ADHD... How do you deal?

[beachgirl200621]

My almost 6 year old step son was diagnosed with ADHD at 4, (he lives with us full time and has since he was about 18 months old.) we went to the dr to aske them about his behavior because we knew his mother was also adhd. we put him on the lowest dose possible of focalin i was literally taking the capsul apart and counting the individual beads inside to make sure he was getting exactly half of the smallest dose possible. this worked wonders the 1st few days and then he had a horrible reaction to it. he started crying for 4-5 hours straight about a dog we had when he was 2 that died. he was unconsolable! we took him off the medications and refused to try again! we did family therapy and urged his mother to come and she did it was all four of us talking to the therapist but ended up being the adults in therapy and nothing to help our son. his mother doesnt get him like she is supposed to there is just so much going on with that there is no way I could begin to type it in this forum... she is basically a mother when everyone is watching but if no one is watching or there is no on ethere she can impress she isnt interested. He hurts badly because of her lack of interest at times im sure. But we are at the point where we are ready to try medication again. i have read up on so much stuff since we took him off the medications that its crazy! I was completly and totally against putting any child especially mine on medication.. I dont know where to go or who to turn to. he just finished his Kindergarten year and he is soooo smart the teacher says but he just doesnt have the attention span most of the other kids have. I attribut it to the fact that he is the youngest child in the class he just made the deadline to start Kindergarten this past year. we need help that is the basis of it all we need help NOW. I'm starting to wonder if there are emotional/depression issues under all this behavior stuff. His mother is not stable at all and there are certain things she has to do or have in order to keep him.. she has not had him overnight since October. he just burst out time to time and decides WOW im gonna be mean and hateful or crazy and LOUD just different combinations of things. it has take ALOT but he is finally listening at home. but with other people its a different story. he hates school and we do not like hearing him say that. also I am worried about how much he is like his mother. she can be happy one minute and flip out the next I am not sure is she is bi-polar but she has all the signs I know she has a history with depression and from what ive read with that kind of history that chances of a child being put on medications for adhd are slim.. i dont want him to keep suffering and I dont want my husband and I to keep suffering either. He stressed my Husband to the max tonight and I dunno how much more he can take. we love him so much but its literally driving us insane! its a constant battle every day for him to do simple stuff. I feel like its gone on so long everyone in our house just has a negative attitude all the time and I know thats not good for any of us. I want my family back and most of all I want that sweet loving toddler back! he doesnt understand consiquences they are always consistant and its like it just doesnt click with him... my 2 yr old already understands what she will and wont get in trouble for and she is 2! I am not understanding why he doesnt get it or doesnt care. I appreciate any and all advice.. Names of medication that has worked for you and what type of Dr your child is seeing. we have just seen the peditrician but I think this time we should go to a behavior Dr. what are some other coditions I should look up or research.. who can tell me the flags for depression or bi-polar in kids? Thanks in advance for all your help and support. It will be nice to hear what other people dealing with the same issues have to say!

 

[ready2run]

google bi-polar in kids and you will get lots of information. you may also want to look into autism/aspergers. I don't think a mothers history of depression will make it so he doesn't get medication for ADHD but i also want to point out that it doesn't sound to me like ADHD is really the problem. he sounds alot like my 6yo step-son but my difficult child also has violent tendancies. for him and other kids with autism or sometimes mood disorders the adhd medications will not help, they will cause more problems because they are not the right medication. difficult child is currently diagnosed with autism, adhd and ODD. we are pretty sure he is bi-polar or has some sort of psychopathy problems in there but the docs are hesitant to diagnose those types of problems at such a young age. he is currently taking risperidone, which is an antipsychotic and is used to treat kids with autism as well as bipolar and schizophrenia so even though i think the diagnosis is off, the medication is right. he still has alot of problems. he is still alot more high maintenance than the average child but there is a huge difference and he even notices that he feels better with his medication. i was also against medication for children but there comes a point when we, as parents, have to accept that sometimes medication isn't 'the easy way out' and when the problems get to a certain point it would be neglectful and almost abusive not to provide that for them. you, as a parent, along with a knowledgable doctor, are the only one who is able to know if you are at that point or not. i hope you find what you are looking for and that you get the help you need for him. being a step parent is hard in the best of cases, and i know how difficult it can be to step in and take over parent a child who is a difficult child. be prepared to argue with professionals to get what you think is best for him, and to wait for what seems like forever for things to fall into place. we started the identification process @ age 2. he started taking medication @ 5 and was only diagnosed a few months after that. start by talking to his family doctor or pediatritian and asking about screening and medication to help him cope. good luck.

