General Questions | ADHD Information
I'm the foster mom to an ADD kid - a 10 year old boy. This child has had a generally rough life, and frankly, ADD is maybe the least of his problems. But, I have some questions that I wonder if you folks out in the trenches can answer for me.
First - he takes Concerta - in the morning. I notice that his behavior is really odd for the first 30 minutes after he takes his pill. Then he kind of calms down and gets under control. But - if we've left the house in those first 30 minutes and he has no access to a clock to SEE that 30 minutes have passed, that weird behavior continues on for several hours. Do the meds really kick in like that? And, does the fact that it doesn't ALWAYS kick in like that mean some of this is behavioral?
Second, I know that at some point in the evening the meds wear off. But, his evening behavior is nothing like his morning behavior. Again, makes me wonder if that morning stuff is learned habit, rather than biology. He sings - almost constantly in the morning. He invades people's space. He moves like his joints are overly oiled - loose and floppy. He's goofy in a really annoying way. At night there's no goofiness. There's defiance, there's deliberately inciting people to anger, but none of that floppy silliness. Is this the rebound effect I've read about on this board?
Thanks for any info you can offer!
My guess is that his strange behaviors are calls for attention. You say that ADD is the least of his problems. Perhaps he isn't really ADD but just "pretending" so he can get more attention? I'm not saying he's not, just that maybe he's exaggerating. Also, if he has to see a clock to change his behavior, then maybe the meds aren't doing anything. Perhaps he needs to be re-evaluated for ADD and/or other conditions. Good luck. It sure sounds like the morning behavior you are seeing has a behavioral component. The Concerta should be kicking around the same time consistently. What happens if he goes without the Concerta? Do you get the same silly/goofy behavior all day long or does he eventually settle down?The night time behavior could be rebound. We haven't experience very much rebound. We do have behavioral issues in the late afternoon/evenings when her dosage wasn't high enough. I think they stemmed from her not having good symptom control during the day and then losing at night.
First of all I really want to give you the biggest hug for helping this poor innocent child who didn't ask to be born into the situation that landed him in foster care. 
to YOU and for finding these boards to help him even further. YOU are awesome ebhs79!!!
So now back to your questions and concerns. It does take about 30 mintues to kick in. I don't know about the clock situation, the meds should just take over once they are in his system. That to me is weird.
My son is 12 and his morning's are goofier than his nights when the meds wear off.
My son is adhhhhhd, severe. He is on concerta, 108 mgs AND guanfacine. He too gets in peoples space but he has stopped with the help of BOTH these meds, concerta AND guanfacine (or tenex - same thing). That is their impulsive behavior.
What is his dosage? How long has he been on it? Any other underlying diagnosis?
When was he diagnosed with adhd, at what age? Do you think he has anxiety, depression?
His looseness could be sensory or needing physical therapy, not really sure. My son also has sensory intergration, I can explain further if you need. He also has a speech delay.
Any feedback from the school? Is he on an IEP or 504 Plan?
Please let us help you both. Ask any questions you need to, it is the least we can do for you after what you are doing for him!! 
best wishes to you ebhs!
Thanks everyone for the info thus far.
I agree with the poster who suggested that we get him re-evaluated for ADD. This child's home life was very chaotic, and I wonder how much of his behavior is a learned response to that environment and how much is biology. Unfortunately, he won't be in our home long enough for that to happen. He's VERY disruptive to our home, and this is'nt a long-term placement. He's a kid who was a friend of my son's who needed a place to be when school started, so we volunteered. After having him in our home for 7 weeks, we realize that we can not do this for a long span of time.
His 'disruptiveness' is likely NOT related to his ADD, but more likely related to his life up til this point. So, I won't belabor all you helpful ears with tales of that. But, I would like to ask a few more specific ADD questions.
First - he's on 50-something milligrams of Concerta - it's the weird colored pink/red capsule. He gets those meds at 6:30 AM. Can anyone tell me with any certainty when those meds wear off? We have been asked if we want to investigate some sort of afternoon booster meds to get through homework, and, while doing homework is a nightmare, I can't figure out if THAT is behavioral or ADD. I suspect this kid has been mostly controlled via his meds - that nobody every tried to teach him to try to control himself - and I don't want to keep giving him that out if I can help it. If he really NEEDS the medication, that's one thing. But, if he depends on the meds to do everything for him, then I want to try to break that dependency.
Second - I don't know if his mother used to give him his meds every day - like did she ever give him med breaks. But, my question is, should he still get his Concerta when he's sick? So far we've only weathered a head cold, and I gave him his medication throughout the head cold. How about something ike the flu or a stomach bug? Would Concerta make him feel worse? Would it upset his stomach? I asked his pediatrician, but the nurse was very vague and unhelpful.
Thanks again!
Yes it does affect the appetite. He probablyb hasn't eaten all day and is starving. Poor thing to be going through this without his parents.He is lucky to have you. and you too care, otherwise you wouldn't have found these boards and be asking these questions.
I am sure you are frustrated because it has changed YOUR house and children, BUT you did the right thing by helping out your son's friend. He needs someone and that is YOU.
I wish he could do homework at the after school program.
OR if you have any rights to med dosages, maybe YOU could ask for a afternoon booster, to get him through homeowork It may affect sleep and eating however, just a heads up.
I would call the doctor and ask. Skip the nurses.
WHo is your contact in the fostercare program? There has to be a caseworker.
He is in 5th grade and should have 50 minutes of homework if he was in my town, he should also try to get help.
Is he on a IEP or 504 plan?
