Girls, ADHD and concerta/ ritalin

[Mousie]

Ok, hoping this thread title pulls in some experience. I have a very problematic DD - nearly 7. She has been diagnosed with dyspraxia, improved with occupational therapy but her behaviour at home remains toxic. She is mouse-like at school, no real friends but no manic/ fidgety behaviour they report of (though big classes and quite chaotic at times). At times I thought she was Aspergers but everyone I mention this to (professional or otherwise thinks not) I am sure she has a few aspergers traits though.

I have just finally had an ADHD diagnosis which surprises me a little - though she played up quite impressively during appointment. I have been prescribed concerta - 18mg, slow release. again, not surprised since I felt her behaviour was beyond basic parenting-skills control. I am hoping for some encouragement out here. I am nerovus about starting her on the meds, will start saturday i think so can watch her all day. I want to know this might really help us and not just be an unnecessary drugging... at times she almost feels schizophrenic, though mainly she is impulsive and violent at home. Have posted on another thread but want fast responses so thought I would try a new thread. Thanks....

Hi Mousie, my ds is 11, profoundly deaf and dyspraxic, we are off to London to start Ritalin for possible ADHD on Monday. He is at residential school and though he can have violent tendencies at school, he tends to save his bad behaviour for me at home. We have punching, hair pulling, kicking, biting and spitting........ Just to let you know you arent on your own...........................

thank you, good to know others are out there...

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Mousie - my ds (8 SLD. ASD, ADHD)is on concerta, although he started on standard (not slow release)methylphenidate which was less sucssessful because of the way his abilities went up and down. I understand boys (more often impulsive!)are different from adhd girls (disorganised/dreamy)so my experiences are of limited help to you. When medication was first suggested (his 5th birthday!) I was like you very reluctant to 'drug my child'. (we had a desperate situation at school so we took the plung)! It is odd how we all react to this type of medication, partly because of the hysteria around us! If the tablets help your child then think of it as any other medication. If they need it they need it! However since brain chemistry cannot be measured (I presume!) its a case of trial and error. I think you will know if it helps, within a few weeks at the most.
Was a Conners rating test done or was adhd dx on the day alone?
That said for our ds concerta has been helpful - perhaps not a lifesaver but important none the less. He gets into less trouble so is a happy chappy again. It has also changed the lives of those around him - he is still impulsive but he has those all important extra nanoseconds of forethought and slowed him down to almost the speed of the rest of us! Sometimes that lack of forethought (aong with the extreme speed and poor coordination!)could seem quite nasty because it put others in danger, broke toys, knocked things over etc. There was no intended malice in it but it was interpreted by others as 'deliberate' or thoughtless. Good luck!

On rereading you thread, I think I may have missed your point! Are you wondering if you should try other things prior to medication? I was assuming from your comment about dd needing management beyond normal parenting that you had already taken the specialised parenting and behaviour management onboard. I know what you mean by specialised (therapeutic) parenting - some children just need very different methods! Personally I think all adhd/asd dx should be offered taylored parenting support (not your average 'parenting course' they are of little use imho!)preferably before medication! The book I find helpful is 'The Incredible years' Webster-Stratton, I'm sure others have favorites.

magso, thank you. I was just looking for reassurance generally. Quite agree about the average parenting course being not at all sufficient for those with harder kids...
thanks for your experiences, it all helps me build up more of a picture. I am still in that shocked state - not sleeping, not really on this planet at the moment but I woudl love to think an improvement - with drugs - could actually be possible.

I understand your shock! I always go into 'trying to fix it' mode whenever a new severe this or profound that comes along, and cant sleep for worrying.
The books all talk about instant almost miraculous change with medication, and may be for some that is how it happens but for our son it was more slow than this- (he has cognitive difficulities and profound language delay so atypical) more like giving him a chance to see things our way a little, a window of better functioning to begin to learn the rules of the world.
I think it is common for 'in the mix' kids to be worse in one setting than another. Ds has much worse motor function in the afternoon/ afterschool so gets frustrated more. I know dyspraxia is not part of adhd but I presume attention also suffers in the same way. Its safer to let off steam at home ( mum loves you anyway) than at school. I often felt my son was trying to make me give up on him after a difficult day at school! I have found the best way is not to expect much (just let him play when he gets home)and be as kind and supportive as possible. Yes life now at 8 is a lot better than at 5 or 6! Sorry to waffle!

