My Child Is Explosive | ADHD Information

Without the medication, she has bigger tantrums. Hitting, kicking, screaming, spitting, bitting, and will make herself throw up. She will be bouncing up and down the walls. She yells and screams all day long. Climbs up all counters, into food all the time.  I agree it's worth trying a slow release med it was always smoother for my daughter, although we never had significant hyperactivity or anger, she was very moody and lots of ups and downs, better on a long acting.

I would first look into a long acting stimulant and see if she does better on that without the ups and downs of the immediate release meds.

If that does not work, you might talk to the doc about using clonidine during the day or moving to guanfacine for 24 hour coverage. Thier is a long thread on guanfacine (Tenex) with lots of info:

http://www.adhdnews.com/forum/forum_posts.asp?TID=24770& PN=2

It is a blood pressure med like clonidine (though not as sedating) and that has effectiveness for defiance, hyperactivity, impulsivity, but not quite as good as a stimulant for focus (which might be ok for now). It is currently used off label, but shire has completed studies for thier long acting form and should get market approval later this year.

True, at her age, she may be able to go stim free if the tenex curbs her impulsiveness.....not much focus needed at that age really.

If not, I think that the longer lasting stims should be given a trial.  It could very well be the ups and downs of the med in and out of her system making the behaviors worse.

My daughter is on 5 mg of Ritalin twice a day. She is also on Clonidine at bedtime to help her settle down before bed. I give my daughter her last dose of Ritalin at noon. The medication start to wear of by 4:00. I like the diary idea. I am supposed to be watching for signs of an episode to happen, but it often hard to see it starting. Once it happens, there is no stopping her. I have tried talking to her after it happened, and she doesn't seem to understand what happened or why she did it. I still wonder why my doctor has my daughter on the blood pressure med. Is there a med that is better at night? She is almost 5, but I hate having her on all of the medication.

The Ritalin is the short acting dose, and is probably what I need to look into if Medicaid covers it. Since it seems like that is when the medication is wearing off.

We still have the bad outbursts, at times during the day even on the medications, but not half as bad as when it is out of her system.

Does anyone know how to stop the behaviors before they happen.
Clonidine is prescribed because it works. It is VERY, VERY common practice to use Clonidine or Tenex to help wiht calming and/or sleep. I dont personally think that is causing your problems, but you never know. My guess would be the ritalin is not at a high enough dose or not the right choice. Talk to your doctor and ask about switching, Ritalin LA or Concerta or both still methylphedinate but are in a slow release long acting form. A lot of people also have good luck with Focalin and Foclain XR also methylphedinate.What does she act like without meds?Does the medication include a blood pressure med?

Clonidine is a blood pressure med.

I am still wondering as Vickie asked if this is only happening when meds wear off or all the time?

It certainly sounds like a med change is probably something to think about. My daughter always did better on the slow release longer acting stims rather than the short acting ones.

I have a 4 year old who was diagnosed 6 months ago with ADHD. My problem is nothing works she control her behaviors. When she gets mad she hits, kicks, screams, bits, and makes herself throw up. She is on medication. I have tired 1,2,3 magic, marble jars, charts, rewards, time out, time in, and taking things away. nothing works. She is in therapy, and does see a psychologist. Any ideas on what I can do to help with this, and to keep me sane?  peaches2639242.8118171296

When is the behavior happening? While meds are in her system, during the time it is wearing off, all the time?

I ask because meds can increase anxiety and cause problems in some kids, the time meds are wearing off can cause problems during rebound, the meds may be too high or too low.

What medication is she on and what kind of doc did the diagnosis and is managing the meds?

This kind of information would help sort out what is happening. You could also keep a diary.

I see my daughter psych on the 21st. I am going to see if we can get a longer acting medication along with a higher dose. She had a speech evaluation today. She couldn't sit through the test. (1 hour long) They are telling me she is not speaking at her age level. I have to start OT for her sensory seeking issues. Will I know if OT is good for her. I tired it before and felt like it was a waste of our time.

