Hi! My personal experience w/ meds…myself & hs age daughter….if she’s been on same med & dose for 4 months & now it’s not as effective, deff schedule Dr appt for med adjustment. We both take an XR in the a.m. and for homework after school my daughter takes a short acting (4hr). But we both see the Dr every 3 months for scripts & med checks, and we’ve both had increases over the past 6-12 months. May just need a slight increase to next dose to see if it helps, if not, Dr may try diff med altogether, such as dexmethylphenidate (Focalin etc). Hope I’ve helped in someway 🙂 best wishes!