Do ADHD meds improve processing speed?

[brownie]

Short history...DS has Asp and was just diagnosed ADHD inattentive based on very low processing speed. The psych put him on the lowest dose of concerta. None of us are particularly happy about the idea but we said we'd give it 7 days. The 1st day we thought - Wow! what a difference! even in his ability to carry on a conversation. Then he didn't sleep much for 2 nights :( behavior went down the toilet and we pulled him off for the weekend so he could sleep. We started again Monday. The last 3 days we see no difference and he has been sleeping fine. So confused! The thing is, it's surprisingly hard to find clear info on this on the internet.

 

What is the liklihood concerta will work in this case? I've seen messages that indicate it will only work if it's due to trouble focusing. I don't know that that is ds's main issue. After all, he has asp and I think even if he focusses he is a slow processor. Any info out there?

 

Brownie

[EKS]

I don't know if the meds improve processing speed or if they just take out the distracted periods that make the processing time even longer than necessary. I do know that when my son has taken stimulant medication, there is a huge difference.

 

From what I understand, it is known that drugs like Ritalin improve working memory, and that can actually have a effect on perceived processing speed.

 

All that said, my son has had four IQ tests, two on stimulant medication and two not. Here are the PSI scores:

 

Age 7, no medication, 9th percentile

Age 9, no medication, 42nd percentile

Age 12, on Dexedrine, 34th percentile

Age 14, on Adderall but at a suboptimal dose, 16th percentile

[PeterPan]

Kai, call me crazy, but did that just show that his processing speed went DOWN with the meds?

[MomatHWTK]

I may be totally wrong, but I don't think treating the ADHD will have any impact on the processing speed if it truly a "processing speed" issue. It is my understanding that those are different brain functions. A non-stimulant ADHD medication might solve the sleep problem.

 

Just my opinion, I can totally understand not wanting to give the medication much time, but I don't think 7 days is enough. Every time we have switched or added medications (even my own) we've seen huge dips and swerves for a week or two before the body adjusts and we can truly tell what's happening.

 

In our case we are dealing with several different issues, each with it's own treatment plan but processing speed is one that we accomodate- not treat. Behavioral therapy in the form of how to accomodate the processing issue would probably be beneficial. (We do a lot of 'recognize the issue/solve the issue' activities.)

[lisabees]

Behavioral therapy in the form of how to accomodate the processing issue would probably be beneficial. (We do a lot of 'recognize the issue/solve the issue' activities.)

 

 

 

Can you explain? Thanks. :)

[EKS]

Kai, call me crazy, but did that just show that his processing speed went DOWN with the meds?

 

 

That's what it looks like. I don't think the meds are causing it though. I think it is just that his processing speed didn't increase at the same rate as his peers, so the percentiles went down. I know that when he was taking Dexedrine, there was a huge difference in how long it took him to do math problems in his head, for example. Prior to meds, there would be a *long* pause and after meds, he would frequently have figured out the answer just as I was finished reading the problem (aloud).

[MomatHWTK]

I'll try to explain... Before, when DS wasn't getting his basic math facts, I wanted to make him keep drilling and practicing so that he could achieve the "instant" recall that makes higher math easier. Now, knowing that he doesn't actually have the ability to instantly recall some things (processing speed) I know that I need to accomodate that limitation. His therapist suggested that we use "cheat sheets" and calculators. DS is much happier moving forward with algebraic concepts that he understands rather than being held back because he can't call up the basic math facts quickly.

 

I am able to see that he really does understand complex subjects, but he is not always going to be able to recite dates and names. The steps in a math problem or a science experiment may be difficult for him to remember, but given a list is is more than able to understand those same instructions and make use of them.

 

Basically what I would consider "cheating" are for him accomodations that he needs. The alternative is to accept a great deal of frustration on his part and very slow work.

 

The other accomodation would be to learn to recognize that frustration and deal with it. The fact is that it will be frustrating to be working through a long division problem if you can't look at 42 and instantly remember what its divisors are. So we learn to deal with the frustration and use trial and error work arounds to keep the limitations from stalling us in our tracks. Long division and multiplication are particularly frustrating because in both you have to hold in short term memory the multiplication/division facts, the addition/subtration facts and the actual steps to the problem (i.e. I multiply here, add here, carry here, put a zero there...).

