Treatment for ADHD or ADD

TopazStone · May 12, 2002

Check the DSM-IVR for the specific criteria that a child should meet for a diagnosis of ADHD. There are several different types as well: Impulsivity dominant, inattention dominant and hyperactivity dominant. As with any psych disorder, it should only be treated when it severely impairs a persons ability to function. Without medicaton, my son cannot sit still long enough to write a sentence, blurts out socially inappropriate things, drives his friends away from him and hits others. He is impulsivity dominant. Medication has been a Godsend-- he is doing well with schoolwork (in the gifted program), but the social skills needs lots of work. Just because a teacher cannot handle a child's behavior does not mean he needs meds; it could be he is understimulated in the classroom and the teacher needs to challenge him more.

Trauma Columnist · May 12, 2002

My son is now 17, was dx'd with ADHD at age 8 yrs. He was on Ritalin until he was 13 when it began to cause behavioral changes. He became depressed, hospitalized several times, been to residential and many other (far worse) problems. He now has been dx'd as bipolar and with meds is doing absolutely fantastic.

Please, as the mother of a mentally ill son, don't put your kids on stimulants w/o getting a second opinion, not just your family doc, but a child/adolescent psychiatrist!!!

Editorial Team / Admin · May 13, 2002

Agree w/above: by all means, get a second opinion, approach it from a professional angle, not just someone's opinion who "thinks he may have ADD." Social misbehavior, impulsivity, distractability, all push friends/teachers away, even if child is academically capable -- and child's self-esteem suffers, as with boobaby's experience, although the drop in her child's confidence was initiated by uninformed teacher or just a poor match of temperaments (he got labeled at some point, and teacher couldn't give label up). We finally made the decision to medicate w/Ritalin after K thru 2nd grade struggling. Study of temperaments and sessions w/family-child counselor ($$$$$, no ins. payment) were helpful, but you can't send all teachers, and guarantee they will learn or use what will be helpful with your child. It is truly frustrating and you feel so helpless, yet mad as a grizzly to protect your offspring. Meds have helped our child, as has time and maturity, and using the principles we learned in temperament classes. When we were first going thru the throes of figuring out what was going on with our child, I would often say to myself, "If I could just get into his head and know how he is thinking, what is his logic, I could circumvent, suggest, guide differently. . ." 'Course, with the impulsivity, it's "Do it, then think." Just try and follow that! Study, read, pray, and ultimately do what is best for the child. If that means changing classrooms, teachers, schools, medication, counseling, SI evaluation and therapy --- whatever it takes to help the child. I could go on and on . . . It is a very volatile issue, as boobaby has illustrated so well. Courage! --- Diana

Jenny P · May 13, 2002

Both of my kids are ADHD; but they are as opposite as can be with their hyperactive behaviors and attention spans. My son (who is now almost 23) was a week old and would be awake and alert for 12 hours straight- then he'd sleep 12 hours. Even now, once he is finally asleep, he is down and out for the count (so to speak- he's very difficult to waken). My daughter, at 19, has only slept all of the way through the night when they put her on sleeping pills- which she didn't like because of the "hangover" effect. When the school asked if we'd had each kid tested for ADD (our son as a kindegartener, our daughter in 1st grade); I took them out of our school and health care systems and had them tested (at our own expense- I think it cost about $500 each time) at an independant educational testing center. So for each child we ended up with 3 sets of matching diagnoses- ADHD. When they told us our daughter had the same problem as our son; it seemed impossible to believe because their behaviors were so different. Both kids ended up on Ritalin and (eventually) Wellbutrin; but now both have been very successful with Dexedrine.

Here in Minnesota, we have a group called PACER (Parent Advocacy Coalition for Educational Rights) which has information and support for families with children with special ed. needs. Their web site is:

http://www.pacer.org/

My kids didn't have special ed. problems, but the information and support I got from PACER gave me the courage to advocate for my kids.

Dianah, someone once told me that having ADHD was like trying to watch a TV program while the channels were continually changing. After watching my son (at age 7 or 8)with his leg in one pants leg, his T-shirt on his head and 1 arm and talking to his sister while trying to put his other shoe and sock on; I could visualize that "Yes, this IS what this child is going through"; someone is "flipping his channels 'way to fast!"

My son got into drugs when he was at Boy Scout camp-- after 4 years of He!!; he finally straightened out after being thrown in prison and getting scared straight. Looking back; I wonder if he was self-medicating with illegal drugs because the Ritalin/Wellbutrin wasn't working. (He's been clean for over 2 years now, and just announced he's going to school for computer programming!)

