My Forum Comments
First, Congratulations on getting him off the risperidone. No child should be on that. I would assume that the sleep problems have been going on long before he started getting off the risperidone and is not a reaction to that nasty medication. Speaking of medications….as one poster mentioned clonidine is certainly worth taking a look at if other things are not working.January 14, 2020 at 1:10 am in reply to: Might need a higher dose of Adderall, but prescriber is very cautious #138349
Great advice by VVALL. The other thing to keep in mind is that everybody is different. There is no “one size fits all” when it comes to medication. Doctors should start off slow and then listen to their patients. 15 mgs is a mid sized dose. It should last for about 8 to 10 hours. One good indication of to low a dose is it not lasting long enough. The more information you can give you doc the better. Chart when you start to notice the med wearing off. If you can go in with concrete examples, there is a much better chance the doc will listen to you.
First, try the guanficine at night. Second, I would think by now that you would have established a relationship with his teacher. That is so important with a young child with adhd. Is this a new school? The year is almost over and the teacher and you are not communicating? You need to try and increase communication with the teacher, not the school board.December 12, 2018 at 10:36 am in reply to: Questioning, Conversation Behaviors causing problems #105213
One of the hallmarks of add is that you get distracted or tune out. She can easily ask a question and then not listen to the answer…which is why she asks again and again. You also can hyper focus when something interests you…which would also cause her to keep asking the same question. I think that a lot of this problem is add related. And, if it is add related, it is going to very hard to change this behavior. Kind of like asking a kid to walk who has a broken leg.
You also state that depression is an issue. If you have a problem and know about it, but are unable to do much about it….and if you are also getting teased then depression is a consequence. In fact depression and anxiety are very common co-disorders of adhd/add.
The one thing you did not mention is medication. Because you did not mention it, I assume she is not on medication. Because she is intelligent, I would assume her grades are pretty good. But do you find she is now taking a lot more time on homework? Anyway, It makes a big difference in how you deal with this problem if she is on medication or not. And this is a problem, especially the depression, that might just only get worse. And I can guarantee you that medications for adhd/add are a much better choice then meds for depression.
So if she is not medicated, this is something that you are going to have to deal with. You might want to read through some of the answers to this link. https://www.additudemag.com/forums/topic/please-help-on-the-fence-about-meds-2/?utm_source=eletter&utm_medium=email&utm_campaign=community_december_2018&utm_content=121018&goal=0_d9446392d6-3a225aa3d1-288295765
Hope this helps. Best wishes.December 12, 2018 at 10:36 am in reply to: getting through the school year/dealing with referrals #105212
It is possible that his medication is not working for him as well as it should. Ritalin LA should last at least 8 hours and it sounds like it is wearing off much sooner. If he has been on the same medication for several years this is really possible.
I also wondered when you said that, “the noise of everyone talking makes his head want to explode.” if he also might have SPD or sensory processing disorder. It is somewhat common for kids with adhd. Are there other things that bother him like bright lights, textures,
tastes, noises, etc? This is something that an OT can diagnose and treat when you get back to the states. More on that here.
And, I do agree with the others. You do not punish him for something that he cannot control. You do practice, practice, practice things at home that he can then carry over to school.
I agree with the last poster. This really sounds like sleep apnea! There are a variety of things that can cause sleep apnea and sometimes something as simple as sleeping on your side (place a pillow behind your back so you don’t roll over) can be a fix…its also very easy to try. But, you really need to be tested.
Wonder how the appointment with your psyc nurse went? Best wishes.
Keep in touch with the doctor about the Adderall use. It seldom works the first time and usually needs to be adjusted up or down. Chances are when its (or a medicine like it) dialed in you will notice the difference. Also make sure you get the extended release (or something like Vyvanse which has a really long time of effectiveness) so it is working at home too.
There are good links that you can share with the parents that they might pay attention to. This is a good example….
you also need to talk to her school teachers. The meds may be working at school, but wearing off by the time she gets home. If so, then …. probably just increasing the dose or changing to a longer acting med will help.
You also need to realize that the meds are not magic. They cannot control years of built up habits. You also have to be actively involved in changing those years of habit. This site has lots of specific ways to work with kids with adhd. take the time to check them out. If you are not actively involved, she will be getting only half of the possible benefits.
The best resource I have found for ADHD medications is the book, New ADHD Medication Rules: Brain Science & Common Sense. by Dr. Charles Parker. If you don’t want to get the book. you can read the essentials at this link….. http://www.corepsych.com/add-adhd-medication-find-the-sides-of-the-therapeutic-window/
Or see his series of short Utube videos on adhd medication here….. http://www.corepsych.com/adhd-medication-tutorial/
another good overall link is this one….. https://www.additudemag.com/stimulant-medications-for-adhd/?utm_source=eletter&utm_medium=email&utm_campaign=treatment_march_2018&utm_content=030818
Hope this helps.
First, it won’t hurt you to try it. You will know within a few days if it is working the way you want it to. And you can document what you can or can not do under the new plan.
Second, there are a lot of new meds out there that function even better then the adderall. For example one Vyvanse pill will last longer then the doses you now are taking and its a much smoother medication.
ADHD medication has always been a trial and error thing because everybody is different. You can’t just say, “oh, this is what everybody takes” That is a good excuse to run from that doctor as fast as you can. However, it does not hurt and may actually help to try new doses.
