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ADHD Parents Together
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Is Behavioral therapy enough?

My son is currently on a 504 plan and I'm working with the school to get an IEP placed instead. He is currently working with a behavioral therapist. I get the question all the time "is he taking any medication?" Short answer, no. I was given Concerta to try out but haven't started yet. I'm waiting for a long weekend to try it. But honestly, I am terrified of giving medication. He is already a very closed off child and it's hard to get answers from him, I fear that if it's effecting him negatively, I won't know. His main issue at school is focus. Has anyone solely worked on that with therapy?

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They say medicine and behavior there together work the best. You could always give it a try.

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Just our own experience and all kids are different- we followed the guidelines and focused on behavioral therapy until age 6 and then added medication. The behavioral therapy had given us all tools that have been very useful but the medication has given him better access to those tools and has been life-changing for us. It did take a couple of tries to find the right med for my son but I am so glad we did. And so is he!

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I'm trying both.. so far I find it has been beneficial to a degree... I'm thinking it's time for a dosage change now.

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My grandson is doing so much better with both Concerta and behavioral therapy. I was scared too and I waited until he turned 6. At first, he had meltdowns at the end of the day as the meds taper off but that has gotten better over time too. His school performance and behavior is much more focused.

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PurpleMom11- thank you for sharing your journey with us. Yes we are doing thearpy and medication.

Many times parents think that starting medication will make a total change in personality, but that is not what happens with the medication. The goal is to just take the bad symptoms away. So this is a medication that will assist with focusing. That is what you will see.

We were told medication only helps with %60 of behavior and that thearpy snd accommodations will impact the rest. It should not make him more quiet.

Please let us know how it goes. You will only see a minor change in him.

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Thank you for all your encouraging words! I know my son needs the extra help and medication is the next step for that. I really hope this new step for us goes better than expected!

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Don’t expect to necessarily start with the perfect medicine or the perfect dosage. My daughter, 9 years old, started medicine in August. It was January before I felt like there was a noticeable, positive difference. That said, I’m taking her to a child psych specialist in adhd in two weeks to make sure that what we’re taking is optimal. Good luck! Be patient.

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in some ways, medication has helped my son during his closed off moments.

A lot of times my son doesn’t want to answers questions / offer info because ADHD seems to hinder his ability to recall - the memory is in there, he just has trouble accessing it. And then he gets anxious about that, and doesn’t want to answer anything.

Medication (and patience) helps a bit with that. Also, asking more specific questions (“what did you make at art?” instead of “how was school?”), adding visual aids when possible (have the school work in front of him when discussing / praising) and time of day (winding down in his room before bed) also help bring out discussions we maybe wouldn’t be able to have otherwise.

Best of luck!

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We are doing both. The medication has actually helped the boys to be less depressed so they are able to enjoy life better.

The therapy gives them to tools to help learn to control this on their own. Medication doesn't fix all problems.

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You don't need a long weekend. It will only last for 3-8 hrs depending on dosage. Try on a Saturday. Dose in morning.

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My son likes the medicated him better. But like many said it may take a couple tries on medication or dosage

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Be aware with medication that it can take time and patience to find the right medication and the right dosage in order to see a change. Some people are fortunate and find a medication that fits with the first one they try while others have to try a few different medications in order to find one that works best.

With my oldest son who has ADHD inattentive type, he was growing so fast during his high school years that I could tell when his medication dosage needed to be increased because his grades would stop dropping. It was an indicator he was having trouble focusing at school and getting things handed in on time again.

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Reg2018-

Thank you for your comment. Doctors don't share this detail with us and we forget they are human and the body is very complex...everyone can learn from this.

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My son and daughter - 13 yr old twins - 7grade) have ADHD. My son has an IEP & daughter 504 (not doing anything but she didn't qualify for an IEP (I didn't push very hard) and doesn't want help. Currently, she is also not on medication but did try 2. My son also has anxiety and is in a special intensive counseling program at school. He also has private therapy and is on Cymbalta (anxiety) and Straterra (ADHD). Even with all of the strategies in place, it is a process trying to improve focus and reduce anxiety and he needs to mature. His meltdowns are virtually non-existent in school now, but still some at home time to time. We have done focus strategies - redirecting, working with an aid in one class, etc. Not sure if it really helped or not. He has always been a good student - more because it's intuitive rather than learned. He gets concepts quick but often zones out (quite frankly, I think it is due to boredom). I guess I would say it is slow going. I tried so many natural ways of trying to manage it all before resorting to medication (I was very against it). But I had to do it, particularly for the anxiety. That said, both my children had bad reactions to medication. My daughter's was more recent in September, when she first went on medication (important to note she had just gotten her period as well). She was put on Concerta. We then increased the dose. She was VERY withdrawn and depressed and expressed harming and suicidal thoughts to friends - however, I don't know if this is true thoughts or just being done for attention. I also think that the medication could have exacerbated underlying depression that had been there for a while. We waited awhile and then tried her on Vyvanse. Took her off as she was very irritable. She is incredibly independent (& stubborn) and does not want an IEP or medication. She struggles to pay attention and is somewhat hyperactive but has made honor roll for both marking periods. My son was on short term guianfacine - it was ok but not very effective. We changed him to long acting and he had "bad thoughts." We tried Zoloft for the anxiety/depression, however, the reaction was the same. He is doing well on the Cymbalta & Straterra - not a cure but helping. Medication is a tough call and not to be done lightly. However, everyone's body is different and reacts differently. I did the genetic testing for both kids. It was helpful for my son but not helpful for my daughter and again, they are twins. It comes down to how bad the symptoms are and daily functioning and self-esteem vs. potential side effects. NOt an easy call. Good luck!

