7 yo with ADHD - meds and therapy?
Our 7 year old daughter was diagnosed with ADHD primarily inattentive a year ago after her K and 1st grade teachers raised concerns about her ability to focus at school. We were able to obtain an IEP and a number of accommodations. She also goes to OT (outside of school) for fine and gross motor skill issues. She reads above grade level and is doing well in math but her teachers are concerned that she will begin to fall behind as the curriculum becomes more difficult. As a bit of background, several of my family members have ADHD but they were quite hyperactive.
Questions:
I would like try medication but my husband is concerned about it affecting/dampening her personality (which is super sweet and funny). If this happened when your children started on medication, what did you do? Try a new medication, lower the dose?
My niece started college last year and the psychiatrist at her college took her off the stimulant medication and now she is struggling with depression. Has anyone else experienced this with themselves or their children? I'm curious if it is common for adults to be taken off the stimulant medication (or do some stay on it their entire lives) and if depression is a common side effect from being take off the medication?
Finally, how do people find child psychiatrists for their ADHD children? Her primary care physician recommended physicians who charge $5-7k for diagnosis. My husband found a psychiatrist who diagnosed her with ADHD using the test results provided by the school but our observations were that his patients were all teenagers. And the doctors recommended to us aren't taking new patients. We looking for recommendations in the East bay --preferably Walnut Creek/Concord area but willing to travel to Berkeley and Oakland for a great doctor!
Thank you!!
Parent Replies
My son's ADD was not severe and we spent several years avoiding medication, trying to get him to pull it together, work on accommodations, etc. Ultimately, we tried and I felt bad for letting him feel bad about himself for so long. He's in the driver's seat about the meds -- does it seem good? does he want to try another? higher or lower dosage? Occasionally, he's decided he didn't want to take it but then he's responsible for the (negative) outcomes.
There have been side affects -- with one med it did make him have a flatter affect. He still liked it, because he did so much better at school. Another parent told me to wait for three months and see if the side effects diminished. They did! A slow-release one made him have insomnia. It was one bad night.
The great thing about ADD meds is that they are out of the body so fast. If something doesn't work well, it's gone the next day. I think that's why I feel so bad about waiting so long. It's so easy to try. Now, we have a kid who's proud of his school work and grades and our relationship (I used to joke that I was so involved in supporting his academics that I was taking 7th grade again) is better.
My kiddo is 9 and also has an inattentive type ADHD diagnosis. They also have a lot of trouble focusing at school and finishing work, but also test at grade level in math and above grade level in reading. I've decided not to put them on medication yet (if ever) because they are meeting all learning objectives, and because of my own experience. I have the same diagnosis. I didn't get diagnosed until I was an adult, and after getting diagnosed, I tried various medications and nothing made a huge difference. I realized that what has made a big difference is all of the coping skills I have learned. I have so many strategies in place to keep me organized, focused, and getting things done. It took me a long time to learn all of these skills, and I did struggle in school, but at the same time, I took very advanced classes, and have a master's degree. This isn't uncommon, especially for girls, with inattentive ADHD.
So I understand the concern of your kid's teachers, my kid's teachers, and my own teachers (and I'm also a former elementary teacher myself!). But personally, given the side effects, I wouldn't resort to medication until your kid starts falling behind in school. In the meantime, your kiddo needs to develop some coping skills. If you don't feel up to the task yourself you can hire a therapist, coach, or occupational therapist. And you're right to seek a more qualified diagnosis. It's important to also determine whether your child has SPD, or has difficulty breathing and or sleeping at night, which can be a primary cause of inattentive type ADHD symptoms (which will go away with treatment, if that is the cause).
Also a parent of a child with inattentive type ADHD. Amazing you were able to get an IEP - congratulations!
My husband was resistant to medication, but research shows that a combination of medication and behavioral intervention is most effective, so that is what we did. We have not seen a change in personality. The only change is in appetite. We only give the medication on school days.
We used Summit Center for the initial diagnosis. We haven't needed an ongoing psychiatrist. The pediatrician is able to provide the prescriptions. I would put your money into a high-quality diagnosis. This is what will help ensure the treatment that does or does not make sense for the particular child.
All the best to you and your family.
Our daughter was 6 when diagnosed. We also resisted medication and tried everything else under the sun to help her. Finally when she was 8, we tried meds, and it was a miracle overnight. She was so much happier. We truly feel we gave her a gift, and specifically a gift that allowed her to do all the things she loved but just couldn't do on her own. Her effervescent personality didn't change at all. We use focalin (in the ritalin family and has less side effects).
