Question from Rockville, Maryland, USA:

I am a former RN and have worked with adult diabetics. Now, I teach first grade. I have a seven-year-old student who was diagnosed at the age of five with diabetes. He is continually disruptive during class, making it very difficult for me to teach and the other 29 students to learn. He talks out constantly, always has to call out answers to questions, makes inappropriate noises, babbles, is out of his seat frequently throwing himself on the floor, crawling around, or laying in the coat area. He talks very disrespectfully to adults and is often verbally hurtful to his classmates. Sometimes, he has temper tantrums and can lash out physically at other students. He does not respect personal boundaries and will often help himself to other students’ property. I am to the point that whenever he is acting out, I have him check his blood sugar. Sometimes, it is high and other times, it is within normal range. Interestingly, when he is very low, he is actually more subdued; I guess he’s somewhat in a stupor. He is very bright and claims that he acts the way he does because school is boring. However, when given more challenging work, he gets frustrated and does not want to do it. In other words, nothing makes him happy.

He did have a psychologist visit the classroom and she suggested a complete psychological and educational evaluation which the parents have yet to follow-up on. They are very educated and are knowledgeable about diabetes. Mom especially, is convinced that her son’s poor behavior is due to the diabetes. They have some of the same behavior issues at home, although she does admit that prior to the diagnosis, her son was a risk taker. I would like to find a way to make this young man’s school experience for the rest of this year more positive but, quite frankly, I have run out of ideas. I allow him freedom to walk the halls if he needs to, provide him challenging activities that he often will not do, let him do “jobs.” I have developed a contract for him listing my expectations from him that we had discussed and the positive and negative consequences to these actions. I don’t know what else to do and I would really like some advice. Do you think his diabetes accounts for his poor behavior?