at a loss | ADHD Information
The Tenex may make her tired at first, but that WILL go away. Good luck!I emailed her psychiatrist last night w/ the details of our weekend and week on Daytrana, and he told me to take her off of it and start the Tenex. I will start it tonight. He wanted me to email him by Thursday to let him know how it is going.
This all makes me so nervous--I just want it to work and for her (and me) to have an easier time.
[QUOTE=MetisRebel] [QUOTE=masd]Thank you so much for responding. It is so nice to have people to bounce these things off of.
School ends May 25. She doesn't need the meds for school at this point, so we could definitely take a break and work on getting the meds straightened out after school is out. It seems like just putting off the inevitable, so I'd rather get to working on finding the right med (that's my personality).
What does "breakdown" mean? Cries? Has tantrums?
By breakdown, I mean meltdown, I guess--tantrums and crying whenever she doesn't get her way. There are different degrees of fits, of course. Today we got into the car to have lunch for Mother's Day. DH had made reservations at an Indian restaurant. DD decided she didn't want Indian. Hates it, in fact. So she sat in the back of the car and cried and moaned the whole way. (then went in, acted okay, ate a ton). Then we went to Home Depot to buy a few things we needed. She refused to get out of the car because she wanted to look at the plants and we weren't going to do that. She asked what we were going for, I told her, she said, "So we aren't going to look at plants?" I said we were not, so she started crying and yelling. If she hadn't thrown a fit, I would have been glad to walk through the garden center with her, but once the fit starts, I can't really do that anymore.
Can you analyze what the difference is between home and school? Does routine help?
I think the difference between home and school is structure and peer monitoring, if that is the right term. We have structure at home, but it isn't the same as at school, you know? They move from center to center in class, they have Spanish on X day, religion on X day, they go to exactly the same playground at exactly the same time. I think the teacher tells them the rules before they go out (don't hurt anyone, physically or with words). I think part of it is that the kids keep each other in line. I do have routine at home--we get up at the same time, go to bed at the same time, I repeat the rules, etc., but it doesn't seem to have the same effect. I will think about this some more and see how I can bring more of the school routine home.
On the hitting--have you tried using kind physical restraint [where you 'hug the child down' and then ask them if they feel in control yet] so her brother is safe and she can "wear off" the excess energy? Has anyone suggested it?
The hitting is weird. It's not like she just loses it and hits him over and over. She hits him or pinches him, then stops. She often leaves the room or immediately apologizes. She knows it's wrong, but she cannot seem to control the impulse. Sometimes she apologizes, other times she looks up because she knows I am coming and says, "Well, he hurt me first." That is usually a lie, and it doesn't make it okay for her to hit him anyway, so it doesn't get us very far.
[/QUOTE][/QUOTE]I've got a few ideas from working with difficult adults and a few foster kids. Can't say they'll work but you can try and I could be wrong but I think I would try the following:
Preparation:
Have you tried offering the reward BEFORE you go? "We are going to the Indian restaurant and the mall. If you behave well, no hissy fits, no hitting [insert whatever] THEN I will take you to look at the plants [get a video, whatever]
The other one I've learned is don't buy into apologies.
I know this sounds really cruel but it my experience--it isn't. Apologies are only useful if someone does not repeat the behaviour they are apologizing for.
Make her take responsibility for hitting her brother. Don't ask either because you don't want to give her the opportunity to lie--and don't ask "why" because at her age, she doesn't really know most of the time.
Example:
"You hit your brother. He is crying now. Do you like it when people hit you?"
SILENCE ON YOUR PART. I know it sound cruel but make her answer "No" even if you have to repeat the question. No matter what happens get that answer.
Then ask:
"If you were the mommy what would YOU do about it?"
And don't let the kid off the hook until she comes up with a real answer. She'll try many tricks to get out of the responsibility. [all kids do--not just yours]
The other thing is--don't get stuck in the negative. Try to find some things she can help with [say, baking cookies] and praise helpfulness as much as you can. If she lends her brother a toy--tell her that was very nice--that sort of thing.
We often get so overwhelmed that we forget the kid does some things right. Also, as hard as it is--stay as neutral as you can [that's easier said than done].
