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ADHD Parents Together
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Back to school

My son is 10 and has just started 5th grade. He has struggled with ADHD since he was 4. He is also struggling with what I think might be SPD or anxiety. We are treating him for ADHD and anxiety. He does take medication in the morning that should last at least 7 hours, but he is still struggling in the classroom (as usual). He is a very bright kid and does make decent grades. He has had issues with sitting still and not being quiet. I got a call from his teacher yesterday and she was concerned because he has no impuls control (tell me something I don’t know)🙄. He is fine in the mornings, but after they have lunch and PE, she states he is very disruptive in the classroom. He does have a 504 plan so that we can try to manage his behavior and the way he learns. We had to take him off of Quillivant XR and put him on Quillichew due to the shortage issue. I’m just looking for any tips and also wondering if anyone has their child on 2 extended release medications during the day. The morning is a struggle for him to get up and get going and the afternoons and evenings are terrible. Any suggestions?

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MonO2Boys-

Sounds like you are doing a great job. Do you have him in counseling where he discusses these issues. We were told medication on controls %60 of impulsive behavior and they need to learn to control %40. But it also sounds like his medication is not lasting long enough. We give our son a second dose in the pm for sports and homework, while it is at equal the am dose it helps a lot.

Also try to not have heavy academics in the afternoon for him since that is a hard time of day. But of he is still not controlling himself on medication, sorry to say it might not be the correct dose and he has not learn to control.his behavior. It may take time and maturity. So much involved, role modeling also is someone at the school helping?

Best of luck

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We also have a second dose in the afternoons for sports and such. We have also been working with a behavioral therapist for about a year now. That’s not counting the other therapists we have already been through the past 5 years. Im going to discuss with his Dr on Monday to get his Quillivant filled and take him off of the Quillichew. You would think it would be the same medication, but for some reason they work differently for him.

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He also has a 504 we are dealing with. Of course, it’s like pulling teeth to get them to make changes for him. It’s only 2 weeks into the school year so I hope that things will calm down. I have talked to his homeroom teacher myself and told her that she and his other teacher might want to speak to his 4th grade teacher and see what she doubt that would help him. I know allowing him to move around in the classroom helped. Most teachers don’t like putting a child off into a space by themselves, but in his case it works best. It’s just getting the teachers to understand this. I’m going to try and look into getting his core classes out of the way within the first few hours of school. I’m currently looking into blended learning schools. I’m not concerned with PE, art or music so much. We can always handle those things outside of school.

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Do you have special educational support? There should be a team at school helping you. Let me also say ( I can tell you have worked hard already) but you are really laying out now what is to come in the future so do what you can now to make him sucuccessful now..

Hope you find school Specialist ( that work in the school distict) to come and help you. You know what works and doesn't, just apply that to the school environment, you can be creative.

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Is quillivant back on the market? It worked so well for us and now we’re struggling to find something similar, the shortage has been horrible.

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I checked with our CVS pharmacy yesterday. They have the 120 and 150ml bottles back in stock. I will be calling his Dr tomorrow to get him switched back. The Quillichew has not been as effective as the liquid.

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Thank you! I’m going to call around and see if it’s back in my area. We’ve tried two different medicines since the shortage and although cheaper, neither have worked like quillivant.

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4th and 5th grades were the worst for us! My son was sent to the office on so many occasions it was like getting a daily cup of coffee! School academics start to kick in durning 4th/5th grade, and we noticed the bigger struggles with our son. Hang in there.... you will make it through this. I’ll share some things that worked for us.... fidgets, bands on the chair for his feet... we stuck Velcro strips inside his desk to run his fingers across it...and our teachers allowed him to advocate for himself (to move to a more quiet location to work).

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I tried Velcro for my son, but he just fidgets with ripping them off. Fidgets do help, but we can’t seem to make it through an entire school day without losing it. Lol.

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My son gets a lot of focus/relief by chewing gum! I wish that were allowed in school. It really helps him!

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Is there a way he can get a little quiet / mindfulness time after PE? For my son, physical activity is good, but it also burns out his self control (which is already in small supply.) Sometimes a little quiet time or even some small sips of a sugary drink (Gatorade, lemonade, etc) help him recharge his self control a little bit.

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I wish their was. The teacher reminded me that they are on a STRICT schedule.🙄

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That is why we have Federal laws which help children with disabilies... Please remember she is a general education teacher who only deals with children who do not have any issues. She is not trained to assist your child.

I would consult with the person who wrote the 504 plan ( I hope this person has a special education background) to talk about things that need to be put into the classroom to help him. Maybe soft velcro under the desk to rub as way help him stay on task. Also is the academic work appropriate for him ( maybe some subjects are not challanging enough, not sure). But if medication is not working it would be a good idea to get that adjusted or have him go at lunch and take a 2nd dose.

Please don't let this go on or the teacher will only get more upset.

Let us know what helps, we are help for you.

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Remember, it is the districts job TO EDUCATE YOUR CHILD. Tell them that they need to cater to each child not just the norm. Strict schedules need to be adjusted to accommodate all! My son just started 4th grade and hasn't made it more then an hour in the classroom. Last year started his running out of class when he felt overwhelmed. He is also extremely bright, bored in school, adhd, suffers from impulse control and is rigid in his thinking, has trouble with transitions. We had wonderful support from our learning center and totally agree that you should push the school to support him with counseling pull out and options to go to the resource room/learning center when he needs a break. It was very helpful for him as well to have a place in the classroom where he can take a break. Hang in there mom, it's hell for us all.

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That is what APE( specialist that adapt regular PE in smaller rooms) this often works at lower grades, a little harder in upper grades.

