ADHD Help

[mrsalmeida]

Hi there,
I just found this website and this is my first post. Bear with me, it may be long.

OK, so my 9, almost 10 year old son was diagnosed with severe ADHD in June, after years of seeing psychiatrists and getting an original borderline ADHD diagnosis. He has always struggled in school, academically and socially. Starting in preschool, every teacher has said he should be held back. Finally in 2nd grade, he repeated , and is now in 3rd.
He got started on adderall, and its like he's a different kid at school, but now at home it is like we are living in a nightmare.
So he started on 10 mg of the extended release, and we felt like it didn't really help, so the doctor put him on 20mgs. Everything was going good, and we (husband and I) decided to have him off the medications on the weekends to give him a break from the medications and help with his appetite. So we did that for a couple of weekends, and all the sudden he was flipping out at home. We then decided to still have him take the medications on weekends, because obviously it was messing with him too much to not be on it during the weekends.
We then had a checkup with a new pediatrician and I was discussing my concerns about his anger and his appetite. So this doctor told us he should be on 15mgs and just take 5mg on the weekends. Well, he was on 15 mgs for a week and got in trouble two days at school had a few horrible temper tantrums at home and ended the week by getting suspended for getting in a fist fight. So we put him back on the 20 mg.
On Christmas night he had a horrid flip out, screaming and yelling and cursing at us, saying he hates us. We took all his presents away, video games away, his cable box, everything got taken away. And ever since Christmas, we have lived in a never ending nightmare.
5 out of 7 nights of the week are ended with him flipping out on us and him screaming that he hates us, and f words and he will look right at me And call me a f'ing bi***.
It takes everything in me not to whoop his ass. I feel so bad for my 6 yr old daughter that she grows up with mommy and daddy being upset all the time, and I have a 6 month old baby growing up in this hell house.
We are at our wits end. We don't know what to do anymore. Please help.

 

[InsaneCdn]

Hi, and welcome. Sorry you need to be here, but glad you found us.

Mind me asking who did this diagnosis? The reason for asking is, lots of us have been through the diagnostic wringer. If you happen to have a complex kid, it's really hard to get the whole picture. The best diagnoses come from a comprehensive evaluation - and even that isn't perfect. But a comprehensive evaluation takes 6-10 hours over several appointments, and tests for ALL the edges - developmental (such as Autism Spectrum Disorders (ASD) or Asperger's), mental illness (such as bi-polar, schizophrenia, personality disorders), mental health issues (such as situational depression, anxiety, PTSD) and educational challenges (such as dyslexia, dysgraphia, working memory, etc.)

Even then, most comprehensive evaluations do not test for auditory processing disorders (which can be co-morbid with all sorts of other problems, and which are frequently misdiagnosed as ADHD).

He's almost 10, stuck with a bunch of 8 year olds in class, will likely be the target of significant bullying (kids with challenges are almost always bullied). And the bullying can come from teachers, too. The work is starting to get more challenging. If he's struggled since the beginning of school, what has HE been saying about school? What does he find hard? Especially, what did he say the first year or two? (By now, if you ask, he'll likely just say that "everything is hard".)

You say he has challenges not just academically, but socially. What was he like as a baby, and toddler?

 

[BusynMember]

I'm sorry you are struggling.

What type of professional diagnosed your son? I recommend trying a neuropsychologist. Pediatricians and talk therapists are not good diagnosticians. Neuropsychologists are psychologists with extra training in the brain and they do tons of testing and often catch things others miss. To me it sounds like more is going on than ADHD. A second opinion in my opinion is a good thing. He has a lot of Autism Spectrum Disorders (ASD) symptoms, especially with the social skill deficits.

Hang in there!!!

 

[mrsalmeida]

Thanks for the replies.

The diagnosis was from a child psychologist at Kaiser, who we have our insurance through. We started the testing when he was in 1st grade, because not only was he having problems at home, but at school as well. School problems such as getting very angry in class when he couldn't do the work, always having social issues, not able to get along with anyone, fighting during recess, storming out of the classroom, ripping up classwork. He has a huge struggle with reading and spelling. It used to be writing as well, but that has improved immensely.Problems at home such as when myself or his dad ask him to do something he would flip out, slamming doors, screaming at the top of his lungs, cursing, getting him to eat is a nightmare and what starts most of the fights. When he was younger, it was always reading and writing that were the issues at school and the major source of frustration and now that he's older, its the social aspect. After he got in the fistfight last week at school, he said he hated school and hated everyone at school. He doesn't really have any close friends that he plays with after school or on the weekends, and he prefers to be playing video games or be on the iPad.
I don't want to bad mouth Kaiser, as they are great with certain aspects of care, but this whole diagnosis and medication prescription has been a complete and utter exhaustion. I am very interested in getting the comprehensive evaluation, I just know kaiser will give me push back. I will just have to get pushy with them.
Also, he says a lot of "I hate my life", sometimes he says " I want to die", and that is the worst thing to hear.

