New here - Grandson has ADHD

[NMR8177]

Hello,

My husband and I are guardians of our 9-year-old grandson, who was diagnosed with ADHD when he was 4. We love him and are thankful for him, but he has been quite a handful for us. He is in 3rd grade this year and we have just started him back on his medication. He takes the generic form of Concerta XR, which is the 2nd one we have tried. He was originally on Vyvanse, which he took for about 1-1/2 years, starting when he was 5. He was in Pre-K that year, and his teachers said it helped him tremendously. The main problem with it was that it killed his appetite, and his growth virtually stopped. At the middle of the year in Kindergarten, we talked to his doctor about our concerns and he said to try taking him off the meds for a while, which we did. His teacher said that she thought he was doing much better without it. He became much more social, was happier, and soon began eating and growing normally.

In 1st grade, he also did fine, although the teacher told us at the end of the year that we might need to consider resuming medication in 2nd grade because more would be expected of him. She had managed him well, but she said he did have trouble focusing and she had to redirect him often.

Last year was difficult, for many reasons. His mother moved back to the area, and this did not have a good effect on him. We started having a lot of behavior issues with him at home - mainly with him being physically aggressive with me when I tried to correct him. We started taking him to a behavioral therapist/counselor and talked to his doctor about starting him on medication again. His 2nd grade teacher did not have any behavior issues with him, but she did say that he had problems with staying on task and focusing. In October of last year, his doctor prescribed the Concerta XR, and the teacher said that it was helping him greatly. Once again, however, he lost his appetite and started losing weight. He was quieter and calmer until the medicine wore off. Then he had quite a "rebound" and we had more discipline problems with him at home. He resisted doing his homework, and he became more impulsive in doing things he knew he was not supposed to do.

We took him to the counselor for about 7 months, but we did not see much improvement in his behavior or attitude as a result. We saw the doctor again, 6 months after he started the medication, and he increased the dose and prescribed a short-acting med to help with the rebound. Again, it helped him more at school, but not at home.

After school was out, we decided to give him a break from the medicine, and he began to enjoy eating again and seemed much happier. We enrolled him in a good summer day camp at our health club, and he enjoyed that very much.

At the beginning of this school year, we discussed the situation with his teacher, and she recommended that we not start him on the meds again until she had a chance to observe him when he was not on it. We are about a month into the school year now, and it is apparent that he is struggling. He says he doesn't like school this year and that he has to sit all day. He says he is bored, and I am sure that he is not making much of an effort to do well. He has had a fight with one of his classmates for the first time, resulting in them both losing recess and having lunch detention for 3 days. He was disrespectful to their substitute teacher and was disciplined for that. His teacher sent a message to me this week, letting me know that he was having a very hard time focusing and staying on task. She didn't say that we should start him back on his medicine, but I think we probably should. The problem is that he is very resistant to taking it now. We gave it to him yesterday, and he complained of a headache and stomach ache all day long. The teacher messaged me about it, and I told her that it could be a side effect but to send him to the nurse and give him Tylenol if necessary. Today he was once again resistant to taking the medicine, and I am not sure that he really took it because he ran away after putting it in his mouth and might have spit it out.

We have a conference with his teacher tomorrow and an appointment with the pediatrician next Tuesday. That is where we are. I look forward to being a part of this group and would appreciate any comments or suggestions you may have.

[Hidden]

First of all, you are an angel for taking in your grandchild. I know that can't be easy! Do not give up! I wonder if the situation with his mother has put some ideas in his head about his self worth and being unwanted? If his therapy didn't help, it could be that he didn't have the right therapist! When you are talking to him, be sure and tell him that he is growing up, and you want him to have more responsibility, that you're counting on him to do his best. Talk about the future, and encourage him in his interests. When my daughter complains about school, I remind her that not all things are fun but that if she wants to be a veterinarian, she has to do her best. We set small goals, such as 30 minutes of homework, then she gets to do something fun for 20. None of us have the answers, and once we figure out one kid, along comes one with totally different interests! Good luck!

[NMR8177 in reply to Hidden]

Thank you for the encouragement and your suggestions. We will definitely never give up on him!

[Elijah1]

If he is only getting medication on school days, this does not let his body get used to it so appetite effect persists. If he is getting it daily, consider changing to Focalin (dexmethylphenidate), which is in the same family as Concerta but is the right handed isomer (hope this does not bring back bad memories of high school chemistry) of methylphenidate so exposes him to less total medication (and, hopefully, less chance for appetite suppression). At the present time, make sure he eats a hearty breakfast and is allowed to eat a late dinner if he is not hungry at dinner time.

[NMR8177 in reply to Elijah1]

Thank you for the information. I will ask the doctor about Focalin next week. Yesterday he did not take his medication (only pretended to) and his teacher said it was obvious that he did not take it. Today he did take it, and she said he was able to focus and do his work so much better. I had a conference with her today, and she had many positive things to say about him. He is very bright, and he is above level in reading, math and especially in spelling. I was dreading the conference because I was afraid he was not doing well academically, which he always has before.