Lakewood Psychiatrist ADHD - Doesn't push drugs

amother

Thu, May 09 2019, 1:39 pm

My 8 year old daughter has ADHD and super high IQ. Her therapists and school wants to explore medication. She doesn't really have much behavioural issues in the classroom, and when she does, it's easily correctable. Socially, she's doing fine, although at times acts silly for her age. At home, while it's obvious she has ADHD, it's really hard for her to clean up, do undesirable tasks, it's impulsive - sneaking food/sweets without permission and sneaks out of bed to read in the bathroom... Her biggest problem is in the classroom. She has very poor executive functioning skills. She doesn't have get books and supplies. She has a hard time keeping up with what her class is doing. She doesn't finish her work and sometimes refuses to do it at all. She can't prioritize her time well. She manages because she is super smart and loves to learn. But she is in a very large class and it's impossible for her to focus properly. In a perfect world, there would be a frum gifted program in our area. But there isn't. She does has ABA support in the classroom, but it is not sufficient and when the ABA therapist isn't there, she's completely lost. This is why they are pushing me to explore medication. I'm hesitant for a number of reasons. Firstly, I'm wondering if ethically it's ok to medicate a child because of the environment we put them in. She is just fine in day camp and doesn't really need support there. Also, I am nervous about the side affects. Right now she is mostly fine at home and I'm afraid of side affects as the drugs were off at home. I have other children with their own packages and since I have ADHD myself, I get overwhelmed easily. I really don't want to rock the boat. On the other hand, meds might help her function in the classroom, hopefully without much additional support and that would be amazing. I need a good Psychiatrist who won't just push medicating and will help me weigh the risks against the benefits.

oneofakind

Thu, May 09 2019, 1:48 pm

There are no good psychiatrists in Lakewood. People have gone to Chemed and Dr. Hirsch looks over the charts and tells the NP what to prescribe. Maybe you want to try alternatives first like fish oils? Maybe she needs a smaller school? There are ADHD coaches, look online. Has she worked with a good social worker who is willing to coordinate with the teacher? That could be helpful sometimes.

amother

Thu, May 09 2019, 2:04 pm

oneofakind wrote:

I forgot to mention that I'm willing to travel and I have decent insurance. She has lots of support and I'm working with a great agency that provides OT, ABA and language therapy focusing on social skills and executive functioning skills. Changing schools is not an option. I haven't tried alternatives like fish oil. Maybe I'll try now until meeting with Psychiatrist

amother

Mint

Thu, May 09 2019, 2:11 pm

I've had a good experience with Dr rugino at children's specialized but I know he is hard to get into. I have a child with Adhd and it's a tough dilemma. A couple of considerations that impacted my decision making- whether it's optimal or not, my child needs to be in school and function for a large part of the day. Do I want my child to continually struggle through each school day. Idk your child's age but it only gets harder as they get older. Also, there is the social and emotional effects long term of continually struggling (even if it's with organization and not academics) and do I want my child to be subjected to that. It's possible that your child may be able to learn skills better when medicated and those skills can carry over to when unmedicated. It's a tough decision with a lot of variables, there is no definite right or wrong, just best for that specific child at that time.
Regarding your concern for when the medication wears off, not all meds have rebound effects and every child reacts differently to each medication. We tried 3 meds until we found what worked for us.
Your child is lucky to have a parent who understands them so we'll and cares. Hatzlocha with your decision. Remember, nothing is set in stone forever, you can always change your mind (or only medicate on school days).... figure out what works for you.

amother

Thu, May 09 2019, 2:52 pm

amother [ Mint ] wrote:

Thanks so much. She is 8 years old. 3rd grade.

amother

Salmon

Thu, May 09 2019, 3:20 pm

amother [ Chartreuse ] wrote:

It sounds like she's really not functioning well in school, despite all the supports- the ethical thing to do is to provide her with the support her brain needs- medication

Agree that this is something very worthwhile to try. The side effects of the medication (if she has any) would be temporary and won't linger if you choose to discontinue the meds. I believe very strongly in doing what it takes to help kids feel successful. You've tried therapy and it isn't enough to fill in the gaps. At this point she needs additional support to feel successful in school, which is where she will be spending the majority of her waking hours for quite a few years.

