Can't get through to ADHD son

Tindle

Wed, Aug 03 2022, 10:16 am

I have a 7 year old son, with ADHD.

He's on ritalin and while the medicine is still in his system, he's definitely calmer, less impulsive, able to concentrate, etc.

The problem is that he doesn't learn from his mistakes and his behaviour is so challenging, I'm ready to lose it!

He steals, he lies, he manipulates and he runs away from school. And this can happen while he's still under the medicine's influence. (He's home already by the time it wears off, late afternoon.)

I don't know what to do anymore! The last time he left school, we gave him a significant consequence. Naive me, thought that would make an impression and cause him to stop and think before he did it again. Nope. He left school again. And this is after just getting in trouble a few days ago for destroying school property and losing his tooth fairy money to pay for the damages. (It was only a few shekels, we really paid. But it was to make an impression - he really likes money.)

I feel like I need a parenting coach who specialises in ADHD behavior and parenting. I want someone specifically for ADHD children. Can someone recommend someone? I live in Israel and would want to meet them in person. Or, not instead of a coach, but in addition, does anyone have any books they could suggest that were helpful?

He is a cute, smart, really great kid but it's so hard to keep that in mind when he just doesn't learn......I'm so frustrated....

amother

DarkRed

Wed, Aug 03 2022, 10:37 am

Ritalin should be an afternoon Med to bridge to evening from a long acting morning Med like focalin.

Once he is on a correct medication regimen you can start working on improving impulsively/social issues/rule following. Until then, he just can't do it.

We had a lot of success with play therapy at that age

mha3484

Wed, Aug 03 2022, 10:48 am

I have learned the hard way that you cant discipline a kid out of ADHD. It doesnt work. All the consequences in the world cant solve his brain chemistry.

I found for my super impulsive child, that one medicine was not enough until this past year which was 5th grade. Guanfacine which is not a stimulant was a game changer. It gave his brain the few moments before acting to stop and think. Once the meds were in a good place therapy helped him very much. I have also found that Collaborative Problem Solving from the book the explosive child was hugely helpful.

amother

Silver

Wed, Aug 03 2022, 12:34 pm

Can you find out why he leaves school? In my experience working with kids, when a child is escaping its either "to something" or "from something".
If you know why he's running away, it will give you an opportunity to provide him with whatever he is looking for, in a safe way.

AlwaysGrateful

Wed, Aug 03 2022, 12:47 pm

I would speak with his pediatrician about a medication increase, or to switch medication.

"Not learning from mistakes" is really just a lack of impulse control. It could very well mean that if he would stop and think about the choice he's about to make, he wouldn't make it. But he can't. Hence, the medication.

I'm not saying that medication solves everything, but just because it's helping to some degree, doesn't mean it's the optimum dosage (or type of medication). Something to think about.

amother

Peru

Wed, Aug 03 2022, 12:56 pm

My son did much better on concerta than on ritalin. He was also on tenex for a year which helped with the impulsivity.
He also no longer has issues with stealing which was a major problem at one point.
The hardest part is finding a psychatrist that will prescribe the right medicine in the right dosage.
Op, there is hope! Hugs!

Tindle

Wed, Aug 03 2022, 3:05 pm

First of all, thank you so much for your replies! I feel like a rookie, and all of this is so new to me. So thank you for taking the time time to respond.

Ok, a few "rookie" questions.

What is the difference between ritalin (or other ADHD medications) and Guanficine/Tenex? Where does focalin fall?

He definitely has impulsivity issues - and sensory - and what many of you explained resonates well. I'm realizing that consequences have no effect on him, hence my feeling that I need someone to explain to me and help figure out how to work with him behaviourally.

Also, Amother Dark Red - I never heard of giving ritalin in the afternoon! Is that common? I can't imagine doing that, because sometimes when it wears off, my son needs a lot of physical activity to calm down - which is ok for five o'clock in the afternoon when he rides his bike, but not a few hours later.

mha3484 and DarkRed - You wrote that therapy helped a lot. What kind of therapy? How did play therapy help in real life - when he's in school. in the playground, etc?

