hi parents
I have a 6yo in 1st grade. And ever since he was in PreK at 4 years old he’s had a hard time in school setting with keeping his hands to himself when getting frustrated, angry or when he’s not able to do what he wants in that moment aka following the school routine.
He is medicated. He’s been on guanfacine extended release for almost a year now. He takes 3mg in morning now. And we recently started sertraline at night.
he goes to weekly therapy also
(We had him try adderall and Ritalin in Nov/Dec and it had a horrible effect - he was over hyper like a motor so we stopped it )
At school he has a 1-1 para for behavior support, gets OT, counseling and 4 periods a week of SETSS to get support w writing. School also has a BIP in place. He does swimming and ninja gym weekly.
And recently started working w a BCBA at home.
We are doing all we could do. But in school he has minimum 1 day a week where he hits either his para or the teacher- some weeks is 2-3 times. But never more than 1x in a day. Usually it is when he’s being asked to stop something he shouldn’t be doing (like taking stuff from teacher area or trying to use iPad) or when it’s time to start new task and it may involve something he’s not interested in like writing. We tell him it’s ok to have feelings and get frustrated but it’s not ok to express it by hitting.
we are beginning to be concerned and wonder could there be another diagnosis here? Mood related?
His diagnosis is ADHD Severe and Level 1 ASD. As well as SLD in written expression
At home he is defiant but he isn’t walking around hitting us every time he gets frustrated w us
And at school he isn’t hitting all day long either but just concerned that this will be forever. I think the school can probably do a better job at figuring out the triggers to avoid getting him to the point of hitting so he can start to learn to use the strategies. And they also don’t do a great job and painting the picture for us on What exactly is happening right before he hits. Like for example - how are they demanding things from him. Because something as simple as the tone can set a kid off.
Anyways not really sure what answers I’m looking for. Maybe if anyone here had a child this age w physical aggression at school and now they are older and are passed it then it will give me hope.
Any advice will be appreciated
I’m always worried about him 😞
Single Mom of 5 year old in Pre-K with ADHD. He is on an IEP and has services.
Please help-ADHD medication 
ADHD/ Behavior Issues
Anger and Frustration
Social challenges for middle schooler
Guanfacine may cause irritability and mood changes...perhaps that's not the right medicine. He may have sensory defensiveness. Perhaps do a genetic test, and see what medicines might work best based on that
would guanfacine show up in that test. I recently did it for my son. But waiting to have appt w psychiatrist to review
To clarify we DID see improvement once he got on guanfacine bc his elopement went away in school and he is much less impulsive. It’s the resorting to aggression in moments of frustration that we need to figure out.
When we experimented w the stimulant in November there was a 2 week period he was NOT on guanfacine and we could TELL that it was actually working bc he was off the rails wout the guanfacine.
I mean you could be right that the guanfacine could be helping w impulsiveness but also causing aggression on back end.
I’ll see if the GenoMind test shows guanfacine. Thxxxx
My 7 year old son did well on Guanfacine ER for a few months on 1 mg and then it started to have extremely negative effects with irritability and mood when we tried 2 mg or went back down to 1 mg, so we stopped it and he is now on 20 mg Vyvanse with a short acting booster in the afternooon (2.5 mg Adderrall) to smooth out the crash from the Vyvanse. He gets nearly full-day coverage still, and the results are much less moodiness, irritability. We spend a lot of time at the trampoline or other parks because he has vestibular/movement hyposensitivity and movement helps calm him down in the way the Guanfacine had initially done in the first few months (sensory processing OT and dietary supplements for protein, magnesium, etc. have helped as well). My son has needed dosages to be pretty low to avoid negative side effects. He could only tolerate 10 mg Vyvanse for the first year when he was 6.
this is great to hear ! the psychiatrist said that at first glance of the dna test he said my son should do ok w Vyvanse. We’ll review it in full in early March. We’re scared for him to try another stimulant but if the dna result recommends it we are open to it. I know sometimes when a child has both ADHD and on autism spectrum we need to thread lightly w the medications. Thx for sharing about the success w Vyvanse. Did you switch to Vyvanse after guanfacine was fully out the system ? Or was it together? Any impact to appetite?