amother

Azure

Thu, May 09 2019, 3:42 pm

Hi, as a kid I was similar to your daughter, although I never received any therapy. I would like to be the voice of dissent here. You mention that switching schools is not an option. I want to ask you to please consider whether medicating her to fit her into her current environment is really in her best interest. Please shop around and find a suitable school for her so that she can grow up with a healthy sense of herself and her place in the world.

amother

Chartreuse

Thu, May 09 2019, 3:46 pm

amother [ Azure ] wrote:

Based on OP's description, it doesn't seem like it's an environment issue- it's a severely challenged child who struggles with basic tasks. Changing schools isn't the answer here

amother

Thu, May 09 2019, 4:04 pm

amother [ Azure ] wrote:

I too was very similar and did not get any help. I really understand her very well. This is why I don't want to change schools for her. It's a great fit for our family and they work with us. She's doing very well socially, and I struggled with that a lot. I really don't want to rock the boat on that. And while she's in a very large class, I don't think any of the other schools in Lakewood have classes small enough to make a difference.

amother

Thu, May 09 2019, 4:13 pm

amother [ Chartreuse ] wrote:

Based on OP's description, it doesn't seem like it's an environment issue- it's a severely challenged child who struggles with basic tasks. Changing schools isn't the answer here

It is very much an environment issue. In every other setting, other than the classroom, she is fine. You can still see she has ADHD, but she is functioning just fine. I also probably painted a worse picture than what's really going on. She participates in lessons and gets 100s on her tests. When there is someone in the classroom keeping her on task, she's usually fine. Sometimes I wonder if having someone in the classroom is acting like a crutch for her, even if the therapists claim their working hard on not to let them happen, because I have seen some regression in organization and being on task since starting ABA. They have made lots of progress in other areas though. And expectations also rise with age, so that may be a factor in the regression.

amother

Salmon

Thu, May 09 2019, 4:31 pm

A couple of thoughts:

1. is there an alternative environment that would be appropriate for her for the next 9 years? Would homeschooling work?

2. Are the executive functioning deficits being addressed? Is she being taught specific tools to compensate for these deficits? To what extent is she able to independently implement these techniques? Looking toward the future, with increasing demands in those realm both in school and in the workplace/ as a mother, do you see her achieving success given her strengths and challenges?

amother

Thu, May 09 2019, 4:37 pm

amother [ Salmon ] wrote:

1. Unfortunately not.

2. She is working on executive functioning with her language therapist who specializes in that. ABA is also working on that, even though it doesn't exactly fit the method. This is what I'm worried about most. Someday she will be out of the classroom. But she will need to be able to multitask as a mother and homemaker. With better executive function skills, more employment opportunity will be available to her...
One benefit of medication may be too help her focus to be able to learn these skills.

amother

Chartreuse

Thu, May 09 2019, 4:40 pm

amother [ OP ] wrote:

Most people with ADHD are fine outside of environments that require attention, focus, and executive function skills. It doesn't mean the environment is the problem- it means she lacks the skills necessary to function in a school setting. These cognitive deficits would be present in any school setting, and unless you put her in special education, will likely impede her ability to progress. So changing the school would not be the first intervention here.

Happydance

Thu, May 09 2019, 5:28 pm

I dont know psychiatrists that work in Lakewood, I hope its ok im chiming in.

One benefit of stimulant medication is that it wears off completely. Its not like an anti depressant which takes 6 weeks to build up in the system and then time to come off.

Why not go to a recommended psychiatrist and try the meds for 3 weeks and then make a decision?

amother

Thu, May 09 2019, 5:33 pm

Happydance wrote:

Yes. There is where I'm probably headed. I just want an understanding Dr. that will take my concerns seriously.

amother

Violet

Thu, May 09 2019, 5:52 pm

My son has ADHD. We finally put him on meds this year, 5th grade, and it has made such a huge difference in his life and ours. It only took two meds to get it right, and he has made huge strides b"H. I am in Lakewood too and we went to Dr. Halana Rothbort in Cedarhurst, big shlep but totally worth it, she was amazing and got the medication right on the first try (we'd gotten the first prescription from someone else).

Good luck, it's a rollercoaster ride but I hope that you have an easy time!

amother

Thu, May 09 2019, 7:07 pm

amother [ Violet ] wrote:

Thanks