Any luck improving focus for a child ... - CHADD's ADHD Pare...

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Any luck improving focus for a child with ADHD on a non-stimulant?

MyWanderfulBoy profile image
23 Replies

My son turned 6 in August and he’s just begun 1st grade. He is not aggressive or oppositional.. he purely cannot focus and is way too easily distracted.. he loves learning but can’t pay attention to instruction and he has very noticeable anxiety in the classroom when he eventually realizes he doesn’t know what to do and has fallen behind the other students who are well into the activity already. His teacher has been amazing and patient and he has a 504 plan for preferential seating, extra time on assignments, use of visual cues, etc., but he can only focus in a one-on-one situation. Has anyones child had success with improved focus on non-stimulants? We’re seeing his pediatrician in a couple of weeks to get the ball rolling with meds. I read about stimulants making the anxiety worse so I’m a bit apprehensive to straight to those. Definitely open minded either way. Thank you :)

23 Replies
Aspen797 profile image
Aspen797

Hi! I hope others will chime in with good ideas regarding medication. Our son is primarily inattentive as well. We have been using stimulants but are going to ask to learn more about Straterra at our next appointment as our son has been having side effects we would like to avoid, if possible.

I did want to suggest—if you haven’t already—to consider an occupational therapy eval by an experienced practitioner. Sometimes our littles have difficulty filtering out all the incoming stimuli and some find that occupational therapy can help.

MyWanderfulBoy profile image
MyWanderfulBoy in reply to Aspen797

Thank you. I’m definitely looking into OT now. I’ve heard so many positive experiences about it.

Pattimum profile image
Pattimum

I know from my son’s experience with Methylphenidate that it does indeed exacerbate anxiety in idividuals who already are prone to anxiety. And the statistics show that majority of people with ADHD also have a coexisting anxiety disorder. In my son’s class there is another child who I know of that was treated with Methylphenidate- also had to stop it because of anxiety and a range of other side effects. Now both my son and the other child are on Atomoxetine.

As for the behaviour in the classroom - it might be like with my son who is about 2 years behind with maths so in maths at school he doesn’t focus as he says it’s all ‘too difficult’ - effect of undiagnosed and untreated ADHD (we only started medication when he was 8 and only now at age nearly 10 he’s on a right medication and the right dose- yes, it took a lot of suffering from a little man until we got this right for him). I mean, put yourself in such child’s shoes- wouldn’t you be anxious and not able to focus when you have to carry on like that every day and there’s is no help?

In maths lessons my son doesn’t focus, he is drawing doodles on his hand etc. This is because he has no clue what is going on and he can’t do any of the stuff and the class is 31 children so because he just sits there quietly no one cares. He has now a tutor coming weekly to our house and she says he’s taking in well and retaining ( yet another proof that non stimulant works!) and by December he will catch up with the 2 years he’s behind and start this grade’s program. He’s only been on a ‘right maintenance dose ‘ of his non stimulant since August and the tuition started in August. So I have a very clear picture - that the non stimulant does work. He is able to focus for 45 minutes. When we do 1 hour lesson- tutor gives him a 5 minutes run around in the garden break. I’d say he has had worse days and not wanting to think and focus, but we use now other strategies too. For example he told me that it’s boring how he gets those stickers and then the reward is always the same- stationary and mini toys from tutor’s box. So now we try a strategy of varying the rewards- let’s say he chose football cards, then maybe he can at the same time work towards a bigger (monthly or per half term) reward of going to the museum of his choice (a day trip). Kids with ADHD need variety and instant reward. They even need a variety of language you use to praise them- it won’t do it if every time you just say ‘Good job’ as this becomes meaningless for them. So that’s the trickiness of this for the school environment…

What I would say, do check what dose your child is on and is it the ‘right maintenance dose’ for his weight etc. In the UK all medication can be easily checked in BNF (pharmaceutical reference book of medicines) and anyone can access it on line or have a look in hard copy at the pharmacy (on request).