The Explosive Child - thank you for the suggestion! I will try to get a copy of that.

Oh, and Amother Peru - thanks for telling me about the stealing. It's really, really hard when I find out that he steals. Frustrates me to no end.

And what's the long term goal? I know that he's only 7 now, but will he need to be on medications for life? How will he learn that there are consequences to keep in mind and control his impulsivity? Is it possible to "rewire" his brain?

mha3484

Wed, Aug 03 2022, 3:12 pm

There are different categories of ADHD medicines. There are stimulants and non stimulants. Ritalin is a stimulant. Guanfacine is an old medication that was originally a blood pressure drug but it is used now to reduce impulsive behavior. I dont fully understand the process, but it makes the brain slow down.

My son did talk therapy where they worked on a variety of issues like controlling his impulses, social skills. I found OT to be kind of eh. I have a different child who is doing OT now and it is helping him so there is no harm in trying it out.

amother

Sage

Wed, Aug 03 2022, 3:28 pm

Ritalin is usually quick-acting. It gets absorbed quickly into the body and wears off a few hours later (4ish, but depends on the kid). There is Concerta, which might be what your son is taking, which is the version of Ritalin that is "extended release." It lasts longer in the body and doesn't wear off in a few hours, usually takes more like 8 hours until it wears off.

Most kids that take Ritalin need to take one dose in the morning and one in the early afternoon (after lunch?). Some kids take Concerta when they wake up in the morning and Ritalin around 8 hours later to top them off for the day, but many kids don't need that and can last on one dose of Concerta all day.

My son went to a therapist for a little while too. They say "pills can't teach skills," but what I found was that he wasn't able to absorb the lessons that she was teaching him until he was medicated appropriately. Once he was medicated, he WAS able to absorb things. Like how to consider other people's perspectives, how to stop and take a breath before making a choice to do something that you might regret later, how to tell when your body is feeling restless and what you can do when that happens, things like that. You want to find someone who is experienced in working with kids who have ADHD specifically.

mha3484

Wed, Aug 03 2022, 4:01 pm

I agree with Sage that meds are necessary for learning the skills to function but as my son gets older, the pre teen years are HARD and I found that navigating school and the social scene with ADHD is not easy. Therapy has been helpful for a whole different set of issues now that the middle school years are upon us. I would not discount it.

amother

DarkRed

Wed, Aug 03 2022, 4:43 pm

Ppl already replied re the difference btwn different meds.
We have had success w focalin(long acting stimulant in the am) and then dosing w ritalin (short acting stimulant ) around "1:30ish"
My son also takes melatonin in the evenings otherwise he can't go to sleep (this is even on days that we skip the afternoon ritalin).

As mentioned, your son won't be able to learn skills without being on a good medication regimen for him.

Once he is on a regimen that seems to work you can start therapy that can help work on missing skills (for example- my son had no social skills at age 5 bc he was so impulsive and labile so in play therapy he learnt how to take turns/share/think about others feelings- couldn't do this b4 he wasn't on meds cause didn't have the capacity to listen or follow through)
Play therapy is therapy where the therapist uses games to work on issues/teach skills.

We still have a long ways to go- now more w filtering and impulsivity (things like yell at a teacher "ur an idiot" or punch a classmate cause for 2 seconds he thought it would be funny and didn't realize he would be in trouble for that and hold himself back). But a lot of this will only come with age and maturity (which is delayed w adhd kids).

He has had some sessions to work on this with a therapist but we stopped (at the recommendation of the therapist) because while he understands theoretically what to do he just doesn't have the ability at this point to apply all these skills "in the moment." Try the book 12 principles for raising a child w adhd by Barkley it explains this very clearly

Hatzlacha