 

We are both learning to recognize processes that require a lot of short term memory storage and transfers from long and short term and then we can work together to come up with ways to modify the process.

[brownie]

OK so maybe 7 days isn't long enough. That surprises me bc it doesn't stay in your system long so to me it should be obvious day 1. And the only day we've seen improvement is day 1. In fact this week the careless errors have increased. I guess I should call the psych office tomorrow.

 

I have seen a number of people with similar IQ scores online....nobody seems to see a boost to processing speed with meds. So if it's actually a neurological connection issue and not a focusing issue for us, it stands to reason that this won't help and we are medicating for nothing. On the other hand, I want to give it a fair shot. DS claims it is helping a bit (don't know if he really knows) but is upset about the affect on his appetite. I don't know if he's made the sleep issue connection yet and I hesitate to mention it. What would be a non-stimulant ADHD drug?

 

Honestly, I swear we get just as good or better results on 2 cups of caffeinated tea.

 

[DyslexicParent]

What would be a non-stimulant ADHD drug?

Strattera and Intuniv are a couple of non-stimulant drugs used for ADHD.

[Ottakee]

It can take some trial and error to find the correct medication. The right one can make a HUGE difference. We use Dexedrine and my girls are both doing very well on it after troubles with Concerta and Adderal.

[Heathermomster]

I'm totally out of my depth here. Back in the day when I discussed possible ADHD with son's ped, she refused to write a scrip unless I scheduled a TOVA to ensure the meds were working. We took the np route and never tried the meds.

 

Maybe discuss getting a TOVA done to discern any measurable difference due to meds? Has anyone done or even heard of this?

[DyslexicParent]

Maybe discuss getting a TOVA done to discern any measurable difference due to meds? Has anyone done or even heard of this?

Yes, DD did the TOVA for the first time when she was being assessed for a non-drug treatment. She surprisingly scored over the 100 average, and this was one of the factors that the psychologist thought that she may have Asperger's Syndrome instead of ADHD. The psychiatrist, paediatrician and two other clinical psychologists had already diagnosed DD with severe ADHD.

 

[PeterPan]

Yes, DD did the TOVA for the first time when she was being assessed for a non-drug treatment. She surprisingly scored over the 100 average, and this was one of the factors that the psychologist thought that she may have Asperger's Syndrome instead of ADHD. The psychiatrist, paediatrician and two other clinical psychologists had already diagnosed DD with severe ADHD.

 

 

TOVA is pretty standard. Kinda makes you wonder about the other diagnoses that were happy to plack on a label without running it. Mislabels abound.

[MomatHWTK]

We went through a psychologist for testing and see a pychiatrist for medications. Our ped did prescribe one medication at the outset for the Aspergers issues (working with the pyschologist) but we quickly moved to the pychiatrist. There can be more than one issue and full testing and evaluation will help you pinpoint what might be going on better than just seeing the pediatrician.

[brownie]

The psychologist told us 90% of those on the AS have ADD anyhow. I really wonder though if it's the same root cause or not, and what the effectiveness rate is with ASP vs. straight ADHD.

 

I am not getting on the ferris wheel of 15 different meds and doses. I'm not just talking side effects. I see a lack of benefit here. If I saw a clear benefit, minimizing side effects would be one thing. But that does make me realize, I am going to email his dev ped on Monday. He knows more about Asp than the other docs. Thanks! Brownie

[Lecka]

My cousin has Aspergers and had major improvement with ADHD medication. But -- my understanding is that it helped with anxiety more than attention, and now he is taking anxiety and/or depression meds.

 

Anxiety and depression do not come across with him the way I think of them. A couple of years ago he was not doing well but in a spacy way, not paying attention. I had no idea he was actually depressed.

 

I think when you read or hear things, some kids/adults may have depression/anxiety and then a certain medication might work a certain way, that it might not for your child. I could really see the way he was acting coming across as a problem with processing speed.

 

[clarise2006]

I don't know if the meds improve processing speed or if they just take out the distracted periods that make the processing time even longer than necessary. I do know that when my son has taken stimulant medication, there is a huge difference.

 

From what I understand, it is known that drugs like Ritalin improve working memory, and that can actually have a effect on perceived processing speed.

