Our youngest son has also had problems with tantrums and understanding consequences hasn’t ever done anything because he simply lacks the maturity and control.
Over the years we have learned that stimulants can increase irritability and make our son even quicker to anger, so it is paramount to make sure the ADHD meds are right. We have tried ALL of the stimulants over the years. Concerta at 54 mg worked the best for years but then everything seemed to stop working when he turned 13.
He is now on the lowest dose of Vyvance, 10 mg, and we also use 50 mg of Strattera to help even out his behavior. He has communicated that he focuses better at school on 20mg of Vyance, but we get too many tantrums at night – which is why we dropped him back down to 10mg.
We also had our son tested to see if he was on the Spectrum when he was younger, at 7, and they concluded he was not. We added a pediatric Neurologist when he turned 13 and he concluded that he has very high functioning Asperger’s and so it is more like Asperger tendencies. We just used this information to read and research more as we are looking out to bring out the best in him. My son already has a pretty thorough 504 plan in place with accommodations at school – no changes there.
We also discovered he has executive function delays – particularly “neurological switching” and what you are describing sounds similar so please consider looking into that with a pediatric neurologist.
One important thing to let you know was that we did a blood draw with his pediatrician at his annual exam and found out he was very D3 deficient. We have now added Omega3’s and D3 pills to his daily routine and I think those have really helped.
It is a beat down every single day for us. Our son has moments of lovely, he is very smart, we are just praying that as his matures his rigidity towards change will lessen.