ADHD and extreme defiance in 5 year old. I NEED HELP!

Discussion in 'General Parenting' started by emmy, Jul 2, 2011.

  1. emmy

    emmy New Member

    My 5 year old son has been diagnosed with ADHD since he was 3 years old. He is currently taking Adderall XR 5 mg and Clonidine .1mg. Lately he has been extremely defiant. He won't listen to us, he will flat out tell us no when we remind him of basic rules (like not hitting his little sister), he throws horrible fits where he screams and yells for hours. I have actually had to restrain him a couple of times to prevent him from hurting himself (yeah, it probably sounds horrible, but I couldn't think of anything else to do but hold his arms to his side). It's getting worse than it's ever been. He is waking up in the middle of the night and getting into everything. I have tried so many things to try to resolve his aggression and defiance, but I am running out of ideas. I have had enough and I don't know how much more I can deal with. Mommy time-outs only work for so long, lol! I need help, but I can't even get an appointment with his dr for 3 weeks. I feel like such a failure, not being able to deal with my own child. I know this can't continue for much longer, he is going into Kindergarden in the fall, and I don't want him to have social or educational issues due to his behavior. Does anybody have any advice?
  2. nvts

    nvts Active Member

    Hi Emmy! Welcome to the's a group of a lot of experience and strong shoulders to lean on!

    How was his early development? Did he hit all of his milestones on time? Any early intervention such as speech, occupational therapy, physical therapy, etc.? Have you noticed any sensitivity to certain sights, sounds, smells, textures, "itchy tags" in shirts, etc.?

    Have you taken a look at what may fuel such a meltdown (aka "triggers")?

    I would recommend setting up a neuropsychologist exam/testing. It's a variety of tests given over a period of time coupled with his history that allows them to figure out a full diagnosis. He might have ADHD that is coming from a more complex diagnosis.

    I would also suggest that you grab a copy of Ross Greene's "The Explosive Child" and then look at the sticky at the top of the Early Childhood Forum to adapt it to smaller children.

    You sound like a great Mom who's really running through the wringer right about now.

    Now don't get discouraged. Things slow up here significantly on a holiday weekend (usually due to difficult child's kicking around and all of the extended difficult child family members as well! lol!). More people will give advice as they can pop on!

    Again,'s a fantastic group of people!

  3. TeDo

    TeDo Guest

    Welcome. It could be he is on the wrong medications or the wrong dosages. How long has he been on these medications? Has the behavior gotten better or worse since the medications started or the dosage was changed? Is ADHD his only diagnosis? I would put a call into the psychiatrist and explain that you need to get in soon to prevent a visit to the ER because he has gotten so bad you've haad to restrain him to prevent him from hurting himself. If you lay it on thick and don't back down, they might "find" time to fit you in. If it gets that bad again, take him to the ER. Keep a diary of his behavior including time of day, what happened right before the behavior started, what he did/said, etc.

    {{{{(((HUGS)))}}}} to you and welcome to our "family".
  4. Malika

    Malika Well-Known Member

    Hello and welcome. I am sorry you are facing this very tough situation with your boy.
    I have very little knowledge or experience of medications. But for me, the fact that his behaviour has got worse since he has been on these medications would definitely be a warning signal. This, to me, points to what TeDo says - he is on the wrong medications or the wrong dosage. Do please get these re-evaluated. Any chance of a a second opinion form a different psychiatrist?
  5. emmy

    emmy New Member

    Thank you guys for the encouragment. To answer a few of your questions, he has been on the medications for about 8 months now, and it has been wonderful up until these past few weeks. His reached all of his developmental milestones early, though he was diagnosed with a sleep disorder (Non-REM Sleep Parasomnia) at 18 months of age. We have been keeping a journal of his behavioral issues, including both the good and the bad, I figured it wouldn't hurt to include both (plus being able to see the good in there helps me not feel so helpless). If it was possible, I would take him to a different Dr, just to get a second opinion, but as it is, we live in a rural area where we don't have too many options. The poor kid has been so angry, and constantly lying. He lies even when it's obvious or even if he isn't doing something wrong. I am surely going to be calling the Dr again first thing Tuesday morning, and insist they get us in. Much more of this, and my husband and I will be needing to medicate ourselves just to handle him!
  6. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I hate Adderrall. Although all stimulants made my son aggressive and mean, Adderrall was the worst. It is also a street drug (as are all the ADHD drugs, inlcluding Ritalin). The teens crush them in pillcrushers and snort them. Needless to say, I am not a fan.

