I think I've accepted

[Angela41]

Angela... that may not be "inattention" at all... it could be Auditory Processing Disorders (APD). Or, of course, it could be classical ADHD-style attention issues. But... inattention to verbal instruction isn't necessarily inattention. Just sayin...

Agreed. My kiddo is a moving target right now. That's why I love this site- there are so many experienced parents whose kids face a variety of challenges. It does make me think.
Activities that engaged my son's hands and/ or his brain helped my son with some of the impulsive behaviors that Malika mentions re: her little boy. Swimming was especially helpful because it is exhausting, and the water is soothing and muffles environmental stimulation. Taekwondo helps because it emphasizes focus and attention to instructions. A visual schedule (or written for older children) can help with focus and opposition issues. Whether or not medication is an option, a lot of kids with attention issues have benefitted from these kinds of activities.
I guess I would consider medication for my son if he was lagging academically, or couldn't function well enough to make friends, or the behaviors were so disruptive to our lives that we couldn't operate with some normalcy (normal of course being subjective Some of the social and academics may be difficult to "catch up" even if things improve later.

 

[JJJ]

This makes me a little sad. J seems like such a neat kid but he is struggling at school and in the community because of his hyperactivity and low impulse control. At his age, he is forming his identity. Developmentally, he is developing a strong desire to have a good friend, wants to do well, will be sensitive to criticism, and finds a sense of security in his belonging to peer groups. While every child needs both successes and failures to learn, J is having a lot more failures and rejections than other 6 year olds.

Tigger has multiple disabilities that impact his behavior. Occassionally he talks about what it was like before we found his current medication combo which has given him great control over his behavior, he calls it "back when I was a lonely" and it breaks my heart. He knew that his behavior was causing the rejections, he just couldn't do anything about it. I'd be worried that J will develop an image of himself as not quite good enough because that is a huge part of the feedback the world is giving him.

Stims are quick in and quick out. The short-acting versions are less likely to cause issues with sleep. (Although Eeyore and Piglet have no difficulty sleeping.) There are also non-stims: clonodine, inderol, etc. that are calming. Many times children who need stims at younger ages are able to wean off of them at older ages as they mature and their social work sessions give them better skills to control themselves.

 

[Malika]

Just when I thought I'd got it sorted out, lol... There are no easy answers here. It just isn't black and white. We could try the experiment with J if his psychiatrist was in agreement though I imagine it takes time to see what the results are going to be. But I just feel instinctively the results would not be this ideal thing... after all, so many kids taking medications still seem to have terrible issues and problems. As for J's self-confidence, it's hard to know. He does, for sure, get a lot of disapproval and rejection and that is horrible, yes. But he seems happy, resilient and self-confident most of the time. Indeed, just tonight when I picked him up from school, he told me "Mummy, I was really good today!" Smiling, I asked the assistant if it was true and she said, "yes, he was happy - he's always happy!" And actually I do hear quite a lot about how medications make children not happy, quite depressed and anxious...
This is not an easy decision, for sure.

 

[InsaneCdn]

Malika... you know my position already, but... two more cents?
Mine were NOT happy. School was NOT going well. "Good" days were rare.
medications made a huge difference.

If J is having mostly good days... then for a minimum you're probably premature to go to medications. (and that's coming from a mostly-pro-medications mom).

medications won't solve the social problem. (trust me on that)
medications won't solve the LDs and other challenges that go with ADHD (such as Auditory Processing Disorders (APD)...)

But... if the challenges of focus in the classroom are great enough to seriously impede education... in my opinion medications are worth it.

 

[Californiablonde]

My son is on Focalin and did a HUGE turnaround. He was a straight D/F student with very poor self esteem who hated school. Since taking medications he has turned into a straight A honor roll student who absolutely loves to go to school. His self esteem is much improved. He is super proud of himself for getting those A's. Without medications he simply couldn't focus long enough to do his work. The pill hasn't affected his appetite at all. He still eats like a horse. Of course he's a growing pre teen boy so that could be why. And sleep is a non issue. He is asleep by 9:00 every night. I can see your hesitancy on medications, cause I was at first too. But after seeing the huge change it did for my child, my only regret is I didn't do it sooner.

