We got our diagnosis on Kitten and she has ADHD. The doctor immediately prescribed medication.
I asked if this was the first line of treatment. She said yes, for the kinds of numbers on her assessment.
I asked if there was additional behavioral therapy we could get in addition to the medication. She said no, she only referred people to behavioral therapists if their children had disciplinary problems.
I said that she gets so frustrated that she routinely melts down at the slightest provocation and can't seem to pull herself out of it. She said that Kitten was probably just frustrated throughout the day and was releasing that at home, maybe it would get better if the medication could help her focus during the day and not get so frustrated.
I filled the prescription with a lump in my throat. I didn't give it to her over the weekend.
And then Monday she threw up. And Tuesday I couldn't find it.
By Tuesday, I had decided to try it. ADHD medication is fast-acting - you don't have to let it build up in your bloodstream over a couple of weeks, it works on the first day. It is active for 8-10 hours in the bloodstream and then wears off. Most are psycho-stimulants that excite the nueron receptors to work harder, better. While it sounds counterproductive to give a hyperactive kid a stimulant, there is science behind it. Because it works for a specific period of time and then moves out of her system, I'm willing to give it a trial. We can always go off it.
On Wednesday, over Pants' strenuous objections, I gave Kitten the medicine. The doctor prescribed one in a capsule that we could break open and dump into a small amount of applesauce for her to eat. The drug won't lose it's efficacy by taking it this way, as long as it is not chewed or dissolved in the mouth.
Kitten's teacher emailed me at the end of the school day and said that, while it didn't solve all of her issues (Kitten still stood in the classroom in a daze until she had to be told to put away her things), she was able to focus all day and finish all of her schoolwork. Success!
Whem Kitten came home on Wednesday night, she was absolutely bouncing off the walls. Flying around like she was on crack. Swimming lessons were terrible - she flailed around like she couldn't control herself or forgot what she was supposed to be doing. She stayed up a bit later than usual, but nothing horrible.
Thursday night was better, not quite so manic, but the coordinator at the after-school program had noticed her hyperactivity that afternoon. I had given her the meds a half hour earlier that morning. It appears she has a period of intense hyperactivity when she is coming down.
Friday night, tonight, her third day on the meds, and she has been a complete basket case. I can't say in the short time we've used the drug that the meltdowns are really worse, but I'm watching. Other than that, it appears that her appetite at home has been fine (some kids stop being hungry) and she is only staying up a little bit past bedtime, not anything serious. The bonus side affect seems to be regularity, something she's struggled with for years.
But I can attest that the drug is not a cure-all. Kitten still needs some help expressing herself, recognizing inattention and correcting it, and I need some advice on helping her with daily routines. After only a few days, I know I need some behavioral therapy.
I have asked another mom how her child was treated and if there was any therapy in addition to medication. We talked for a bit and when it was clear her doctor's theories matched mine, I called to make another appointment. I want another opinion, another approach.
I won't necessarily take her off the medication. It definitely seems to be helping at school and she is on the lowest dose possible. But I want some more tools for the inattention, the inability to break down a task into smaller actions, the difficulty with concepts of time and other abstract concepts. I want to get her some help with her emotional outbursts and her anxiety issues. The medication-only approach does not work for me - I want more.
4 comments:
I think you're totally on the right track. While the medication can help her focus, if she doesn't learn the skill sets she needs while she's focusing, when she is off the meds, she won't be able to manage. You might want to keep asking about the dosage - maybe things will level out as her body gets used to it, or maybe they'll let you try only giving it to her, say MWF? They sure can help though!!!
But yeah, she needs to learn coping skills that she can take with her throughout the rest of her life, so I totally agree with the need for behavioral therapy of some sort, not only medication.
You might be able to get (some) additional classroom help for Kitten now that she has an official medical diagnosis. Ask about getting her some social stories and/or a picture chart with a basic breakdown of her "I just got to school" tasks, since it sounds like that's consistently a difficult time of the day for her. You may want to ask about a 504 plan (I think) that could get her some help with putting her things away in the morning and starting her day off on the right foot. It would involve a bunch of meetings and she'd end up labeled in "the system," but then you've got some official status & leverage you can use, especially when she goes to a new classroom next year.
Good luck! :)
My brother has ADD, borderline for the hyperactive side. Medication wasn't an option for him at the time, not that my parents would have taken it.
For him, coping skills are the key to his success. The help he got for his dyslexia ended up helping him with the ADD as well. (great teachers really) I agree with Ms. Huis, get her in "the system" and see if you can get the district to do some OT. There are great communities online that may have some ideas about what to go looking for too.
The other things I know that are triggers (I have an adult friend with ADHD) are artificial colors, especially red, and some flavorings. There is also a lot of evidence that a breakfast that include more protiens than carbs can help as well.
Oh, Happy Veggie has a good point - I heard a LOT of anecdotal evidence from parents that more highly-processed foods tended to cause more problems for their kids with ADD/ADHA- the artificial colors, and/or corn syrup and/or whatever else is in them as preservatives and flavorings and such.
I don't know how much sleep she gets regularly, but I've heard a very regular sleep schedule (& sometimes more sleep) might also help a bit. Not a cure, but anything that helps her focus can help her learn.
You know that is a very good point about the processed foods. I never really thought too much about it, but we used to eat a lot more processed foods than we do now. I was chalking it up to maturing and getting older/developing better coping skills. I wonder if I inadvertently helped her but moving away from that stuff into more natural foods.
I agree with the others though, she does need to be taught coping skills.
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