Hand-Holding please, DS1 is aggressive and violent

[blackcurrants]

DS1 has ADHD and SPD. His school have been fantastic, he has a 1-to-1 learning aid and he goes to the Occupational Therapy room in the school twice a week for scheduled therapy to develop his fine motor schools, and whenever he needs a break from the classroom/is getting overstimulated etc.
He's had a wonderful Kindergarten year (I live in the USA, he's going to be 6 next month), and has met/exceeded all learning targets, made some friends and generally just blossomed .Until last Tuesday. This past week he has changed completely in a really horrifying way. He's become aggressive and violent and was excluded from school twice last week and this week Monday and Tuesday until they basically said, 'look, send him to camp already." (school technically finishes on Thursday). We wondered if the aggression was due to the fact that his little brother was already at this camp and he wanted to go.
So: today it's his first morning at camp, where DH is a counselor/group leader and DS2 is having a lovely time in the tots section ... and DS1 tried to punch another kid at 9am for winning at Ludo. And then ran away.

I just sobbed at my kitchen table (it's my week off between finishing teaching normal school and starting to teach summer school). I have no idea what to do. We've got a therapist scheduled to help him with impulse control but it can't start until 2 week's time. We've just started him on ADHD medication (brand name is Focalin) on the lowest dose and it has made absolutely no difference to his ability to control his behaviour.
He's so unhappy and I'm so desperate for help.

Honestly, I don't even know what I want from you MNers except a bit of a hand-hold. It's been the most godawful week, he's so unhappy and hates himself (his exact words). His school counsellor described 'low coping skills, which creates low-self-confidence, in a negative spiral') and that's about right.
Guuugh it's so hard seeing him so miserable, and worrying about him hurting himself (he was throwing himself at walls last Tuesday) or other kids (like this poor kid he nearly clocked this morning).

Bump.

Ive no advice but didn't want to leave this unanswered.

Hi, I didn't want to read and run. I have a ds with ADHD who went through a violent aggressive stage at the same age as your son. Medication and maturity have improved things considerably. He is no longer physically aggressive and verbally lashes out less but it does still feel we walk on egg shells around him sometimes.
It takes time to get to the right dose and type of medication so don't despair it isn't working yet. When you do get meds right things do start to fall into place a bit and some of the low self esteem you say your son has will hopefully go. It is awful for these kids to not be able to control their impulses and repeatedly get things wrong and be in trouble all the time, it really does start to affect them.
I have no real advice other than gets the medication reviewed, try and build his self esteem, keep him busy and active but not over stimulated. We don't tend to do camps or clubs out of school has my ds gets overwhelmed and over excited by them. We do a lot of things close to home that are familiar to him. Also most importantly look after yourself. Having a child with ADHD is hard work and you can't look after him if you are not in good shape yourself.

Thank you both.
I talked to our lovely pediatrician on the phone, who said we've started at the very lowest dose and we will step it up tomorrow. It's a shame it's not working for us at the lowest dose, but we're at 5mg and that's very low, so we're going to step it up to 10mg tomorrow.
DH told me that DS1 had a much better day after the 9am rampage, and really enjoyed the highly structured, highly physical day of sports and art and hiking (which is why he's at this camp). It's 4pm and they'll be home soon, so I'll hear all about it.
I went for a brief catch-up with a friend, which I normally never get to do without our kids being there, and I feel much better. It was just that sense of flat-out despair of "oh god, now THIS situation isn't working, but this was supposed to be the better situation!" that made me so desperate this morning.

Glad you have spoken to the paediatrician. 10mg is what my son started on. He is nearly 9 and on 30mg. I didnt really notice much of a change in him until he went from 20mg to 30mg but everyone is different. Keep faith in the process and keep taking care of yourself.

Oh OP you sound so exhausted and like you just want the best for him.

Can the camp agree some things he can do if he feels angry? Something physical to direct his energies at? Somewhere safe he can run to? Sorry if that's too basic an idea.

Thanks! He came home absolutely glowing and told me all about how great the camp is.
Our state schools finish today and tomorrow, so this has been the camp at quarter capacity (both kids and teachers) - from Monday DH won't have to do the very first shift starting at 7.30am, so they can all have a calmer start at home and arrive in time for the first activity at 9, rather than waiting around in a room full of games and colouring things. This will help DS1 immensely, because he will then move from activity to activity in highly structured 45 minute blocks, with each one having a designated person who tells them the rules, and each one coming in an order he expects.
This camp really is his idea of heaven! If we can just get him to settle in. . .
He took the 10mg with only minimal grumping this morning. He's a big lad for 6, he's very tall and 26.5kg, so it's not totally surprising that 5mg didn't touch the sides.
And yes, thank you, I was just so tired and despairing. He got himself up immediately on the alarm this morning and was dressed before any of the rest of us, vibrating with excitement to got to camp again. Long may it last!

Good news: the 10mg has been incredibly effective. He's a different boy - calm, happy, engaged, able to take part in the things everyone else is doing, able to finish putting his shoes on before he bouncing away. No more hitting himself, no more running at walls . . . he's so happy!

Great news!