    Also, most young children's first diagnosis is ADHD. it is rarely the last or the only one. Perhaps stimulants are not for him. Are there any psychiatric disorders on either side of his genetic family tree? Why not tell us more about your family. Has anything recently changed? Does your son understand how to socialize with his same age peers? Does he have a few narrow interests that he obsesses over?
  7. april1974

    april1974 New Member

    Emmy Welcome....If the medications are making it worse than that needs to be evaluated asap...from what I've read if the medications make things worse then it's not the oppropriate medication or diagnosis(possibley) 3yrs old seems so young to be diagnosed, but I'm not a dr. I think you have to sort out the "normal" from the not normal and it's not uncommon for kids to say mean things about younger sibs but at 5 he shouldn't be getting into things in the middle of the night, have you tried a lock on his door to keep him safe or a bell to alert you when he does get up? Hope you find some help soon
  8. emmy

    emmy New Member

    Sorry it took so long to get back here, it's been a busy week. A little about our family: I am 27 years old with a history of depression (mainly during and after pregnancy), my husband is 32 with a history of depression, anxiety, and learning disabilities (he was never properly diagnosed and his parents didn't really care when he was growing up), in addition to our 5 year old (with ADHD, sleeping disorders, Reactive Attachment Disorder (RAD), and a seizure disorder), we have a 3 year old daughter (her only issue is a heart murmur). The only recent changes around here have been summer vacation. As a preschool teacher, I have the summer off, and both my children were enrolled in preschool, so they also have the summer off. We have been keeping our children on a strict schedule similar to that of preschool, while including many opportunities to socialize with other children. My son usually does a great job socializing with children his own age. Before his dr put him on the Adderall, he was having extreme difficulty with socialization, to the point where none of his peers wanted to play with him or even sit by him. I had a meeting with his teacher, and discovered that he was not understanding the concept of personal space, and was constantly jumping around and touching all his peers. His dr then put him on Adderall and it was such a wonderful change. He was interacting great again, and no longer had the issues with his peers. It wasn't until the past few weeks (after 8 months of being on the medications) that he had the problems. I was FINALLY able to get him in to his psychiatric and he doubled his Adderall XR dosage to 10 mg per day, so we'll see what comes of this. We go back again next week to reevaluate how the new dosage works.

    As far as his interests go, he has always had "obsessions," whether it be a movie or certain toy. For a while it was anything having to do with trucks, and for the past few years it has been Toy Story everything. When his latest issues developed, he seemed to lose all interest in pretty much anything. He will watch tv for about 5 minutes, color for 5 minutes, play with a puzzle for 5 minutes... you get the point. He is jumping from activity to activity, complaining that he is bored, then working himself into a meltdown. When he doesn't get what he wants, it's a full blown meltdown. Doesn't matter if he just wanted to shower before his sister took her bath, or wanted ice cream at 2 AM. I am trying to pick my battles, but it's hard.

    In regards to April's comment, yes 3 is very young to get the diagnosis. His behavior was so extreme that they were able to get the diagnosis. He would literally spend hours running back and forth through the house, wouldn't sit down for more than 30 seconds, wouldn't eat (because he didn't want to be still for that long), and even more. It was horrible! It was a battle just to get him into the car for the 20 minute drive to the doctor. We had one dr who thought he might have some form of autism, but the first psychiatric we saw said that he didn't, but I am going to ask for a neuropsychologist exam, and I have ordered a copy of The Explosive Child.
  9. TeDo

    TeDo Guest

    Sounds like you're on the right track. I would definitely keep looking into the Autism Spectrum Disorders (ASD). My son has ADHD and Autism Spectrum Disorders (ASD) and the ADHD medications work for the hyperactiveness. My son however, like MWM's, can't take stimulants.

    Keep doing plugging away and keep an eye on the medication situation.
  10. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    He sounds like a walking diagnosis for Pervasive Developmental Disorder (PDD)-not otherwise specified or Aspergers in about five years (they often get it wrong in the early years). My son had similar obsessive interests. They changed, but he always had one. That is not consistent with ADHD. It's more consistent with Autism Spectrum Disorders (ASD). Time will tell. Meanwhile, get all the interventions you can. They will greatly enhance his life. Often these kids seem more functional than they are when they are still see their "Oddities/quirkiness/inability to fit into life far more when they are older and kids are not as forgiving.
  11. emmy

    emmy New Member

    So, today is day 2 of 10mg of Adderall XR instead of the 5mg. My poor little guy has been crying all day long. The littlest things are setting him off, i.e. his flip flop fell off and he burst into tears, crying for a whole hour. Is this normal for medication changes? He hasn't had a rage issue today, but it seems to be completely opposite: instead of anger and rage- it's crying.
  12. TeDo

    TeDo Guest

    Sounds like it's not working the way it should. I would call the psychiatrist back and tell him/her. This is not good for your little guy. I wouldn't give him the higher dosage until you talk to the psychiatrist. I agree with MWM. He sounds so Autism Spectrum Disorders (ASD) and stimulants aren't going to help. My difficult child also socializes fine with other kids but he still has issues reading social cues and misinterprets their words, actions, and motivations which leads to problems at times. My difficult child's biggest issues in the socialization dept are in regards to adults and strangers.