 

[Malika]

Hello and welcome. Sorry you are having such a hard time with your boy at the moment.
Reading your post, I felt like you were asking for the treatment before the diagnosis has been made... On the information you have given, I would feel that there is a place for further evaluations before you take any medications decisions. A neuro-psychologist evaluation and a second psychiatrist opinion. You don't want to go down the route of more mistaken medications if you can avoid that, I would have thought.
I understand that these things in the States are not straightforward and depend on your insurance. That may complicate the picture for you. But in your shoes I would want more professional input, as you yourself suggest.

 

[BusynMember]

I would take him a neuropsychologist or child psychiatrist. ADHD is usually the first, but usually not the last, diagnosis kids get. Stimulants only work for ADHD. My son was diagnosed with ADHD/ODD first and put on stimulants, but they made him mean and aggressive (he is not like that normally). As time went on, his diagnosis changed to autistic spectrum disorder, which is far more accurate. He isn't on medications now.

It takes a long journey before a child is properly diagnosed and medicated. It is just not the norm that one professional will get it right the first time. It takes a lot of patience and exploration. If you don't feel right putting him back on medications, don't. If he doesn't actually have ADHD the medications can make him even worse.

The first thing I'd do though is get a thorough evaluation.

I have a questioin: Did his birthmother drink or use drugs while she was pregnant? If so, that can cause a whole other set of problems that may look like ADHD, but are actually a whole other ball of wax.

Glad you found us ....but sorry you have to be here.

 

[LittleDudesMom]

"I am not understanding why he doesnt get it or doesnt care."

Hi Beachgirl and welcome to the site. I just pulled that quote out of your post because I believe it is an important attitude piece for parents. You, as an adult, don't understand - do you honestly believe that he does? Children with these challenging issues, especially younger children like your stepson, are just as much in the dark, or even more so, than we are. Trust me, he wants to be good. He would rather not struggle. He obviously can't give what is expected and that is when you have to stop and realize it's not fair to have expectations he cannot meet right now. It's a set up for failure and frustration.

Remember that a pediatrician treats the body of a child. Your stepson needs someone who specializes in the mind, so to speak. Get a referral from his pediatrician for a good neuropsychologist or child psychiatrist. You don't specifically address his behaviors in your post, but you will need to be ultra-specific with the new doctor. Start keeping a journal of his meltdowns and struggles. It's too bad the school year is over and you can't get something from the teacher - that would have been a help - input from someone other than family. It's clear that you understand genetics play a huge role with our challenging kids. But know that a good team around your stepson can make a huge difference.

You are doing the right thing by intervening while he is so young. Early intervention is very critical. A number of years ago, a member who has her doctorate, did a study through her university and found that one of the biggest positive impacts on "difficult children" was early intervention by families and schools! So you are on the path. It's not always going to be a smooth path and it's not always going to be a quick run. Finding a good doctor, doing therapy and evaluations, finding a medication(s) that makes a difference, changing expectations, working with the school, etc., takes time and energy but can make a HUGE difference in your family life and the chance of future success for your stepson.

So find a doctor, take the time to read through our board and our archives (some great posts that have been saved over the years), and keep posting. This is a remarkable place to be - most of us came here when we were "lost". It has been a life-saver for most of us.

Sharon

 

[jennd23]

I agree that a good evaluation is a must! Even without much info (by way of specific behaviors) he sounds a lot like my son. You can google almost everything these days and diagnose him yourself but its so much better to have someone who knows what they are doing diagnose him for you.

In the mean time I would look at autism spectrum disorders, just get a feel for it and see what you think. My son has the same thing with consequences. Even natural consequences, a while back he was jumping on the couch and face planted onto the arm of it and knocked his tooth out (it was loose already, but still...) he cried, laid around for a while because he was so "hurt" from it, less than 20 minutes later he was back to jumping on the couch. I know that's a silly example, but its the same with all consequences. He just doesn't "get" them.

I really appreciate the step parents who post on here, it is really nice to hear how you think of these kids as your own. I think it sounds like he's got a good support system with you and husband.

