As you probably know, medication is not a behavior pill and 18 mil of Concerta is a starting dose and a very low one. Most people don't see much if any difference at that dose and demands and pressures are far lower at home. The goal is maximum benefit, minimal side effects at the lowest dose possible. The goal is to have more good days than not so good days. However, even when you have the correct dose and med, while it gives the child the ability to make a choice, sometimes, like any other child, they don't make the right choice. Also, if your child is riddled with anxiety, it overrides the effectiveness of the medication but in your son's case, like any other patient, your son needs to go through a trail of medication until the correct med and dose is achieved.
Teachers and staff also need to understand from the get go that medication is not a behavior pill, will not make the child perfect and they should not have unrealistic expectations. Once your child is on effective medication behavior won't be an issue for the most part because it curbs the impulsivity and your son will be able to make a choice rather than act on impulse. If your child has an IEP, by law the school must accommodate your son and help him reach his full potential and on effective medication he will. If they are not doing their job, don't hesitate to contact the supervisor of special education in your school. Once your child is getting maximum benefit from he medication, you will know it immediately because most of the issues you now deal with will be non issues. Hang in there. It does get better :)
IT DOES GET BETTER!
OK, that said, like everyone has already said, meds arent a cure all and there are going to be days ,sometimes a lot in a row, where other things are going on and the meds won't compensate. I'd give it a little more time if this is really the only "big" incident. See how things go. Maybe something else is going on. A little stress now that school is in full swing. Maybe a social thing going on, a bit of boredom where he is obviously academically ahead. This is Kindergarten. A year of getting them used to school. It wont impact his entire education (although we all feel like it will while we're living it). Keep journaling all this. You guys are doing great. We all know how awful the dreaded school calls are . Hang in, you're going to get it right. If he continues to struggle, call the doctor.
Good luck, we all feel for you, this is NOT fun..........but you'll be ok.
OK, I'm having a really bad day today. Our 5yo son started full-day kindergarten on August. 15. Since that time, he's been doing pretty well other than a shoe-throwing incident and challenging the teacher a handful of times (albeit a couple of times he threw a fit). We even got a call from the principal saying what an improvement she'd already seen in son this year (he went to preschool at the school last year in the peer-model program) and how wonderful he was doing.
Then things come crashing down when I get a call from the special ed teacher to set up an IEP meeting. (We have an IEP with indirect services, meaning his teacher can request help/insights if needed. He did so well with preschool at the end of last year [after starting meds, unbeknownst to the school] that this was deemed sufficieint.) Apparently son throw a HUGE fit over not getting to sit at the orange table (his favorite color), got aggressive with his classmates (although I don't know the details), and the safe seat didn't work so he had to go to the specical ed tachers office. He took over an hour to calm down. All of this while on medication. (He started Concerta 18 about a month ago and had been doing well on it at home. More agreeable, less impulsivity.)
I feel like each day I wake up wondering if my son is going to have a good day or a bad one. And I can never predict what will trigger it, as some days he would blow off things like the orange table even without meds. I am so sad and frustrated. Husband tries to handle, but I know he's beyond frustrated as well. Are we on the wrong med? (This was the first day of aggressiveness, which was our main problem in preschool.) How do you judge what makes a good med as I know every day won't be perfect even on meds? Am I wrong to feel like my son is the only one who acts up or is judged harsher when he does because of the IEP? He is so smart (ended up at level 19 on a reading test and teacher stopped because he was so high, when others in his class are at level 4/5) but I'm afraid the school won't ever get him to his full potential because the behavior issues will get in the way.
So, does it ever get better?????????
Maybe he just needs a bump up on his meds. I think it is pretty normal to do well on the first dose a few weeks then need to be bumped up a time or two. Yes, it will get better. My ds was 5 when we started meds three yearsMomKC said: Thanks, everyone. Unfortunately, my perfectionist side gets really stressed out by all of this. Appreciate all of the input!
Hi! Your 2 posts struck me for a few reasons.
1. First bit of advice- Say GOODBYE to the perfectionist within (at least when it comes to your expectations for your little boy.) You and your son will be happier for it, I promise you that.
2. I have a son that was a really precocious reader and also had lots of impulse control issues, not anger/temper, but still there is something in common our sons have. A reading enrichment program curbed some of the negative behaviors. The teacher said that at circle time, especially when they were doing phonics and letters... my son was at his worst behavior, and it was obvious to the teacher that asking a hyper/impulsive kid who knew all the answers to sit and behave (and not show off and call out all the answers) during phonics was too hard. So, twice a week- he was taken to the recource room where he was able to read high level books with the special teacher. He even completed the second Harry Potter novel with her by Christmas break! BUT there was one condition- he had to participate in phonics time the other 3 days in an appropriate way. The teacher gave him 4 poker chips before phonics time. If he wanted to answer a question he could but every time, she would take 1 poker chip away. She tried to encourage him to save his poker chips for hard questions, but if he called out an easy answer- that was ok- but once he was out of chips- no more calling out answers. He could still raise his hand and she might or might not call on him. But anyway- it worked pretty well- expectations were clear- he learned to deal with sitting through something that wasn't really interesting or that was too easy (a good skill to have for smart kids) and he had his reading needs met.
3. Who has evaluated your child to prescribe meds? Is there a diagnosis? I am wondering if you have taken him to a psychiatrist or psychologist or ijust a pediatrician. If it is just a pediatrician- I would get him an appt with a psych professional. From what you describe his behaviors are kind of severe, I would definately want to make sure the most complete and appropriate treatment options are being considered.
Best of Luck
Thanks, everyone. Unfortunately, my perfectionist side gets really stressed out by all of this. Appreciate all of the input!MominKC
MominKC,
Yes, it does get better.
18 mg of Concerta is pretty low dose. It may work at home because there is less stress and hubbub at home. School is much more demanding and he may need a higher dose to deal with school.
My son is 12 (13 in Nov.) and things have gotten better. The early years of school were some of the toughest for us. I pulled my son out of public school in the 4th grade because it was too stressful and he was bored because of the rigid schedule they have in our public schools. He could pick up a concept in 15 minutes but was forced to work on it for 60-90 minutes.