? about ADHD symptoms and medication

[sbgrace]

My son has a pdd-nos diagnosis that he received at 2.5. He's one of those "fits but doesn't" kids and I honestly think he might be better identified as NVLD if we were to pursue further testing.

 

But, I really think he also has ADHD. I know spectrum stuff can blend but there are a lot of ADHD specific symptoms (combined type--major attention issues but also hyperactive and impulsive).

 

Teaching him is hard because he is so easily distracted. I am constantly redirecting and refocusing-even in the middle of a single math problem. But he learns. I can accommodate well enough that, so far, I think we're doing ok educationally. There are concerns with weight issues on ADHD meds (we struggle with failure to thrive) per his geneticist. So I have always felt as long as we could manage educationally we'd just do that.

 

But it's the impulsive stuff and impacts there that I wonder if medication would help? It's almost (unintentionally--he's not thinking about what he's doing) destructive. I know it puts other kids off though the social stuff alone would probably do that anyway. I'm sort of fed up. He just doesn't think through his actions. Even when he does he has a very hard time not following through with impulses anyway.

 

Would ADHD meds help with impulsive behavior? Would they help with constant fidgeting and talking? Do they, instead, mostly help with attention and focus?

 

How do you weigh pros and cons?

[jujsky]

I could have written large portions of your post. My son wasn't diagnosed pdd-nos, but he fit much of the criteria. He also fits the criteria for NVLD, though because it isn't in the DSM, so it's not considered a valid diagnosis.

 

We had him evaluated at Children's Hospital in Boston almost a year ago, and he was officially diagnosed with ADHD (combination type -- he sounds VERY much like your son -- fidgety and impulsive), developmental coordination disorder, and learning disorder-nos (which I truly think would be classified as NVLD if it was recognized as a separate disorder).

 

I have always struggled with the idea of medication. I felt that medication wasn't necessary in most cases and should only ever be used as a last resort. We tried everything else. We tried fish oil supplements. We tried various behavior modification therapies. We did pretty much everything except dietary changes because he's so incredibly picky that if we started cutting things out he wouldn't eat anything at all, and he's already so thin. I always maintained that medicating him would be my absolute last option. Well, we got there. We started medicating him this summer. His pediatrician is wonderful, and we share the same views about medication and ADHD. He started him on the lowest dosage of Concerta possible, and he did constant rechecks. Where DS's weight is already an issue, he checked him more frequently than is typical. After 6 weeks on the first dose and no behavior changes, he upped him. He was on that for another 6 weeks with no changes, and then he upped him again. We saw a difference within a couple of days.

 

You know when you have a rare, really good day with your son and you see this focused kid with all this potential? One of those days when all of his good attributes shine through? It was like that, only instead of it being a rare day, it's all the time. I was so scared medication would change him and turn him into a zombie-shell of his former self. I was afraid of losing the light in his eyes and his sense of humor. It's all there. All the good parts of him are still there, but the negative behaviors are dialed way, way back. I'm glad he was 9 when we found the right dose because he was able to tell me how it made him feel. He told me before there was a lot of noise in his head and so many thought whirling around at once that he would jump from one thought to another and couldn't concentrate. Now he can focus on one thing at a time. Given the choice, he says he would stay on the medication. He says, "I like that I don't get in trouble all the time." He's doing better in school. He's doing better socially. He's not nearly as impulsive and he's able to focus so much better on everything. It is amazing to see him in the morning before he takes his meds vs. after. Before he takes them we'll tell him to get dressed and make his bed. 10 minutes later we'll call up and ask if he's dressed yet. Nope -- he was going to get dressed, but had to do this or that, and that reminded him he needed to do this other thing, and then a bird flew by his window and he stopped to look at that, etc. After he's taken it and it kicks in, the distraction-factor is more in line with that of my neuro-typical daughter's. He still fidgets, but not as much. He still talks excessively, but when I tell him he needs to wait or hold onto his thought for a minute he is physically able to do that now. His focus is ....well, he CAN focus now. Before he couldn't at all, and now his focus is what I'd consider normal for a 9 year-old boy. He's not nearly as impulsive as he used to be. Instead of lashing out and hitting his sister, he balls up his fists and says, "I really want to hit you right now!" He's able to hold back and stop himself from doing things where before he would just do them without thinking, and would honestly say, "I don't know why I did that," when we'd ask him why.

 

He did drop weight, to the point where I was alarmed (5 lbs in the span of 4 weeks is a ton for a kid who is already scrawny) but at his last meds check-up his weight had gone up. The pediatrician said that is to be expected once he stabilizes and his body is used to the medication.

 

I'm not into a one-size-fits-all approach, so please take my story for what it is -- my personal experience with this. Your experience may be different. We tried so many other things and this was the only thing that gave us good results. My kid is finally happy and the white noise inside his head is mostly gone. For him and for our family, medicating him was the best decision we could have made.

[Tokyomarie]

Julie, I just wanted to stop by and say I'm happy to read your good report. I remember that frustrating time when you your son was evaluated. It sounds like things are going much better now.