 

All that said, my son has had four IQ tests, two on stimulant medication and two not. Here are the PSI scores:

 

Age 7, no medication, 9th percentile

Age 9, no medication, 42nd percentile

Age 12, on Dexedrine, 34th percentile

Age 14, on Adderall but at a suboptimal dose, 16th percentile

 

[clarise2006]

I work with many students who come in with attention and processing delays.  What I have learned in my training is that if processing speed is already delayed, then stimulant medication slows it down more.  If there are not problems with processing speed, then a low dose of stimulant medication may help.  The important thing to do is find out why there are attention problems and if processing speed is an issue.  My experience has been that many of the doctors prescribing the medication are not considering processing speed and prescribing higher doses than may be necessary.

 

[Kat w]

The NP we went to perscribed med for my guy with very low processing speed.

 

I haven't gotten them filled. She sweared by it. I've been having trouble making that leap yet tho.

OTOH, I feel like I'm doing him an injustice if it did work.

 

My DS 12 is on them. I guess, I probably should try it. Sigh.

Hard to know what to do in these cases. I know I need to try. ...jus..hard.

I'm going to follow this post to see what experience others have with it.

Hard. :/

Edited August 9, 2016 by Kat w

[Kat w]

Yes, someone mentioned intiv . we use that for nighttime for my 12 yo. He has it for a number if reasons, so it helps. I'm not sure for him we see an improvement in the ADHD part, it elliviated other things tho.

 

His ADHD is pretty...*powerful* lol. So maybe that's why we don't see it help the ADHD.

Edited August 9, 2016 by Kat w

[kbutton]

My kiddo on the spectrum had sleep issues with Adderall because of the extended release. He has had NO TROUBLE with 4-6 hour methylphenidate (we did have one generic that didn't work). It took some time to get the dosing right--we started small and worked our way up. Then we had a bump up after he'd been on it a while. He's still far from the max dose. He takes a second dose later in the day, and as long as he has it before 3 PM, he's fine for sleep. 

[Tiramisu]

Yes, DD did the TOVA for the first time when she was being assessed for a non-drug treatment. She surprisingly scored over the 100 average, and this was one of the factors that the psychologist thought that she may have Asperger's Syndrome instead of ADHD. The psychiatrist, paediatrician and two other clinical psychologists had already diagnosed DD with severe ADHD.

 

This is just too familiar.

 

For everyday, practical purposes, I'm starting to think it's better to just call it ADHD in cases like this. Clear, obvious attention issues are something people are very familiar with, while HFA is really so poorly understood even among specialists. If one says it's ADHD, teachers and others will understand the basic difficulties and will have some idea what to do. If you say HFA, they are clueless.

Edited August 9, 2016 by Tiramisu

[Tiramisu]

My cousin has Aspergers and had major improvement with ADHD medication. But -- my understanding is that it helped with anxiety more than attention, and now he is taking anxiety and/or depression meds.

 

Anxiety and depression do not come across with him the way I think of them. A couple of years ago he was not doing well but in a spacy way, not paying attention. I had no idea he was actually depressed.

 

I think when you read or hear things, some kids/adults may have depression/anxiety and then a certain medication might work a certain way, that it might not for your child. I could really see the way he was acting coming across as a problem with processing speed.

 

Another point about the meds with the ASD thrown in there, sometimes they help impulsivity more than attention.

[PeterPan]

This is just too familiar.

 

For everyday, practical purposes, I'm starting to think it's better to just call it ADHD in cases like this. Clear, obvious attention issues are something people are very familiar with, while HFA is really so poorly understood even among specialists. If one says it's ADHD, teachers and others will understand the basic difficulties and will have some idea what to do. If you say HFA, they are clueless.

 

That doesn't make sense to me.  If the attention symptoms are due to the HFA and there's not an actual or consistent inattention component showing up, that's your BIG CLUE that behavioral work would be effective.  The HFA/ASD diagnosis is essential to qualify for funding.  

 

It's pretty fascinating to see how much working on behavior, on social thinking, on noticing how other people are thinking and feeling, on self-regulation, etc., can improve the inattention symptoms.  My ds has one of those funky variable things, and for him the behavioral route has been very good.

 

Besides, telling someone they dc has ADHD when they have ASD would just set the teacher up for an expectations mismatch.