OT needs to be very consistent. You will have to do the work at home also. My younger daughter has some sensory seeking issues and OT was great with her. This had nothing to do with ADHD. So yes if OT diagnoses her and gives you therapies and they are done correctly and consistently they should work.

What do they plan to do with the language concerns? Who diagnosed the ADHD? I am just curious. Was there learning tested? Any detected learning disability? Non verbal learning disorder can mimic ADHD, although at age 4 it is kind of young. I ma just curious with the coexisitng sensory and speech/language concerns. These can certainly appear with ADHD also.

 

I am not sure what they plan to do yet. At this point she told me what was wrong and that was it.
Her Psychiatrist diagnosed the ADHD. There has not been any time of learning tested. Who do I need to go to for this.
The speech lady told me to look into an IEP plan for her to. Who do I go through with this since my daughter is not in school yet. She is in Pre K?

Is preK at the public school? If so they will do the IEP. If not will she be in Kindergarten next year? If so contact the school, in writing, as soon as possible requesting a full CORE evaluation. They will redo a lot of what has been done. A full CORE eval does Gross motor, fine motor, psychological, academic testing. They will then see if she eligible for services. They may accept your outisde testing as it was just done recently. Tell them what was done when you request your eval. Ideally a neuropsychologist will do the testing. Again 4 is kind of young though. They cant do extensive psych testing until around 6. But if they test now and there is any question they will have this to compare later.

Diane, I should contact the school she is going to now than, since pre kindergarten is in a child care? Contact the public school she would go to. A private Day care wont have these services.

Thanks for the feedback, however my son is also ODD. aND wouldn't this promote more aggressiveness?

 

I'm trying to decide between taekwondo and swimming, or gymnastics. Like i cant keep up with all this energy of his when he gets out of camp. They obviously don't do much sports with them. And it is an ADHD summer camp. He needs jumping, throwing himself. He loves to tackle me.

 

 

No it would not make him more aggressive. It should help him focus his energy. Any martial arts. Gymnastics is GREAT. My high energy 5 year old LOVES gymnastics, always moving the whole time.

Read the book The Out of Sync Child. I am not sure if your son has sensory issues, but if he is seeking those kinds of activities the list of activities on the book will help.

taekwondo is a great sport for kids. Theya re acitve and dearn focus and discipline. Our kids though may or may not be able to to focus enough to grasp. Worth a try.

Hey!

 

My son who is 7 was the same way. He got kicked out 5 times out of school for jumping on the teacher and scratch, bite, kick you name it. Explosive, either provoked or not. Our children are like that. The doctor had him on Depakote, Focalin, Risperdal for the longest. However it was ok for a while, because i think the dose was low. Things got worse. The doctor had to admit him to stabilize him and monitor him with meds. He is now on Risperdal 1mg at night .5 in the am. Clonidine .1mg at night. Depakote 250 mg in am and pm and adderrall 20 mg in the morn. He is sucha  changed kid. Before he would never eat before the change of meds. He was 41 pounds June 2nd/07. Today he is 47.5 pounds. He used to be bones, now he has a belly and a butt. Its incredible. Depakote is a mood stabilizer, i think that and the risperdal really help. Clonidine helps him sleep at night.

Anyone have any suggestions if taekwondo is a good sport for children? He needs an activity after camp. Toohyper.

 

Laura

My daughter has been accepted into a public school Pre Kindergarten program. We saw the phych yesterday. He put her on Concerta 18mg, and also kept her on the Clonidine at night. I am hoping the new medication will start to work better than the short acting Ritalin. I am to the point that my daughters tantrums are making me melt down. 

Good luck. Keep trying it can be quite the challenge finding the "right med" or "right med combination".

Be sure to request an evaluation quickly when school starts. She should be able to receive OT and her speech;language help through the school. You will also be able to have any classsroom modifications in place before Kindergarten. These kids with sensory issues may need formal Ot and sensory breaks throughout the day. Dont wait too long as the paperqork and red tape can take months. Push to have it done as early in the pre K year as possible. It's nice you have the summer to try to work out her meds. You're in a good place! Some people dont get this process started until later.

Try to take care of yourself. The tantrums can take their toll for sure.