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I appreciate your honesty. Thank you for sharing.

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We tried Concerta with my son (diagnosed with moderate to severe combined type ADHD) and it was a disaster- he got weirdly intense and could not stop talking. For the first time in his nine years, he could not go to sleep. We stopped the medicine immediately and are just doing therapy and accommodations, such as he is allowed to stand up while working and take breaks when needed. . Some of what is hard about my son is ADHD and some is just that he is a kid and has a lot to learn. All kids are challenging some of the time and it is a hard thing to know what part of it is ADHD He is full of joy, curiosity and unquenchable spirit. If his impulsivity and trouble focusing start to make him too frustrated or unhappy, we will try medication again. I agree with others that this is an individual decision and there is no absolute right or wrong.

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Thank you for sharing! My son, although he's quiet, he's such a sweet heart. If that changed for the negative, I'm not sure I'll be able to continue either.

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Thank you for sharing your experience with medication, the journey is long.. Our son is 12 years old and we have tried so many. But it was not until I started working with a child psychiatrist that we found the right combination. Our son is smart, loves learning and is competitive in sports. With all of that said he can not function with out medications. As soon as it wears off we know. Our son's personality has stayed the same, but the annoying symptoms ( excessive talking, lack of focus, immature behavior impulsive behavior) are gone when on medication.

The way we did it was we knew life could be much better for him with the right medication and we continued with the Specialist.

Hope this helps, glad you are able to help him control things now.

Take care

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I understand your concerns. The wrong medication doesn't work with child a and does wonders with child b. I have two adhd children and one medication helped one and the other it caused seizures.

I do have a question are you changing for the school? Perhaps this website: schoolpsychologistfiles.com... might help with that decision. Concerta verses no medication? Each medication responds differently to each child. Have you researched Concerta? I don't remember that particular medication doing very much for my son. There are other drug choices. If your child is closed off, is he ASD? If so perhaps a medication that is supposed to improve concentration is not the best choice. Have you contacted a non-profit such as autism speaks or autism.org?

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I would love to know more about how medication to improve focus might not be the best choice. He was tested for autism but as I was told, the margins are really tight so his numbers didn't show him being autistic. He is currently being evaluated for asperger's. No diagnosis yet. I am leaning towards starting medication so he's not overloaded with work. I feel overwhelmed, I can't even imagine how lost he may be. His grades are lacking and not all of his teachers are as understanding or knowledgeable about ADHD. The pediatrician offered to start with Concerta as a first medication then move from there.

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I am sorry I didn't mean to sound that way; I should have said be wary. research all medications they want to give him. And don't be alarmed if the first medication doesn't work. Each person responds differently to each medication. If you are concerned about a medication, maybe you could speak with the pharmacist or someone with Chadd; chadd.org/ A non-profit for to help Families with ADHD. It is an excellent place for support with a wonderful knowledge base. Again Sorry I didn't mean to upset you.

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Absolutely not! Please don't think I was offended! I am very interested in the point you brought up. My son sees his therapist today, I'll ask about the connection between autism & adhd/ medication. Thanks again for your insight.

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How did it go at the doctor?

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Therapist informed me of a new diagnosis but needed another form filled out before telling me. I'm thinking she confirmed Aspergers but she hasn't contacted me since.

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When my son (now 11) was six he went on Concerta. We saw the difference immediately. He told his teacher "I can hear everything you're saying now." We still have issues but the medication (which my husband was against at first) has made all the difference. We were lucky that the first drug they tried worked. I know it's not for everyone, and it made take a trial and error process to get the right one, but give it a chance.

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I think you will do well by having a combination of medication and therapy. You want your son's attention and focus to be on point in school so he is learning all that he can. How will you know what he is a capable of if you do not at least try it? Also, how will you feel if he does not succeed in school and your decision could have made a difference? Just a question to ponder.

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Hi - glad to see you have so many amazing responses! I realized I never actually answered your primary question.

In a lot of what I’ve read, behavior therapy with a child at a counselor is actually not terribly effective to address ADHD, especially if the child is not medicated. (However, counseling can be fabulous for comorbidities and dealing with feelings.)

The most effective behavior therapy for dealing with ADHD are parent training and school accommodations. The problem isn’t that people with ADHD don’t know what to do - they know what to do, they just can’t access / act on that information when they need it. The behavior modifications need to be at the place the problem is happening - so parent training to deal with things at home & school accommodations to deal with school.

Combining this with the right medication is the very best treatment option, from a purely ADHD standpoint. I’m not as knowledgeable about spectrum disorders, so I’d definitely consult your pediatrician/ prescribing physician. Young boys are also notorious for masking one disorder as another - so sometimes treating one disorder can help another.

Best of luck!

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Thank you for taking the time to comment! I've gotten so much helpful advise. It's hard when doctors are asking me to disclose all the little things wrong with my child- in order to help him- when all I see is my sweet boy! But today is the first day he goes to school meditated. He did well during the weekend, I can't wait for him to come home & tell me about his day!

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Yes - all the questionnaires can be maddening! I felt like I could honestly give totally different answers at different times of the day.

I hope the day went well!

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