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He's Driving Me "Nvts"
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<blockquote data-quote="smallworld" data-source="post: 120796" data-attributes="member: 2423"><p>Beth, I agree with WFEN that nothing can go forward until you straighten the medication piece out. Although my son doesn't have AS -- he has a mood disorder -- we just went through a similar situation with getting his medications right. He was extremely oppositional and emotionally shut down before he went into day treatment. Now that he feels better with a new medication mix, the oppositional behavior is lifting and we can go on to the next stage (in his case, being able to attend to school).</p><p> </p><p>Some basic rules of medication changes that I've learned over the many years of medication trials with my kids:</p><p>Make one medication change at a time so you know what is doing what.</p><p>Start low and go slow (we sometimes start even lower than the drug company recommends).</p><p>Give the medication time to work before adding or subtracting.</p><p>Ask yourself: Is he better or worse than before the medication change?</p><p> </p><p>This last question is particularly important in your difficult child 1's case. Is he better or worse since Strattera was added? And is he better or worse since the Concerta dose was increased? If he's worse, it's an easy decision to dump Strattera and get a new read on baseline behavior with only Concerta on board. The new baseline will determine whether you lower the Concerta, change to a new stimulant or add something else to address residual symptoms. You should also be aware that over time Concerta can cause mood issues, most notably depression (it happened to my son after 1.5 years).</p><p> </p><p>Some other thoughts for you: I don't know many 9-year-olds, much less 9-year-olds with AS, who take responsibility for their behaviors. While we as parents want that and even expect that, I think it's unrealistic at this point (given age and neurological makeup) but definitely something to work toward as he grows and matures. I'm sure you've read The Explosive Child, but I think Greene's theories bear reviewing. The struggle to take responsibility isn't about parent vs child but parent working with child to make it happen. </p><p> </p><p>One more question for you: I don't pretend to know more about AS than what I've read on this board, but wouldn't working with his AS issues help with his behaviors? This just seem intuitive to me.</p><p> </p><p>I'm sorry you're struggling so. I hope you find ways to make some inroads with difficult child 1 soon.</p></blockquote><p></p>
[QUOTE="smallworld, post: 120796, member: 2423"] Beth, I agree with WFEN that nothing can go forward until you straighten the medication piece out. Although my son doesn't have AS -- he has a mood disorder -- we just went through a similar situation with getting his medications right. He was extremely oppositional and emotionally shut down before he went into day treatment. Now that he feels better with a new medication mix, the oppositional behavior is lifting and we can go on to the next stage (in his case, being able to attend to school). Some basic rules of medication changes that I've learned over the many years of medication trials with my kids: Make one medication change at a time so you know what is doing what. Start low and go slow (we sometimes start even lower than the drug company recommends). Give the medication time to work before adding or subtracting. Ask yourself: Is he better or worse than before the medication change? This last question is particularly important in your difficult child 1's case. Is he better or worse since Strattera was added? And is he better or worse since the Concerta dose was increased? If he's worse, it's an easy decision to dump Strattera and get a new read on baseline behavior with only Concerta on board. The new baseline will determine whether you lower the Concerta, change to a new stimulant or add something else to address residual symptoms. You should also be aware that over time Concerta can cause mood issues, most notably depression (it happened to my son after 1.5 years). Some other thoughts for you: I don't know many 9-year-olds, much less 9-year-olds with AS, who take responsibility for their behaviors. While we as parents want that and even expect that, I think it's unrealistic at this point (given age and neurological makeup) but definitely something to work toward as he grows and matures. I'm sure you've read The Explosive Child, but I think Greene's theories bear reviewing. The struggle to take responsibility isn't about parent vs child but parent working with child to make it happen. One more question for you: I don't pretend to know more about AS than what I've read on this board, but wouldn't working with his AS issues help with his behaviors? This just seem intuitive to me. I'm sorry you're struggling so. I hope you find ways to make some inroads with difficult child 1 soon. [/QUOTE]
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