Symptom: Children with bipolar disorder often have a reversal in their sleep/wake cycle and it is extremely difficult for them to get to sleep at night and to wake up early in the morning. He or she seems half comatose or extremely grumpy and sleeps through first and possibly second period, often missing important class material and doing poorly on tests in the first two periods.
- Schedule academic classes later in the day when the student is more alert and emotionally available for learning.
- Allow the student to take important tests later in the day when the student may be able to focus better.
- Allow the student to begin the school day a little later.
Symptom: The student has daily and seasonal fluctuations in mood and energy and is therefore more attentive to classwork at certain times and less attentive at others.
- Create formal contingency plans when the student is unstable and is experiencing periods of withdrawal or fatigue (a symptom of the illness and often a side effect of the medications).
Symptom: The student can experience great irritability, building to a rage if not recognized and dealt with in an appropriate and timely manner.
- Assign a staff/school person who the student can go see when he or she feels unable to cope. This can be a counselor, school therapist, teacher, or any other person (campus monitor, school nurse, etc.) with whom the student feels safe and whom the student trusts and chooses. Give the student a permanent pass and a private signal that only he and the teacher understands so that he can make a private exit in front of the rest of the class.
- Offer the student a private place to go to calm down when feelings are overwhelming.
- Schedule regular meetings with the school psychologist to teach the student self-calming and anger management techniques.
- Assign an aide in the classroom to prevent situations that may cause the student to lose control.
- Administer a Functional Behavior Assessment to identify triggers that cause the student to lose control. Then write a Behavior Intervention Plan to be added to the IEP which provides appropriate interventions for problematic behaviors. This can be as simple as identifying stressors which cause untoward behaviors.
Symptom: The student has periods of excessive anxiety and sadness.
- Assign a safe place and person where the student can regroup and calm down –preferably someone with whom the student can talk easily.
- Have the student keep a journal in which he or she can address anxiety-producing thoughts and school experiences which can be shared with the school psychologist and the student’s personal therapist.
- If the treating psychiatrist recommends the use of a light box, provide this daily during a study period in the resource room.
Symptom: The student is very perfectionistic and has difficulty making transitions.
- Reduce writing by allowing the student to use a computer so the page looks neat to him or her.
- Allow student to finish tasks before moving on.
- Have all teachers cue the student as to transitions and the time they will occur.
- Provide an aide who will give support during non-supervised periods of the school day (lunch, recess, escort to and from the bus waiting area, etc)
- Allow student to transition ahead of the rest of the class (going to lunch room, library, etc)
Symptom: The student has difficulty with peers. The student may have poor social skills, be bossy, misperceive the behaviors and intentions of others, and be socially inappropriate at times.
- Arrange for the student to learn social skills and group behavior by meeting with the school social worker, school psychologist, or the guidance counselor.
- Develop a social skills class and have the student participate in it.
- Place an aide in the classroom who can monitor social interactions and report incidents of social conflict. The aide can interpret and explain to the student how things occurred which may be outside the student’s perception. This aide can advocate for the child, act as a friend, make the child feel safe, and alert the school if there are any incidents of bullying going on.
Symptom: The student becomes overheated and overstimulated in gym classes and begins to suffer discomfort or to cut class.
- If the student participates, he or she must always have access to water and rest.
- The student should have the option of less competitive physical activity such as Yoga. Tae Kwan Do, weight training, aerobics, etc.
- The student should be graded based on attendance rather than participation.
- If necessary for the student’s emotional well-being, have an Adaptive P.E. written into the IEP until such time as the student is ready for mainstream physical education.
- If inclusion is an issue or a desire on the student’s part, the student could be appointed score keeper or equipment manager.