Dr. Paul Abrinko is a child pyschiatrist whom we have happily used for many years now -- (510) 496-6014 ; %20PaulMD [at] PaulTAbrinkoMD.com (PaulMD[at]PaulTAbrinkoMD[dot]com) •
To answer your questions in order: we did not find that our child’s medication had a dampening affect on personality, only that it helped the symptoms it was prescribed for.
Our child is on college; the medication is extremely helpful. If it’s needed, college will have a program for your child like the IEP / 504 your child currently has, but she will be self-advocating for it, of course. I wouldn’t stick with a doctor who suggested our child come off medication.
One of the first things we learned about ADHD is that it is a medical diagnosis, not a mental health disorder, at least during childhood. Our child only transferred to the Psychiatry dept. (from pediatrics) after their 18th birthday.
Certainly there are drawbacks / side effects to being on any medication; the question of whether to take a medication is always based on weighing the benefits & drawbacks, no matter the condition. We’ve found it far more helpful than harmful.
I have an ADHD Inattentive teen. My advice is to try the meds and see how it goes. There is no downside to trying meds for a few days. Then you can make a more informed decision about whether to continue. Our child has been on meds since the second grade and is now a senior in high school. We have needed to adjust dosages and brands over the years but even not-quite-working meds have been dramatically better than no meds. It's all about pros and cons. We let our child decide whether he takes meds and typically he doesn't take them on weekends or holidays. Personality-wise he still is the same person on meds. His appetite is dampened on meds so we have needed to make sure he has a big breakfast and big dinner with plenty of snacks available. But he's 6' 5" so obviously the meds did not "stunt his growth" as an acquaintance once warned us about. In the past, some dosages made him unable to fall asleep at night, so we'd change the dosage or use melatonin at bedtime. But for the past few years we have not had this problem.
My daughter, now a thriving recent college graduate, struggled throughout her elementary school years. She had an assortment of learning issues, worsening social problems over the years, with resulting depression and anxiety and poor self esteem. She was not diagnosed with ADD, but both times she was tested at the UC Department of Psychology ( a fantastic resource) we were told she had many attributes of ADD, inattentive type. She saw learning specialists and therapists throughout elementary and high school. In 7th grade she became significantly depressed and was put on antidepressants, and we were advised by her doctor that ADD meds might make her depression and anxiety worse, so we did not try treating her ADD until a few years later.
Fast forward to high school- in her sophomore year, things were great socially, but academically she was failing classes. She vowed to turn it around. She began taking Adderall, and on Day One came home saying,”I could concentrate today, and it wasn’t even hard!” Long story short, in junior and senior years she excelled academically and creative, her self esteem was hugely better, she had a large friend group, and was far less anxious, and no longer depressed. She was able to stop antidepressants.
After her first year in college, she stopped taking Adderall ( she had only ever taken it on school days) and continued to do as well without it.
As I look back, I wish we’d tried a stimulant years earlier. If we had I think she might have struggled far less at school both academically and socially, been far less anxious, had better self esteem, and might not have become depressed. I think untreated ADD caused/ exacerbated all her problems, both social and academic.
As others have said, stimulants are out of the body very quickly, and one can assess the effectiveness soon after starting to take them. Why not try?
In closing, I will recommend most highly her psychopharmacologist, Dr Lisa Hardy, in San Ramon (925.362.3861)- just so warm and wonderful. And her gifted therapist, in Berkeley, Dr. J.J. Kelly (510.595.7594). In both cases, I can’t imagine better doctors. I am so very grateful to them both.
Congrats on getting an IEP in place for your child with ADHD.
We have 2 kids with ADD, 1 actually w ADD, 1 with ADHD.
We knew they had focus issues in school as early as 1st grade but did not give them medication until they started to falter in school. When this happened they also started to experience some self-esteem issues related to their inability to keep up in class which was really noticeable to both kids about 4th and 5th grades. If you start medication (which has been really beneficial for both kids as far as school work and focus) work closely with the teaching staff to see how their affect is in class. Are they flat? having struggles interacting with other kids when on medication? They probably need a different drug and you can relay this info to your prescribing provider to make a change. We only give them medication during the school day, not on weekends or holidays. They do tend to have a decrease in appetite at lunch related to the medications so we give them big breakfasts and pack high protein snacks for right after school when they can be ravenous when the drugs wear off. Otherwise, they like the fact that medications help them so much in school when prior to meds they were really struggling to maintain focus and keep up. We do offer them the choice to stop meds if they'd like. So far neither has wanted to.
Hope this helps!
Original poster here-- thank you for everyone taking the time to respond. Some of your posts brought tears to my eyes. I am planning to reach out to the doctors listed. THANK YOU!!