For some reason my son’s psychiatrist kept him for months on a too low dose for his weight. It’s very clear with Atomoxetine that following successful titration, the maintenance dose is 1.2-1.4mg per 1kg body weight. My son was kept for a couple of months on half of that, then I booked appointment and it was slightly increased and then I had to book another appointment (in a couple of months) to eventually get my son on a ‘right maintenance dose for his weight’. It’s a private doctor and we pay from our pockets (our private insurance doesn’t cover this) so makes you wonder why I needed to have 3 appointments within 6 months …I suppose I will leave it as a ‘very caring, very cautious doctor who wanted to be using the smallest dose yet effective in symptoms control.😉 However because the dose was too low- for months my son didn’t have good symptoms control at all! So do check as this might be the case- that the non stimulant is not doing what it should be doing because the child is on a ‘too low dose’. Also non stimulants don’t work instantainiunly. Because they work on neurotransmitters in brain they need to build up- I think it says it takes about 6 weeks for Atomoxetine but all the stuff I am reading in medical journals says that the true benefit is seen in the long run- after good few months.

I am aware that a very small percentage (about 10% of people) metabolise Atomoxetine differently and hence these people have to be on much smaller dose. I believe in the US there are some routine tests available which establish how this person metabolises this drug and then you can set exact right ‘maintenance dose’. In the UK these tests are not available - it’s done by slowly, over weeks, titrating medicine and stopping on a maintenance dose that’s not causing side effects yet controls symptoms.

I hope this helps and that you will find a non stimulant that works for your child. I know I am bias because of our very bad experience with stimulants but I’d I were you I’d stay clear of stimulants. It’s just my personal opinion after 8 months of suffering when my son was on stimulants.

MyWanderfulBoy profile image
MyWanderfulBoy in reply to Pattimum

Thanks for the advice with the dosing.. Good to keep in mind. My husband is on it for adhd as well and he’s having success so far so I’m hopeful a non-stimulant will help our son too.

Pattimum profile image
Pattimum in reply to MyWanderfulBoy

Would you be able to message me privately what medication and how your husband (adult) is finding it, let’s say side effects. I am already thinking ahead when my son starts puberty. I am worried that adults are facing different types of side effects on Atomoxetine.

MyWanderfulBoy profile image
MyWanderfulBoy in reply to Pattimum

Sorry to get back to you so late! My husband is on 80mg Atomoxetine (moving up to 100mg next week) and on 2mg Guanfacine (moving to 4mg next week). His main side effect is drowsiness.. the Guanfacine gets him very tired so he takes it in the evenings but he still has a hard time at work from the drowsiness. His medical Dr (not his psychiatrist) said it causes lower blood pressure so he’s been checking it with an at home kit to make sure it doesn’t drop too low. So far so good.

KnitOwl24 profile image
KnitOwl24

Hello! My daughter is 6 as well and in first grade. She has combined ADHD and we started on stimulants and it was horrible. She had terrible side effects. We did the genetic testing through Genesight after that and found she cannot tolerate stimulants and so went with Qelbree. She has had success with focusing on it, and being calmer in general, but we have some other side effects now and are seeing a pediatrician who specializes with psychiatry in a few weeks to discuss the medicine. She has Autism as well which makes things more complicated. Despite all that, I wish I had done the genetic testing first and had not put her through the stimulant trial in hindsight. And we have a list of non-stimulants to try which is helpful moving forward.

Best wishes!

MyWanderfulBoy profile image
MyWanderfulBoy in reply to KnitOwl24

Thank you. Please share the list of non-stimulants if you get a chance. I’m going to ask the pediatrician about the genetic testing.. sounds like good idea.

KnitOwl24 profile image
KnitOwl24 in reply to MyWanderfulBoy

Sure! She is currently taking Qellbree and they had also listed Strattera and Guanfacine (though we haven't tried either of those two yet).

Also know that the Genesight testing is on a sliding income based scale, which we found helpful in affording it.

Best wishes!

ECJH2022 profile image
ECJH2022

KnitOwl24 that’s all wonderful! Would you mind sharing your list of non-stimulants you might try? I am going to ask our pediatrician about genetic testing.

My son is 6 and has ADHD - inattentive type, sensory processing disorder and social anxiety. He goes to OT once a week which has been phenomenal. He’s currently finishing up sound based therapy which helped him to become desensitized to certain noises. He is only on supplements at this point, which is magnesium citrate, multivitamin with omega-3s, inositol, DHA, zinc and iron. All of these things have really helped him to be calm and reasonable, which helps when you’re trying to get him to focus.

MyWanderfulBoy profile image
MyWanderfulBoy in reply to ECJH2022

I’d love to know more about the supplements.. Where do you get them? What brands? Thank you! So happy your child has had such success with them :)

momlife7 profile image
momlife7 in reply to ECJH2022

I do also recommend DHA/Omegas we also supplement B vitamins and D in the winter with a quality multivitamin

anirush profile image
anirush

I have 2 grandsons who started on medication in kindergarten with two different experiences, and both have severe anxiety. One was started on Focalin XR and did wonderfully all through grade school, was on honor roll etc.

