My daughter is 12 and has ADHD Inattentive Type. We started meds recently after she came to me saying she felt her brain wasn’t working 🥺. She’s very well behaved and bright and fun, but very slow with transitions, distracted, and extremely forgetful. She loses things, leaves a trail of messes, and just takes forever to do stuff like getting dressed for school or eating. She doesn’t have a good awareness of time.
She’s been on Concerta 27mg for about a week (upped from 18) and I see no difference with being able to complete tasks or remember things. She says she can’t tell if meds are helping or not. She says she has “good days and bad days”. Focus really isn’t an issue…she can sit still and focus pretty easily. She’s the opposite of hyper but easily distracted and “spacey” (for lack of a better word).
What is the next step here? Change meds or continue to increase the dose? Are there specific meds that help with remembering and completing tasks and being less distracted? We follow up with the pediatrician this week.
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Hi! I am the mom of a 9th grade daughter with ADHD inattentive type and mild anxiety. Who is on Concerta 36. We are a family of 4 all with ADHD… 11th grade daughter has ADHD hyper focus with anxiety. Husband has ADHD inattentive and I have ADHD hyper focus with anxiety. Although we have 2 of us with each ADHD type, it affects us all differently. My youngest currently is the only one on medication. The children are the only ones professionally diagnosed. However I had them diagnosed because of my own understanding of what I was going through and trying to figure out my husband and our marriage. Executive functions have been our friend-enemy… aka frenemy.
Our youngest started on Concerta 18 and over 2.5 years has grown to Concerta 36. It took her about 12 months to recognize if it was working. I believe this was due to maturing/ growing up at the same time and just learning to recognize inner differences, being mindful enough to recognize them. Along with me constantly asking different questions to assess what she at first couldn’t express. We also had her only taking meds on school days or days with a great amount of focus/ patience would be needed. So that may have given her a comparative from school day to weekend. After 4-5 months on Concerta 18 I started to recognize that she was calmer on the med days. Slowly she started to voice to me that she could feel that on med days she was more effective, mindful, on task, could focus/ less anxiety on say a timed 1 hour math test more than when she didn’t take the med.
Do You see a difference, even if slight, when she is in the med?
After that moment she could then tell me ‘I think I would like to try to move up to Concerta 27’. That was in the start of 8th grade. Then in august before 9th grade she came to me and asked to talk about moving up again. That her current dose doesn’t feel as supportive. She now takes meds most everyday except if she sleeps past 10am on a weekend like teens can. sleep is an important factor in this house.
It’s been a journey. During that time she grew taller, more weight and importantly she grew in and matured. So our Concerta journey has done so with her. We were counseled to always let her be an active part of the medication path and ADHD journey and that has worked well. Slowly as she matured she is taking more responsibility for her ADHD. She lets her close friends know she has it. She’s not afraid to talk about it in public and has even done reports at school and speeches supporting herself and other students on the same journey.
That’s the positive side of it. There are with all human journeys pros and cons. She struggles with memory, immediate recall, short and long term. Reading a room or humans in a room is not a skill she’s conquering yet… aka interrupts a-lot. Her bedroom is very tidy but her school bag and notebooks are not at all. Her writing is so smart but the organization to her thoughts and therefore writing need a lot more organization. Time is eiether creating anxiety in her or she’s totally lost the sense of it depending on the activity. Her fuzzy brain fights mindfulness constantly. That’s how we came to recognize something different was happening to her. This started at early puberty for her. Hormonal shifts in our life cycle are normally when people “feel the onset of ADHD” and begin to recognize executive dysfunction. She has a high IQ but on timed tests doesn’t do well. She aces homework and projects thankfully which balances out other stressful memory or timed assignment grades. My youngest describes her head as being fuzzy when not on her med or towards 3pm as it’s wearing off. Unfortunately high school is longer than middle and homework time means the Concerta is almost out of her system since she takes it at 8am. She has to try extra hard from 4-10pm to maintain. In contrast my oldest, who is not on meds, describes her brain as fizzy pops when her ADHD is affecting her. For the good and bad ADHD hyper focus helps with school, projects and getting an education (like a rabbit hole) but not at all in your personal life.
My youngest was a straight A student and well rounded until about 6 grade. Unbenounced to us she was using her IQ and memory to really just look at something once and test well on it. From the outside she looked like a great student and easy going child. With the onset of puberty came louder ADHD signs and a lot less mindfulness. High school also brought so much more required information into her world. She never was hyperactive but very creative, great imagination and as you say ‘spacey’ or as I have said would make a great ‘barefoot on the beach gypsy girl’. I now believe that’s the lack of executive functioning and specifically mindfulness which leads to the loss of time managment and or self managment of tasking.