BjOnrs · May 13, 2002

For the past three school years I have struggled with the thought that my daughter was showing ADD/ADHD symptoms. Each of these years took a lot of different interventions combined to keep her off any medication, but when the time comes to go onto medicine there is little doubt. Don't just stick some med down a kid as a Fix it all because it doesn't fix it. You still need interventions and hard work to help these kids. Teachers are quick to score these kids high on the scale because the majority of them (not all) are to lazy to do anything extra to help these or any other kid that is different. But remember the Doctor uses the school's observations as just ONE part of the child's evaluation. :eek:

Editorial Team / Admin · May 13, 2002

Hmmm, I just wrote out a long reply and it disappeared. . . frustrating because I don't have time to write it again, must study for ACLS. Later --- Diana

lkushen · May 13, 2002

It sounds to me like the teacher is the one with the problem. One of the diagnostic criteria is that the symptoms appear in more than one environment (ie home, school, grandparents), thus the need for questionnairres by multiple people involved in the child's life. It is true that physicians are quick to prescribe stimulants and be done with it. I wasn't willing to stop there.

Both my daughter and husband are ADHD - went through channels of family doc, neurologist, psychiatrist for consensus on diagnosis before coming to conclusions, then attempted behavioral therapy for my daughter before Ritalin. Now also have other diagnosis including Aspergers (High IQ form of Autism) to deal with, but helps us to understand her.

Many ADHD are at different ends of the spectrum, either gifted or Learning disabled. These kids are entitled to IEPs in school to help them if needed (yes, you can even get an IEP for the gifted ones). Utilize the free resources of the school counselors as well. Get ready to kick, scream and fight for your child for the next couple of decades. Be present for your children in the school, and have frequent communication with the teachers.

There are support groups all over, check your local resources for availability. Most important, educate yourself about exactly what the disorder entails. This helps you better understand, as well as discuss it when necessary. Be prepared for lots of stereotypes about the disorder and the treatments. Finally, always question treatment appropriateness rather that simply just going along with it.

Good luck.

hogan4736, BSN, RN · May 13, 2002

Personally, giving pharmaceutical speed (Adderal, Dexedrine) to a 6 year old is criminal. I took the stuff years ago (I was 22 years old)...It helped me study, but felt THE SAME as cocaine!!!!!!!!

When a 7 year old tells you "my brain is going 100 miles per hour" (a DIRECT quote)...there is a problem, and don't let the FAMILY DOC tell you otherwise (by conservative estimates, pediatricians are prescribing 40-50% of this stuff today!!!)

These pills are way overused in our children. Take it from someone who has taken the stuff, not someone who thinks he knows what it's all about!!!!!!

Wake up parents!!!!

hogan4736, BSN, RN · May 13, 2002

oh, and for those who will come at me w/ the age-old "it has the opposite effect on kids" argument...save it!

I worked peds psych for 10 years, and spent 40+ hours/week w/ these kids (does the pediatrician/psychiatrist do that???)...same effects.

Why do you think clonidine is prescribed at bedtime??? To help the kid "come down" (similar to why coke addicts drink beer/smoke weed at the end of their binge)

Besides, has anyone read the PDR for most psych meds?

quotes:

"not for use under 12 years of age"

"has not been tested on children"

"not for use under 8 years of age"

why aren't the docs and drug companies telling parents this stuff? (though I do partially blame parents FOR NOT ASKING THESE QUESTIONS!!!!)

In my clinic earlier this year, I took care of a 6 year old kid who was taking Rispirdol!!!! Would the prescribing doc give it to HIS 6 year old???????????????

boobaby42 · May 13, 2002

God bless all of you. Thanks for all the comments and personal experiences. I hope all of the children get the therapy that is best suited for their situation. The evaluation process is time consuming and costly, but necessary for a proper diagnosis and treatment regime. Too many people in my area depend too much on the recommendations of teachers. It would be perfect if all the teachers were thinking of the child's best interest. Unfortunately, some just want a quick fix, a zombie in the classroom, a child that doesn't present a challenge. This is my opinion, and most teachers are not like that. Most teachers are very professional and practice with a professional code of ethics.

Far too many times, a child is placed on medicines without proper testing. Here to, the doctor writes the prescription too quickly to satisfy the parents or teacher. Now, this is my experience. I'm sure it's not like this everywhere. I hope to God it's not. My ADD patient's, in my opinion, just need attention, consistent discipline, support and encouragement from the family and a teacher that will take a little time out to give 1 on 1 help. I would wager that this treatment plan, given prn for 1 month would solve a lot of the ADD in my hometown. : )

Thanks again.

nightingale, RN · May 13, 2002

I will read this thread with interest because over the years some teachers have tried to label my son as ADD. I do not agree that he is. I am opposed to medication for him as I feel it is unwarranted.

B.