Some questions, thank you!

[lonkonk7]

We have a four-and-a-half year-old boy with combined type ADHD, diagnosed three months ago. He is a sweet and intelligent kid, who loves his younger brother, but has a lot of difficulties with hyperactivity and impulsivity. There was a noticeable improvement after starting guanfacine, but over the last few weeks it seems like the hyperactivity and impulsivity have been ramping up. My wife and I both work full time, and we and our nanny are exhausted, constantly attending to him and always trying (and feeling like failing) to correct/teach him without hurting his self-esteem. A lot of times lately we feel hopeless.

Wondering if anyone has advice on the following:

1. We increased his guanfacine (immediate release) dose from 0.5mg twice daily to 1mg twice daily the last few days. It doesn't seem like it has helped. He doesn't have significant side effects (he does say he is cold more often than before being on guanfacine). Would it be worth talking to his psychiatrist about going up on the dose further, or trying something else?

2. He has been doing occupational therapy at school (pre-K) and once a week outside of school (he also has sensory seeking). We are not sure if it is making much of a difference, and the private OT is really expensive (we are looking for in-network options now). Have other people seen a positive effect of OT, and does it take a while to see differences? He has been doing the private OT for four months.

3. I have read that hyperactivity may improve with age. Have people seen this with their children, and at what age is it typical to see this?

4. Would it be worth having him see a child psychologist as well, or is it too young at this age?

Thank you so much for any advice!

[LisethHIS]

Hi, lonkonk7,

Thank you for contacting CHADD National Resource Center on ADHD. Parenting can be really challenging, but please know that you’re doing a great job. I recommend looking into play therapy for your child and consulting a behavioral specialist for guidance or to create a plan. Here's an article on how occupational therapy can help with ADHD. medicalnewstoday.com/articl... At CHADD we have group parent support groups and parenting course- here are the links if interested- chadd.org/affiliate-locator/ and chadd.org/parent-to-parent/ publications.aap.org/journa... triplep.net/glo-en/home/

Hopefully these resources are helpful.

Best,

Liseth

Health Information Specialist

CHADD's National Resource Center on ADHD chadd.org

[Mamamichl]

child psychologist is always a boon. At this age, they do play therapy to help the kid with confidence and to learn through their toys’ experiences.

Although it would have been better as Christmas presents, looking into indoor swings, gymnastics bars and trampolines help with pent up energy and not affect the adults so much. For sensory, you can also get chewelry (basically rubber pendants kids Chan chew on). I’m a sped teacher and my sensory kids love these items a lot.

I’ve been trying to get my kid into OT and on medication because her doc is old school, it’s been tough. I would try a different non stimulant like stratera. Guanfacein is supposed to lower blood pressure. It actually made my kid feint after multiple family members were getting light headed on the med. sometimes kids feel the light headedness and they get scared, others get goofy. Also, in the adhd world, it’s normal for medications to stop working, especially with stimulants, but usually it takes longer.

[Onthemove1971]

Thanks for your message. Yes, we had so much success with a Child Psychiatrist. They were an important part of our team and really helped dial in the right type, dose and timing of medication. They should help for all of the necessary changes in medication. As kids grow their needs can change and they are the specialist that knows what to do with medication. The other thing that really helped us were to try to balance outside activities ( sports team vs individual) and if not sports things like arts, cooking, trampoline park, nature walks, etc) so our son had a way to do things he loved without school pressure.

We did not do any OT and not sure if his school setting can help so you are not having to pay for it.

Have you considered sleep and how much he gets? Weighted blankets help some kids. Also some use white noise/sound machines, dark shades, etc.

Yes, for us therapy helped becuase we dis it together. I brought up issues we were having and we mom and child worked on solutions to try to solve the issues.

I have a really great saying that helped guide me... "if it works.. then it is working". For us things worked and for others it did not.

This group is amazing, if you are struggling with ( over eating, lying, school issues, peer struggles, etc.) anything you can search old posts and there are most likely previous post to assist you.

We are always here to support you in this journey!.