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<blockquote data-quote="susiestar" data-source="post: 365103" data-attributes="member: 1233"><p>This is one of the major reasons to not start two medications at once. You just do not know which is causing the problem. Or to make two medication changes at once. Risperdal was awesome with a stimulant for my son. He stayed on concerta and risperdal for 4 years. IF your son has adhd the stimulant will NOT speed him up. It simply does NOT work like that in a person with ADHD. It allows them to slow down, exactly the OPPOSITE of what a stimulant does to someone without ADHD. It is one of the things that non-ADHD people have the hardest time understanding. It IS a paradoxical reaction to the stimulant, but it is all due to the differences in the way the brains and bodies of people with adhd and those without it work. </p><p></p><p>It is likely that the stimulant is causing the tic. It would be my first guess. It is also the easiest to prove or disprove. Stims are fast in and fast out. They do not stay in the body for days at a time. In just a day or two your son would have the stimulant out of his system. If the tics are gone then they are problem due to the stimulant. If you add the stimulant back in and the tics start up again then you will know they are the cause. You may or may not have the same result from other stimulants so I would personally try another one or two until you see if one will help.</p><p></p><p>The other medications for adhd are actually antidepressants like strattera. They are not very effective antidepressants for depression but somehow they help adhd. It can take up to six weeks at the target dose to know how well strattera will work. It would take a couple of weeks to know if strattera will have any effect at all. This is one reason most people try stimulants first. (Lots of people worry that putting a child with adhd on a stimulant will lead to drug abuse when they are older. Research shows the opposite is true. If they are effectively treated for their adhd they are far LESS likely to search out drugs to abuse because they have no need to self medicate. Of course this is dependent on the child/teen/adult truly having adhd.) </p><p></p><p>Risperdal can be causing the tics also. Have you spoken to the psychiatrist about the tics? If the risperdal is causing the tics then he would likely need to try another antipsychotic. Any of them can have side effects, bad ones or mild ones. If it is helping enough to really change things then likely it would be worth it to at least try another one. It will take more than a day or two to taper him off of risperdal and to have the medication leave his system. That is why it is likely a faster road to the cause to remove the stimulant first and see if it helps. Usually a couple of days does not make enough of an impact on tardive dyskinesia as to make it permanent. At least that is what our psychiatrists always said. </p><p></p><p>It really IS hard when our kids melt down when other kids are having a good time. We feel embarrassed that our kid is acting out, like we have done something wrong because our kid is not "behaving", sad because we are missing yet another possible good memory, and even sadder that our child has so many problems that they cannot even enjoy something simple like this.</p><p></p><p>It sounds kind of like your son was just super overstimulated by the program, esp when it came time for him to have to perform. The most common fear is of standing up in front of people to speak or perform. It isn't just in adults. Some kids never are able to stand up and sing or whatever. While it is cute to watch when the kids are all up there, it can be truly terrifying to some children. It isn't uncommon even in kids who do not have other problems. Esp at your son's age. Your son may just not ever enjoy performing. At some point he might, but the more you push him to do it, and the more he sees that you are unhappy the worse the situation will get.</p><p></p><p>Our library has an amazing summer program. Not only the reading program with prizes, but two different performances a week, 3 shows of each. the auditorium at the library has singers, poets, acting troupes, dogs that do tricks, storytellers, etc... for 9 weeks over the summer. The performers are all excellent. My older kids loved each and every show. They were happy to turn in their reading logs to get prizes.</p><p></p><p>Then came thank you. thank you has sensory integration disorder. thank you cried and wailed through every performance. I had to find other parents for Jess to sit with because I HAD to be in the other rooms because he just could not cope. he melted down. He would escape and run like a madman through the room, even when every other kid was sittiing in rapt attention. For a while I worked on "teaching" him to "behave". After a week of that misery I realized he truly was unable to cope. So we listened through the closed doors. Or stayed in the main part of the library. Or read books in another meeting room that was empty. I even let him run up and down the hall as long as he didn't yell on some days. After a year or so of that he wanted to try the performances. We left before they were even half over that entire summer. The next year he sat through three of the shows. I was SO PROUD. He had to work to stay there, and it had to be something he really WANTED to see, but he did it.</p><p></p><p>It seems to me that your little guy's meltdown wasn't about wanting to behave poorly or to upset you. He may not even know what it was that upset him so. If he knows, he may not have the ability to put it into words. Has he been evaluated for sensory issues by a private Occupational Therapist (OT)? I think it would help all of you learn how to help him through these things.</p><p></p><p>In the meantime it is important to change the way you look at times like these. Rather than looking at it as difficult child choosing to melt down or behave badly, try to see it as difficult child being unable to handle the noise, the people, the singing, the movements, the people watching him, etc... after a week of working really HARD to adjust to something very new. VBS is very new to him, it is a short period of time (1 week) but is packed with unfamiliar things, transitions, parents not being there, expectations he likely doesn't fully understand, and then performing in front of a group with a group of kids, all at once (in his mind). By the end of the week he just had no more coping ability left. Then just as he finally got calm he had to go back in and it all hit him again, hence the second meltdown.