Please help!

[Kimmie2110]

My son is 8 years old. He takes medication for his ADHD. His behavior is school is fine. However, his behavior at home with me is challenging. I'm a single mom and required to do everything on my own. He is recovering counseling in school and in the community. I want to try something different for the New Year, because what I've been doing is not working. Please help!

[Mwadhd]

Our child is the same, and then became combative with me too, and I'm the helper, the one relied on. We've done more intensive counseling and looked for someone good with adhd and less cbt based, and have started abilify to help with agitation. I haven't been threatened by my child since they've started the med, but certainly is still an entirely different kid at home then what shows at school.

[Trying1978]

We too have the school vs home split with our two kiddos with ADHD: a just 7yo boy & an almost 9yo girl. It's beyond frustrating. The best advice I have gotten so far from a counselor was to let them vegetate with something for a bit as they transition out of school mode and the meds are also getting out of their systems. Of course, this is almost impossible to do with lots of activities, our jobs, not to mention the 3rd kiddo, who just turned 3, etc, but we are trying it when we can. I think I've asked a similar question in previous posts, if you want to click my user name and see.

But I feel you, as they say; it is not only tough but also infuriating. Hang in there!

[Hidden]

My son has always been like that- at school fine, following instructions from teachers and staff- although not achieving much as he was so inattentive that he just sat there not doing much, and of course as long as a kid just sits there, the teachers don’t care.

At home it was a different story - everything was a ‘no’, even oppositional about eating his dinner, any daily routine- everything oppositional and shouting that all he wanted to do was playing and that he hated me if I dared to ask him to do his spellings or maths or any homework. So we just had power struggles and shouting daily and the more I’d ask him to do something he would just be even more oppositional.

I kept reporting this at school and I was basically in between the lines told that it was ‘my fault, because I was expecting too much of him’. So I am sorry, but this was a lot of nonsense because my son is very able and all I was asking him was like ‘eat your dinner because we have to go to swimming lesson’ it ‘let’s go spellings because you have a test tomorrow’.

So anyway, I will stop rambling about my son. What I am trying to say that the breakthrough for us was diagnosis of ADHD. School never even vaguely suggested that he might have ADHD, I think they were just taking him as a ‘special needs, not able and why the mother expects the chicken to fly like an eagle’.

Ever since he started taking Atomoxetine things started changing for us for better at home- slowly but really for better. He slowly stopped being so oppositional, he responds to rewards chart and he doesn’t have melt downs after school when I ask him to do more revision etc (only 5-10 minutes I ask him, not more). He also is able to do after school sports etc and I don’t have to walk like on egg shells worried that he will flip and tell me ‘I am not going to swimming, I hate it.’ He has full on week and he’s coping and enjoying things and I don’t have to worry ‘Oh if I ask him to do spellings it will get him into bad mood and then he will tell me he doesn’t want to go swimming’. Honestly before medication I am sorry to say but at times I hated my son. I love him dearly but I just didn’t like him as a person.

Then, mind you, we also had a year when my son was even worse- more oppositional at home, aggressive, and a big mess- this was when he was taking stimulant Methyohenidate which we were told was first line of treatment for ADHD. This medication made him even worse than he was before diagnosis.

So for us a big change for better was starting him on non stimulant Atomoxetine which works 24/7 and somehow works especially good for children who were oppositional - that’s what psychiatrist told us anyway. Also my son has a maths tutor now, who comes for an hour weekly, and she does catch up maths with him and she also manages the rewards chart (I have no head for this😄).

You didn’t say if your son is on meds but I’d say non stimulant ADHD medication is a way to improve things for children who are oppositional. Stimulant meds will only make it worse.

[YellowPlaid in reply to Hidden]

This really resonated with me- my nearly 9 year old daughter is so defiant and stubborn and refuses to do even basic things every day- it becomes completely debilitating. We are just transitioning her off of Guanfacine because of terrible nightmares and insomnia, but had considered a stimulant instead. I'll ask her psych about Atom... and see what she thinks. Anything to help the opposition and over-reaction would be soo welcome.

