Give me the good/bad with ADD medications

[bethben]

Dd who is going to school because I am overwhelmed with other children is doing fine with school for the most part, but at her yearly physical, I was asked about if we wanted to have ADD medication for her. Let’s just say it’s obvious she has it. I’m meeting with her teacher tonight, but when is it good to start this if at all? She does fine with written work—anything on the computer (which seems to be 1/2-2/3 of work), she does lousy. I’m guessing her attention to computer articles and computer tests is not what it should be. So, is the medication a good thing-bad long term-or neutral?

 

If you’ve seen my other posts with my family, say a little prayer for me. I’m crying “uncle†and starting to wonder if I’m getting near my breaking point.

 

 

 

 

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[maize]

Can you get neuropsych evaluations for her? When possible I like to have as much information as possible to work with.

 

I would want an official diagnosis and an IEP in place; she needs to know that when she struggles with executive function it is not because she is lazy or bad or broken. It is because this is not a strength for her brain so she needs extra support and scaffolding and tools.

 

With medication, sometimes you just have to try and see whether it helps or not. We've done medication trials for a couple of my kids without seeing huge improvement but we are far from having exhausted available options.

Edited October 17, 2017 by maize

[bethben]

I’m already getting a neuro-psych for my ds for a different issue. Would I need such a thing for an IEP? I’m pretty sure the doctor would diagnose her with ADD. Her previous doctor already put wording to that effect in his notes. If she could have less computer learning, she would do better. Her grades on paper are A-A+, but they don’t factor in computer learning for some reason. Those grades are in the C-D range.

 

 

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[City Mouse]

A diagnosis of ADD or ADHD alone does not automatically qualify a student for an IEP. There has to be an "academic need" for an IEP, and what is required to show "need" can vary between districts. Most places where I have worked if the kid is passing than that is "good enough" and there is no "need"

 

For my DD, the right medication works wonders. Her doctor preferred to start with Ritalin based ones because it has been around so long that all the adverse side effects have been well documented. It can take time to find the right dosage and formulation- short acting or time release.

 

For what it is worth, I work with similar aged students (4th-5th grade) at a computer based charter school. It is not uncommon for some students to treat online work like it is a video game and just click to get done. Math can be especially challenging to the ones who think that since the math assessment is on the computer there is no need to work out the answers on paper first.

[maize]

A doctor can diagnose ADHD. Neuropsych provides more info, but I understand it is not always possible to do full evaluations for every child.

[bethben]

Well, met with the teacher.  My gut instinct was correct.  She is able to self regulate at this point enough to not have problems learning in school.  She even got on the honor roll (i question that based on some test scores, but it's what the main teacher and other teachers gave her).  My wait and see if her grades start to suffer plan has been working so far.  I guess I'm not opposed to medication, I'm just not seeing the need at this point.  I also still do want to know if there are negatives to medicating her in the future.

[PeterPan]

Coursera had a course on ADHD taught by a physician a while back. You might haunt there and see if they run it again. It would be the more thorough discussion you're looking for. When the issues outweigh the risks, you'll know and make the jump. 

 

You might, in the meantime, do testing for retained reflexes. 

[Mrs. Tharp]

Current research says that overall there are few to no negative effects to medicating but that it is more effective when done with behavior therapy. The book, Getting Ahead of ADHD, by Joel Nigg, outlines the most current research on meds, therapies, nutrition, exercise, etc. I highly recommend it as a jumping off point. 

[nature girl]

Well, met with the teacher.  My gut instinct was correct.  She is able to self regulate at this point enough to not have problems learning in school.  She even got on the honor roll (i question that based on some test scores, but it's what the main teacher and other teachers gave her).  My wait and see if her grades start to suffer plan has been working so far.  I guess I'm not opposed to medication, I'm just not seeing the need at this point.  I also still do want to know if there are negatives to medicating her in the future.

 

 

If she's able to self-regulate, learn and attend, I'd highly recommend getting a further evaluation, if possible. I'm sorry, I haven't followed your daughter's story, but what is it that has made you believe she has ADD? 

 

(ETA: I ask this only because the main symptom of ADHD is the inability to self-regulate attention and/or behavior.)

Edited October 18, 2017 by nature girl

[bethben]

I just Googled ADHD symptoms-- copy and paste time:

 

Easily distracted by extraneous stimuli.

 

Loses things necessary for tasks or activities

Forgetful in daily activities

Talks excessively.

Appears “on the go†or acts as if “driven by a motor.â€

Interrupts or intrudes on others (e.g., butts into conversations or games).