</p><p></p><p>It really is HARD to change how you look at his behavior from misbehaving on purpose to being unable to behave as expected. It is a giant shift in perception that takes the blame and much of the anger out. Of you can make the shift in perception you will then focus on helping him learn to be able to cope and to keeping expectations and the environment to ones he truly CAN handle. Once that is made and you understand what he can and cannot cope with, then you can start to help him learn to handle more intense stimuli and situation. I know it SOUNDS like you are "giving in" to his "bad behavior" (meaning the meltdowns). In reality you are teaching him how to learn to cope with more and more.</p><p></p><p>It is a slow process. Lots of work. But so is almost every other aspect of parenting. Heck, even childbirth is no snap but we learned to muddle through, didn't we? </p><p></p><p>There is a lot of grieving that we have to do when we truly realize the problems our kids have. When we truly see how these change the world for them it is super hard to accept as a parent. It is important that you allow yourself to grieve for the dreams you had for your child. What he would be like, how you would do this or that with him, what you would do as a family, the milestones he would reach and the memories you would make. No one asked for this, not the child or the parents. </p><p></p><p>Our kids are on a path we never ever dreamed we would travel with them. It is full of so many good and not good and just plain awful things that we never dreamed would be part of OUR lives. We cannot accept the new path and embrace what we CAN have and enjoy with our kids unless and until we acknowledge that we are on this other path and that it won't be what we expected. Once we allow ourselves to grieve then we can accept where we are, who we are, who our kids are, and the journey we will travel together.</p><p></p><p>While NONE of us would have chosen this path, once we are on it we learn it has incredibly rewards that we would have totally missed out on, that so many parents never get lucky enough to know. </p><p></p><p>be gentle with yourself. Let yourself work through the anger and disappointment and grief. Remember that your son did not choose it either, but that he is willing to share it with you. </p><p></p><p>I am so sorry about your job. It is a tough time to be out of work. I am disabled and fighting for disability and my husband has been out of work since August. File for unemployment as soon as you can. I would check it out online as soon as you can before you are laid off. Find out how much COBRA is for your insurance. There ARE federal grants to cover a big part of the cost of COBRA. File with social services for any aid you qualify for. Check into temporary agencies to see what opportunities are there. Some of the work might be working parking at football games, but it will help. </p><p></p><p>This is going to be a really stressful time for the whole family. Don't forget that you can rant and vent here, as well as get ideas and hugs. If you cannot handle ideas it is okay to say so. Just tell us you need to vent, or rant, or whine or whatever, then let it out and ask for a hug. We won't mind. I promise.</p><p></p><p>{{{{{{{{{{hugs}}}}}}}}}}</p></blockquote><p></p>
[QUOTE="susiestar, post: 365103, member: 1233"] This is one of the major reasons to not start two medications at once. You just do not know which is causing the problem. Or to make two medication changes at once. Risperdal was awesome with a stimulant for my son. He stayed on concerta and risperdal for 4 years. IF your son has adhd the stimulant will NOT speed him up. It simply does NOT work like that in a person with ADHD. It allows them to slow down, exactly the OPPOSITE of what a stimulant does to someone without ADHD. It is one of the things that non-ADHD people have the hardest time understanding. It IS a paradoxical reaction to the stimulant, but it is all due to the differences in the way the brains and bodies of people with adhd and those without it work. It is likely that the stimulant is causing the tic. It would be my first guess. It is also the easiest to prove or disprove. Stims are fast in and fast out. They do not stay in the body for days at a time. In just a day or two your son would have the stimulant out of his system. If the tics are gone then they are problem due to the stimulant. If you add the stimulant back in and the tics start up again then you will know they are the cause. You may or may not have the same result from other stimulants so I would personally try another one or two until you see if one will help. The other medications for adhd are actually antidepressants like strattera. They are not very effective antidepressants for depression but somehow they help adhd. It can take up to six weeks at the target dose to know how well strattera will work. It would take a couple of weeks to know if strattera will have any effect at all. This is one reason most people try stimulants first. (Lots of people worry that putting a child with adhd on a stimulant will lead to drug abuse when they are older. Research shows the opposite is true. If they are effectively treated for their adhd they are far LESS likely to search out drugs to abuse because they have no need to self medicate. Of course this is dependent on the child/teen/adult truly having adhd.) Risperdal can be causing the tics also. Have you spoken to the psychiatrist about the tics? If the risperdal is causing the tics then he would likely need to try another antipsychotic. Any of them can have side effects, bad ones or mild ones. If it is helping enough to really change things then likely it would be worth it to at least try another one. It will take more than a day or two to taper him off of risperdal and to have the medication leave his system. That is why it is likely a faster road to the cause to remove the stimulant first and see if it helps. Usually a couple of days does not make enough of an impact on tardive dyskinesia as to make it permanent. At least that is what our psychiatrists always said. It really IS hard when our kids melt down when other kids are having a good time. We feel embarrassed that our kid is acting out, like we have done something wrong because our kid is not "behaving", sad because we are missing yet another possible good memory, and even sadder that our child has so