I also suggest that you get a good sitter and get out more. Difficult children can drag us down with them if we don't have some quality of life, left!
MetisRebel39215.6333333333[QUOTE=Diane V]
well I guess you're right you are putting off the inevitable. For me, when my head not all wrapped up in school I can think better. Sorry turning it into me.
Sounds like you just havent hit the right "mix" yet. We've recently added Tenex for tics, some days she has none, then there's days like today that it is AWFUL> but I can say she is CALMER on the Tenex. Try to hang in until you do that.
[/QUOTE]
I don't want to make it harder than it has to be, though--so maybe it is better to take her off of the meds for a little while, then figure it out this summer. But how long do you usually try something before figuring out whether it works or not? Do our 5 bad days on Daytrana count for anything, or does it take weeks to figure out whether something is going to help?
The psychiatrist says the Tenex works well for ODD, so maybe adding that in will help. I know how hard this all is on me as a mother, I cannot imagine what it must be like to be inside DD's head dealing with all of this.
The tenex alone could be a good way to go for now. Make sure to start really low an make small changes. We started at night for a few days then added the AM dose; and for each increase we started it at night first for a few days. This allows the body to adjust to the med and can reduce drowsiness and other potential side effects. My youngest is on 2mg AM and 2mg night with a 1/2mg booster after school for demanding social situations. This has worked well for this school year.my expereince is 5 days is plenty to see a result, but others on this board will say it can take longer. To me extreme unhappy doesnt go into bliss, but use your judgement. After three plus years we are also waiting it out until summer to again try a different plan. For others they hit that right "mix" right away or within a year, you just dont now. Sorry, not trying to be blesk, just that it WILL work out. I agree with Vickie, give the Tenex a try...............you'll see some result there. That does take a bit of time to sort of level out.
You may also ask about Adderall which is a stimulant medication but it is in a different family as compared to ritalin, concerta, focalin, and Daytrana.....my son tried all of the above and the best is Adderall...the others made him crabby
Good luck
As I was reading the posts, I was thinking the same thing that vickie posted. Tenex alone for now. It seems like her main issues stem from impulsiveness, hyperactivity and over the top reactions to small (to us) events, which are things that Chase had issues with on the stim as well. He is older, so he also needed help with focus, which, since your daughter is younger, she may not need for years if ever. Tenex alone may be enough to curb her hyperactivity, impulsive behaviors and smooth out her moodiness.With the trouble you are having with the stimulants it may well be worth a try! Talk to your doctor about it and see what he/she thinks about trying tenex alone, then adding the stim later if needed.
OK, I will tell you all of the above. Trust the professionals, you are doing everything right. I wont say DON't second guess beacuse I've been doing this for years and STILL second guess. My daughter still struggles with meds. She has such AWFUL tics it breaks my heart, but we stick it out until the end of the school year...............again.
Now moving forward, when does school end? Can you just take a break? Maybe she cant handle the methyphedinate family of drugs (we can't). All your meds have been in this family. It is SO, SO difficult to wait it out. There are so may options out there you dont have to all be unhappy, but it takes so much (stupid) time, it is not easy at all.
oh and dont apologize for anything [QUOTE=masd]First of all, I apologize for basically posting the same post over and over again for a week. I'm just so confused about what is the best thing for DD.
It IS confusing--especially right now that dd is struggling and so are you. Post all you need to if it will help relieve some of the stress you're feeling.
DD's issues are a lack of impulse control and inflexibility, mostly. She seems to have a plan in her head of how she wants life to proceed, and whenever there is a change (the "right" person doesn't want to sit by DD, I say "no" to her, etc), she has a complete breakdown.
What does "breakdown" mean? Cries? Has tantrums?
Her IQ is very high, but she is in the lowest reading group in kindergarten because she can't sit still to read and refuses to try anything that is hard for her or requires some focus and persistence to master. The impulsivity is a major issue at home--she hits her 4 YO brother all the time, she spills and breaks things, and so on.