 

[DDD]

Although it may be possible that sleep issues arise for some children I think it is a matter of parental timing and of course dosage. None of my three had any sleep issues. on the other hand, stimulant medications are not given at dinner time, lol. One other factor to consider ti how the parent approaches the inclusion of medications. If the parent is anxious and says "oh, I hope you can sleep tonight" or "gee, I hope this doesn't you a headache.etc." We'll we all know how that often ends up. DDD

 

[JJJ]

With the 4-hour Ritalin, you can just start with one pill a day and see how he does. With Piglet, she can take up to 3 doses per day but on weekends and holidays she often doesn't take any because I don't care if she can focus on tv and twitter. As she has gotten older, she had gotten much better at telling when she is struggling because the medications have worn off and with balancing her schedule to maximize the benefit.

 

[whatamess]

Malika,
Devil's advocate here: some people might say if your child had strep throat you would give antibiotics or if they were diabetic you wouldn't deny insulin, so why, when it becomes a dysfunction of brain chemicals do people refuse therapeutic medications to ameliorate the life-impacting symptoms? I will tell you that I viewed adhd medications as imposing my adult will on an innocent child and fundamentally thought as you do -that my child was born this way and we should live with whatever conditions cause him trouble. I do have to say that medications like ritalin are so quick in and out that the fretting and mental gymnastics weighing all pros and cons is really out of proportion to the innocuous-ness of the medications. I do think, that if at some point you steeled yourself to try the medication, your mindset as it is now would likely veer you toward seeking any negatives reactions that might support your feelings that the medication was bad/dangerous/ineffective, etc.
I am able to play both sides of this because I have been on both sides, so I leave you with this thoughtful video:

http://www.youtube.com/watch?v=o8limRtHZPs

 

[confuzzled]

focalin: no sleep issues here either (some very VERY mild appetite issues)--and like california mom...my only regret was not doing it sooner.

it was a game changer for my kid, so much so that she even knows it. it made all the difference in the worldl

if a person is accurately diagnosed and needs medications, they need medications. you wouldnt tell someone with diabeties to try to deal without their insulin...sometimes coping skills can only get one so far, and one can only over-compensate so long before the house of cards they built starts to crumble.

all i know is, one can never say never. its just not that simple.

 

[confuzzled]

lol--gmta!

 

[IT1967]

I am totally torn on the issue of medications. I'm having 2 totally different experience with-my 2 difficult child kids right now. My son who is a easy child/difficult child 2 - has been on Intuniv since August and recently added Concerta 18mg. I pray I'm not jinxing myself by saying this, but he's doing really well - *knock on wood*. He's 7, about to turn 8. We had tried a few other medications about 6 months before starting the Intuniv (all stims) and they had horrible side effects for him, so we discontinued them. The stimulant medications are out of their system within a day is my understanding. But I think we're in a good place and I do think the medications have helped him. However, on the other hand, I've been struggling with-my difficult child 1 (about to turn 10). We just started trying medications for her since August and so far, do not have the right medication and I hate what the potential side effects are, so I'm in the process of weaning her off what she's on now (Risperidone) and maybe try her on Intuniv to see if she has a good result like my son did. What I'm trying to say is that I waited a lot longer before putting difficult child 1 on medications and she is in a really bad place now. I'm worried about her social life being affected (it already is) and long-term future for her. Both my kids have the same issues. Every day I'm asking myself what might have been if I started her sooner on the medication as I did for my son. Maybe I wouldn't have had to even consider the horrible medication I have her on now if I'd started out sooner. I'll never know and maybe she'd be a ton better now, or maybe she wouldn't. But I am upset with-myself for not trying medication for her sooner. I feel like I'm playing catch up with-her and praying she'll stabilize. Bottom line for me - as of today, I'm happy I have my easy child/difficult child 2 on medication, but extremely unhappy to have my difficult child 1 on medication right now.

 

[DammitJanet]

With a low dose stimulant you will know very quickly if it is working and trust me, a child who is young does know when they arent fitting in. Jamie would come home crying every day because he wasnt like his peers. When he finally got to the correct dose everything kicked in for him and he began to understand why he was in school. It was a whole game changer for him. I will never forget him getting off the bus on Friday's sobbing his little heart out because he didnt get a lollipop because he didnt get an A on his spelling test. Even though I always gave him a lollipop at home it just wasnt the same.

 

[Angela41]

My son doesn't take any medications, but there were/are times in his development that we thought we might have to consider it.

I would (and might) go down a medication road if I see that school advancement, social relationships, and normalcy (i.e. if our family must bend backwards and sideways to get our son to meet basic expectations). I'm neutral on the subject of medication, and admire that you have given it so much thought.

