We Need Serious Advice! | ADHD Information

My DS may not have quite the aggression that you mention, but it has been a major part of his problems at school. He did alright in preschool, though he spent a lot of time in the office with the director. They attributed it to his social immaturity. The following year we went through three schools. The first two were half-day programs, which I thought would be easier, but ended up being a disaster. Last spring, we switched to full day kindergarten, and it wasn't too bad, but he had an incredible teacher who also had a degree in psychology, and had been hired specifically for behavioral issue interventions. This year was another story. First day of school he was in the office for bloodying a nose, numerous more discipline write-ups, no recess (like that helps the problem, but whatever), and finally a suspension all in the first two months of school. I also had to start driving him to and from school, because the bus was just TOO much for him. I later learned from a friends' daughter that he was being bullied/teased on the playground and bus. This may be a reason for the lash-outs. Of course, DS's problem is impulse control. Lots of us get mad, but we don't go around hitting, or threatening to kill others. My son used this sort of language all the time. He had a few write-ups for this, as well.   
Now, that isn't the whole story, because he is also the sweetest, most caring boy, who cries when he sees a hurt animal or a crying baby. Loves to snuggle, and can't leave the car without an "I love you" sign. The thing is, that he is a boy of extremes, with no self-regulation. It could be that for right now, your son is aggressive because he is feeling anxious, and that is one way he deals with it. My DS has had great improvement on self regulation with Straterra, but these same issues were made worse on the stim meds. My DS just happens to be in that 20% that don't respond well to stims. Other folks on this board have mentioned combining other meds with the stims, and that has helped. I, personally, didn't have that offered to me as an option by the ped, but it might help.
It is interesting that you said others haven't seen a case as severe as your DS. My son's ped said almost the same thing to me, but his actual words were something like, "I've only had to sit in this room with him for 15 minutes, but I honestly don't know how you do it." Talk about a heartening statement to make to a mother. But, I try not to let stuff like that get me down. One of the best things that ever happened to me was finding this board. Other parents may not have the same exact scenario as me, but they have similar experiences. And, even when I want to pull my hair out in frustration, I still love my children. The fact that you are seeking answers and solutions is the first step. There are parents out there who don't even do that much, either because they just don't know how, or they don't care enough. I was told recently that my son is still young, and there is still time to try and help him succeed. Don't get too discouraged. If you have any other questions, feel free to PM me, and we can compare specific instances. Who knows, you might even be able to offer me great advice that had never occurred to me, or vice-versa! Hang in there.       

This sounds a lot like my son!  I thought about a couple of possibilities when I read your post.  First, it sounds like he has Sensory Processing Disorder.  That can explain the aggitation and problems with sound.  If he is "sound sensitive" or "sound avoidant"  it can really make him go out of control at what seems like strange times and for no reason. Also, the reaction to sound is not constant either.  A sound may REALLY bother him one time and he'll be fine with it the next.  That's just the nature of SPD. Stimulants aggravate my son's SPD. 

The other issue was anxiety.  It sounds like he has anxiety. Again, stimulants aggravate this in my son. It makes him angry, frustrated, and moody.  With my son, the Ritalin worked great for his hyperactivity and impulsiveness but aggravated these other things.  His doctor added Tenex/guanfacine and it REALLY helps with the anxiety and SPD. Maybe you should ask your doc about it. It allowed my son to continue to take Ritalin when he otherwise couldn't.  Right now we're giving Strattera a try to see if it will work because it's much easier on the SPD and anxiety.  The jury is still out on it though... If it doesn't work we're going back to the Ritalin upping the dose of Tenex.

Good luck and I hope it gets better for you!

Hello,
I am brand new to this forum, so here is a brief history of my son.  He is now 6 years old, in grade 1, suffering ADHD and ODD....so far that's what we know, but we are sure there is something more.  After being kicked out of every preschool and daycare (except one) and having rifts within our families, we only discovered that he is ADHD last year when he was in kindergarten, which was a complete disaster!  He was sent home several times a week and was in the principal's office literally everyday.  Things improved when we finally got him diagnosed and treated with Concerta.
Summer was okay, considering he didn't have to deal with being in a classroom.  So along comes Grade 1....the 1st week he was sent home once, then we were able to get the funding for him to have an Educational Assistant, who sits with him everyday to help him keep his cool.  October and November were really, really good, huge improvements noticed by us and the school. Due to insomnia, the doc changed his meds and after trying a couple more, we are back to Concerta, which WAS working well on the school side of things.  Well, now he has been sent home 3 times in 2 weeks...We just don't know what to do, as we feel we've tried everything, but realize that's not possible and are prepared to do whatever it takes.  Here are his symptoms:

-extreme frustration when he can't draw, write or color something perfectly...he will rip apart his work, hit the EA, throw things, or run out of the class.
-no swearing at home, but he's been swearing at school.
-extremely sensitive to noise, but not everytime.  He hasn't completed one full gym class yet this year....even though he's a total athlete.
-never takes the responsibility for anything, there is always an excuse or it is someone else's fault...he seriously doesn't recognize the cause and effect thing.
-we are thinking he must have huge anxiety.
-can often put himself down...afraid I will leave him sometimes.  I keep assuring him that I love him just the way he is and will never leave him and I'm always on his side, no matter what.
-extremely stubborn and just has soooo much anger.

There is more, but that's what I can think of right now.

We've been told by several people that have worked with kids with ADHD, that they haven't ever seen such a severe situation, particularly the anger and perfectionist behavior.  My husband and I have learned the 1-2-3 Magic approach, which helps really well at home, as well as rewards.  We have also learned how to dumb down our own anxieties about this and be cool, calm and collected throughout his tantrums,etc.
He goes to play therapy, which he loves.

Has anyone out there had such an extreme case?  If so, what was the solution?  Any success stories?  I really need some encouragement right now, as it seems we keep coming back to square one.

Thank you so much for listening (reading).

I haven't had to deal with this, BUT, is your concerta at the right dose, does he need a increase?

We use guanfacine in addition with our son's concerta to relax him. A lot of adhers have comorbid conditions, our son had anxiety. He also has sensory integration and one of the signs is sensitivity to sounds. There are others as well.

One more thought, do you think bipolar????

I wonder if he is depressed? Has anything happened to him? Did you ask him?

I would have him re-evaluated and explain all this. For your son to be very athletic and not finish a gym class is a red flag, along with the melt downs due to possible frustration, depression, or trauma.

Just want to help.

Along with all his other issues--diagnosed or suspected--I think he's very, very bright.  Being "twice exceptional" has all the ingredients for being exceptionally frustrated and anxious.   His great ideas and expectations, etc.  get sabotaged by the ADHD or other traits.  How absolutely maddening! (or, depressing, depending on whether or not the frustration is directed outwards or inwards).

Just my hunch/theory...

ps--I'm watching Charlie Rose right now--a great program on our "social brain".  Fascinating! 
Thank you everyone for your advice!  We have been to the pediatrician again and he is referring us to mental health to have a closer look at our boy.  I will take all your advice into account when asking these people my questions.  Thank you so very much!!!  So nice to know we aren't alone. Good luck and please keep us posted!