On the hitting--have you tried using kind physical restraint [where you 'hug the child down' and then ask them if they feel in control yet] so her brother is safe and she can "wear off" the excess energy? Has anyone suggested it?
DD's issues have not been at school, though her teacher has noticed. DD attends a centers-based kindergarten, and I think that enables her to be successful even with her various issues.
Can you analyze what the difference is between home and school? Does routine help?
DD turns 6 tomorrow. Her psychologist, who has seen DD for a little over a year, diagnosed DD w/ ADHD in February. The psychologist had been saying for months that she thought the issues would end up being attentional, but that it was too young to diagnose DD with ADHD. Finally the psychologist ended up making the diagnosis. She suggested we try meds and referred us to a child psychiatrist, who couldn't make an appointment for DD until October.
Oh dear. I can't imagine your pain over that. Is there anyway you can get them to call you if someone else cancels and get in sooner?
In the meantime, the psychologist suggested we work with our pediatrician to see if a stimulant alone would help DD. We started with 5 mg of Focalin, moved up to 10. The Focalin was wearing off right when school ended, so it wasn't enough for us--DD was having rebound that affected her after-school activities, including playdates, and she was miserable to be around. Plus, the Focalin wasn't in her system to help w/ the impulse control at home, where it was most needed.
The prescribing pediatrician switched DD to Daytrana last week. We have seen absolutely no improvement, and DD's behavior and moods are actually worse. The psychiatrist had a cancellation, so we happened to get in to see him last Thursday. He agreed with trying the Daytrana, thought the Focalin was definitely not the right way to go if it was wearing off at 2:30-3:00. HOWEVER, he wasn't sure about the psychologist's diagnosis. He said he sees the ADHD, but even more than that he sees ODD. He said that stimulants help with ODD as well as ADHD, and that he might add in Tenex next week.
This is going to take a while to get it all sorted out. It WILL get better but meantime it's going to be a rough go.
The psychiatrist prescribed 2.5 mg of Methylin for the mornings, which became difficult for us once DD started on the Daytrana (very distracted and irritable), even though the patch wouldn't have kicked in until later on in the morning. I'm not sure why she suddenly went from being managable with close attention in the mornings to being defiant and distracted, but somehow it happened with the Daytrana, even a mere 15 minutes after I applied the patch.
Yesterday I gave her the Methylin, which just made her hyper in addition to the defiance and moodiness. The Daytrana worked the same as it had been--not at all, and seems to be a negative. My mom commented that DD's behavior on medication seems worse than it was before, and I think she's right. We saw a brief improvement on the Focalin, but she was still moodier than usual, and the benefits faded away after a few weeks.
Keep on top of the doc and I'd suggest counselling for the whole family, if its available.
Dh decided not to give DD her medication this morning. She has been so much more pleasant to be around. Don't get me wrong, she is still HIGH MAINTENANCE, has cried many times today, and just while I'm typing this has interrupted me at least 20 times, as if she has forgotten that I asked her to give me 10 minutes and set a timer.
Have you seen Ogram's marble method here? That might help a bit.
I don't know what I'm asking. I guess I want someone to tell me to trust the professionals I'm consulting. I want someone to tell me not to second guess myself all day long.
Don't second guess yourself all day long
You're doing the best you can under some pretty trying circumstances. As for the pros--just keep on top of what's happening and keep a bit of a journal so they get accurate information.
I want someone to say, "YES, she has ADHD and this is the best way to proceed." DD is doing fine in school, but I'm concerned about first grade, when she will have to sit in a chair and copy from the board, etc. I want to get her impulse control in line with where it should be before she starts school again in the fall. I just want her to be happy.
Maybe I just wanted to type all this out?????
Of course you want DD to be happy. You love her. That's a good starting point. By next year, maybe the medication will have worked out and she will do just fine. You never know.
She's only 6 and you have a whole lifetime to go. If you make a few errors along the way, you have lots of time to correct it or apologize.
[/QUOTE]
MetisRebel39215.6032638889Thank you so much for responding. It is so nice to have people to bounce these things off of.
School ends May 25. She doesn't need the meds for school at this point, so we could definitely take a break and work on getting the meds straightened out after school is out. It seems like just putting off the inevitable, so I'd rather get to working on finding the right med (that's my personality).
