
September 11, 2001
Behavior
Question from Alabama, USA:
I have a third grader in my class who was diagnosed with type 1 diabetes two weeks before school started (six weeks ago), and I would appreciate some advice about the impact that diabetes has on behavior in school.
This student has a history of behavior problems going back to Kindergarten, and his behavior has changed little since entering the third grade three weeks ago. The following is a list of behaviors that I have observed and documented since school began this year:
Needs three to five reminders to start and complete any assignment.
Must be constantly monitored when working on individual seat work or he doesn’t do it.
Stares/daydreams during low or high sugar level times.
Copies answers from other students to complete his assignments.
Distracts students near him by talking, poking or bothering their things.
Interrupts lessons with inappropriate comments, interrupts conversations.
Pushes/shoves/hits other students.
Extremely argumentative and sometimes defiant when behavior is corrected by school staff or parents.
Very disorganized with school supplies.
Blames others for reasons for behaviors.
Has poor social skills and is often purposefully mean to other students.
Disregards school and class rules.
Exhibits attention-seeking behaviors.
Lies about his behaviors and makes up/exaggerates stories of events that may or may not have happened.
Lies to school personnel about what other teachers have instructed him to do/not do.
Has been caught stealing on more than one occasion,
— etc.
Previous teachers have all observed some or all of these behaviors. He has been consistently falling below grade level in reading since kindergarten. He was referred for testing last year for reading and disruptive behavior problems. Testing indicated definite learning disabilities in reading and pronounced behavior problems. Testing was completed before his diabetes was diagnosed.
This student is very verbal. He is extremely impulsive. He has difficulty with self control. He has difficulty following oral and written directions. He has poor time management skills. His general self-concept and self-esteem seems good. His insulin and diabetes management at home and school is structured and monitored. I realize it will still be a while before his insulin is correctly adjusted.
My dilemma is that his previous teachers and I have tried every behavior management strategy we know with each having little long-term effect. His parents are of the opinion that his behaviors are just “him being himself”. Now they are insinuating that maybe he has had diabetes all this time — maybe since kindergarten — and diabetes may be the factor in his past behavior problems.
Can diabetes cause all/any of the above mentioned problems?
Answer:
You can not have type 1 diabetes for years and be undiagnosed. Fluctuating blood sugars can affect mood and concentration, but not at the extreme level you describe at the consistent and frequent rate that you describe. Moreover, his behavior and learning problems existed long before he was diagnosed with diabetes.
Questions I would ask: Have his parents taken him for a formal evaluation by a mental health professional? What kinds of behavioral programs are they doing at home? Is he in a behavior-disordered classroom? What other services can your school system provide for children with learning and disruptive behavior problems?
JWB