I say all of this to hopefully give you just one example of a comparative or to give contrast which sometimes can have us see things clearly or spark an idea of a new direction.
Our journey with Concerta took time. At the same time you hope your child will grow and their brain and nervous system will catch up with each other. So you can work off of meds as an adult, maybe. That their ability to express feelings and be mindful of their own inner body changes will increase. It takes time.
We have also worked with diet, physical activity/ exercising/sports/ body movement, supplements and minerals, sleep schedule and frankly every kind of schedule I can print out. Lol. Checklists and post-it’s everywhere in the house to help with tasking. With 4 different ADHD journeys going on I’m sure we look unique from the outside. Thankfully my own ADHD hyper focus makes me a great project manager and researcher. Not great at some other things, like resting, however.
We all take D3, methylated vitamin Bs, probiotics, and vitamins that have a mix of whole food vitamins/ minerals/ prebiotics. My kids don’t love all of that. My research and reading says it helps. I can see that the better quality nutrition we have the better humaning we can do. I’m a big believer in the mind gut connection.
I also have tried to keep fake sugar, sodas, foods with fake ingredients or food coloring out of the house. That part is hard with teens. They eat alot of food outside of my control now, which is natural as they get older. However since they still come home every evening my husband and I can see the outcome. Lol. However soon they’ll go to college and need to do this all for themselves. It’s my job to share the skills and have them practice them before that moment.
I know this was long- sorry! I only write long. Ha!
My advice… Be patient. Give the med and your daughter another month unless things are really haywire and you and the dr decide differently. Have your child be an active part of all these conversations. Grow together. Remember that the expert in the room is only the person who knows more than the rest at that specific moment. If you read up enough than that may become you. Follow your gut. Trust that your child (or companion in others cases) is not intentionally trying to make things hard. ADHD and all it’s spectrum side pieces needs a-lot more research and understanding. Oh yeah, and once again TRUST your gut not always your parent brain. Keep an open mind and an open heart.
Sending parental high five to you for extra strength!
Thanks for your response! I’m very intrigued that it took 4-5 months to notice the meds working because the doctor told me it would be 4-5 DAYS and then we could switch to a different one if we weren’t seeing a positive change. I guess what Im wondering is whether medicine will help with remembering and getting things done or just focusing, which isn’t much of a problem.
I believe the doctor is technically correct… however the child may not notice if it is helping or may not be able to express the changes happening inside. That process may take longer. We have not found it directly helps with memory. It does help with having the brain/ thoughts stop racing around so much so that my daughter can more easily be mindful and practice memory skills. If your brain feels like it’s constantly playing a game of musical chairs then it is difficult to practice other skills such as memory, patience, kind words, concentration.
I think hopefuljourney’s post was very good in that she described so well the common difficulties for kids with inattentive ADD and how medication for our kids is a bit more nuanced. Kids with ADHD—yes, you immediately see a new ability to sit and engage. Kids with inattentive ADD were already sitting! It was there mind that was not engaged. So recognizing how medication is effecting your child’s focus when on medication will depend on what they are trying to stay engaged with.
For example, our son doesn’t ‘need’ medication for hanging with friends and during the summer, but he definitely does for homework completion and classroom focus, because that is where he struggles with staying focused and getting work completed.
Along with ADD often comes executive functioning struggles and, for many, slow processing speed (despite being very bright). While medication does not fix these things, it can help, especially as a child is also learning coping strategies to overcome them. Learning coping strategies and finding work arounds (watches that quietly buzz as reminders, checklists, routines—even making responses to written work routine, placing household items in locations to trigger a remind, waterproof clock in the shower, etc, etc) is especially critical for our kids. Many of our kids have 504 plans or IEP’s at school that allow for extra time on tests, ability to record lectures, etc) Medication without these other pieces will still help, but will not be nearly as helpful.
In a nut shell, do not give up on medication. The effects are more nuanced for inattentive kids and it may take both you and your child a while to recognize impact. Do not underestimate the critical importance of therapy/coping strategies/ practicing mindfulness/ advocating for school accommodations for add related difficulties as this is where it’s at with inattentive add.
Thank you for this. We already have all the accommodations and creative supports in place but she was telling us she needed more. We’re talking to pediatrician again today. You reminded me we can try a watch again (she tends to misplace it) so thank you for that and your insights that it may be a subtle improvement. Not what I hoped but helpful to know.