    You state he has sleep issues. Lack of adequate sleep can also cause unexplained crying but usually not to this extent. I do think it is the Adderall.
  13. Autismkids

    Autismkids Member

    In addition to medication problems, you mentioned he's getting up at night and getting into things. My first priority with my ds is sleep. You said he has parasomnias, but do have a copy of his sleep report? It will usually give you more answers than the Dr shares.

    In my case, I was verbally told my ds has MILD sleep fragmentation, and mild obstructive sleep apnea. After reading the report, I now know his MILD case of sleep fragmentation means that he he had 94 arousals during a 6 hour study. 82 of those were spontaneous and 12 were related to apneas. I consulted with a new sleep Dr who agrees that his degree of arousals is not mild. I have no idea how we're going to fix his sleep, but this is currently our (his team and I) biggest project right now.
  14. emmy

    emmy New Member

    With his sleep report, he had 133 arousals, and he does not naturally go into the REM cycle of sleep. We have had to do a lot of sleep therapy, with melatonin, relaxation techniques, massage, music therapy, and a few other methods. As of his most recent study, he was able to go into the REM cycle for 2 hours. We have been working on this with him for the past four years. I can tell when we have a regression in sleep behavior just by looking at his eyes, poor little guy looks like he has two black eyes when he hasn't gotten at least 1.5 hours of REM.
  15. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Was he taking Adderrall when he had his sleep study?

    My son AND daughter, who is not Autism Spectrum Disorders (ASD), both have taken stimulants and that alone interfers with sleep. It is your decision of course but I hate JMO of course.
  16. emmy

    emmy New Member

    He was not taking the Adderall during the sleep study. I actually did not give him any medications today, and we only had 2 meltdowns so far- we've been averaging about 6 a day. My husband and I both agree, the medications are making it worse. He is able to control himself a little more before going into a meltdown, and has actually been a bit more flexible. He has been wearing the same clothes for 4 days (thank heavens he takes them off at night so I can wash them!) but today he actually wanted a different shirt! I am taking him back to the doctor this week, and until then, we are not giving him any medications.
  17. HaoZi

    HaoZi Guest

    I'd also look into Autism Spectrum Disorders (ASD), I'm with the others on that. My Kiddo (and I) both have sleep issues as well. Autism Spectrum Disorders (ASD) kids also react oddly to a LOT of medications, often badly. He needs a full neuropsychologist evaluation and you might want to go ahead and contact the school he's going into about setting up an IEP for him.
  18. emmy

    emmy New Member

    So, my son's dr took him off all medications for another 48 hours. Haven't seen as many meltdowns, although he has been bouncing off the walls all day and ignoring most everything I say. He was awake at 3 am this morning, and now it is past 11:30 pm and he is still going. He didn't fall asleep until midnight last night. So, yes, I am going off of less that 2 hours of sleep, seeing as it took me an hour to actually fall asleep. I don't know how much more of this I can take. I am so looking forward to when he goes to his children's group tomorrow (through our counseling office). I am sending my 3 year old to my mother in law's and I am going to take a 3 hour nap!

    Sorry, I think I just needed to get that off my chest.
  19. keista

    keista New Member

    That word BOREDOM rings bells for me. I agree with the others that it could be an Autism Spectrum Disorders (ASD), but could also be anxiety - something else to look at. Hmmmmm could be both.

    DD1 gets into boredom mode. First time I posted her activities for one afternoon on this forum, I was swamped with "Have you screened for ADD?" For her it was ruled out.

    The boredom comes from a search for joy/fun, but nothing seems to fill it. "Relaxing" doesn't seem to be an option. The child needs to do SOMETHING, but can't figure out what that something is. From an observer's point of view, it can certainly look like ADD.
  20. InsaneCdn

    InsaneCdn Well-Known Member

    Sounds to me like most of the other problems could be caused just by the sleep issue... which would also explain why the medications aren't helping and/or making things worse.
    We've fought the fatigue battle with mixed success... but the impact is HUGE. Those dark circles... deep enough to "swim" in... yup. been there done that.

    Somehow, there has to be a way to get something close to "enough", "quality" sleep. Without that, any other diagnosis and/or any other intervention is probably going to be skewed.

    And yes... sometimes the only answer for the parent is to find a way to get that nap so WE don't end up in the same situation as the difficult child!