it again. They are toddlers so they have their fits but compared to their brother they are much more behaved then he was at the same age, even now i can say the lil ones are more behaved then he is at age ten. Oh boy....
I like you am at my wits end. Please any comments are much appreciated and welcome!

Chrisa Hickey
September, 28 2011 at 9:09 am

My son is 17 now but never shows remorse when he's not stable.
I pause because when he is stable, not only does he behave better, but he does have remorse for doing things he knows are wrong. It's an important distinction. Tim can't internalize why he didn't brush his teeth when he's not stable.
The middle school years (about 5th grade through 9th) are the WORST for kids with mental health issues. There's the pressure of fitting in, the anxiety of growing up, the hormones, oh LORD the hormones. Stuff goes out of whack really quickly, and that includes med levels.
All I can offer is get a blood level check if you're really concerned about meds. Maybe you'll be surprised to find that he's grown and he's really not at a therapeutic level anymore. Maybe he is, and you can eliminate that from the equation. Then it's all about setting boundaries, sticking to them, devising and practicing coping skills and repetition of said skills until he's 18 or you're blue in the face or both.
Hang in there!

Barb Bohan
September, 28 2011 at 4:45 am

Having a child with mental illness is difficult day in and day out with 24 hour concern. But the fact that he didn't take an ounce of accountability here doesn't mean he hasn't internalized anything in my opinion. When I was in 5th grade, I used to try to play hooky a lot to avoid going to school because my poor eyesight had already been noticed at school and I was trying to avoid the inevitable of getting glasses. I didn't really realize how bad it was to be deceptive at the time. Children can have some degree of being accountable without having the full impact hit them. I totally feel for him wanting to go skating and so looking forward to it. Someone I know had his son try to forge a note to the teacher for his misgivings. I don't know his exact age at the time but think it may have been around third grade. He signed it Mom and Dad.

Ari Hahn
September, 27 2011 at 4:55 pm

There are so many issues and complexities here that I am hesitant to voice an opinion, even from (or especially from) my own experience. But since this is a public blog, there are some points that I would like to comment on.
Most benign: 10 years old is not an unusual age to try to forge a parent's signature, especially when a night of fun with the whole class is at stake. Even for a kid with mental illness. It is just that 4th graders are really bad at it.
I agree that more meds will not help the issues here. Cursing instead of hitting is as good as medications can help. Any more than that will "deaden" him.
He is not wrong when he thinks that consequences are bad things that other people are doing to him. I wonder if he can connect positive consequences? Can he see that he can get "rewards"? Might that be a path to begin to teach consequences?
Do you have any "partners" at the school? Somebody that would agree that cursing instead of lashing out physically is actually an accomplishment that (in the best of circumstances, at least) should be reinforced on the way to better behavior? Is that a goal that you might need as a parent?
"If he never makes that connection....." well, of course, if something never happens then.... but why contemplate the worst case scenario? There is always hope. So maybe it will take him longer, but if the parent is expecting the worst, then he or she will not have a great mindset to see the little improvements that might occur (even randomly) that need to be noticed to make progress.
There are so many ways to "help make the connection." Not "do what you are doing." but to inspect your actions and reactions and his actions and reactions for what ever positive you can find, and do more of that. When people give that answer they think that raising a child with mental illness is essentially the same as with a child without problems. It is on some level. They just don't realize that the pressure of every day saps the strength to constantly and consistently work with every little detail as if it were normal.
You need a professional that can help put that normal process in a non-normal life.

Always Sick Chick
September, 27 2011 at 9:00 am

My goodness. I did the same thing when I was about to turn 12. I was going to have a sleep-over birthday party right after our report cards went home. Like your son, my problem was in P.E. I never dressed out. I always forgot my gym clothes. I got a D in P.E. as a result. The lowest grade I'd ever gotten.
I knew that if I told my parents, I wouldn't be allowed to have my birthday party. So I hid it from them until after all my friends went home. I knew it was wrong to do it, but I felt like the risk was worth it so that I could have my party. However, I associated consequences with my own actions. I always thought my parents were too strict.
As an adult, I know better, though.
Oh, and I tried to forge my mom's signature in 2nd grade. LOL

September, 27 2011 at 6:03 am

Bob seems very smart. It's going to be a long road and I can say that because I'm in the same boat. My son is 13 and has ADHD and anxiety. We are having a hard time with school, mainly he hates it and doesn't want to go. I had to call the school twice already to come pick him up. I'm hoping he is learning that we won't let him stay home. Otherwise it's going to be a long year. Good luck with Bob.

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