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bump for mousie. Any info will be helpful to me too.

hi

we tried the concerta today - not a good day, she has been very tearful and a more extreme version of herself, throwing herself dramatically all over the place and complaining of feeling weird, she has dark circles under her eyes and looks beat up - very reluctant to give her another dose tomorrow. and I had such high hopes for a calmness and change in her...

Oh Mousie, that must be so disapointing! Its so hard not to get hopeful! Sounds like you need to speak to the paediatrician for advice. It used to be standard to try out immediate acting versions to check suitability I think- before slow release. Did you try a second tablet today?
I remember tearfulness in Ds when he first tried immediate action mythylphenidate- we actually gave up with it at first, in part because of it! However Ds (who is very impusive and speedy) calmed and slowed down on it. We did not see much benefit immediatly (just less extreme speedyness), it took a while for ds to adapt, but we notice on days he doesnt have it now! Also ds got a bit 'stroppy' and tearful recently in the weeks before his dose was adjusted, so it is also possible the dose is not optimal.

no we didn't do anohter today - but she has been heaps calmer - not sure if this is because i have been hugely attentive to her (feeling she was put through hell yesterday) or because she is getting day two of it in effect - (but I don't think it works like this..) so maybe a much smaller dose would work. will ask all these questions friday,

thanks for support, it really helps to know others are out there...

I dont blame you!
Yes all the literature says the medication is only effective when in the body and leaves it quickly, but I've always felt (very unscientic!)that with ds there is some longerterm helpful effect.
Hope you get answers on Friday.

I have a daughter of nearly 10 who was initially dignosed as Dyspraxic , then as having ADHD. I too was very shocked at the diagnois, and prescription on Ritalin. BUT, it had drastically improved her life and happiness, mostly because she can handle friendships better and is not always being told off. Our paed. started her on straight Ritalin, just quarter of a tab, ( 2.5mg) and built up over a couple of weeks to 10mg twice per day. This worked quite well, but the wearing off and starting up can be quite bumpy, so we swopped to a sustained release.

I would stress that it is a matter of trial and error getting the dose right and it does take a while to settle in. DO keep going back to your paedietrician to adjust the dose, if its not optimal and don't be fobbed off.

I've read very widely on the subject and believe that this IS a safe drug. More importantly, the health problems caused by these childrens impulsivity can be considerable and these have to be weighed up against the downside of drugs.

Things that have helped us:

1. When she is older get her to learn to touch type, dyspraxics struggle to write at same time as process. Alsion Townsends courses in London are brilliant but pricey.

1. Trampolining:

Fantastic for dyspraxics and great exercise, probaby the best single thing we have done, and one of cheapest.

1. Lots of exercise, dyspraxics can struggle with sport, oddly swimming is the thing they tend to be best at, and its simply because all children get taught to swim properly,unlike ball skills which they tend to learn on their own ( so don't). Find something she likes, that is energetic that is a bit different from rest of her class/siblings so she can be good at it and its her own thing. You'll probably try lots of things before she settles but it will be worth it. Ice skating is good for co-ordination apparently.

4.Make sure she gets enough sleep, hard to manage I know, we resorted to melatonin ( prescription only, occasionally)

1. Have you had an Ed Psych report done, sometimes ADHD is confused with giftedness, very bright children get bored and disruptive. Frankly I think it is much more attractive a label but just a big a curse.

Read Mel Leveines books, Driven to Distraction and Delivered from distraction. They are really reassuring.

Good luck, and bear inmind that under that difficult exterior you undubtedly have a very bright, very creative and loving individual...