 

[beachgirl200621]

I feel like I need to clarify myself. Our peditrician has diagnosed him with ADHD. We have gotten teachers involved His pre-k teacher filled out the assesment from the school for the diagnosis. We pushed for therapy before because I know medication alone isnt the key.. the therapist we were sent to was great but he didnt work with my son he worked with the adults basically to help us cope with his behavior. And as far as us setting goals that are out of his grasp... not to sure about that one. I feel like our "family rules" are the most common you can get. I expect my children to be respectful to others and to obey our rules such as no jumping on the furniture or running in the house.. be kind to one another, share, yes maam no maam yes sir no sir... please and thank you being polite and open about things. these have always been the rules and consistency is the key.. I was asking about medication because I want to research more different types so I can feel more comfortable about this. I know that his mither is part of the problem.. it seems SOMETIMES his behavior and choosing to act out is worse when he goes long periods without seeing her. I know he hurts. We are trying to help him.. Ive looked at the autistic spectrum ive never really noticed a link between him and that specific spectrum. There have been times where he has been just down right MEAN to his sister, and also my husband. The other day they walked into my sister in law house and he kicked my husband between the legs as hard as he could for no reason what so ever. I used to work in day care and I have seen many children that are not "difficult child" but "normal" he is nothing like the "norm" he is constantly whining over something... ALWAYS! there isnt a day that goes by that he isnt whining, he bounces off the walls 90% of the time or he will be sitting watching tv and all of a sudden jump up and make weird sounds (like a baby) or an animal or something or either start jumping around. He cannot sit still.. he is ALWAY complaining of being itchy..? (dunno if that has anything to do with any of this but figured id put it out there) He is a very loud spoken child we always thought that was because when he was younger he failed his hearing tests we thought he couldnt hear but now his hearing is fine. His teacher has told me he has no attention span what so ever but he is very smart and that right now he is about the middle of his class but if he doesnt get his attention straight that next year the students that are below him will end up passing him because all though they might not be quite as smart as him they have the attention span that he doesnt have.. he has started lying to his mom when she does call telling her we wont let him do this that and the other (I dont understand why he feels the need to lie, or make up something that never happened. Its not bad stuff just silly stuff) And as far as me not understanding why he doesnt get it or doesnt care I know he is just as confused as we are. you can tell some days when he is just trying so hard to make us happy and trying to do his best.. I GET IT he doesnt know whats going on with himself any more than my husband or I do. I dont expect him to know what is wrong with him. I have just never seen a child that didnt understand consiquences before at least not a child who was about to turn 6. He is loving 99% of the time he wants to be the center of attention, and when he isnt the center of attention for 5 minutes he flips out. pouts or just whines. He is VERY impulsive he does things before he thinks about them. he will just blurt out right in your face for no reason.. well to us there is no reason but of course there is a reason to him. Maybe this post will better describe him and I can get more accurate feedback? I hope so Im glad I found this site and Hope it will be helpful to me in the future. if you all have any difficult child children that sound like him please feel free to contact me. I am anxious to do my own research before our dr appointment so I can go in with the knowledge I feel I need to udnerstand what is going on so that I can ask the right ?'s and get the best help for my son. Thanks again

 

[ready2run]

you can't see the relation to autism?

Common symptoms that autistic kids have:
(this list is just off the top of my head, based on things you pointed out that are symptoms)
-not understanding cause and effect ie. doesn't grasp the idea of consequences
-hyperactivity
-constantly moving around ie. stimming, it isn't always the obvious hand flapping. it can be jumping, wiggling, pacing, any kind of movement really.
-making weird noises that aren't really purposeful other than for their own enjoyment(also a stimulant)
-itching all over(sensory issues)
-BEING LOUD, autistic people are often loud and sometimes too quiet, some have trouble regulating their voices
-acting out like when you say "WOW im gonna be mean and hateful or crazy and LOUD just different combinations of things" this type of behaviour is fairly typical
-'doesn't care' they often seem like they don't care because of the usual lack of empathy or seeming lack of empathy that is part of the package. they don't understand about how their behavior effects others, and can't read other peoples emotions/reactions to their behaviour.
-crying about a dog that died 4 years ago... i know he was having medication problems at that time but the fact that he even remembers the dog shows that he, like people on the Autism Spectrum Disorders (ASD) spectrum, has a good long-term memory. it's pretty normal for aspies to have vivid memories of early childhood that normal people wouldn't have.
-'for no reason what so ever' it often seems like people with Autism Spectrum Disorders (ASD) do things for no reason but they think so differently than you and i that they actually do have reasons we just don't understand them.
-low attention span, they tend to get really bored quickly with information that is not related to something they are very interested in.
-lack of self-control ie. being impulsive
all these symptoms you described are pretty much almost the same as if you looked up a list of symptoms for high-functioning autism.


