Gifted Issues Discussion homepage Forums Twice Exceptional ADHD and the stimulants are prescribed :(

Visited pediatrician today. He felt the unspecified ADHD diagnostic was correct, but the IQ scores were too low and werent even close. Dr is prescribing Quilivant.

My husband is very upset. I told him we are out of options, that there are no alternative schools and this is what happens to kids like ds when thrown into a class of 24 with one overworked teacher and unrealistic expectations coming down from the hierarchy.

If anything his behaviors are worse in his new classroom, but I can't bear switching him back to the other teacher who I associate with the witch in the Wizard of Oz.

This is a hard blow to take. I'm afraid all they will now see is ADHD and not the fact that he is brilliant. And I wonder what happens if he can't tolerate the meds? He already leans to the anxious side of things already. I guess I start the countdown until he graduates!

Do you feel ADHD is a diagnosis that is more apparent and understood or are the # of cases actually increasing like we see in the Autism Spectrum? Too many questions and not enough answers!

I am sorry your family is feeling unsure. Did your husband attend the appointment? Could you schedule a follow up for questions?

Is Quilivant a stimulant? I've never heard of it.

I think stimulants can cause anxiety, esp. if the dose is too high. But the worst thing that can happen is you try it, it does not help or you see bad side effects, you take him off, and are back to square one. You might even find that the meds settle him down and he is less anxious. You never know til you try it.

I'm not sure how much the school knows but if he's not on a 504 plan or IEP it's up to you how much you share with them. Most of DD's teachers know nothing about her ADHD and she does so well on meds they would have no reason to guess. I tell all the regular classroom teachers when she starts each new year so that they can keep me informed of how things are going and if there is anything strange happening that might be due to the meds, but not the others who only see her for a short period of time. I don't think anyone thinks anything of the ADHD, and the teacher last year thought she was doing great, and was uninterested in even talking about it.

hard to say if ADHD is on the rise or if it is simply diagnosed more. Kids with ADHD have higher levels of pesticides in their systems (on average) so there is probably a environmental component to it (maybe multiple unknown things), but also genetic. The older generations were probably the ones who got paddled a lot in class and labeled the troublemakers, but not diagnosed.

I don't remember it at school in the 1970's in NZ. But our classrooms were a lot less frenetic. Group work, bright colours and table instead of desks are fine for most kids but the individual,quiet working at your own desk was probably easier if you had ADHD or sensory issues. I think it was easier for me as I hate heaps of noise and group work.

We had one out of thirty in my 7th grade class with ADHD ...we all knew she had problems with hyperactivity and had no patience at all with her, I still feel bad for her. Who knows how many inattentive type were in my class? they aren't as obvious to other kids.

Here is a great lecture on ADHD:



I have been watching Dr. Barkley's entire series on ADHD on youtube and it is very, very enlightening. I am trying to learn as much as I can b/c my son is being evaluated for it as well and I do think there is a very good chance he will be diagnosed with it. The most important things I have learned from this series are: (1) It is a very real and very debilitating disorder and, as a result, it is really important that it be treated; (2) while it is very serious and debilitiating, it is VERY manageable and treatable. I am no longer as afraid of DS trying the drugs to manage it once he is properly dx'ed; (3) From his series on adult ADHD I realize now my father and brother were/are very, very likely severely ADHD (and no it wasn't diagnosed back then but my father was beat A LOT in school and at home as a child as was my brother. My father is dead now but I believe my brother is still very severely adhd and it does affect his quality of life greatly particularly his interpersonal relationships; (4) 1 in 6 kids do grow out of it (he said research has shown that number could be as high as 1 in 3 but they are not sure yet) but it needs to be treated regardless.


I hope this helps you and your child These lectures have educated and helped me so much coming to terms with this. Now I am almost anxious that he be properly dx once and for all so we can start managing and treating this.

Also, I have learned enough from Dr. Barkley that we will probably start DS on non-stimulant meds b/c of his anxiety and tendency towards axiety tics. The stimulants are great for kids without anxiety, ocd and tic tendency but my kid has those so we probably will not go that route.

Good luck and hang in there. It really is a very, very manageable and treatable disorder - so much more so than any of the other disorders so if your going to have a disorder this is a good one to have b/c they have great meds and therapies.

I wouldn't say it's "easily treatable". My third cousin who is eight was put on a stimulant and they removed him from treatment because he lost 3 lbs the first week. Other children develop tics similar to Tourette's. The stimulants can cause children to have long term growth delays.