What does "breakdown" mean? Cries? Has tantrums?
By breakdown, I mean meltdown, I guess--tantrums and crying whenever she doesn't get her way. There are different degrees of fits, of course. Today we got into the car to have lunch for Mother's Day. DH had made reservations at an Indian restaurant. DD decided she didn't want Indian. Hates it, in fact. So she sat in the back of the car and cried and moaned the whole way. (then went in, acted okay, ate a ton). Then we went to Home Depot to buy a few things we needed. She refused to get out of the car because she wanted to look at the plants and we weren't going to do that. She asked what we were going for, I told her, she said, "So we aren't going to look at plants?" I said we were not, so she started crying and yelling. If she hadn't thrown a fit, I would have been glad to walk through the garden center with her, but once the fit starts, I can't really do that anymore.
Can you analyze what the difference is between home and school? Does routine help?
I think the difference between home and school is structure and peer monitoring, if that is the right term. We have structure at home, but it isn't the same as at school, you know? They move from center to center in class, they have Spanish on X day, religion on X day, they go to exactly the same playground at exactly the same time. I think the teacher tells them the rules before they go out (don't hurt anyone, physically or with words). I think part of it is that the kids keep each other in line. I do have routine at home--we get up at the same time, go to bed at the same time, I repeat the rules, etc., but it doesn't seem to have the same effect. I will think about this some more and see how I can bring more of the school routine home.
On the hitting--have you tried using kind physical restraint [where you 'hug the child down' and then ask them if they feel in control yet] so her brother is safe and she can "wear off" the excess energy? Has anyone suggested it?
The hitting is weird. It's not like she just loses it and hits him over and over. She hits him or pinches him, then stops. She often leaves the room or immediately apologizes. She knows it's wrong, but she cannot seem to control the impulse. Sometimes she apologizes, other times she looks up because she knows I am coming and says, "Well, he hurt me first." That is usually a lie, and it doesn't make it okay for her to hit him anyway, so it doesn't get us very far.
well I guess you're right you are putting off the inevitable. For me, when my head not all wrapped up in school I can think better. Sorry turning it into me.
Sounds like you just havent hit the right "mix" yet. We've recently added Tenex for tics, some days she has none, then there's days like today that it is AWFUL> but I can say she is CALMER on the Tenex. Try to hang in until you do that.
[QUOTE=masd]Thank you so much for responding. It is so nice to have people to bounce these things off of.
School ends May 25. She doesn't need the meds for school at this point, so we could definitely take a break and work on getting the meds straightened out after school is out. It seems like just putting off the inevitable, so I'd rather get to working on finding the right med (that's my personality).
What does "breakdown" mean? Cries? Has tantrums?
By breakdown, I mean meltdown, I guess--tantrums and crying whenever she doesn't get her way. There are different degrees of fits, of course. Today we got into the car to have lunch for Mother's Day. DH had made reservations at an Indian restaurant. DD decided she didn't want Indian. Hates it, in fact. So she sat in the back of the car and cried and moaned the whole way. (then went in, acted okay, ate a ton). Then we went to Home Depot to buy a few things we needed. She refused to get out of the car because she wanted to look at the plants and we weren't going to do that. She asked what we were going for, I told her, she said, "So we aren't going to look at plants?" I said we were not, so she started crying and yelling. If she hadn't thrown a fit, I would have been glad to walk through the garden center with her, but once the fit starts, I can't really do that anymore.
Can you analyze what the difference is between home and school? Does routine help?
I think the difference between home and school is structure and peer monitoring, if that is the right term. We have structure at home, but it isn't the same as at school, you know? They move from center to center in class, they have Spanish on X day, religion on X day, they go to exactly the same playground at exactly the same time. I think the teacher tells them the rules before they go out (don't hurt anyone, physically or with words). I think part of it is that the kids keep each other in line. I do have routine at home--we get up at the same time, go to bed at the same time, I repeat the rules, etc., but it doesn't seem to have the same effect. I will think about this some more and see how I can bring more of the school routine home.