as for the mother stuff, of course it effects him. any kid wants their mother, so of course he is going to have worse problems when he misses her. you can't blame all the problems on her not being there consistantly though, because he does have you and your other half there as consistant parents which is what he needs. the lieing is probably just his attempt to get attention from her or in hopes that she will come rescue him. what i meant when i said her mental health shouldn't effect him is that the doctors will be able to medicate him as necessary and her problems are seperate from that. they won't base his diagnosis on her, although it would be good to tell them about her issues. like i said earlier, the medications they use to treat autism symptoms and bi-polar are the same (often risperidone or rispridal)

 

[ready2run]

check out the parenting forum on wrongplanet.com (autism forum), give them a copy of your posts here and ask if they think he fits.
also, any therapy is going to involve you and most of it will be for you to learn to cope with his behaviours because in most cases there is no cure, medications can take the edge off and the rest i mostly the people around him learning to deal with him productively, not him changing.

 

[Malika]

Hello and welcome.
Diagnosis by distance and on the basis of your description is obviously not reliable - no one here would claim that it is. You have perhaps been given some suggestions - eg autism - that are just for you to investigate or have evaluated and then if they are not applicable, at least you know you have examined possible causes of this behaviour that troubles you (and him).
From what I have heard many people saying, if a child really does have ADHD, Ritalin works instantly - you can see the improvement in attention span and capacity at once. And I have also heard people saying that medications have made an enormous difference to the life of their child and consequently their family. And this is being said by someone who is no particular fan of medications! But that too is something for you to think about, to speak to a psychiatrist perhaps and to try. If there IS a medication that could really, fundamentally help your stepson, of course you would want to try it.
Best of luck.

 

[BusynMember]

Without reading all the posts (it's still early ) It sounds like autistisc spectrum to me too. The cluelessness and the weird noises are status quo for the spectrum. Many make weird throat noises (it's a stimulant) or plain out growl (my son did this...lol). Not "getting it" is a symptom too. They tend to lack good life and social skills. Autism Spectrum Disorders (ASD) kids are as hyper and lack attention skills just like those with ADHD so often they are misdiagnosed as ADHD when they are actually on the spectrum. Has he ever seen a neuropsychologist?

 

[beachgirl200621]

Thank you Ready2run!! Thats what i was looking for! You have hit the nail on the head I do believe Im waiting to the pediatrician's office to call me back so soo what they think Im armed with info and ready to fill them in! You all have been so helpful and I really hope this is the light at the end of the tunnel and we can finally get him the "help" he needs as well as the help we will need to understand how to handle our difficult child thanks a ton!!

 

[wintak]

so if he's on the spectrum, are there medicines that can help him with his cluelessness etc?

 

[BusynMember]

The spectrum is more hopeful in my opinion. There are interventions that can bring these kids sometimes close to normal with good outcomes. But treating an Autism Spectrum Disorders (ASD) kid for ADHD will not help so it's important to know. S

Some Autism Spectrum Disorders (ASD) kids respond to certain medications. My son is medications free. He has improved 80% from when he was a toddler. He is now eighteen.

 

[exhausted]

Hello and welcome.
I have raised an ADHD child (he is now 23 and very successful) and have been both a special education and regular education teacher for a total of 25 years.
You have gotten some good advise and you know instinctually that you need to see a psychiatrist and probably a neuropsychologist as well.
My other advise is to attend the NAMI Basics course on children. There you will be introduced to many things which are invaluable to parenting a difficult child. One of the first things you learn is that symptoms in children overlap greatly and diagnosis is difficult, changes over time, and yes-can depend on the evaluator experiences and bias. Autism Spectrum Disorders (ASD) is a big hot bed right now, just as ADHD was when I raised my son. Get good professionals.( NAMI does not cover Autism Spectrum Disorders (ASD) by the way)

All the symptoms and behaviors you listed-exhibited in my son when he was young (with the exception of kicking his father). He is not on the spectrum in any way. He did also have sensory issues-tags itched,didn't want to wear collars, no toe seams on socks... He did and still makes noises. He sings and hums little sound bites over and over (thank God they change daily). He plays the drums with his mouth (he is a drummer as well). He doesn't do this now in innapropriate places because we intervened early with school, home,psychiatrist,assessments, and yes ritalin. We raised him in a very structured home using behavioristic methods which worked because we did this over time and it matched the way he was being managed in school. At first, until his impulses were more controlled by ritalin, he could not connect the dots between behaviors and consequences.This method has had little effect on our daughter who is another duck all together.