many problems that they cannot even enjoy something simple like this. It sounds kind of like your son was just super overstimulated by the program, esp when it came time for him to have to perform. The most common fear is of standing up in front of people to speak or perform. It isn't just in adults. Some kids never are able to stand up and sing or whatever. While it is cute to watch when the kids are all up there, it can be truly terrifying to some children. It isn't uncommon even in kids who do not have other problems. Esp at your son's age. Your son may just not ever enjoy performing. At some point he might, but the more you push him to do it, and the more he sees that you are unhappy the worse the situation will get. Our library has an amazing summer program. Not only the reading program with prizes, but two different performances a week, 3 shows of each. the auditorium at the library has singers, poets, acting troupes, dogs that do tricks, storytellers, etc... for 9 weeks over the summer. The performers are all excellent. My older kids loved each and every show. They were happy to turn in their reading logs to get prizes. Then came thank you. thank you has sensory integration disorder. thank you cried and wailed through every performance. I had to find other parents for Jess to sit with because I HAD to be in the other rooms because he just could not cope. he melted down. He would escape and run like a madman through the room, even when every other kid was sittiing in rapt attention. For a while I worked on "teaching" him to "behave". After a week of that misery I realized he truly was unable to cope. So we listened through the closed doors. Or stayed in the main part of the library. Or read books in another meeting room that was empty. I even let him run up and down the hall as long as he didn't yell on some days. After a year or so of that he wanted to try the performances. We left before they were even half over that entire summer. The next year he sat through three of the shows. I was SO PROUD. He had to work to stay there, and it had to be something he really WANTED to see, but he did it. It seems to me that your little guy's meltdown wasn't about wanting to behave poorly or to upset you. He may not even know what it was that upset him so. If he knows, he may not have the ability to put it into words. Has he been evaluated for sensory issues by a private Occupational Therapist (OT)? I think it would help all of you learn how to help him through these things. In the meantime it is important to change the way you look at times like these. Rather than looking at it as difficult child choosing to melt down or behave badly, try to see it as difficult child being unable to handle the noise, the people, the singing, the movements, the people watching him, etc... after a week of working really HARD to adjust to something very new. VBS is very new to him, it is a short period of time (1 week) but is packed with unfamiliar things, transitions, parents not being there, expectations he likely doesn't fully understand, and then performing in front of a group with a group of kids, all at once (in his mind). By the end of the week he just had no more coping ability left. Then just as he finally got calm he had to go back in and it all hit him again, hence the second meltdown. It really is HARD to change how you look at his behavior from misbehaving on purpose to being unable to behave as expected. It is a giant shift in perception that takes the blame and much of the anger out. Of you can make the shift in perception you will then focus on helping him learn to be able to cope and to keeping expectations and the environment to ones he truly CAN handle. Once that is made and you understand what he can and cannot cope with, then you can start to help him learn to handle more intense stimuli and situation. I know it SOUNDS like you are "giving in" to his "bad behavior" (meaning the meltdowns). In reality you are teaching him how to learn to cope with more and more. It is a slow process. Lots of work. But so is almost every other aspect of parenting. Heck, even childbirth is no snap but we learned to muddle through, didn't we? There is a lot of grieving that we have to do when we truly realize the problems our kids have. When we truly see how these change the world for them it is super hard to accept as a parent. It is important that you allow yourself to grieve for the dreams you had for your child. What he would be like, how you would do this or that with him, what you would do as a family, the milestones he would reach and the memories you would make. No one asked for this, not the child or the parents. Our kids are on a path we never ever dreamed we would travel with them. It is full of so many good and not good and just plain awful things that we never dreamed would be part of OUR lives. We cannot accept the new path and embrace what we CAN have and enjoy with our kids unless and until we acknowledge that we are on this other path and that it won't be what we expected. Once we allow ourselves to grieve then we can accept where we are, who we are, who our kids are, and the journey we will travel together. While NONE of us would have chosen this path, once we are on it we learn it has incredibly rewards that we would have totally missed out on, that so many parents never get lucky enough to know. be gentle with yourself. Let yourself work through the anger and disappointment and grief. Remember that your son did not choose it either, but that he is willing to share it with you. I am so sorry about your job. It is a tough time to be out of work. I am disabled and fighting for disability and my husband has been out of work since August. File for unemployment as soon as you can. I would check it out online as soon as you can before you are laid off. Find out how much COBRA is for your insurance. There ARE federal grants to cover a big part of the cost of COBRA. File with social services for any aid you qualify for. Check into temporary agencies to see what opportunities are there. Some of the work might be working parking at football games, but it will help. This is going to be a really stressful time for the whole family. Don't forget that you can rant and vent here, as well as get ideas and hugs. If you cannot handle ideas it is okay to say so. Just tell us you need to vent, or rant, or whine or whatever, then let it out and ask for a hug. We won't mind. I promise. {{{{{{{{{{hugs}}}}}}}}}} [/QUOTE]
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