ADHD/ADD/ODD

[heather1215]

Hello all! I have a 7 year old stepson who we had tested for ADD. When the results came back that he had combined ADHD and ODD. He started on Focalin 5 mg in May and we seen a great improvement in school. We chose not to give him anything at home because we felt as though we could handle the behaviors. However, now they have bumped his medicine and changed to the generic of Focalin 10mg XR. His behavior at home is outrageous. He is lying, saying very nasty and inappropriate things, whining, crying, destroying things. I assume it comes from the Defiant Disorder. Sometimes the way he acts its as if he could be on the spectrum slightly. When we did the test and the school test the way we answered it put him slightly on the spectrum and the way the school answered it did not put him on the spectrum. I think the comedown from the meds are making his behaviors worse. Is this something that anyone has experienced? We are getting ready to see a new physician and I am wondering if we need to have him retested to make sure all DX are correct and we are getting him the help and meds he needs. *Side note- there is extreme mental health issues on the bio mothers side so I dont know if this makes are difference.

[Onthemove1971]

Thank-you for joining the group. I am so sorry this child is struggling. All behavior is a form of communication..So getting to the bottom of why he is lying is very important.

Most children with ADHD that are taking medication, need the medication either in a long acting dose or in a regular dose with a "booster" so they can use this tool to help themselves control their impulses. Many children who take medication benefit from seeing a child psychiatrist to help manage them long term. They understand different types of behaviors and how medication help them.

Most schools focus on the impact the behavior has on education. When this happens they can offer a child either a 504 plan or an IEP (Individual Education Plan). These plans are "road maps" to help teachers and school staff know what supports a child needs.

There are many parent training supports like ADHDdude, these can help parent learn about how best to parent a child that struggles with the symptoms of ADHD.

We hope you find support here.

[Coconut12346]

additudemag.com/anger-issue...

This article from ADDITUDE was very helpful to me. My son has a hard time controlling his impulses when his medicine wears off or in the mornings before he takes it. Not all the time, but a few times his reactions are disproportionate to what was said or what is happening.

[Mamamichl]

Welcome! My partner has to have a booster mid day that helps him taper off in the afternoon so his brain doesn’t feel shocked when the med wears off. Maybe ask your doctor if that is a good option for you. Have you tried talking to your kid when he is level headed about how the med feels? Also, it’s possible you are just his safe place and when he’s been masking all day, he comes home and letting loose, which can be extreme. Do you know any grounding techniques you can work through him with? If not, maybe counseling can help with that.

[Fish1fish]

Have you had any genetic testing done, like Genesight? You may find out there is an incompatibility with stimulants and your child. Your story sounds like ours a bit, and in our case rage was being caused by stimulants.

[arrh121]

Our 7 year old was diagnosed with ADHD and ODD a couple of years ago. He does well at school and his challenges are mainly at home where he can be irritable, defiant, and very temperamental. It ranges - some days are very good, some days are hard.

Stimulants set him off more (or made him zone out) and we started seeing a child psychiatrist who has helped us figure out the right medication and doses for him. He is now on two non-stimulant medications which have helped.

As far as non-medical interventions we did PCIT which helped us better understand how to deal with some of his behavior, though medication has made the largest difference for us by far.

Punishment systems simply didn't work, reward systems have helped a little (we do a weekly allowance which he is eligible for if he cleans his room, gets ready in the morning and night, does his homework on his own, and makes his own breakfast).

Good luck with everything!

[hygienehollie in reply to arrh121]

What two non stimulants does your child take?

[arrh121 in reply to hygienehollie]

Guanfacine ER and Atomoxetine

[hygienehollie in reply to arrh121]

My son takes Clonidine and we’ve seen improvement with that some. He also takes Metadate CD. We’ve tried probably 6-7 stimulants but none of them seem so help a lot with focus/impulsiveness etc. as much as we’d like. And some of them have been real bad with side effects or comedowns. We have talked about trying Strattera or Quelbree in addition to the Clonidine to see if it might help more. How long did it take to notice improvement with the Strattera? And what do you feel like it helps control the most?

[arrh121 in reply to hygienehollie]

We saw improvement with the atomoxetine fairly quickly, maybe within a few days to a week. Hard to say for sure but it seems the guanfacine helps us with impulsiveness and the atomoxetine helps us with mood.

[lll435]

My son has many of those behaviors too during the come down. Have you tried going back down to 5mg to see if things improve? That might help to determine if the dosage is too high.

[heather1215 in reply to lll435]

We have not. The physician chose to up the dosage as she said most kids do better on 10mg then 5. We still had issues from the comedown with the 5 but not as much as we do with the 10

[Knitting20projects]

2 thoughts:

1) are you giving him the medicine on the weekends/at home? if it helps him function at school, it might be worth helping him feel his best and function well at home. Even if you can "handle" his behaviors at home, everyone may be happier, including him, with him on medicine in both settings.

2) what evaluation did each of you do for autism? eg "at home" and "at school"? if these were just screening questionnaires to see if he scores above a certain threshold to consider a full autism evaluation, I would strongly recommend not using those to decide if he has autism or not. Maybe your school districts do a full diagnostic autism evaluation? Ours don't in my state. In a really defiant kid, despite a diagnosis of ODD, with a strong family history of mental illness, I would keep ASD on the list. The medical evidence we have is that older kids are still underdiagnosed. Definitely do what is right for your family---just want you to have some additional information in case it seems like autism has been eliminated as a possibility.

[heather1215 in reply to Knitting20projects]

Thank you so much for your response. He is given the medication on the weekends (we assume). He goes to his llama on the weekends. We give her the medication but not sure who is actually taking it. Yes the questionnaire is what we used to determine his ADD and ODD and what she said was how we answered put him slightly on the spectrum but not the way the teacher answers. We are going to see a new physician and hopefully he will be more help then the current one.

[Knitting20projects in reply to heather1215]

Good luck! It is definitely a marathon, not a sprint. Hope you feel more supported and understood by your new doctor.

[MustangGma]

I am a grandparent raising a grandchild. She is dx with FASD, SPD, severe ADHD. Epilepsy and hearing loss. Nor dx with ODD, but we've been thru it. 1st, maybe try extended release version of meds? Effects are more slow to go.up and come down. Might help. But also, if there is any chance that FASD is a factor. Dx or not, join some online groups, do some research AND very important, take some parent training. My girl is 8 now and it's been a long run but we're getting thru the days now without too much trauma...to any of us. Things could and will change but take it day by day...really.

[Onthemove1971 in reply to MustangGma]

We are so happy you are here helping everyone, but especially your granddaughter. Thank you!

[MustangGma in reply to Onthemove1971]

Thank you. She has become my life's work. Will always help anyone who I think may drop into my realm of knowledge.