Gifted Issues Discussion homepage Forums Twice Exceptional Time to homeschool again?

Yes, he has had chronic constipation since birth. He is doing much better with this now though (just over the past 6 mos) and is no longer taking medication for it. He usually goes once every day or once every other day.

Grinity-thanks for the ideas. I will talk about that with the teacher.

We had our meeting today, and it actually went very well. Dh and I are soooo relieved after attending this meeting. The administrator, who has a master's in child development, basically said that ds is struggling emotionally and socially (which we knew, of course), and she wants to help us get to the bottom of it. She feels there is definitely more going on than ADHD, and she does have a lot of experience with lots of children, many of whom have had ADHD. She said that with the medication, the gap between social/emotional development and intellectual development should be closing to a degree. She seems knowledgeable about giftedness and understands asynchronous development, but thinks there's definitely more going on that that.

She said immediately that she didn't want me worrying that they were going to tell us ds was a poor fit for the school. She said, "We are here to support you and ds and help your family."

She suggested a child psychiatrist that she took her son to for similar issues. Also, other parents from the school have used this doctor and had a positive experience. My mother has some experience with her as well through her job, and she said good things about her as well.

Also, the administrator recommended that we see the child psychologist from the same practice who specializes in the issues that we are dealing with, including ABA and CBT! She recommended individual therapy for ds and family/parent therapy for us. She said she or the teacher would go with us to the initial psychiatric appointment if we wanted them to. That way, we can make sure the doctor gets a complete picture of what's going on. Also, she wants to make sure that we are all using the same techniques from home to school, so that ds has that continuity.

She also recommended their school psychologist do the neuropsych testing, but I think we'll stick with the neuropsychologist. Her thought on that was that we'd all be working together, and these are all people from the same team who work closely together. I like the idea of the neuropsychologist rather than school psychologist for this testing though.

They definitely think there is some mental health component going on, and the administrator specifically referred to depression. She was definitely knowledgeable and knew the signs to look for. She did say she was not qualified to diagnose anything, but she thought the child psychiatrist was the best place to start.

She and the teacher expressed concern that the current ADHD medication (Ritalin) could be contributing to the increased anxiety, aggression, and anger. Over the weekend, we observed some definite negative changes in behavior. Ds just seems angry.

I called the developmental behavioral ped today, and she said that these symptoms are on the list of "serious side effects" for stimulant meds and that maybe ds is just not going to tolerate stimulants. We can try Strattera, but I am inclined to do nothing until we see the psychiatrist. She will do blood work as well, which our doc never did. Not sure if it's necessary, but we'll take all the info we can get.

Overall, dh and I feel so relieved because we finally have a cohesive plan with lots of support. This way, we have an entire team working to help ds. Not one time was there any indication that they had their own interests in mind. They even suggested a guide (helper who is a psychology student) to be available in the classroom to help ds. We'd do this after he is evaluated and specific goals are set up. Again, this would help to make sure he gets the support he needs and the continuity of "treatment" and behavior techniques between home and school.

I can't believe we're getting all this help through a private school! Of course, we have to pay for some of the services, but it's nice to have the help coordinating it all.

I was floundering and about to fall apart myself. I needed someone to take charge and say, "Ok, this is what we need to do. We're going to figure this out together and address it." We are really grateful as this meeting went so differently than we expected.

As for now, we are going to stop the stim meds and continue to give the B12, B6, Folic Acid, Omega-3 Fatty Acid supplement, and vitamin supplement formulated for attention and concentration. We'll see how it goes. If all hell breaks loose without the medication, I'm not sure what we'll do. We can't see the psychiatrist until Dec. 2.

Thanks for all the ideas and support. If you made it through this novel of a post, thanks, and I'd love to know what you think!

That's great news!! I love having a team to support our DS also. It does make a big difference. It sounds like you are moving in the right direction. Nan

Jen: that's awesome. You are on the right track! And I'm glad the school is stepping up to help you more. You will figure this guy out, and he will flourish with the right help.

DeeDee

I can't wait to read the sequel!
More seriously, this seems like a good time to stop the Ritalin and see how things go. Anger can be from so many things, from medication, to an often overlooked symptom of Depression.

I'm so pleased that the school is working with you. Yippee!
I would still persevere with the daily emails. In the begining you can simply express your appreciation for the teacher and not even ask her for a positive - just report on a positive your son did at home and how he just glowed when your praised him for it.

Just a thought - you are going to need some prop to get you through the next 6 months, yes?

Love and More Love,
Grinity

Thanks everyone!

No meds today: inattentive, lots of frustration resulting in meltdowns, however, no anger or yelling at others and no aggression. Continuing with B12, B6, Folic Acid, Omega-3, and "attention vitamin supplement". I'm considering giving him his medication tomorrow because he gets so frustrated when he can't focus and do his work.

We were able to get an earlier appointment with the psychiatrist. In fact, we are going Thursday of this week! Not much time to prepare, but so glad we're getting in there. I need to call the doc tomorrow to find out if we should give ds his Ritalin before the visit or not. I'll update after the appointment. Thanks again for all of the support and advice. You guys are amazing!

