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

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.