Ritalin???

[procrastimater]

I am a regular - have been on MN since 2005 but am using a different posting name for this thread.

I have an 11yo dd in 2015 she was given a diagnosis of Autistic Spectrum Disorder - High Functioning. She has follow up appointments with the paediatrician very infrequently. One this week, last one Dec 2015. So every appointment is precious time to get some guidance / input from the NHS minimal as it is.

Dd is a very well behaved child at school, she does not get into trouble and her school are helping by giving her life skills classes and there is a centre she can use for breaks and lunch time so she is not wandering aimlessly during unstructured time.

At home she is a bit insular and tends to spend all her free time on her special interests - at the moment Undertale and minecraft - so she plays these games, watches videos inspired by these games and draws pictures inspired by these games. She is a bit difficult to get motivated to do other things she will quickly lose interest and focus when doing homework, she will occasionally forget to go to the loo she will be asked to do something do half or less then wander off. She will lose things constantly and is incapable of getting ready in the morning if I don't line up her clothes and prompt her throughout. She can walk home from school alone but I need to talk to her on the phone all the way (this has been the arrangement since year 5) it is a ten minute walk.

We asked dd what she wanted to raise with the paediatrician and she spoke to them about her obsessions and how much time she spends on them. We raised the disorganised and forgetful, unfocused side of things as that is the main barrier to the smooth running of her life - as so much is incumbent on me being 'on' all the time to compensate.

The Paediatrician then raised some very specific questions and filled out a checklist - she suggested dd was exhibiting signs of ADD non hyperactive Attention Deficit disorder. This was a bit unexpected - then she ran through the drugs that would "help". Basically Ritalin and similar.

We were handed a couple of questionnaires - one for school and one for us, we are to get them back to the paediatrician for assessing and then if it seems she has enough indicators for ADD she will be given a prescription for a Ritalin type drug. We will get an appointment in 3 months to run through the drug affects/ side affects see if it is helping adjust the prescription if necessary...

Anyway I am trying to get my head around it all - we kind of nodded along and tied down a schedule yesterday - the appointment was quite fraught as dd was a bit upset, having all the focus on her 'problems' was stressful for her - she was lovely afterwards though and needs us to help her decide what is best. We are certainly only going to consider a drug treatment if it will help her and she wants to do it. But I am completely outside my comfort zone - I know a couple of parents with children with ADHD and they are very different - the children are hyper and need some help calming down and managing a school day. It is not like that with dd she is very quiet and well behaved at school, but she reports herself how difficult she finds it to settle and focus in lessons, other children are distracting, she is better in lessons she enjoys of course but there are not many of those aside from English at the moment. She will do homework and forget to hand it in, she will forget to do homework and she needs cheerleading to get through homework once she starts.

Anyone know / have experience of Attention deficit without the hyperactivity? Do the drugs help? I am scared to contemplate them but I don't want dd to be held back by my ignorance. AIBU to have an instinctive resistance to the idea?

Sorry, not expecting you to catalogue. This sounds exactly like my kid:
Dd is inherently unfocused and detatched, she is not making a choice or being deliberately awkward that is the difference regarding focus. I know she gets upset when she feels stressed and lost trying to do homework etc.
Which has made me think quite a bit.I'm not sure if some of ds quirks and difficulties are just personality traits (shared by other family members) or something else. Not meaning to hijack, just got me thinking.

Please will you update as to the effect of the Ritalin if that's the road you go down?

The problem with the idea of trying other methods is that other methods typically work best in conjunction with medication, it's not an either/or thing, and so what tends to happen if you try other things before medicating is that the patient becomes frustrated because they cannot fully utilise the useful skills and techniques they are learning through the other therapies (e.g. behavioural therapy, occupational therapy, CBT) which frequently leads to a reluctance to engage even after being medicated. (In layman's terms, they just think "what's the point?") This is important because with this kind of disorder so much of the symptoms are behavioural.

Better to try medication first, see if the patient gets on with it, if they do, then great - also follow up with other therapies, because medication doesn't solve all of the issues on its own. If they do not then, again, other therapies can be tried with a different focus as at least you would know that medication isn't an option.