[jujsky]

Julie, I just wanted to stop by and say I'm happy to read your good report. I remember that frustrating time when you your son was evaluated. It sounds like things are going much better now.

 

Thank you :) Everyone IRL who knows him has remarked on how much he's changed. The best thing is the changes he sees in himself. Everything is clicking for him and he's realizing his true potential. It's beautiful and gratifying to witness it.

[Ottakee]

My 16dd fits the same profile. We held off on medication until one day at about 7 or 8 years old she bolted across a busy parking lot because" you don't have to watch for cars EVERY time". She was so impulsive that it was causing trouble.

 

We tried a few meds but settled on Dexedrine which works very well. No weight loss either.

[DyslexicParent]

I used to think it was silly to consider evidence-based medication as the "last resort" when there are so many snake oil and useless "cures" being pumped and tried by desperate parents. Unfortunately, all the ADHD drugs prescribed have failed, i.e., we did not notice much benefits compared to the side effects. I am now trying to figure out which of the "unscientific" alternative treatments I should try first to help my child and hopefully she will be off the drugs one day....

[Guest Krista Lueders]

My son was diagnosed with ADHD 2.5 years ago and we struggled for about a year (though Kinder) with therapy, diet changes, just about anything to not have to put him on meds. We were lucky that he was able to be in a private school that year and there were only 6 children in his class, but he was still in trouble daily. There was one boy in the class who would have bad ideas and my son would, on impulse, follow along. When asked about his actions, he knew they were wrong, but that thought never crossed his mind at the time. As he went into first grade, we had to switch to ps, and I decided to try the meds. We saw a change the first day. He's currently on Concerta and Intuniv. Normally, Intuniv is an evening pill, but he was getting to the point of paranoia at bedtime, seeing shadows moving and being convinced that someone was going to hurt him in his bed. We talked to his doctor and he suggested moving the pill to in the morning. Evenings are sometimes challenging, once the meds wear off, but during the day, he is focused, attentive, and not at all "zombie-like". He still has his personality, his quirks that make him who he is, but he's not destructive, he's not as quick to anger. I'm hoping that in the next couple years, we can work towards not needing his meds, but for now, it's working.

 

We are also having the weight issues that have been mentioned. DS is 7 and weighs 46 pounds, the same as DD, who is 5. He doesn't eat dinner much, and lunch is usually a Lunchable that goes half uneaten. We keep a "snack drawer" in the pantry that has healthy snacks such as granola bars, snack crackers, and protein bars (Clif makes a great children's protein bar called "Z-Bar" that my kids love!!! I find them at Target) and the kids can get snacks from there if they're hungry. They also have a drawer in the fridge with yogurt and fruit cups that they have access to. I've found that around 8pm is when the meds are fully out of his system and he is STARVING!!! He will usually finish his dinner plate at that time and then move onto the healthy snacks. I let him have one "non-healthy" snack if the dinner plate is cleaned, but after that, it's healthy only. That system seems to work for us. Hopefully you are able to find a system that works with your DC also!

[Nakia]

My youngest dd, Cora, who turned 7 this past Sunday, has been on ADHD meds for about 6 months. She started on Adderall, but it decreased her appetite so much that she ate next to nothing for the 11 days she was on it. We switched to Concerta, and she's done very well on it. I will go so far as to say it has changed our lives. I could (almost) deal with the hyperactivity, but her impulsiveness was so severe, I was literally scared for her. She just could not be reasoned with, and she did things you'd expect from a toddler, such as running out in to a busy parking lot at the grocery store or climbing on to and jumping off our vehicles. She just didn't get the danger. The hyperactivity was interfering with her learning, and I couldn't get much done with her older sisters because she was literally sucking the life out of me. I feel bad saying that, but I'm just being honest. It was so sad. I just couldn't enjoy my girl; she was so exhausting.

 

I enjoy her again. She is spunky, full of life, loving, happy, joyful. She's still the same girl, but now I can talk to her, and she listens. She has learned so much over the last 6 months about controlling herself. She still has a long way to go, and we just upped her Concerta dosage, but our home life is so much more peaceful. My biggest fear was that she would be in a stupor and not her lovely self, but she is still Cora. <3 She told me about a month after starting the Concerta that her brain "feels better." The meds definitely help with her constant fidgeting and talking, though she still fidgets and talks a lot, lol. I can deal with that though.

 

Another unexpected advantage of helping her by starting meds is that I've been able to devote more time to my middle daughter, who has (probable) LDs and vision issues.

 

Now as far as weight loss, she did lose 2 lbs, which was 5% of her weight, in a 3 month period. Her weight as stabilized, but she hasn't gained anything in 3 months and isn't back to where she was when she started meds 6 months ago. Her weight has dropped from the 50% for her age to the 25%. Her doctor is concerned, especially since we increased the Concerta dosage. Currently, I am just feeding her a big breakfast and realizing that she will just pick at her food during the day. Then she usually eats a big dinner and is ready for a big snack around 9:00. I'm trying to increase her calories by offering more dairy and other healthy calories. It's a challenge, but we're just going to keep plugging along.

 

Hope you can find something that works with your kiddo!