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My eight-year-old son has been diagnosed with anxiety and depression. He has been taking his medication but still has bouts of behavioral problems. He has also been evaluated with learning disabilities although over the past three years the evaluations have not been consistent.

He has learned to manipulate to get out of situations he does not want to be in. For example, throwing temper tantrums worse each time to get sent home from school. As soon as he walks out of the school, he is a totally different child - well behaved and happy. How can I tell when his behavior is manipulative and when it is due to his anxiety?

It is important to differentiate the cause of the behaviors; however, the interventions are the same. I would suggest that the first step focus on why school is stressful. If he has learning disabilities, these should be clear on formal and current testing. You should not have to suspect. If your school system is minimizing or avoiding recognizing LD or treating the LD, seek outside help. If the cause of the behaviors is the frustrations and failures caused by his LD, an important focus will be to provide the necessary remedial interventions plus classroom accommodations.

Next, I would try to clarify the anxiety and depression. Are these problems only present during school time but not seen on holidays or summer? Are they present all year long? Has he had problems with anxiety or depression for many years or is it only recent? You might need the help of a mental health professional to clarify if the anxiety is secondary to the academic frustrations or are the cause of the academic difficulties.

Your son is yelling for help. He is desperate enough to act out in order to get out of school. Please act quickly to figure out the reasons and the best interventions. (first, does he have LD; is he below grade level in skills; second, are there other reasons than school to explain his behaviors.)

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