[Hidden in reply to YellowPlaid]

Atomoxetine (Strattera but we use generic) has really saved us. But I know it’s not for everyone- like any other ADHD medication, instead of helping it can actually have side effects and make kids manic etc (that’s what I read in leaflet and medical journals about the side effects and it was scary to read, to the point that I requested my son’s general practitioner to do a full blood count on my son, check his liver function, his kidneys, everything as I was worried about adverse reaction) and some children have genetic variant which means they metabolise it differently and they need much lower doses (I think in US there are tests for it but in the UK it’s done by very very slowly over months introducing increased doses). Also some children get really sedated by Atomoxetine but it is said that often after a few weeks adjustment period the body gets used to it and there is no day sleepiness. I know there is also Qelbree which might be similar helpful for ‘oppositional’ as it’s also good for anxiety and depression so kind of 3in 1 ADHD medication. Qelbree is not yet licensed in the UK so would be no help to my son as we can’t get it here. I think (that’s my opinion but I think there is some research on it) some of oppositional behaviour is because of underlying low mood and anxiety but kids can’t express themselves. And I also think that kids sometimes start behaviour (let’s say oppositional) and then it almost like they don’t even know why, it’s then part of them, they can’t in their little brains comprehend why they are doing it but they keep doing it, like a pattern. Hence any medication that treats ADHD and mood/anxiety is probably better for those kids? Again, that’s my speculation because it worked for my son.

However we are also doing very simple behavioural intervention- me stepping away and instead my son having a tutor doing maths catch up with him, because with me he was in a pattern of defiance and spending hours just refusing. And with her - he just does it and also he responds to her ‘rewards’ chart where for me, especially in the past (before Atomoxetine) he would like say he hated it and didn’t care and he would really not care about the ‘rewards’. Almost like being programmed to say no to me but not to a tutor. And now slowly he even does maths for me- let’s say if I say let’s do 10 questions and then you can play on Nintendo, he will flip a bit but then actually do it. It’s like Atomoxetine rewired his brain slightly so he has a ‘normal’ response to ‘rewards system’.

Stimulants on the other hand do exacerbate anxiety and can impact negatively on mood so I’d say not a good shout with a kid who already is oppositional … Worth also looking at asking doctor for adding Periactin (antihistamine) as it’s over the counter and good record of safety in children (it’s even used on children who go through chemotherapy to increase their appetite as they are off food during chemo). Periactin is a mild sedative and given in the evening helps kids sleep, for some reason it actually also improves mood. Worth asking your doctor.

[anirush]

Sometime kids keep it together at school and let their hair down at home. It isn't easy to deal with that. Also medication sometimes wears off late afternoon or evening.

Keep up with the counseling and with his doctor about medication.

[Karkura]

hi Kimmoe2110. Similar with an eight year old boy and I was also a single mom from when he was 4 until last year. Went back to doctor again and they suggested a 4pm small dose of Ritalin which he takes also in the morning. And lunch. It’s made a world of difference. His bedtime moved back about 30 minutes but has helped him immensely.

[momwifedaughtersis]

hi, wanted to share something I’ve been reading about, and a strategy to try: There is a thing called “pathological demand avoidance.” I think it is more commonly discussed in people with autism, but my ADHD 10yo shows some elements of it. My son really hates being commanded to do things. At times, even asking him a direct question stresses him out. One strategy has helped, when I remember to do it, is to rephrase demands as observations and declarative statements rather than requests or commands. Eg, “it’s time that we put seat belts on so that we can drive safety” instead of “put your seat belt on.” It’s even better if you can add an element of choice to give the child some control, like “your shoes are by the front door, but if you prefer to wear your Crocs those are in the cubby.” I find that phrasing things this way often works like magic for my kid. Hugs to you - I know it’s not easy.

[FeeY]

Going off what momwifedaughtersis said a helpful book might be "Declarative Language Handbook: Using a Thoughtful Language Style to Help Kids with Social Learning Challenges Feel Competent, Connected, and Understood " It's not a very long book and it explains this approach. You can get it on Amazon. Good luck! I know what you are going through. Same kind of troubles in our house...