On the hitting--have you tried using kind physical restraint [where you 'hug the child down' and then ask them if they feel in control yet] so her brother is safe and she can "wear off" the excess energy? Has anyone suggested it?
The hitting is weird. It's not like she just loses it and hits him over and over. She hits him or pinches him, then stops. She often leaves the room or immediately apologizes. She knows it's wrong, but she cannot seem to control the impulse. Sometimes she apologizes, other times she looks up because she knows I am coming and says, "Well, he hurt me first." That is usually a lie, and it doesn't make it okay for her to hit him anyway, so it doesn't get us very far.
[/QUOTE]First of all, I apologize for basically posting the same post over and over again for a week. I'm just so confused about what is the best thing for DD.
DD's issues are a lack of impulse control and inflexibility, mostly. She seems to have a plan in her head of how she wants life to proceed, and whenever there is a change (the "right" person doesn't want to sit by DD, I say "no" to her, etc), she has a complete breakdown. Her IQ is very high, but she is in the lowest reading group in kindergarten because she can't sit still to read and refuses to try anything that is hard for her or requires some focus and persistence to master. The impulsivity is a major issue at home--she hits her 4 YO brother all the time, she spills and breaks things, and so on. DD's issues have not been at school, though her teacher has noticed. DD attends a centers-based kindergarten, and I think that enables her to be successful even with her various issues.
DD turns 6 tomorrow. Her psychologist, who has seen DD for a little over a year, diagnosed DD w/ ADHD in February. The psychologist had been saying for months that she thought the issues would end up being attentional, but that it was too young to diagnose DD with ADHD. Finally the psychologist ended up making the diagnosis. She suggested we try meds and referred us to a child psychiatrist, who couldn't make an appointment for DD until October.
In the meantime, the psychologist suggested we work with our pediatrician to see if a stimulant alone would help DD. We started with 5 mg of Focalin, moved up to 10. The Focalin was wearing off right when school ended, so it wasn't enough for us--DD was having rebound that affected her after-school activities, including playdates, and she was miserable to be around. Plus, the Focalin wasn't in her system to help w/ the impulse control at home, where it was most needed.
The prescribing pediatrician switched DD to Daytrana last week. We have seen absolutely no improvement, and DD's behavior and moods are actually worse. The psychiatrist had a cancellation, so we happened to get in to see him last Thursday. He agreed with trying the Daytrana, thought the Focalin was definitely not the right way to go if it was wearing off at 2:30-3:00. HOWEVER, he wasn't sure about the psychologist's diagnosis. He said he sees the ADHD, but even more than that he sees ODD. He said that stimulants help with ODD as well as ADHD, and that he might add in Tenex next week.
The psychiatrist prescribed 2.5 mg of Methylin for the mornings, which became difficult for us once DD started on the Daytrana (very distracted and irritable), even though the patch wouldn't have kicked in until later on in the morning. I'm not sure why she suddenly went from being managable with close attention in the mornings to being defiant and distracted, but somehow it happened with the Daytrana, even a mere 15 minutes after I applied the patch.
Yesterday I gave her the Methylin, which just made her hyper in addition to the defiance and moodiness. The Daytrana worked the same as it had been--not at all, and seems to be a negative. My mom commented that DD's behavior on medication seems worse than it was before, and I think she's right. We saw a brief improvement on the Focalin, but she was still moodier than usual, and the benefits faded away after a few weeks.
Dh decided not to give DD her medication this morning. She has been so much more pleasant to be around. Don't get me wrong, she is still HIGH MAINTENANCE, has cried many times today, and just while I'm typing this has interrupted me at least 20 times, as if she has forgotten that I asked her to give me 10 minutes and set a timer.
I don't know what I'm asking. I guess I want someone to tell me to trust the professionals I'm consulting. I want someone to tell me not to second guess myself all day long. I want someone to say, "YES, she has ADHD and this is the best way to proceed." DD is doing fine in school, but I'm concerned about first grade, when she will have to sit in a chair and copy from the board, etc. I want to get her impulse control in line with where it should be before she starts school again in the fall. I just want her to be happy.
Maybe I just wanted to type all this out?????