Help at School: For Parents of Bipolar Children

Many bipolar kids have learning disabilities or other problems. Here are some ideas to help your bipolar child be a better student.

Educators can significantly reduce classroom stresses for children with bipolar disorder, thereby allowing them to succeed in school. Academic stresses, like other stresses, can destabilize a child with bipolar disorder. Regular meetings between parents and school faculty, such as teachers, guidance counselors, or nurses, will allow collaboration to develop helpful school structure and strategies for the child. The child may need particular changes (accommodations/modifications) to the workload. Bipolar disorder may need to be considered be a "disability," just like a broken arm or asthma.

Accommodations, modifications, and school strategies may include the following:

• Check-in on arrival to see if the child can succeed in certain classes that day. Where possible, provide alternatives to stressful activities on difficult days.
• Accommodate late arrival due to inability to awaken, which may be a medication side effect or a seasonal problem
• Allow more time to complete certain types of assignments
• Adjust the homework load to prevent the child from becoming overwhelmed
• Adjust expectations until symptoms improve. Helping a child make more attainable goals when symptoms are more severe is important, so that the child can have the positive experience of success.
• Anticipate issues such as school avoidance if there are unresolved social and/or academic problems
• Anticipate social difficulties and reduce opportunities for possible bullying by others. Children with bipolar disorder are often on a different "wavelength" than their peers and their behavior may be viewed as unusual. It is not uncommon for them to be socially isolated, and they may be targets for bullying. More often than other children, they may be ill-equipped to handle teasing in an appropriate way.
• Allow children to discreetly and frequently accommodate needs caused by medication side effects, such as excessive thirst and frequent bathroom breaks
• Set up a procedure that allows the child to quickly and safely exit from an overwhelming situation. Designate a place and staff member that is always available when the child needs to de-stress.

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• Expect and accommodate learning and cognitive difficulties, which may vary in severity from day to day. Despite normal or high intelligence, many children and adolescents with bipolar disorder have processing and communication deficits that hinder learning and create frustration.
• Use alternative discipline approaches if children are unable to control their behavior. Traditional approaches to discipline are unlikely to produce the desired results, and an approach that is effective one day may not work the next day. Alternative strategies include providing additional time and then repeating a request, developing a list of options from which children may choose, and designating a special place for students to go during times of stress.
• Because transitions may be particularly difficult for these children, allow extra time for moving to another activity or location. When a child with bipolar disorder refuses to follow directions or to transition to the next task, schools and families should remember that anxiety may be the cause, rather than intentional inflexibility or oppositionality.
• Use behavioral plans at school that are consistent with those used at home. Please refer to "Interventions At Home," above, for details regarding behavioral plans.
• Encourage the child to help develop interventions. Enlisting the child in the task will lead to more successful strategies and will foster the child's ability to problem-solve.
• Please click on School-Based Interventions for a more complete list of school accommodations for children with bipolar disorder

Flexibility and a supportive environment are essential for a student with bipolar disorder to achieve success in school. Parents and school faculty may be able to identify particular problem times, such as transition times or unstructured periods, and develop remedies to reduce the child's difficulties in those situations.

Sources:

• American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC: American Psychiatric Association, 1994
• Dulcan, MK and Martini, DR. Concise Guide to Child and Adolescent Psychiatry, 2nd Edition. Washington, DC: American Psychiatric Association, 1999
• Lewis, Melvin, ed. Child and Adolescent Psychiatry: A Comprehensive Textbook, 3rd Edition. Philadelphia: Lippincott Williams and Wilkins, 2002

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