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    Joined: Dec 2010
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    If she is too anxious to ask for outside help, perhaps working through some of the materials at the Purdue Online Writing Lab might help her out. They've been useful for my son, who has Asperger's and a Disorder of Written Expression.

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    In our experience, if the med shows initial trackable, graphable effectiveness, it rarely loses that clout in less than six months...more often a couple years. Weight gain does play a role but rarely weight loss. We use Excel to track responses to med changes after several bad doctor experiences. What we have noticed...
    -Meds don't change sensory issues. DS's writing issue appears to be a sensory motor planning issue (which can manifest in anxiety masked as perfectionism). We hope OT will automate some of his lacking skills. For writing, meds without therapy proved ineffective even while the meds were highly effective in almost every other life-quality category, including mood and social.
    -Meds can be completely ineffective if the child is getting too little sleep.
    -We sometimes use on-and-off-meds timed math facts tests to identify whether a med is working properly for the boys...get a baseline to track production.

    QUestion...how long did your psych take to titrate up to the 20/30mg dose? Did he give you worksheets to track titration over several weeks? Track side effects? On that dose weight loss is not surprising--and insomnia might also result depending on when she takes the second round. Around here sleep loss is the #1 reason for med inefficacy and lack of productivity. On the higher doses, we've also learned that meds don't fully leave the system until well past their purported "window"...if at all, depending on the frequency of dosage. Might be interesting to find out when your DD did written work in relation to med intake if she says she wrote while off of meds.

    Last edited by ilmomto4; 01/05/12 12:04 AM.
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    I didn't read all the replies (just got back to Texas last night from 2 weeks in Thailand!) but to answer your question about ADHD meds that quit working after a while - yes. It is quite common. Especially during the transition through the teen years and into adulthood. It doesn't mean she doesn't have ADHD, or that she's outgrown it. She might be better able to cope with it, however. She's old enough to understand how her ADHD effects her and I'd encourage her to continue to see a psychologist if not a psychiatrist, still, on a regular basis.


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    Nik Offline OP
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    Okay, I am revisiting this issue given recent events. I thank you all for your responses and I apologize for the gap, I have been overwhelmed with the events of the last few months.

    Originally Posted by ilmomto4
    QUestion...how long did your psych take to titrate up to the 20/30mg dose? Did he give you worksheets to track titration over several weeks? Track side effects? On that dose weight loss is not surprising--and insomnia might also result depending on when she takes the second round. Around here sleep loss is the #1 reason for med inefficacy and lack of productivity. On the higher doses, we've also learned that meds don't fully leave the system until well past their purported "window"...if at all, depending on the frequency of dosage. Might be interesting to find out when your DD did written work in relation to med intake if she says she wrote while off of meds.

    I believe we started at 10mg am and 10mg at noon, after a week that was no longer effective, we went to 20mg/20mg and after a couple weeks that was not effective, then we went to 30mg/20mg and that worked very nicely for a few months. We were not given any suggestions or advice about tracking effectiveness. The insomnia was pre-existing and didn’t get worse with the meds (it may even have improved slightly) DD wrote the essays about 2 months after quitting the meds but she wrote them on the last day of the semester under the threat of expulsion and I think the adrenaline may have helped. Unfortunately she decided that was effective but that method failed to work for her in the next semester. So here we are.

    My DD has never been to a Psych, she was always against it but is now willing to go.

    I want to set up counseling, CBT and med trials with professionals who know what to look for and how to monitor effectiveness. What kind of professional am I looking for? Psychiatrist? Psychologist? Therapist? Counselor? Do I need to put together a team myself?

    I finally found a counselor with an opening on my insurance plan who specializes in ADD and Anxiety, she does CBT, biofeedback and neurofeedback but she can't prescribe meds.

    Our doctor (a DO general practitioner) had no trouble prescribing meds last summer but she doesn't seem to have a lot of expertise in ADD. I had to request an EEG as they weren't planning on doing one when they first prescribed the meds. We had no follow up from her at all. When we called in that the rx seemed to lose effectiveness, we were given new prescriptions with higher doses until we ran out of time and were at the highest dose for methylphenidate according to the nurse who seemed to be misreading out of a book.

    Should we just go with the CBT counselor and ask our general DO to start trying different meds? Am I looking for the wrong kind of professional to start with?

    sorry for my neediness, my brain is full

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    Nik, I persist in thinking that your DD's issues stem as much from her autism as from her ADD.

    If you can find one, a team will be best. My DS's autism case supervisor (psych) manages behavioral therapy, but works closely with another doc who can prescribe meds (in your DD's case this is likely to be a psychiatrist). IMO you are more likely to find an autism doc who can also treat ADD and anxiety than an ADD/anxiety doc who's equipped for autism.

    The counselor you found might work well for behavior change (the behaviorist principles of CBT are similar regardless of the diagnosis, they treat symptoms on a case-by-case basis)-- but my bet is that your DD will do best with someone to manage meds with her, and that you will need to add someone like that to your team.

    I would not let a general practitioner prescribe meds that alter the brain. My strong preference is for a specialist who's seen lots and lots of kids and young adults with autism, anxiety, and ADHD.

    DeeDee

    Last edited by DeeDee; 05/20/12 10:30 AM. Reason: punctuation
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    Nik Offline OP
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    Originally Posted by DeeDee
    My strong preference is for a specialist who's seen lots and lots of kids and young adults with autism, anxiety, and ADHD.

    DeeDee

    Yes, I agree, I would add someone who has also specifically seen lots of gifted females with ASD...but WHERE do I find this specialist? What do I search for? I have spent hours and the 2 people I found that might come close have 7 month waiting lists!!!

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    Originally Posted by Nik
    I have spent hours and the 2 people I found that might come close have 7 month waiting lists!!!

    Put yourself on both lists and also keep looking.

    That's my approach to life.

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    I don't know if this is helpful but I had a thought that maybe you could do phone consultations with an aspbergers specialist who then wouldn't have to be local.  I googled "aspbergers specialist" to see if they had a list like hoagies keeps for gifted specialists.  The first link was for a thread on college confidential which was here:
    http://talk.collegeconfidential.com...rgers-specialist-but-none-my-region.html


    So... The essays she got done were the recent ones or the ones in January?


    Youth lives by personality, age lives by calculation. -- Aristotle on a calendar
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    Nik Offline OP
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    Originally Posted by JonLaw
    Put yourself on both lists and also keep looking.

    yeah, we're on a couple lists.

    I had our doctors office call the one that I thought looked best to see if they could get her bumped up on the list due to the fact she was depressed and had urgent need. The great sounding doctors office called back and told me they would not be able to see my DD, not now, not ever, they were taking her off the list! No explanation why. I'm not sure if it was something my doctor told them or if it was just a psycopath working in the office. Why would they say that?

    Thanks for the link La Texican, there’s a lot of links in that thread, right now I am overwhelmed but I’ll look through them once I recharge.

    The only essays she produced were the ones in December 

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    There are some physician finders from this home page: http://www.aspergersyndrome.org/Home.aspx

    Our best help has always come from the autism centers of research hospitals, specifically children's hospitals (I know she's not a child any more, but you can still call them for referrals).

    DeeDee

    p.s. If you are googling you will get more hits with the correct spelling: Asperger's Syndrome. No offense meant, just a correction.

    Last edited by DeeDee; 05/21/12 04:35 AM.
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