If they want you to try lowering the dose ….get from them a checksheet that you can use to tell if it is working or not. If they can’t tell you what to expect – that would not be a good sign. I can provide links that you can use to tell if you are being underdosed if you are interested.
Do keep in touch, this information will help others.May 1, 2018 at 1:14 am in reply to: How to help my son focus and complete work in school #83306
Your first question was, “1. advice to keep him focused at school.” The time the teacher gives to write 3 sentences is a very small part of the day. The bigger question is, does he have trouble focusing during other parts of the day. For example, how is he doing at math? There are lots of techniques – like fidgeting, moving, etc that can help with focus. But if he really is having trouble focusing for more then the 10 or so minutes given for this assignment….You probably should talk to his doctor about his medication. Intuniv is a great med and many times is given at night in conjunction with a stim med during the day. Intuniv really does not help with focus that much. I think that is the issue that you really need to discuss, as this problem will probably only get worse.
In terms of his writing. Get your hands on some of the old topics and practice with them. But try having him draw his thoughts out or try turning the assignment into a video game which he writes about. See if the teacher will simply allow him to complete the assignment at home, if he has drawn out some ideas. But practice this at home. It should be pretty easy to get him to be able to do some “canned” results.
But, after 37 years in education at the elementary and middle school level, I think there is something else going on here. Not writing 3 sentences in a journal is not worth telling parents he needs to be disciplined at home. And by the way, if this is the only writing they are doing…..well, thats a different story. Do get more info from the teacher about what is going on at school. And ask your son. How does he feel about school? As a 5th grade teacher (and well, as a principal too) I saw kids begin to fall apart about 4th grade because their innate intelligence could no longer keep up with the subject matter. And that was usually due to the inability to concentrate.
it is possible that he has SPD ( sensory processing disorder) which would explain why the medication is not working. More on SPD here – https://www.additudemag.com/adhd-sensory-overload-spd-and-adhd-in-children/?utm_source=eletter&utm_medium=email&utm_campaign=parent_april_2018&utm_content=041418
If the medication is working, then he may have an undiagnosed learning disability (as others have suggested) that is preventing him from learning.
And thank you for mentioning what meds he is now on. It is also possible that he needs to be on a different type of stim medication like adderall or Vyvannse, because Concerta is not doing for him what it should be doing. Do his teachers see a lack of focus or hyperactive activity while he is at school? If so, his meds may not be working for him. More of this in this link – https://www.youtube.com/watch?v=ObnMSU_BagI And also listed with this link are some of Dr. Parkers thoughts on anxiety which you might find helpful.
Opps, just noticed that you are the original poster which answers my question about what grade he is in now. And thankyou for the information about his medication. That still might be part of the answer, but thats for his doctor and you to figure out. The video link I posted will help with that.
A good question was raised by one of the above posters. Third grade went really well! Why??? Is this more a problem of the teacher being stricter or demanding more? I would talk with the 3rd grade teacher and see if she can shed any light as to why things are not going as well. Has his medication changed between 3rd and 4th grade? How about his sleep habits? I would also try and talk with his new aide to get her impression of what is happening in class.
Finally, you said that they want to keep him in his seat and work. There are lots of studies that show that kids with adhd need to be able to roam or move. fidget gadgets help, but moving helps the most. In his IEP, is it written that he can get up and move around? And, of course, many times the correct medication will help with the hyperactivity of movement. Humm, that leads to one other thought and that is about Sensory Processing Disorder. It can look a lot like adhd, but it is treated by an occupational therapist and the traditional adhd medications will not help that much – although it is not uncommon to have both.
Here are two good links. And I have several more if they are needed. But take the time to check these out – it would answer a lot of what is going on.
I hope this helps. This has to be so frustrating for you!
To ajsd: if school is still the same, then something is not working. He may well have a reading, or writing, or hearing, or even vision problem that has not been identified. Has he been fully tested for more then just adhd?
Kids give up because they just can’t do the work. The question above is looking at one reason why he cannot do the work. The other may be that his medication is really not allowing him to concentrate. You need to talk to his teacher to find out how he is doing/acting in class. Can he pay attention, does he stay on track, or is he tired and out of it? It may be that he is undermedicated. Concerta is a great med, but he might need an adderall based medication. And, of course, he might be overmedicated. That is why it is so important to get a feeling for how he is doing in class. This video by Dr. Charles Parker should also be helpful – https://www.youtube.com/watch?v=S0gir0CPLjo
And, of course, the other thing that can help at school is a 504 plan or an IEP. Does he have either one of these?
By the way, what grade is he in now?
Yep, I can say that after 37 years in education (well and another 8 or so as the CL on the adhd medhelp forum) that kids with a decent amount of intelligence and adhd start to hit the wall at about 4 grade. The math usually does them in (and its going to require many extra hours of tutoring to catch him up).
In my opinion, he has given up. He has gotten tired of hitting his head against the wall. If this continues…anxiety, depression, and self medication will follow.
While some have hinted at it,I will be more blunt. You need to get him on medication. I have worked with kids in the classroom who were unmedicated. They were wonderful kids. We had a great relationship. I would give them 3 days to finish a test….and they just could not concentrate long enough to do even that.
So yes, as adhd momma said, what you are doing (and you have been trying the right things) have not been working. It is time, while you still have the time, to try something else. Because, once middle school starts, life really gets interesting. I, as several of the above have lots of good information on medication. Just ask and we can send it to you.