Jen, in your shoes I'd hesitate to go back to the Ritalin dose you were using-- yes, it's short-acting, but extreme swings may be just as irritating and confusing as lack of focus. Do you have a smaller dose available? Have you talked to the doc about off/on dosing?

What is "attention vitamin supplement"? Is it FDA-approved? Do report everything, not just prescriptions, to the psychiatrist when you go.

I'm glad you got in so early!

Best,
DeeDee

Yesterday, I gave a slightly smaller dose. These are instant release, so you can cut them in half. He still had 5 meltdowns at school and was cranky with me after school. I definitely think the Ritalin helps with focus, but I also have no doubt that it's contributing to the emotional mood swings. He tends to get frustrated easily and have crying fits (gets down on himself) when un-medicated. When medicated, he still does this a good bit, but not quite as often. With medication, however, he has more angry outbursts and is irritable and extremely touchy (goes off at the drop of a hat). Someone can bump into him, and he thinks they did it on purpose. When not medicated, he is still quite sensitive, but he doesn't blame others. His negativity and anger is more self-focused, which isn't good either. If I go lower on the dose, it doesn't help with the focus, but it still seems to make him cranky. I think we need something else altogether, maybe a non-stimulant like Strattera! Haha, go figure, Deedee. Where have I heard that? : )


No, it has not been FDA approved. It is similar to multivitamin; it's just in liquid form. It has extra of a few vitamins and is loaded with fruit and green vegetable extracts. I ran it by the compound pharmacist who does my HRT and vitamin supplements (all based on my blood work). I will ask the doctor about it today as well. It's called Liquid Health Attention Dietary Supplement. I know several people who RAVE about it.

For anyone who is interested, the Omega-3 supplement we use is called Barlean's Organic Oils-Omega Swirl Lemon Zest. It tastes YUMMY!

Also, the B vitamin is called Superior Source B-12, B-6, & Folic Acid. We know someone who's daughter uses this and Omega-3 exclusively for ADHD, no ADHD meds at all. It is effective. Of course, that's one child, but it's interesting. This is a child who had to be hospitalized because of violent behavior related to Vyvanse. She had toxic levels of amphetamine in her body when tested.

I'll let you know how it goes after the appointment.

I don't have much time to add lots of details right now, but basically here is the doctor's opinion:

Official diagnosis right now: Gifted, ADHD, Anxiety

Possible diagnosis according to the doctor: PDD-NOS(pervasive developmental disorder, not otherwise specified); the doctor says he meets some of the criteria for a spectrum disorder on a very mild scale, but not enough to diagnose Asperger's (at least not at this point). He feels ds's anxiety is a result of his rigid thinking-thinks things should be "this" way, and when they are not, ds melts down. He also referred to the fact that ds was colicy, has sensory issues(both sensory seeking and sensory avoiding together), atypical responses to ADHD medications, difficulty reading social cues (ex: thinks people are being mean when they are not and doesn't know when to stop correcting people even when they are not being receptive to his "help".), extreme sense of justice, and adherence to rules. I just can't think of everything right now, but it make some sense coming from the doctor. I don't know if we'll end up with an Asperger's diagnosis at some point or not. I hope not, but I guess it's a possibility.

The more I read, the less convinced I am, however. Especially reading the DSM diagnostic criteria. I am willing to accept this diagnosis if it is, in fact, accurate. BUT I'm NOT willing to squeeze him into the ASD box if it doesn't fit.

Right now, we are using Ritalin IR, Prozac (starting very slow), and we are considering CBT. He may also have a "guide", or helper, at PE and possibly in the classroom if needed. We are really hoping to see a difference in the emotional regulation issues with the SSRI.

Will update more later. Thanks again for all of the support.
Jen

DS7 is improving significantly (especially at home) with the addition of the SSRI (prozac). He is on day 3 of Focalin, a stimulant med we have not yet tried. It's extended release and supposedly very smooth, so hopefully ds will have fewer ups and downs throughout the day. It doesn't last more than 6 hours, however, so he'll probably need it twice daily. We tried not giving stimulants at all, but EVERYTHING got worse...focus, emotional regulation, concentration....

So, we'll see how he does with this. The more time we've all spent talking with the psychiatrist and psychologist, it's looking more and more like we're dealing with gifted/adhd issues and not a spectrum disorder. DS does have anxiety, likely due to perfectionism and frustration with asynchronous development. Not to mention, anxiety and depression occur in both sides of his family. His emotional regulation difficulties are very typical of kids with ADHD, and it's not unusual for stimulant meds to NOT help as much with these types of symptoms. This is an aspect of ADHD I was less familiar with, but I've learned a great deal recently about the lack of emotional regulation skills in children with ADHD.

Hopefully we'll find the right combination of medication/counseling to help ds. He starts CBT tomorrow with a pediatric psychologist. I've met with him, and he is really wonderful. I like the fact that we are going to get some hands-on practical strategies to try at home and at school. The psychologist will go into the school to observe and demonstrate implementation of the strategies in the classroom setting. We'll all be able to use the same terminology and encourage use of the same techniques/strategies.

Thanks again for the support and advice.