"I teach in an AI classroom that is housed in a regular school. My students are in grades 3-6. I have a particular student (age 10) who responds well to a picture/icon schedule while out in regular ed or in the classroom. His only problem is that he has sudden outbursts of crying(bellowing)for mom. I feel that his day has a balance of sensory activities, physical activities, academic, and so on. We have tried a star chart with him where he can work for a preferred activity by earning stars for being a "big kid, No crying". He bellows for mom. He does not cry for anything else and I do not feel that his crying is for attention or avoidance. I think that he is truly sad and really does miss mom. We also use a family photo in his schedule since he often asks,"When will I see mom?". We put the photo on a Velcro schedule right after the school bus. I really feel like it is a true separation anxiety as would be seen in a preschooler. The good news is that in the past years he was biting and scratching many times a day. This behavior has diminished, but has been replaced with the need for mom. It is a problem because he is loud and he looks like a baby to the other 10 year olds. He is bright and keeps up with the classroom work and expectations other than the crying. Mom has shown her son HER schedule so that he doesn't have to wonder where she is. He knows that she is at work and is happy that he is at school with friends. She meets the bus everyday at home when he is dropped off at the end of the day. All in all, his parents are a great help to him. Do you have any other ideas of how to help him with this true sadness? We were thinking that it needed to run its course just as it does with preschoolers; however, it has been about 3 months now. It has not increased or decreased with intervention. (We have also used social stories). I am at a loss on this one. Thank you." B.G.

Answer: Dr. Pam DiLavore, Lead Psychoeducational Therapist, Raleigh TEACCH Center

It sounds like you're doing a great job of understanding this child and meeting his needs. I agree with you that he may just need to go through this period of feeling sad about missing his mom. You are doing everything right, and continuing to do these things consistently and with understanding of your student's perspective is likely to make a difference in the long run.

The only suggestions I can add are a few refinements of what you're already doing. It's perfect to have the picture of this child's mom at the end of his schedule after the school bus so that he knows he will see her then. I wonder if it might help to also have a time built into his schedule (earlier in the day than he typically starts crying) when he can spend some time in a quiet space looking through a photo album with pictures of all the people and animals in his life, including his mother or doing other activities such as drawing a picture of his mother or writing her a note. He could have a specific break card on his schedule that would indicate this activity. Maybe he could have a card that shows/says "I need a break" available to him, in the same way that a help card or bathroom card might be available to him. When he starts getting upset, he could hand you or his other teachers this card which would act as a ticket to get to his quiet space to look at his album. This strategy should be included in his social story that could be reviewed every day.

If this is actually successful in helping him to stay calm, you would eventually want to limit the number of times a day he could do this, perhaps by giving him a specific number of cards that would be gone once he used them up. At first, however, you might want to give him unlimited access to using the cards until it is quite clear to him what the card means and that it can really work for him.

Another idea might be to have a specific time on his schedule that he can talk to his mom on the phone each day. That has a pitfall, though, in that the phone call itself (or ending it) may upset him. One other strategy that sometimes helps is to teach relaxation techniques during calm times on a daily basis. These techniques will have to be practiced over and over again, and there should be a concrete or visual cue that reminds him to start the relaxation (perhaps one of those stress balls he can squeeze). Then, when he starts getting upset, you could give him the cue to do the exercises. Eventually, he may be able to do them even when he is upset. Good luck with everything; he sounds like a sweet boy.