Our friends ds who graduated last year was on 3-4 meds and finally was home bound due to severe anxiety issues after a teacher made comments in class that he wasn't fit for the honors class because he could only do half the work of the other students. He developed such severe panic problems that it appeared he was having seizures, but they were panic attacks.

The only girl I know who had ADHD dropped out after being a social outcast. Our pastors ds had to be homeschooled after he started high school because he couldn't keep up with the homework and focus in school. He still has severe social issues!

While there may be individuals who are successful, most people have a very difficult time surviving school. It's a lifelong struggle and "easily treatable" means there are medications available to treat the issue, not that it cures the problems. Just my 2 cents.

I think if you watch the link I posted you'll have better information and have more hope. Instead of relying on anecdotes, educate yourself about the disorder and the treatments.

Oh and I don't think I ever said it was "easily treatable" rather I said it was "very treatable" and "very manageable"... And it is, particularly compared to the other disorders such as bipolar, anxiety, etc

My pg ds8 had a misdiagnosis of ADHD - which is a long story in itself. A couple of weeks ago I took him to the pediatrician's office for his annual and was talking about his current treatment, misdiagnosis, previous misguided advice, etc.

The pediatrician and I both said that the first line of treatment should be diet and then neurofeedback or other alternative routes before meds. I know others may disagree here with me, but if I had followed the advice of the former pediatrician (who is a colleague of the present one and in the same practice!) I would have put my son on meds, possibly done more damage than good, and never got to the root of the problem to begin with. The current pediatrician agreed with me.

I'm not saying that meds are not sometimes necessary or warranted with an ADHD diagnosis. I'm just saying that I'd get a second or third opinion before pursuing meds and/or exploring alternative treatments first before the meds.
That's my 2 cents.

About a year and a half ago, I took my ds to a 2e expert on the ADHD diagnosis because I questioned it and the lower IQ scores with signs of him being pg. 2e expert asked if I had considered medication. I immediately asked her, "what about neurofeedback" - based on seeing it a discussion on it here on this board! Well, that was the end of our discussion on meds and then the start of our discussion of getting to the heart of the neurological/sensory/attentional issues with ds.

Questions:
--Is this a regular pediatrician? We use a developmental pediatrician who specializes in the medications and issues relevant to our child; we find that her expertise is reassuring. I would be reluctant (as you and your DH clearly are) to let a regular pediatrician, no matter how fine, prescribe meds of this kind to my child. This is a personal preference on my part, not necessarily what most people do.

--You seem to feel that class size/ school is at fault here. My perspective is that for a child with a disability (like ADHD), whether or not the child is medicated, environment and teaching should be optimized through a 504 plan or IEP at school. At the same time, a child with ADHD may not thrive without medication, even in a smaller class-- neither meds nor behavior strategies are usually the whole answer. Feeling driven to medicate by a poor school situation is a hard place for you to start this journey (though not atypical). I would encourage you to begin working on making school better.


You can request a Functional Behavior Analysis from the school as part of a complete educational evaluation (which is necessary to get a 504 or IEP). That will provide information about how to make school better. You can also offer private diagnostic information to the school team during their eval process.


Stimulant ADHD meds are short-acting and typically out of the system quickly. A developmental pediatrician can help you sort out whether the anxiety is severe enough to warrant treating with a non-stimulant like Strattera instead, or prescribing an SSRI along with the stimulant. It *can* be a hard process to get meds right. But done well, it can make a huge difference for a child.

THIS... (frustrated sigh). My DS9 who loves his fruits and veggies (he eats much better than DD11) is the one with the ADHD (combined) diagnosis. I tried organic and it cost a fortune... and I didn't really see a difference, so I'm inclined to think that part of his issues were developmental at the time (this was several years ago). I'm glad to be reading this thread, though, because now that he's a bit older and has changed and improved (ie developed!) I might try organics again.

My two cents also. I ABHOR the meds-first approach, particularly with a condition such as this that is so subject to mis-diagnosis. If there was a definitively medical test for it (such as there is for diabetes), then it would be different.

My DS9 has never been medicated, and yes he struggles sometimes, but he has also dramatically improved and outgrown many issues (he was diagnosed at age 7 with "severe" combined type).

Just to be clear - I'm not anti-meds - sometimes kids really need them. I'm just tired of the "a pill for every ill" approach in our system that makes you wonder if the doctors are more concerned about their fee than the patient's long term well being.

My apologies if I've offended anyone... that wasn't my intention.