 

[InsaneCdn]

The diagnosis was from a child psychologist

How much interaction did this person have with your child? What kinds of tests were actually run? Any feedback from teachers, parents and others?

Knowing what has already been done, might help strengthen your case for a re-do.

 

[mrsalmeida]

Not much, actually. He was put in a room with a bunch of other kids and observed, and we filed out a questionare and his teacher filled out a questionare and that was it.
I just looked at the calendar and his next appointment happens to be tomorrow afternoon. I am going to demand we get a comprehensive evaluation. I feel so stupid, but is there a way I can word this demand or what should I tell this doctor to let her know how serious this is? I feel like Kaiser just tries to do whatever is easiest for them.

 

[HMBgal]

Oh boy. I feel like I know your little guy. And even down to the Kaiser child psychiatric services thing. They never did a real comprehensive evaluation, either, and when we asked about it, they were quite sure of the diagnosis from observations. I'm personally not sure about that, myself. The social skills group (huge bust) and the anxiety group (wasn't helping him and he making the other kids a nervous wreck) was useless, too, and that's about all they had to offer.

I'm assuming he has an IEP at school? Because my grandson tests so high academically, they wouldn't give him anything more than 504 (kind of joke, those). Schools are reluctant to "label" a kid with emotional disturbance, but once Kaiser added on the anxiety disorder piece to the ADHD, it at least got him on an IEP and generated some other support services through our local mental health services through our county. Our Kaiser said that after awhile and so many visits, they said he needed to be referred out for more one-on-one talk therapy. I'm not sure if your Kaiser works that way, but they were adamant that he need an IEP and did send a letter to the school district. So, the people who are supposed to do that have yet to show up for one visit at this school, but we are on it.

I'm assuming you've looked through here and found some of the books that many of has read and have helped us reframe and look through our kids with different lenses? Explosive Child, the Lost at School website, to name a couple that have helped us. It's so hard and I sure feel your pain. You've found a great place here.

 

[InsaneCdn]

I wish I could remember all the ones that were done on our last evaluation (it's a few years ago now and I don't have it with me). But we are talking TESTS here, not "observation".

I know we have had this discussion on these forums before - it might be under Special Education, or general, not sure which. Search for terms like "comprehensive evaluation" and "testing"

 

[mrsalmeida]

Thank you so much, I will dig in around this website.
He does have an IEP at school, and the one thing we have going for us is that this school has been amazing. He gets taken out of the regular class several times a day to go in RSV classes and be likes that, because he feels special that he gets to leave the class.
What do you guys think as far as the taking privileges away? Because so far, it hasn't helped and I feel like it's just a waste of time.

 

[InsaneCdn]

If, as somewhereoutthere suggests, he is on the autism spectrum, then punishment doesn't work. What does work is absolute and total consistency - rules are rules. Help him do what has to be done. Make it a habit. And reward every small step toward success. Consistency will help with other things, too. Like - have a "after school" routine. Including something to look forward to. Same for every other regular transition, because transition points are really hard.

 

[HMBgal]

Taking away privileges hasn't worked for us, but catching my grandson "being good" and demonstrating the things that matter to us (kindness to others, helpfulness, taking a shower without WWIII starting, picking up after himself, etc) has seemed a better use of our time than being enforcers, which just sets off temper, melt-downs, foul language, threats, and personal safety scares. He does work for things, and at first it was short cycle: do five minutes of schoolwork and the reward happens right away. Anything long-term just causes more anxiety and anger. We've identified some things that he will work for: iPad time and playing with his Kendama--that's about all we've identified actually. If we tell him that if he uses foul language at school he'll lose the chance to go on his field trip next, that's too far out time-wise. And once he's lost the privilege, what is there to stop him from really running at the mouth and/or messing up at school? Finding what his triggers are is helpful, too. Recess and unstructured social time was devastating for my grandson. Guaranteed bad stuff happening. So we have him an alternate recess where he reads and helps the first graders (he's in 4th). He really loves it and it makes him feel good about himself and keeps him out of trouble. Win-win. InsaneCdn's suggestions above have worked for us, as well. And if anything changes, front-load it--warn them it's coming. If we don't--holy smokes. It's a long process and it's been two-steps forward and one back. And sometimes it's two steps backward and one forward. Dang. But once you hit on the right combo of things, you will see small victories.