At breaking point with adhd child

[GG1986]

After some advice, or even just some support and kindness.
My 8 year old was diagnosed with adhd last year, we are also waiting for autism assessment, referral was sent in the summer.
She is usually such a lovely girl, but the meltdowns are becoming unbearable and the way she speaks to me is so upsetting, I just don't know how to stay calm or handle it. I am screamed at and told to shut up, go away, that she hates me and no most days. She is defiant and won't do anything I ask(eg can you help tidy your toys away please or it's time to come off your tablet now as it's bed time) she won't go to the toilet by herself, I have tried to refuse to help her but it ends in another meltdown to the point where we have to give in. She asks for food constantly, but refuses most things, diet pretty much consists of cereal, pizza, chips and chocolate(she is nearly underweight on bmi scale) she is unmedicated at the moment. I just don't know what to do and how to handle her and spend most evenings crying once I've gone to bed. Any advice?

why not medicate?

I am still unsure whether to medicate because it suppresses appetite and she is already nearly underweight. Also the paediatrician said that the medication is for use during school day and not school holidays or evenings, so we wouldn't see any benefits at home.

Have you tried some PDA strategies? Some people find Yvonne Newbold’s resources helpful. Also Ross Greene’s book The Explosive Child.

With the food difficulties, have you looked at ARFID?

Scope offer mentoring to parents of DC recently diagnosed/on the assessment pathway.

What support is DD receiving at school? If school life was easier home life is likely to improve too. Don’t rule out medication because you believe you won’t see any benefits at home - a) surely if DD benefits at school that’s a good thing, and b) if it helps at school there will be less of the coke bottle effect.

the adhd brain is 24/7 365 days a year. not all dr's suggest m-f 9-5 meds only.
adults who have learned other coping skills can choose if and when to self medicate and i might say the same of older teens post uni.

the psychologist that will monitor the meds has loads of options and dosages to find one that helps the most with as little side effects as possible.
her diet might improve if her brain isn't all over the place.

Following

This ongoing thread might be helpful
https://www.mumsnet.com/talk/special_needs/4800866-starting-adhd-medication-and-staying-on-it-ongoing-support-thread-for-newbies-and-experts-including-medikinet-equasym-concerta-strattera-and-others

How are school supporting her? Are adjustments in place? Is she well understood or is she attracting a lot of negative feedback for not having the skills or emotional regulation to cope with situations in the same way as her NT peers? @KeepGoingThomas is right this can have a big effect at home.

Hard though it is, I would try to lower demands/adjust expectations and work on the quality of your relationship, trying to build as much positive reinforcement of your connection and enjoyment of each other as you can. She is not making poor behavioural choices or is indifferent to your feelings; rather, she likely lacks the developmental capacity to respond to her feelings of overwhelm more adapatively. Thinking about this from the point of view of brain function may help? A working assumption commonly suggested is that DC's executive functioning (controlling impulse control, self monitoring, self organisation etc), will be 30% or so behind her peer group). It's really hard to be this child (as well as this parent!) - so lots of compassion for yourself and each other is needed. It will get better as she gets older and these missing skills develop more; in the meantime it's a question of making up for this gap by reducing stress in the environment, descalating situations when they are triggered, repairing your relationship after rupture, and helping her to feel calm, supported, understood and loved.

This may sound like a big ask of you, and it is, but it may also improve the ratio of good times to challenging times, which can make everything feel a bit more bearable.

ADHD can also lead people to struggle to regulate how they eat. Medication has been a game changer for us on this. More and more is known about how effective medication is for round 80% of people with ADHD. Might be benefits of exploring before the transition to secondary school which is typically particularly hard for ND children.

Firstly, it’s unbelievably hard to parent ND children. And no one I know of a parent age was parented how we now know (think we know?) ND children need to be parented so I feel it’s doubly hard breaking the cycle.

I agree with @Deliria - it would be great to give her some opportunity for praise. The examples you give as to when she doesn’t do what she’s told (tidying up and stopping screentime) are not ever likely to be done when she’s consistently feeling overwhelmed/dysregulated. If she ever asks nicely for something, praise it.

I would also lower demand - you role model by doing so if she needs to just watch you today for now then that doesn’t make you a bad parent. Nor does leaving the place untidy if it upsets her to see her stuff moved - within reason, maybe you can find a compromise when she’s calm. My DC are much nicer after fresh air and a walk - Christmas lights spotting anyone?

*watch you TIDY for now