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We had to change from a 504 to an IEP as he got older. He takes a dose of medication at lunchtime although that doesn't always getting through the day either.

Good teacher will allow small space at the back of the moon for them to stand up and move around as long as they're not disrupting the rest of the class. Sometimes having hard candy to suck on will help them Focus. Neither of my grandsons schools one of them have fidget spinners or anything like that because they said they were too distracting or the kids would start playing with them instead of using them to help concentrate

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My child blows right through xr capsules so we find (in our case) 10mg ir focalin at 7, 5mg ir focalin at 11am and 3pm to get him through the day.

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Have you guys considered a multiphase ( they release a small amount over a long period of time) medication with a higher dose? That is what my son takes and it lasts until 3pm, it really works for him. We also take a drug for focus and that is a 24hour drug when we take at night so it helps the next day.

Can't say enough about our Pediatric psychiatrist who really knew how to prescribe these medications to work for our son. What a difference, but I am not sure how long these will last before we will need to increase or try another.

Best of luck

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My son has such a fast metabolism that the meds don’t last as long in his system. Quillivant XR is the only one that we have found that will last him 7-8 hours for a school day. Then he takes 10mg of Focalin that lasts about 3. We have tried all of the 24 hour meds with no luck.

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What’s the 24 hour drug your son takes at night?

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Intuniv (guanfacine).. he takes that in the pm to counter the stimulants to sleep at night. It's a great mix. But I will say his am medication is the best.and having a multiple phase with a higher dose is the best for us. The afternoon is jot as effective.

Best of luck to you in finding the right mix. I never thought we would be taking 2 different drugs.

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Ah... we tried adding guanfacine to my sons routine (takes Ritalin) and it was terrible for him. Seems to work for so many kids, I was so hopeful. Oh well, the search goes on... thanks :)

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His metabolism is crazy high. Plus hes only 39-40 lbs. Pediatric psychiatrists are basically all non network and my husbands insurance will not cover any out of network services. Also, I dont know about you, but they are very expensive and few and far between. I took him to one, it cost me 575 dollars and his conclusion ( because he cant has a difficult time regulating his emotions was to prescribe lithium). The first follow up visit would he 475 and then 375 for all subsequent visits.

Others that are also out of network charge between 500 and 600 for the first visit and then 200 to 300 each subsequent visit. I just cant afford that.

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Unfortunately, we have the same problem. I have tried every one who is on our list for insurance. Only one takes children under 14 and he is not taking new patients. Our mental health system (especially for kids) is really crappy.

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I understand what you are going through. I thought my daughter metabolized Adderall XR extremely quickly and we had the genetic test to see if that was the case. Test showed us that she does metabolize it very quickly so we are increasing her dose of the XR. if things go as planned, the peak will be higher and the time it stays in her system will be longer. We are also trying to add clonidine to carry her through the day once the medicine wears off. Only on our second day of clonidine but fingers crossed that it works. Don’t know if any of this helps, but maybe you can glean a nugget of info from our experience.

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Hi I’m surprised you were prescribed clonodine during the day to help. My son was prescribed this at night to help shut down his brain and was a sleep within an hour. I’ve been told kids that have a fast metabolism typically don’t do well on XR drugs and my son was one of those. We increased the dosage and milligrams and neither worked. He worked much better on having a small dose of meds at breakfast , lunch then late afternoon to help with homework. He takes Focalin and it’s the only drug that has helped him focus and control his impulses.

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Interesting. I hadn’t heard that. Wow. Lots to think about. Thank you. The clonidine is given to her at night but not to shut down her brain. It’s being given in conjunction with the adderall for concentration and behavior because we don’t want to give her more adderall throughout the day since she doesn’t eat when she’s on it.

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Interesting. Does she get tired on it? My son took a clonodine (.01 ml) and a 1.5 melatonin gummy to go to sleep. I had to stager them 1 hr a part and it was the only way to help him get on a normal sleep schedule. He recently came off the clonodine over the summer given he’s getting less meds than during the school year. Kids typically don’t eat on XR which was another reason I took my son off. With the short acting drugs he’s able to eat a good healthy breakfast and eats well at lunch as well before he takes his lunch dose. Just something to consider. We always had the school nurse or camp counselor (summer) help us during administer the lunch and late afternoon doses given we both work and it works fine. We also bought him a watch with alarms and it reminds him when he has to get his afternoon doses of meds. He’s a pro at it now at 13.

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Hi my son also had a very fast metabolism. Our 1st dr put him on Focalin XR twice a day because he was chewing through it in 4 hrs. He was very quiet, didn’t have much energy, wouldn’t eat, and couldn’t focus after 4 hrs. Switched him to another psychiatrist and she said kids with fast metabolism do much better on short acting drugs not XR . We switched to short acting (4 hr dose) and what a big difference. My son goes to a Catholic school so no 504 or other accommodations other than a small (15 kids) math class. He has severe ADHD but can focus and not get in trouble with smaller multiple doses of meds vs the XR. He’s now 13 and we’ve been doing this for 5 yrs. I’ve never heard of the meds your child is own but you may want to consider multiple short acting (4 hrs) dose of the drug or try another drug. With the right drug it should help them so they don’t get in trouble and can focus. We tried 7 different meds/doses before we found the right one. Plus it took me 3 different drs. I know it’s frustrating and a long journey so continue to have faith and move on if the drugs aren’t helping.

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We too had to switch from a 504 to an IEP. You can get much stricter accommodations with the IEP. His grade school thought of it first but finally gave in. His middle school has been very cooperative and put some great programs to help him succeed.

After all these years medication is still trial and error

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