I have taught many kids with many diagnosis over the years. I will tell you that kids on the spectrum are so very different from each other in many ways. To me they are more highly variable than ADHD kids. I have had children diagnosed as high functioning autistic who were on stimulants to help with their attention. My neighbor girl,who was my student in 4th and 6th grade, and now attends my charter school, has been very successful since both a stimulant and antideppresant were added.I have had kids on the spectrum who did not show any loving responses, and others who were so charming and loving.Some who stimmed, other who didn't etc..

My message then is seek the full scale evaluation and involve everyone who has knowledge of his behaviors. It will take huge amounts of effort and energy to manage and to deal with what ever diagnosis you recieve. husband will have to learn with you or it will be hellish. No matter what diagnosis you get, be prepared for changes and medication issues and therapist changes. Take care of yourself and your marriage-this is hard when kids are young, but you must. Keep us posted.Hugs!

 

[Malika]

So here's a question I have had for a while, if I may. If Autism Spectrum Disorders (ASD) is actually almost indistinguishable from ADHD in some cases, what does the Autism Spectrum Disorders (ASD) "consist of"? What does it mean to say someone is autistic in these circumstances? This has been causing me not a little confusion

 

[exhausted]

Malika,
Im no expert, but one of the big difference is social interaction (which is also not ok with ADHD) and language skills. By the time I get these children at school, the differences are very noticable-it's when they are so young that it is most difficult between the two. I just copied this from a site talking about the spectrum-I put the Asperger stuff because in my experience this is where the differentiation gets tough.Also this poster mentioned her boy's high intellegence (Aspie characteristic). Usually autistic spectrum disorder kids have language delays where they don't speak until later. by the way the new DSM coming out is suppose to be" lumping" all these together-can't remember other diagnostic changes.
Unlike some children with autism spectrum disorders, children with Asperger syndrome tend to have good vocabularies and grammar skills. But they usually have other language problems, such as being very literal and having trouble understanding non-verbal communications, such as body language.
Other symptoms of Asperger syndrome may include:

• Obsessive or repetitive routines and rituals
• Motor-skill problems, such as clumsy or uncoordinated movements and delays in motor skills
• Social-skill problems, especially related to communicating with others
• Sensitivity to sensory information, such as light, sound, texture, and taste

 

[BusynMember]

Not all Autism Spectrum Disorders (ASD) kids have speech delays. Aspergers kids don't.

ADHD and Aspergers can be very similar, depending on the kids. I often think you get one diagnosis. or the other depending upon the professional doing the diagnosing. An Aspie can be an "odd duck" but live a very successful life once he learns the social rules. It varies a lot. Neuropsychs tend to get things right most often in my opinion.

My son's teachers had NO idea he was a spectrum kid. Because he is well behaved in school and suppresses his stims there, they could not see a difference between him and a child with ADHD and constantly told me to put him on stimulants. He could sit in his seat (and did), but was (and still is) extremely fidgety.

I work at a Head Start. There is a little boy there who I am sure has autism. Actually, most of us know it, but his diagnosis. is only ADHD and we aren't allowed to say anything to the parents. He is on Adderrall and it does dope him up, but not in a normal way that you'd think it would for ADHD. He gets glassy-eyed and barely moves on the Adderrall. When it wears off, he is like the wind, nobody can catch him. He throws things around, hits other kids, screams a lot, and throws tantrums. He is going to be sent to a special school next year for his "ADHD." Truly, these kids are foolers. The symptoms of the diagnosis. overlap. But nobody but the kids parents feel this boy is simply ADHD. I feel so sorry for him. He tries, but all the other kids always say they don't like him.

Good luck! The journey is long and it can take years to figure out our sweet little "foolers."

 

[JJJ]

ADHD is on the spectrum

You won't find all doctors agreeing with that statement but there is a growing contingent that believe that ADHD is past of the Autism Spectrum so they look at using the inteventions that work on some autistic kids to try and help kids with "just" ADHD.

There isn't an "Autism medication" but they can medicate the symptoms: hyperactivity (stims, Strattera or Clonodine), anxiety (anti-anxiety or anti-depressives), aggresion/anger (anti-psychotics), and so on...medicating an autistic child (really any neurological, developmental or psychiatrically ill child) is far more art than science.

 

[exhausted]

Unlike some children with autism spectrum disorders, children with Asperger syndrome tend to have good vocabularies and grammar skills. But they usually have other language problems,

Yes midwest mom-I agree and that's what my post said.
JJJ-There is also a growing community of Docs who are in disagreement with saying ADHD is on the spectrum and the current and future DSM still seperate them. I agree- In the long run it's treating the symptoms that matter. Finding a label is useful if it is possible. Over labeling has it's down side as well. Thus we call in the professionals (and hope we are in the hands of good ones).