I have not and I hate to admit it but it feels overwhelming and nearly impossible to control because I hear dyes are in everything. Is this something you have had success with?
Yes it is absolutely helpful. Kids with ADHD should be minimizing their sugars and eating more protein and fruits and vegetables anyway, none of those things contain dyes.
Dyes are in a lot of things but they are not in things we should be eating anyway. Focus on whole foods and store brand organic packaged foods because those will not contain dyes.
Trader Joe’s and Aldi are both stores who try to stay away from dies and excessive bad ingredients.
I would also suggest trying a couple months trial of micronutrients from Hardy brand nutritionals. There are a bunch of clinical trials showing that they make a big difference for kids with ADHD and autism.
Hi, we’ve tried other brands of micro nutrients but not Hardy. Although over the last few years I’ve looked into them. Mostly haven’t tried them due to overwhelm of trying to do so many other adhd support pieces. Can you share what specific product(s) of theirs has worked or not for your family? When I look at their offering I get brain locked on where to start. Thank you!
Okay, thank you. Ours meals are healthy, organic, high protein homemade snacks, but then the kids get dessert every night and sugar every time they are with friends it seems! I do shop at TJ but didn’t know that about the dyes there. I’ll also try Hardy now that she can swallow pills. Thank you all for your good ideas, insights, and encouragement! I’m grateful for you all! We keep our senses of humor and patience around here but I was feeling discouraged as I thought meds would make a big difference right away!
sounds like you are on the right track. just double check for dyes and MSG. Nothing wrong with dessert especially after a healthy meal. Just try to keep it from being a total sugar bomb on a regular basis. There are some options better than others.
We're in the same boat over here: 12 year old with combined type ADHD and we just upped his doest from 18 to 36 Concerta. 18 was great at first and then it was like nothing was in his system and his ability to emotionally regulate, remember much of anything, or even have a conversation was difficult (his thoughts were all over the place.) We increased to 36 after about 6 months of giving 18 a go (that was too long to wait but we he's my stepson so I don't have control over when we get to up his meds, other parent has to sign off and is to on board with meds to begin with.) When we started 36 he was really aggressive and irritable and I got worried we needed to switch meds completely (like legit frightened of his behavior!) But we gave it another 2 months and so far he's a lot less irritable but the memory issues are coming back.....I don't know if that's just natural due to what a person "cares about" or does not. But I'm mostly concerned with executive functioning for things like hygiene, school work, and chores. If he doesn't remember the details of 3 hours ago because he doesn't care, can't make him care - but getting him to remember to brush his teeth before he leaves the house, yeah that one we're struggling with or even getting him to bring his homework home.
1) If the meds aren't helping, it might be something other than (or in addition to) ADHD. Maybe try one of the non-stimulant meds (e.g. Straterra, Wellbutrin) that are also antidepressants, since that could kill two birds with one stone.
2) I was diagnosed late as well (my first year at university) and when I started on meds, some effects were like a light switch, while others took time. Your daughter has behaviour she's learned and embedded into her life for 12 years, and even without ADHD it takes people time to change habits. I look at meds as being a tool, not a catch-all solution. It will take your daughter time and support to change her habits, and the meds will hopefully make learning those changes easier. I highly recommend she watch a YouTube channel like "How to ADHD" which comes from am informed place, is hosted by someone who lives with ADHD and openly talks about some of the things that are challenging even with treatment.
More than anything, what was most helpful for me from the diagnosis was the realization that there was a reason I couldn't do certain things, and that it wasn't a character flaw or lack of willpower, but a developmental issue. That meant that rather than continuing to try failed strategies, I could shift my focus to creative solutions and workarounds.
Medication can be an important part of the picture, but it's only one piece of the puzzle. There also needs to be an overhaul of how you and her teachers see her, how she sees herself, and how she approaches problems. There's a lot of learning to be done, and a lot of time learning to understand.
Thank you. I appreciate all these thoughts. I like the idea of helping her (and me) change habits. She’s my youngest so I’ve definitely picked up the slack for her while my others are less demanding in terms of help. Years ago we took her for a six hour neuropsych eval and everything besides ADHD was ruled out. Shes very smart and has great social skills. I’m thankful we didn’t start meds til now because she has learned to strategize and cope in lots of good ways, but I do think I’m expecting too much from the medication. Doctor wants to try one more increase since we’ve had no side effects and see if that makes a difference. I’m also going to look at this summer as a chance to challenge her to do more executive functioning on her own. I’m also going yo get her on a better sleep schedule. Thanks again!
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