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What's with the biting thing?
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<blockquote data-quote="Marguerite" data-source="post: 361628" data-attributes="member: 1991"><p>Terry, what you describe sounds a lot like rebound. What we have seen with rebound coming off ritalin (or concerta) is either an increase in aggression or an increase in emotional lability. Or a lot of stuff in between. With Concerta, you can also get rebound continuing into the next day, if medications are skipped. In other words, if you give your kid a vacation from medications over the weekend, then you will see some rebound on Friday afternoon (as with other afternoons) but also on Saturday (sometimes even worse) with things easing back to more stability on Sunday.</p><p></p><p>We found aggression was a big problem with difficult child 1 on any form of Ritalin. difficult child 3 tried Concerta and accidentally was on a lower dose than he should have been. We found some rebound, but also not as much benefit as we'd seen on dexamphetamine. Then we put the dose up to where it should have been and we saw even more rebound. With difficult child 3, the rebound showed up as extreme talkativeness (almost like pressured speech) and an increase in impulsivity. It wasn't really obvious to us because to a certain extent, as medications wear off you get a return to how the child is normally without medications. Rebound is where it's more than a return, it's a pendulum swing even further.</p><p></p><p>We were away for a family weekend while difficult child 3 was on Concerta, when we had the chance to compare and work it out. difficult child 3 forgot to pack his Concerta. Normally he would have a weekly pill container packed, but with the Concerta he'd been taking one pill from the bottle, so no need to carefully set out his pills (which he did under supervision). But he forgot to throw his bottle of Concerta into the family pill pack. We discovered this on the drive north, when difficult child 3's extreme hyperactivity and talkativeness about nothing at all, let us know he was unmedicated. I rummaged in my handbag and found an old bottle of spare medications (dexamphetamine) I always carried. It had enough for a day. husband rummaged and found HIS supply of spare medications - one dose. So we put up with the crud while we were in the car, and dosed difficult child 3 with a tiny amount of short-acting dex when we got to the family gathering mid-afternoon. We knew it wouldn't laswt long, but it would help. However, we were surprised to see the difference in him; although we knew medications were wearing off again very quickly, difficult child 3 was still able to sit quietly with his computer game and even talked to his uncle (fairly normally, not the 'pressured speech' stuff) about how to play the game. Next day we dosed difficult child 3 with a combination of short-acting and slow-release dex, knowing we were giving him a much lower dose than he really needed - and he managed to stay in fairly good control even so. It wasn't a learning situation and he was a bit bouncy, but he was not at all aggressive (verbally or otherwise) and he was controllable. Again as it was wearing off - no pendulum over-swing. No rebound.</p><p></p><p>It was a good comparison for us, it taught us a lot about the difference between a kid with rebound, and a kid who simply has worn off his medications.</p><p></p><p>The biting - certainly, it could be entirely rebound.</p><p></p><p>Also, since your son bit his friend, you know it's not just you. You know you shouldn't have spat your tea at him; if he had done that to you, you would have been angry and seeing it as a very difficult child thing to have done. I hope you apologised to him, at the same time as talking through the whole incident. He needs to know you are fallible too, so he can see that self-control is something within the grasp of everyone as well as something everyone has to work on, not just him. It sets a good example for your son and shows him how to apologise, if he sees you doing it when it is appropriate to do so. Especially if there is any Aspie component to him - these kids learn best when they imitate your example. Or the examples set for them by others. That is why, when a bad example is set, it is so difficult to undo the damage. And we don't always know when those bad examples are being set. A difficult teacher, a bullying classmate - they all undo a lot of what we are trying to put in place, as parents.</p><p></p><p>I can't recall - have you tried him on risperdal? It might smooth out the anxiety/stress component that could be a factor in this biting/rebound. That was where we saw improvement with our boys, although once they had left mainstream, there was less stress and anxiety, and therefore less need for the risperdal.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 361628, member: 1991"] Terry, what you describe sounds a lot like rebound. What we have seen with rebound coming off ritalin (or concerta) is either an increase in aggression or an increase in emotional lability. Or a lot of stuff in between. With Concerta, you can also get rebound continuing into the next day, if medications are skipped. In other words, if you give your kid a vacation from medications over the weekend, then you will see some rebound on Friday afternoon (as with other afternoons) but also on Saturday (sometimes even worse) with things easing back to more stability on Sunday. We found aggression was a big problem with difficult child 1 on any form of Ritalin. difficult child 3 tried Concerta and accidentally was on a lower dose than he should have been. We found some rebound, but also not as much benefit as we'd seen on dexamphetamine. Then we put the dose up to where it should have been and we saw even more rebound. With difficult child 3, the rebound showed up as extreme talkativeness (almost like pressured speech) and an increase in impulsivity. It wasn't really obvious to us because to a certain extent, as medications wear off you get a return to how the child is normally without medications. Rebound is where it's more than a return, it's a pendulum swing even further. We were away for a family weekend while difficult child 3 was on Concerta, when we had the chance to compare and work it out. difficult child 3 forgot to pack his Concerta. Normally he would have a weekly pill container packed, but with the Concerta he'd been taking one pill from the bottle, so no need to carefully set out his pills (which he did under supervision). But he forgot to throw his bottle of Concerta into the family pill pack. We discovered this on the drive north, when difficult child 3's extreme hyperactivity and talkativeness about nothing at all, let us know he was unmedicated. I rummaged in my handbag and found an old bottle of spare medications (dexamphetamine) I always carried. It had enough for a day. husband rummaged and found HIS supply of spare medications - one dose. So we put up with the crud while we were in the car, and dosed difficult child 3 with a tiny amount of short-acting dex when we got to the family gathering mid-afternoon. We knew it wouldn't laswt long, but it would help. However, we were surprised to see the difference in him; although we knew medications were wearing off again very quickly, difficult child 3 was still able to sit quietly with his computer game and even talked to his uncle (fairly normally, not the 'pressured speech' stuff) about how to play the game. Next day we dosed difficult child 3 with a combination of short-acting and slow-release dex, knowing we were giving him a much lower dose than he really needed - and he managed to stay in fairly good control even so. It wasn't a learning situation and he was a bit bouncy, but he was not at all aggressive (verbally or otherwise) and he was controllable. Again as it was wearing off - no pendulum over-swing. No rebound. It was a good comparison for us, it taught us a lot about the difference between a kid with rebound, and a kid who simply has worn off his medications. The biting - certainly, it could be entirely rebound. Also, since your son bit his friend, you know it's not just you. You know you shouldn't have spat your tea at him; if he had done that to you, you would have been angry and seeing it as a very difficult child thing to have done. I hope you apologised to him, at the same time as talking through the whole incident. He needs to know you are fallible too, so he can see that self-control is something within the grasp of everyone as well as something everyone has to work on, not just him. It sets a good example for your son and shows him how to apologise, if he sees you doing it when it is appropriate to do so. Especially if there is any Aspie component to him - these kids learn best when they imitate your example. Or the examples set for them by others. That is why, when a bad example is set, it is so difficult to undo the damage. And we don't always know when those bad examples are being set. A difficult teacher, a bullying classmate - they all undo a lot of what we are trying to put in place, as parents. I can't recall - have you tried him on risperdal? It might smooth out the anxiety/stress component that could be a factor in this biting/rebound. That was where we saw improvement with our boys, although once they had left mainstream, there was less stress and anxiety, and therefore less need for the risperdal. Marg [/QUOTE]
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