The other could not do stimulants at all. He has been on Straterra for years although we have had to add other medications to his mix.

As they have gotten older it has taken more medications to control their anxiety.

You never know what is going to work for your child until you try it.

Trial and error is awful but every child's metabolism is different.

MyWanderfulBoy profile image
MyWanderfulBoy in reply to anirush

Thank you. That’s so interesting.. I’m happy to hear they’ve found what works for them :)

ADHDgifts profile image
ADHDgifts

Best thing I learned almost too late (with a 14 year old) is to seek OCCUPATIONAL THERAPY. Many handle executive functioning and can really really help. I had no desire to start meds before this time (also on a bunch of asthma meds so adding more was undesirable) but if I could change anything it would be to seek OT immediately.

MyWanderfulBoy profile image
MyWanderfulBoy in reply to ADHDgifts

Thank you. Getting into OT for sure. I’ve been hearing nothing but positives.

momlife7 profile image
momlife7

my son is also 6 and struggled in kindergarten we tried lots of natural stuff trying to avoid medication. sounds very similar inattentive adhd, needs one on one to stay on task and we suspect some social anxiety after covid he is an only child. School staff seemed clueless as to what to do with him so we decided to try Methylphenidate. We were going to try nonstimulant as well but honestly I didnt want to waste more time risk falling behind more than he already is. He takes mon-fri off weekends and breaks is the plan because we have zero issues hes super easy for us. So far its made a world of difference in school.

MyWanderfulBoy profile image
MyWanderfulBoy in reply to momlife7

Thank you. This is so good to hear because it looks like that’s what’s about to happen for my son. We’ve just seen his pediatrician and are seeing her again for a follow up to hand in the Vanderbilt forms and get the rx. She said stimulants are the best first course of action for children and non-stimulants are good for if he can’t handle the stimulants. We feel this is coming at the right time because we can’t stand to see him suffer anymore and he’s beginning to feel “different” from his classmates for not being able to keep on task and continuing to interrupt the class.

IheartDisney profile image
IheartDisney

My son is now 10 and has been on Guanfacine for 2 yrs. It has helped tremendously slow him down and keep him in his seat. We tried a couple of stimulants but he could not tolerate them. I did find though as he has gotten older, he has been able to focus more. Remember, they are 2-3 yrs behind what their actual age is. One of the things that did help us was because he has a 504 plan, the school did purchase him a special standing desk. It also has a bar underneath which I think is used to raise it up and down, but he moves the bar all day with his foot and that helps him to focus as well. He really needed one on one help in school and a lot of redirection from his teacher, but again, now that he is in 5th grade, it has slowly been getting better. He still needs to sit by the teacher and she does redirect, but there isn't as much hand holding like when he was younger. He also does better in small groups instead of larger so that is also in his 504 plan.

BVBV profile image
BVBV in reply to IheartDisney

May I ask how many mg your son is on and if he takes in the evening or morning?

IheartDisney profile image
IheartDisney in reply to BVBV

he takes 2 mg in the morning. He didnt like it at night because he said it kept him aeake and he couldnt fall asleep

fuscia13 profile image
fuscia13

Well he's six, so is focus will be short lived until he's older. You could try some short mindfulness practices with him. 5 minute full body scan meditation. Things to help him learn to be present and let thoughts pass without engaging. These are things we can all do to improve focus. If you can make it a game, like don't look at the pink elephant in the corner, who can ignore it the longest kind of game. We live in a world of distractions and we all need to discern and prioritize the information we are receiving all around us. ADHD brains struggle to prioritize, especially since we are looking for new and interesting input. But I'm sure there's a fun way you can practice acknowledging the distraction and choosing to not engage with it at this time. In meditation they call it coming back to center or returning to the breath. Your son will have to learn to live with the distractions tugging at his sleeve and how to acknowledge it without engaging with it :)

MyWanderfulBoy profile image
MyWanderfulBoy in reply to fuscia13

He’s been doing neurofeedback to help with blocking out distractions and improve focus and we already do mindfulness exercises at home.. he’s also done behavior therapy which helped wonderfully with controlling big emotions. Bottom line is he’s unable to follow along, pay attention and complete tasks like all his same-aged classmates have the ability to do because they do not have adhd. My question was regarding experiences with non-stimulant medication with interest in hearing about experiences with stimulants as well.

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