Yes, he is on an IEP. I'm somewhat familiar with that system, since my son is in it too. He is on a reduced homework load. The teacher gives him what she feels is one hour of homework for HIM, not the average fifth grader. Still, it takes anywhere from 2-4 hours a day. I'm not blaming the school for that. Frankly, I think a lot of that issue is behavioral. His mother NEVER held him accountable for homework - going as far back as Kindergarten. I think the shock of actually being expected to DO homework is a lot, but we aren't backing down from that. And, he's dealing with the fallout of years of educational neglect. He doesn't know any of his math facts, which are integral to doing fifth grade math. The school is offering him special help - which I think is great - but he can't get anywhere near caught up. And, he can't get ANY closer to being caught up if he keeps handling his homework like this! We sit right with him at the table, foresaking our own son, and still it takes him hours and hours to do the work. Last night he had 2 math worksheets with maybe 15 problems total, and also had to copy over his spelling words. It took 2 1/2 hours. He even spelled a few spelling words incorrectly - when all he had to do was copy them from one sheet to another!
There is a 40 minute period in the afterschool program for doing homework. And, he does work on it then, But, those 'teachers' are not equipped to go over it with him, to make corrections or check his handwriting. So, pretty much everything that comes home from there needs redoing, since he just does it as quickly and poorly as possible.
DCF is NOT being helpful to us in this matter. The specifics aren't important, but let's just leave it as "not helpful". So, information or assistance from them is not forthcoming. But, it IS plentiful from you, and I do appreciate that.
Stims wear off after 8 hours. The homework behavior is called medication rebound. It is from the medication. It is not ADHD, and it is not behavioral. They get meds unless they are throwing up or seriously ill.I wonder if a boost of concerta/short acting would help for homework. IS it possible for him instead of going straight to the after school program to stay with a teacher and do homework after school?
He definetely should be in summer school due to regression.
Can you call a TEAM meeting with the school and bring up all of this? Or even call his teacher and let her know of his struggles at home?
My children are told that they are given homework in 5th grade that should last 50 minutes. If it takes them longer, just send it back with a note and the teacher will help them in school.
Again, he really is lucky to have you. Your son is also a good friend for sharing his parents!!
DCF is a problem it seems like in most states. We here in MA have our problems with them as well. I am sorry you are not being helped, even though you are helping another.
I would love to ask questions, but I don't want to be personal.
Again, he is lucky he has you, not sure if there is anyone else that would be there for him!
He is on 54 mg, I think. is it like a brick reddish? My son is on two of these each day.
Do you have his pediatrician or prescribing doctor's information? I would contact his prescribing doctors and let them help you with these questions.
We personally still give our son his meds when he is sick. If he has like a stomack virus, and is throwing up, we obviously don't.
We give it to our son around 6-6:15am and get until about 10-12 hrs out of it. It all depends on the metabolism. Now my son eats and you can tell it has worn off, BUT the nights at first are nothing like the mornings. The mornings are tougher for us.
We never give our son med breaks. He has adhd 24/7 and needs his meds. It is also hard to stop on the weekend and then start again on Monday. I have heard it is havoc on the child. I had done that trying to add calories on my son's bones, but he was zombied out on Monday due to the affect.
REMEMBER, once the med is worn off it has left the system, there is nothing left. It does NOT build up on the system!!
You are such an angel to be helping this poor, innocent child. Remember that, through all the frustation headache and hearache. You are awesome!! He will remember you for this and love you as well for it!!
Yes - it is a brick red capsule. Thanks for the info. Is Concerta one of the meds that affects appetite? I didn't realize that, but there are nights when the child eats an insane amount of food at dinner time.
Is your son still able to do his homework by around 5 PM? That's when we pick our FS up from the afterschool program and finishing his homework takes HOURS!
And, I do have the prescribing doc's information, but when I asked the question about giving him the meds when he was sick the nurse was unhelpful. She suggested that I just call the doc's office whenever he was sick. Well, that would work just fine if the doc was reachable at 6:30 AM when the child would normally be getting his pill!
Thank you for the accolades, although I really don't deserve them. A REAL angel would be able to handle this child better or even love him, despite his issues. I think YOU guys are angels, because you live with this stuff every day, and love your children dearly, in spite of it all!
We're actually in Mass, so you probably know alot about the problems we've been having ith DCF.
Regarding getting assistance from the teacher - I'm also having problems with the school - but not exactly the kind of problems you'd expect. The school is actually coming down on us for being too hard on the kid! I've had arguments with them in which the school insists that schoolwork that I think is incorrect is marked correct, since they say that they "know the child and know what he meant to write". Now, most of the problem is poor handwriting, and, although this child will never win an award for penmanship, he CAN in a manner so that his answers are legible. I know this because I have samples of work that he's done in the past few weeks that are beautiful! But, I think the school is stuck in 'pity mode' and refuse to make the child accountable. I've told them how long it takes to complete the homework, and I've also told them that I don't think that he should be getting LESS homework, since the load is already very reduced and, I think, at a very fair level. It would take my non-ADD child about 20 minutes to complete the assignments that my ADD child receives, and I think that doing 1/3 the load of most kids is reasonable for a bright, ADD boy. I'd love it if the teacher would spend time after shool with him doing his homework. After all, she's educated in helping these kids - I'm just a mom. But, I'm not getting that impression from the school. They're just anxious to maintain the status quo and not offer/do any mroe than they're doing.
You hear all about the MCAS I am sure, living in Mass. This young boy is why they have them. Schools were passing children and graduating them from high school when they couldn't even read and write.
Your foster child still has to pass those tests. These teachers are NOT helping them. I would mention this to them. I feel sorry for what they are doing TO him.
Again, you are doing a wonderful thing for this child. If the school district can not teach this child, then he is entitled to be educated elsewhere. AND passing him just because they feel bad for the situation he is in, is again NOT helping him. They should feel bad for him AND help him.
Is there anything I can do to help you, since we both live in the state? Where does this child's future lie?
If you want to PM (private message) we can chat there.