 

Every time I've ever gone into the doctor's office, she is all over the place.  She's talking talking talking, figiting with stuff, moving around, and having to go on the doctor's chair with the wheels (she's 10) when she's been told every single time we've gone to the doctor to not do it.  Every doctor we've seen asks me about if she has ADD.  She's not nervous and enjoys the doctor's office.  

She will stop moving when she's creating something, but her mood swings up and down - she blurts out what she thinks (at home), she frustrates easily, she interrupts people's conversations at the playground (I know this because she's insulted when they get mad at her), I've been telling her to not forget to do something daily for 6 years and she still hasn't gotten it, she has always done better outside because she can move around, and I could go on and on.  If we go on hikes in the mountains with her, I'm still nervous that she's going to do something impulsively and get hurt.  I treat her like she's five sometimes because she still acts like it in impulsivity.  She is very justice and rule orientated at school so she is determined to follow the rules set out for behavior which is why I think that goes better.  

[MerryAtHope]

Current research says that overall there are few to no negative effects to medicating but that it is more effective when done with behavior therapy. The book, Getting Ahead of ADHD, by Joel Nigg, outlines the most current research on meds, therapies, nutrition, exercise, etc. I highly recommend it as a jumping off point. 

 

Is this book mainly for helping children, or is it useful for adults with ADD?

[sbgrace]

Those things you posted--she struggles with those? It's affecting her relationships? Because a lot of what you describe there are the things I think the medicine (Ritalin here, short acting) help most for my son. Impulsive behavior (resulting in that intrusion/interruption; and just behaviorally doing whatever pops in the mind), behaving as if driven by a motor, constant talking, etc.

 

Now the attention, which is what I thought was the main issue based on your OP--well, you still have to attend to the correct thing. I also was going to say that I wouldn't necessarily assume ADHD if she was functioning fine academically outside of computer use. My son has better ability to attend medicated, but that doesn't mean he uses it to stay attending/he still struggles. He is better able to begin work he would rather avoid when medicated. 

 

Upside--you will likely find improved functioning, socially and academically when you find the right medication. 

 

Downside--it can take a while to find the right medication. Sometimes, often in our case, you try a med that has side effects. Sometimes those outweigh the benefits and the medication can't be continued. I'm sure it's also possible to try one that just isn't effective, we just haven't hit that. All ADHD meds my son has tried (I think 5) have helped, some a lot, but my kid is sensitive to side effects. In our situation those have most often been either insomnia or anxiety spike or both. He does fine with his short acting Ritalin. 

 

 

[bethben]

All of my dd's tendencies don't seem to affect most relationships.  There are some girls that really can't handle her tendencies, but she seems to have a lot of friends in her opinion.  I guess I'm OK with where she is now.  I am doing the research because I'm not sure long term as school gets more intense she will continue to be OK.  Ironically, if we decided to homeschool her next year, I would medicate her.  Her ADHD affects the homeschool atmosphere more so because she doesn't have the outside pressure to be acceptable to peers and a teacher.  

[nature girl]

The truth is, you won't know if your daughter will have negative effects until the time comes when you decide it's worth a try. We're lucky in that none of the meds we tried had horrible effects (one made her a little too emotional, the other more irritable when it wore off.) The med she's taking now has virtually no negative side effects at all, she hasn't lost weight, she falls asleep easily and isn't anxious, and it makes a world of difference. (As with sbgrace's son, it doesn't solve all issues. It makes her more willing to sit and start the work, but is less effective in helping her maintain attention, and to some extent she still has issues with emotional regulation. It makes a huge difference in her behavior and social skills though, and that was our main concern at this point.) Again it's worth asking, and searching to see what the potential issues might be, but they differ so much from child to child.

 

As an FYI, there is a meta-study that suggests the benefits might "wear off" after 2 years, which makes me believe it's better to hold off for as long as you can, until it really becomes necessary. As OhE said earlier, when that time comes, you'll know. For us, home schooling was difficult, but do-able because my daughter is an only child. Much as I loved being with her and teaching her, her behavior was starting to affect our relationship, which is why I made the decision to move her to ps. And she's severe enough that she wouldn't have survived in ps unmedicated, couldn't care less what the rules or social norms are (in fact she'd probably go out of her way to break them. We tried a couple of unmedicated school days last year, just to see, and they were miserable for everyone.) It seems like your daughter is much less severe. But again you'll know and hear from the teacher if the workload gets to be too much. And if it does, it's worth trying to see if any effects are worth the benefit. As I said, many kids have few to no issues. 

[Mrs. Tharp]

Is this book mainly for helping children, or is it useful for adults with ADD?

 

It's aimed at kids, but I think it could be helpful for adults too, absolutely.