I will absolutely echo what has been said here- my son (six) is completely aware of how he is regarded by other people. He still talks about how some kids made fun of him at age four for his eczema, and how, at three, some boys wouldn't let him play with them at the park because he was a "baby." When he was at his "worst" he would tell me that one of his preschool teachers didn't "like" him. Just because they don't voice it, doesn't mean that they don't "get it."

 

[Malika]

The thing is... medication really wouldn't make my life any easier much of the time, if I were to look at it from the selfish angle. The effect would be wearing off in the evening after school with all that that involves - increased hyperactivity, increased opposition, etc. And then.... these substances are strong ones to be administering into six year old bodies, and in no way "natural" (unlike insulin to rectify diabetes). This side of things is a valid concern! It's a difficult balance. And then... there is another hyperactive kid at the play centre where J goes on Wednesdays and he is apparently much more turbulent and uncontrollable than J (though J gets really wild in his company, I am told) - and he is taking stimulants!! I just don't see this as an obvious option. Doesn't mean I would never consider it, obviously.

 

[InsaneCdn]

Well... you don't know whether it would make your life easier or not... yes, the medications wear off. But for some kids, it reduces the effort they have to put into their day, which means they come home in better shape.

Having said that... J is still J on the weekend - it doesn't make much diff if he's had a full day of school or not. In which case... not much advantage at home.

 

[confuzzled]

The thing is... medication really wouldn't make my life any easier much of the time,

its kind of not about making YOUR life easier.

 

[Malika]

Ummm... it's a two-way process, involving the quality of J's and my relationship. And you did chop off the bit where I said my comment was to look at it from a selfish angle

 

[InsaneCdn]

Ummm... it's a two-way process, involving the quality of J's and my relationship.

Can I rephrase that?
It's a three-way process, involving J's quality of life, your quality of life, and the quality of the relationship between you.
in my opinion... anything that improves ONE of those is worth investigating. If it might improve TWO of them, it's a high priority.

 

[buddy]

Just when I thought I'd got it sorted out, lol... There are no easy answers here. It just isn't black and white. We could try the experiment with J if his psychiatrist was in agreement though I imagine it takes time to see what the results are going to be. But I just feel instinctively the results would not be this ideal thing... after all, so many kids taking medications still seem to have terrible issues and problems. As for J's self-confidence, it's hard to know. He does, for sure, get a lot of disapproval and rejection and that is horrible, yes. But he seems happy, resilient and self-confident most of the time. Indeed, just tonight when I picked him up from school, he told me "Mummy, I was really good today!" Smiling, I asked the assistant if it was true and she said, "yes, he was happy - he's always happy!" And actually I do hear quite a lot about how medications make children not happy, quite depressed and anxious...
This is not an easy decision, for sure.

Neither Ritalin nor Concerta have caused sleep issues and Q takes his last Ritalin around 7:30 PM! It not only didn't stop him from eating but because he had so little attention, it made him be able to sit and eat. Now my nephew on the other hand, is straight adhd. He is very hungry first thing in the morning. So, he gets his medication at school right upon arrival. IT does kill his appetite but once it wears off he eats to make up for it. He has short acting Ritalin for homework sessions on the weekend and does Concerta during school days.

When Q was little and first tried to see if a stimulant would help?.....we did a tiny dose of short acting Ritalin. The good thing about those medications is that you can trial it and see in short order if it might help and you can stop it and be done with it easily. So, if you ever do decide that it is an option (have seen it go both ways and you have read that too....some kids parents find out later and wish they had started sooner and others regret ever having tried it)...it has to be that the possible benefits outweigh the negatives. If it is affecting his social and academic life to a degree where it is shaping his self esteem, it could be worth a try. If at this point all the many positive activities you provide him with...and where he succeeds gives him a solid sense of positive self, and he is making progress (even if not like the other kids) in school....then it is not something you really need to decide on now.

It won't need to be an all in or all out decision though. You can try it and decide to stop if you ever do make the call that it is worth a go.

 

[Malika]

Yes, thanks for that considered reply Buddy I know I will feel like we've failed if he goes on stims - I'm not saying that is 'justified', it's just a feeling. Probably so many parents go through these processes of struggle in terms of the medication decision. I just sense that for J medications will cause as many problems as they solve - I may be wrong! I'm more attracted to having him accept himself as he is, with his differences, and others likewise, though I appreciate that may be a tall order. And thanks for the suggestion of the book, IC. It looks like a useful read.