DS was diagnosed with ADHD and was put on matoride XL straight away. It has been the best thing ever for him. We didn't have to wait at all. School/We did the questionnaire and he was only borderline at school but high at home and they gave us the prescription there and then.

He is a different child. We also use other techniques along with the meds but if he misses a day it is very noticeable, to him also.

Hello I am resurrecting this thread as there have been developments. The questionnaires have been completed and returned and the Dr has confirmed a diagnosis of ADD inattentive type. She has offered a telephone consultation and a Ritalin prescription. We are researching drug treatments for ADD and talking to dd about what she wants. I am nervous about it still but I feel much better informed thanks to this thread

When your adolescent daughter is crying over her maths homework and incapable of managing her emotions something needs to be done.

just to say a telephone consultation is not really good enough.
pre-ritalin a medical check is needed for your dd.
ritalin can cause problems with blood pressure and heart and so these should be monitored closely in clinic, or with the GP - monthly at first!
It can raise the BP, and good practice requests an ECG before the first prescription so you have a baseline for the heart.....monthly heart rate and BP, then 3 monthly readings only when stable on the meds.
Weight and height must also be taken as the medication is calculated according the the childs weight.
If all of this has not been done then please do ask for another consultation - no matter how busy the Consultant is, this should be arranged!
hope that help!

bigmouth. Yes your GP or consultant should do weight height & BP. ECG would be helpful.
Our older lad did nt have ecg but younger DS was put on combo of concerta & later Ritalin added he then had ecg. I am on concerta and will be having regular BP done. I already had ecg for different condition.

Concerta is a longer acting form of Ritalin. I am not in uk but concerta is first one of choice as it 'should' last over the school day. Then in early evening Ritalin can be added in. To help with study.

bigmouth the only regret I ve had over my 2ds is not getting Dx & medicated sooner. I few concerta ect as just levelling the playing field & even then they struggle. Having HF autism and ADHD my younger DS is extremely smart but struggles greatly with social relationships sticking at study or music even though he loves it...
Medication is nt a cure but it is imo & personal experience a really useful aid in living a normal life.

I am 44 now and I went for private assessment and I only wish that I done it sooner. The levels of anxiety that I lived with all through my life. Not getting the fitting in (cos I d be too chatty one minute & standoffish another) losing things, over sharing is a huge problem for me, really low self esteem ect.
I did well at school but that is because I was really bright and hyper focused. Got an honours degree ect but did nt actually study work in the fields I wanted to because I liked confidence. I have a wonderful DH but with out him I would nt function as well in things like cooking cleaning house work.

What I am trying to say is the younger the person is the better.

Thank you for raising the height /weight and blood pressure issue, the Dr did instruct us to get blood pressure etc. checked at our local surgery prior to filling the prescription. We will be talking to her on the phone regarding any more questions or concerns we might have and also arranging a follow up appointment to review in 2 months if dd starts the medication.

Ok, I nearly didn’t reply as you specifically asked about ADHD without the H! My 10yr old was diagnosed a few yrs ago and we are pretty sure he has ASD too.
He is lovely, such a sweet and caring child and wasn’t failing at school as such. He’s incredibly bright, currently in the class above. I refused methylphenidate at first because 1) I was devestated at the diagnosis and 2) I just felt wrong giving him drugs plus the side effects sounded horrible. A year later and he just wasn’t coping at school. He was a constant distraction to his peers so was never integrated into the class and his impulsiveness was beyond dangerous. Add to that the overwhelming feeling of being naughty and I had a 8yr old who was depressed and suicidal (really)
So in utter desperation I agreed for him to go on the meds. The first few weeks on a low dose did zero and I was gutted for him. They increased his dose and it was like a switch had clicked. 2yrs later I have a happy, confident child. It’s completely changed his life.
Side effects- took us a while to work out what worked best for him. It was finding that balance between getting his food, meds and sleep all working at the right time!
I’d say his appetite was the biggest issue but we work round that and he hasn’t lost weight. As long as he has his second dose before 1pm sleep isn’t an issue but we have used melatonin to help occasionally.
His hyper ‘come downs’ from the meds are pretty hard but the advantages far out weigh this.

My advice would be to try because you will never know how much it could help her. I still beat myself up that I didn’t try them a year before..... good luck!