 

When I meet people who don't have a flying fig what to do with the information, I just say he has some SN, we know he has them, thanks by.  Then afterward I ask them if he had behaviors.  :D

[Guest]

The first part of this post was just temporary and I have now deleted it.

 

To the OP, read as much as you can and know your options. Then YOU and DAD decide what course of action is best for your child. There are other options out there and the doctors should be making these resources available, as our ped did.

 

I wish you all the best!

Edited August 10, 2016 by Guest

[Kat w]

.....not only is the HFA/ASD diagnosis important for funding, fir us, it's been essential in targeting therapies and making progress.

 

We hit a rut of spinnin our wheels for a short time. The diagnosis, changed the way therapy was employed.

 

I've worked with both boys, since my oldest was diagnosed , the same way. Knowing more 'how to' has made a difference for us.

 

Eta' and will be the course if action for future therapies.

Treating ADHD looks different than plans in place for HFA/ASD.

 

Maybe a different doc can refer you to different places/types if therapy? Maybe? :)

Edited August 10, 2016 by Kat w

[Tiramisu]

That doesn't make sense to me. If the attention symptoms are due to the HFA and there's not an actual or consistent inattention component showing up, that's your BIG CLUE that behavioral work would be effective. The HFA/ASD diagnosis is essential to qualify for funding.

 

It's pretty fascinating to see how much working on behavior, on social thinking, on noticing how other people are thinking and feeling, on self-regulation, etc., can improve the inattention symptoms. My ds has one of those funky variable things, and for him the behavioral route has been very good.

 

Besides, telling someone they dc has ADHD when they have ASD would just set the teacher up for an expectations mismatch.

 

When I meet people who don't have a flying fig what to do with the information, I just say he has some SN, we know he has them, thanks by. Then afterward I ask them if he had behaviors. :D

I would of course be honest with specialists like behaviorists and people qualified to work with this issue.

 

Our major difficulties are very specifically the EF stuff you have in ADHD, so I see calling it something teachers would understand and be able to address helpful. The NP told us directly to use strategies for ADHD.

 

I'm also influenced because I'm dealing with a teen with relatively mild behaviors and no history of behavior problems in school, who would have strong opinions on disclosing, etc. She was always a model student in terms of behavior, which is actually common for girls. She just forgot to do homework and hand things in, and that affected her grades because any late assignment in our schools is recorded as an F.

 

Like the PP, other specialists have thought it was ADHD so I'm not just making that part up for convenience. Even the NP admitted another NP may have given the ADHD label. On the day she did the computer ADHD test with the NP, she tried really hard, did well except for visual attention deteriorating, but came out crying from it. To me that's a problem, but not enough of one for our NP. Similar test on another occasion with the OT and she bombed. So who can really say.

Edited August 10, 2016 by Tiramisu

[Tiramisu]

I'm looking back on the original post.

 

I think Conerta is one of the meds that's supposed to be one of the more helpful ones, according to a research article someone linked here a while back, on using meds on kids with ASD AND ADHD. I don't remember anything about processing speed specifically, and processing speed is not an issue I am dealing with.

 

Something from that first post struck me. The WOW part. I went to see Temple Grandin speak this year and she talked about medication use, and she said exactly that. You want that WOW factor.

 

You might want to think about that WOW you had. Is it something worth recapturing? Considering you seemed ambivalent about meds in the first place. If you decide to, you might want to adjust dosage or change meds. What you see in the first few days is not what you'll see long-term, and that goes for the good and the bad.

 

We had a hugecWOW in the beginning and it was worth making adjustments. It helped behavior immensely but that was mostly for impulsivity. I also noticed comparing our long-term schedules, with the same curricula, work always was completed with meds. That wasn't the case without meds. And testing with meds was extremely successful. We had a long period off meds to clear a medical issue so I had an unusual opportunity to compare on and off behavior.

 

I'm not sure about the processing speed part. Are there any coordination problems? Your DS might be a candidate for Interactive Metronome and that was very helpful for self-regulation, divided attention, etc. we are not using meds at all this summer and we are still having fewer problems than before.

Edited August 10, 2016 by Tiramisu

[Guest]

Just linking what our pediatrician gave us as alternative therapies for ADHD. Linking it for anyone that may be interested or may find it useful.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796535/

[Guest]

deleted for privacy

Edited August 11, 2017 by Guest