Here's an interesting article from a few days ago. http://www.nytimes.com/2013/12/30/h...ys-zeal-for-drugs.html?pagewanted=1&_r=0

I do have to say that I can't imagine any kind of cognitive or behavioral therapy alone being effective with DD's ADHD. The meds cause an almost immediate and dramatic improvement. I took her off for a couple days over break and within hours she took a marker and drew all over the walls and furniture. I gave her a magic eraser to clean it all up which caused yet another mess (completely soaked flooring). She doesn't do that sort of thing on meds. We have never had the option (with our insurance) to try any kind of therapy without spending thousands of dollars but we have a new plan and will be looking at it to see what we have covered and if it helps. Our old insurance would cover meds but nothing else in relation to ADHD, not even a comprehensive evaluation. The OT apparently has some ideas on how to improve executive functioning and processing speed, but I also want to talk to a psychologist.

Our take and that of our trusted medical team is that the meds give the person enough focus to learn and access the missing skills; but of course the skills must also be taught and practiced in order for this to pay off.

I would agree with DeeDee, but I think where this sometimes gets confusing is that many parents on a forum like this probably consider it perfectly normal parenting practice to deliver training that some kids might need to receive as "therapy" in addition to medication.

I often look at differences between my DH and I and find it very hard to tell what differences come from only one of us having ADHD and what differences come from skills that one set of parents had to teach and the other set of parents was clearly completely lacking themselves....

Certainly what we see in our dd is that medication allows her to learn skills that she was not able to absorb without meds. Once learned she can still apply those skills off medication, bi with far FAR greater effort required. But those skills weren't things I would have sought therapy for... It's just stuff we couldn't teach her without medication...

To everyone - many thanks.

You ever feel you just don't know where to start? I called a very well know hospital near us and they don't accept children like ours in the neurology dept. because he doesn't have issues like seizures, brain trauma etc.

I've read and read and I guess we suck it up and accept that our bright child has ADHD. And that he may never prove his IQ because he does poorly on certain tests. DH and I do know that there ate sensory issues. Attention (or lack thereof) can't explain the fact that he is highly sensitive to smells, and some make him gag.

We have started a low dose of Quilivant. So far, at first we thought we saw a slight improvement in mood. Today was awful. We had an 1 1/2 hour drive for an eye screening. He was very argumentative and during the eye testing he acted horrendous. "Typical" ADHD behavior which is not typical for him. I don't get it. Is he putting on a show? Sometimes I think he does it because he knows I can't spank him in certain situations, because he can usually turn off a lot of the behavior when we leave. I guess we will have to increase the dose until we see improvement.

I feel like I have been sinking into a depression over all this. No one that I have known has ever had a good school outcome If they also had ADHD. All I see is endless IEP's and meetings with angry school personnel. We're half way thru Kindergarten an I'm already tired of it all. We had a friend whose son had such horrible times at school he developed panic attacks that looked like seizures. Horrific. I live with the fear that this extremely bright kid won't survive school, manage college, an will work for a grocery store the rest of his life.

At home it seems his forgetfulness had gotten worse in the past few months. Our major issue at home is ARGUING! He thinks he knows everything. Tonight he wanted to argue that the 1/4 moon was really a 1/2 moon. All that he learned from a Berenstein Bears episode on fractions. He thinks he can spell every word, but he hasn't even developed complete proper speech, so he spells like he talks. (Which is hilarious) however he doesn't want to be corrected - ever.

I did find a counselor that specializes in gifted kids with a six week wait and a 2 hour drive. Praying she has ideas, as she is well versed in ADHD in gifted kids.

Once again - thanks! I guess this is my group therapy

DD is doing very well in school since she was medicated in March of 1st grade. Before that, not so much. She basically sat there looking completely zoned out and did everything 10 times slower than everyone else (if at all). But with the meds, we have had very few problems. Her processing speed is slow and I want to get her a 504, but it's not because she is having any major problems. It would add very minor adjustments (like allowing her to wear headphones in class or give her longer time to take the SAT) which could help her out.
She just got a card in the mail from her teacher, telling her that she is a great student, so hardworking, and organized as well (yes, organized--LOL). She is one of the top 2 or 3 kids in her grade in terms of achievement scores, even after being grade accelerated. This is the kid who just wrote all over the walls with a marker when she didn't have her meds. So don't despair--ADHD doesn't necessarily have to be a major handicap if it is treated appropriately. It may take you a while to figure out what works best for him. We had to try several different meds with different doses for each med.