The more I consider it, the more I begin to think something like this might actually work for me. A routine, and the pics can be of anything.

Sigh. I do a horrible job of taking pictures to begin with. For a long time, I didn't have a phone with a decent camera, and hate keeping track of an actual camera, so I hardly ever took photos. I still rarely take photos, though I have a decent phone camera now. For me personally, if I am taking a picture of it, I am not fully appreciating the moment. I'd rather be 100% there. And I really, really, with all my heart despise how people now insist on documenting every dang activity with a picture. I think I've swung entirely the other way without fully meaning to. (This is not directed toward the pp who documents things in their week. That's different.) I do need to take more of the kids, whether I enjoy it or not. And figure out albums and such.

Thank you, that is very helpful. I hope the NP turns out to be good.

I've thought about this possibility too. Sometimes it seems like this might be a piece of it, and then other times not.

Is it common for counseling to be required along with adhd meds? We were referred to a local counseling center, with the thought that they had available telehealth visits wih a pediatric psychiatrist. However, the therapist who called to set things up said it's not a pediatric psychiatrist and recommended a pediatric psych NP in a town about an hour away. She also mentioned that the psychiatrist they work with requires therapy along with adhd meds. I asked what kind of therapy specifically, and she said just general play therapy. As an aside, it was a bit odd, as she gave an example of a child she worked with who was coloring and drew herself burying her mother in sand. "So you can imagine what *that* means." I kind of felt as if she were already mentally deciding dd's issues were our fault. I'm open to the idea that we could be doing something wrong, no one is perfect, but I really don't think we have *caused* her adhd. It was just odd. Anyway, I'm just wondering if it's a common thing. It was mentioned above that some peds prescribe adhd meds, I think, and I assume they're not doing therapy with it. While we're not necessarily opposed, I hadn't really considered it. Eta: thinking about it more, we actually would be opposed if the counselor does not have experience specifically with "Asperger's". My husband (on the spectrum) and I both have found that it is less than useless to work with a counselor who does not "get" it.

This does sound like dd. If she had impulse control and could calm her mind a little, (in other words, if we find the right med), I think she'd be very much able to be reasonable about it. She's always been most compliant when she fully understands the reasoning behind something.

My husband introduced us to The Crafsman SteadyCraftin channel. It is calming, interesting, hilarious . . . all at once. It wouldn't be everyone's cuppa, and I'm not as into it as dh, but we all enjoy it.

For me, personally, one thing about crochet items in particular is that so many at craft fairs and such are in colors and patterns that are not modern at all, like in a way that I'd never have it thrown over my couch or something (or wear it) because it would be too clashing. (It's not like I'm on the cutting edge or anything, I just mean in general). Since your daughter is young, she's probably using more modern colors and patterns anyway, but just thought I'd throw that out there. Eta: I'm another one who will rarely ask for prices. I really don't like it when the price isn't visible.

Thank you, that is *very* reassuring. Now I only need to worry about it entering the toilet while I am sitting down. The odds of that happening do seem slim.

🤯😬😱🤮 I just postponed my trip to the bathroom. Now contemplating the horrors of this possibility.

Thank you! Impulse control and attention are the two specific areas that would really make a huge difference for her. That's great to hear about the food. The more I think about that, the more ok I feel about it.

Yeah, every couple years what has been working no longer works, and it takes a few months to get settled, then it's fine for another couple years. Not T4 only. It's not a huge deal, just that the change and figuring it out is so disruptive to everyday life. Any dr visits take a whole day each, due to travel, plus whatever I'm not doing bc I feel horrible. That's why I really hope this telehealth thing works out. I'm probably just projecting and it'll be fine for her. 😜 Yes, her being picky is mostly due to sensory. She's not badly restricted in what she eats. Protein and fat-wise, she likes beans and will do a bit of PB too, and whole milk dairy. Cashews. She's not big on guac, but we may try those, thanks. I was pretty picky as a child (and still am on some items), so pretty understanding. I think also she just burns a ton of calories. She is *constantly* moving.

Thank you, @Storygirl that's very helpful. A pediatrician is an hour away, we don't have any locally. We actually just saw a NP for the kids' yearly yesterday, and he said that typically in our area it will be a pediatric psychiatrist who prescribes and oversees it. He put in a referral to a counseling center very near us that he thinks is working with a psychiatrist via telehealth visits. Since that is only a few minutes from us, I'd like to try that route first. We should hear from them next week. DD isn't underweight now, but pretty thin and a picky eater. So we'll have to watch it closely. Thank you for the suggestions on meals. Though I do feel we're at that point, I'm a bit bummed that this likely is the start of years of needed adjustments for her. I mean, I know it's necessary. Shoot, it's necessary with a lot of types of meds. My thyroid meds work for a while and then don't, and then it's a pain to get it settled again, and then . . . on and on, same cycle. It's just a pain and frustrating. But, of course, the effects are worth it.

Oh, I bet that's where I heard it too.

It's crazy the things I missed. Unfortunately, I did not think I liked history for a number of years into adulthood, and kind of avoided it. (Wonder why?) I wish now I had used those years to learn more, because now I don't have the time. Well, I'm learning along with the kids, of course, so in another decade I will be more knowledgeable. 😄 I don't remember ever hearing about the internment in school, but I did know about it. There's plenty more I don't know, though.

We never made it past the Civil War in any history class I ever had, with one exception. Every year, we worked straight through the book and ran out of time toward the end of the Civil War. (I do not recall ever studying world history in school, only American.) The one exception was a class in 10th grade that I assume focused exclusively on WWII. I assume this because all I remember from that class is the "Kill Japs!" motto the teacher repeated daily for the whole semester.

What has been the response from the company so far?

Another thought, I so much appreciate having read experiences here about people who wished they had medicated earlier and/or about how their dc felt/feels about it. Prior to reading here I had mostly just heard from people who refused to medicate. Maybe that was the right choice for them, and that's fine. But it's good to realize that there *can* be good outcomes and there *are* circumstances where the current or future outcomes from not medicating outweigh other concerns.

No, surprisingly, I'm not concerned about what anyone will say. I have moments, of course, but my concern about what other people think has diminished considerably in the last few years. 😂 I feel like we've done what anyone can reasonably do already, and as you say, *she* is expressing her own need for something more. If an 8 year old can articulate to me that she needs help making her brain work better, that she wants to control her body and is unable to, that she cannot seem to make herself stop and think even for a second . . . and I have access to a means to likely make that happen (with what we consider an acceptable amount of risk as far as side effects, etc) . . . then it's hard for me to justify *not* doing it. Eta: Re it being hard to have perspective . . . I was meaning that sometimes it's easy to view things as normal that really aren't. Especially now when we're not around other kids much. I accomodate so much just naturally, and it feels normal. Just hard to have accurate perspective right in the thick of it. Like, I went back and read my first post to dh and realized - I'm describing a bright child who *purposefully* jumped into a small fire simply because she could not give it a half second's consideration. And I'm asking, have we reached the point it's a problem?!? Duh! That ship has sailed. But at the time, and even when I was typing it, it's just one more thing. Normal. Good advice on that last, thank you. We will definitely keep her involved.

Lol I wish I was energetic! I'm highly motivated, that's it. 😁 And thank you, I feel encouraged. It's hard to have perspective when you're right in the middle of it.

Her comments are partly from the interoception and zones work, and partly because we've always just talked about stuff like that. 😁 I agree, I feel like the interoception and zones is helping us now, but the real benefit will be in a few years when it has become automatic. I'll look into the l-tyrosine, thanks.

She usually eats eggs, oatmeal, and whole milk. Do you mean higher protein than that?

No, she's never been aggressive at all. We did a lot of OT when she was little (I'd have to look up the dates, but around 2-3 years old. Also, last summer we did a fresh eval with the developmental optometrist and (I'll pull up the report and check for sure) I think retained reflexes were specifically checked and she had none. Both when she was little and during vision therapy, we worked specifically on retained reflexes. There isn't a local OT here; however, ds will likely be getting some OT soon and I was thinking I'd do an eval for her too since we'll be there anyway. I've put that off because OT is just such an endless pit and I wasn't ready to dive in again. We're working on interoception and zones here at home. Not that a trauned OT wouldn't be better - I'm sure it would - but just to say that she does have a few tools in that area. If I could find an OT with training in this area, it would be great bc dd would respond better if someone other than me were encouraging her to do it.

We've just about decided to try meds wih dd8. (ADHD combined, severe. Also ASD1) There have been some instances lately where she's done kind of crazy things and she has really started to recognize and dislike feeling like she can't control herself. (for example, leaping down from their fort directly into a bed of hot coals ("I just wanted to do it, so I did it. And, mom, my feet hurt. Why, why, why doesn't my brain stop to think?!?" Fortunately, she moves fast and had only a couple small closed blisters.) She's been drinking coffee in the mornings, and it definitely makes a difference. She says it "slows my brain down." It seems to just kind of take the edge off behaviors, and make it where, with a lot of effort, she can use tools to calm down and accomplish things. She still frequently makes comments like, "it's just soooo hard all the time." Or "it feels impossible to just stop and think." It really does seem to me that she has to constantly work to control things. While coffee makes it bearable for the rest of us, I'm concerned about her. She's working as hard as she possibly can, and things are really just at an acceptable level, not optimal by any stretch of the imagination. My instinct is that she would enjoy life so much more if she could not have to work so darn hard every moment. Even in something as small as a math problem - she has the knowledge where she could actually be having fun (on a couple of good days, where she could focus well for a few minutes, she's even commented with surprise, "this is actually fun!") but it's like she just can't hold on to the thoughts long enough. Am I feeling right, that we've reached (passed) the point we should definitely try meds? If so, is Ritalin the place to start? She does *not* need her appetite suppressed, and we were thinking maybe could take it after eating in the morning and then would be worn off for a meal later. Any thoughts on this?

I believe I would speak with someone higher up in the insurance company as well. We're in the middle of something similar, and it sounds like the same process has happened with us, BUT when the provider and collection agency contacted me *after* receiving the balance bill letter (which informed them that they are now dealing with the lawyers and not me) I notified insurance and their lawyers took care of it. I haven't heard from them again. (Ours is different in that the provider doesn't need to provide anything; it's a bill that was audited by insurance and adjusted, and the provider is billing the patient for the adjustment.) So while it sounds like your insurance has started the process, it doesn't sound like they're following through in a timely manner. I have no idea as to any legal obligation the insurance company actually has. But it seems like usually they have some kind of dept to do things like this. I'd try to talk to someone in that dept who can move things along, if possible.