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  1. #1
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    Default Trying everything before meds, when to do meds?

    I am 99 percent sure we will be getting an ADD/ADHD dx for ds early next month. The psychiatrist said at our meeting that he is waiting for the teacher's input but given what he had so far he was just debating the H. I subsequently saw the teacher's form and her answers were pretty consistent with ours.

    So now we have to figure out where to go next. The psychiatrist suggested that we should consider meds. I am willing to do that. But I also want to consider whether we/school can make sufficient accommodations for ds to succeed without meds.

    When people say they tried everything before going with meds, what is "everything?". How did you approach deciding whether to go with meds?

    Thanks for any input!
    Catherine

  2. #2
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    For us, basically everything came together all at once. We sought out a dx with a psychiatrist when we saw her really suffering with self-esteem issues. On the verge of being depressed. The constant corrections in behavior (calm down, pay attention, etc.) at school and at home were really taking a toll on her. She was struggling to do what typical kids could do seemingly without effort. Socially the behaviors were also affecting her. Keeping focused on topic with conversation, game playing, etc.

    She received therapies for plenty of other things (ot, pt, speech, social, anxiety) and I just didn't see how therapy was going to address these adhd-related issues. We did not try diet...she is pretty self-limiting with diet already and was not prepared to fight that battle with two other kids around plus health issues with one of them. I do know that many people like to try Feingold first. Also tried things like fish oil...didn't see any change.

    So when she did get the dx, we put her on meds and got accommodations in a 504 for things like preferential seating and help with organizing/planning (as the meds don't help too much with this aspect of ADHD) all at the same time.

    After reading the book "Driven by Distraction" I became more comfortable with the idea of medication for ADHD.

    Best of luck deciding. I know it's not easy and we all arrive at our decisions differently.
    DD1 - 1996
    DD2 - 1999
    DD3 - 2005

    Surfaces are for working, not for storing. - Peter Walsh

  3. #3
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    missym is offline Bargain Alerts forum moderator
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    Default

    At the advice of our psychologist and ped, we tried accommodations first and gave it some time before trying meds. We had concerns about meds because DD is super, super skinny to start with and she is very sensitive to the amount of sleep she gets. In our case, classroom adaptations + a wonderfully understanding teacher have made a huge difference.

    But I'd say we have close to an ideal situation right now. If things had continued the way they were last year, I don't know that we'd still be med-free. She was having a lot of anxiety, starting to show esteem issues related to school, etc. Even with some accommodations last year such as preferential seating, constant correction on the part of the teacher ("Gwen, pay attention!") was really wearing her down. And this was with an "excellent" teacher.

    I feel like we're in a delicate balance, and it wouldn't take much (like a less understanding teacher next year) to tip us back the other way.
    Missy
    Mom to DD1 '03 and DD2 '05

  4. #4
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    Thank you! DS likes school. He is generally happy. He is not struggling socially. I think he is being corrected some at school, and certainly some at home, but I don't feel like it is constant. BUT he is falling behind academically. That is the big concern at this point. DH is worried that if we wait too long to try meds, ds will be turned off of school and we won't be able to change his mind. I am worried about weight as ds tends toward skinny anyway. Are sleep difficulties another side effect? He is a terrible sleeper. . . . .

    Catherine

  5. #5
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    Ironically, DD was not doing badly academically....because she had all those wonderfully flexible, accommodating-type teachers. Unfortunately, we are seeing academic effects now (despite meds) because of the organizational/planning piece and the amount of work in middle school along with the independence that is expected at that level. I can understand your DH's concerns. I was afraid that the damage that was happening to dd's self-esteem would become unreversable. What grade is your ds in?

    As far as weight: DD was/is skinny and when she was on a stimulant (Focalin XR) she was megaskinny. People commented. But both her pediatrician and psychiatrist did not feel like it was severe enough to be concerned. She is now on a non stimulant (Intuiv) and she is at a more normal weight.

    As far as sleep: DD never really had an issue luckily with the medications affecting sleep. The stimulant had worn off by bedtime (she took the meds maybe around 7am and would go to sleep at around 830/9pm).

    If you do end up having a discussion about meds with the dr, I'd mention the weight and sleep. Maybe he/she will suggest trying a nonstimulant first.
    DD1 - 1996
    DD2 - 1999
    DD3 - 2005

    Surfaces are for working, not for storing. - Peter Walsh

  6. #6
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    He is in second grade. For whatever reason, I think of meds as being more appropriate the older the child is. I guess it just seems like with early grade school kids the environment ought to adapt more to them. I don't know. I am certainly not saying kids should not be put on meds in grade school, just my general inclination.

    I did mention the weight issue and the psychiatrist agreed that it was a legitimate concern, but felt that most people worked around it, for example providing a substantial breakfast before giving the meds and allowing post-dinner snacking to make up for not eating at lunch. . . .

    Thank you!
    Catherine

  7. #7
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    Yeah, dd didn't start meds until around 3rd grade (or 4th...I can't remember exactly).

    If I were you, once I received the dx, I would definitely give accommodations/strategies a try before meds. Especially, since your ds doesn't seem to be suffering globally (right now academics only seems to be the concern)...keeping a close eye on his mood, self-esteem, attitude towards school, etc. JMHO
    DD1 - 1996
    DD2 - 1999
    DD3 - 2005

    Surfaces are for working, not for storing. - Peter Walsh

  8. #8
    HIU8 is offline Red Diamond level (10,000+ posts)
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    My DS just started meds 2 months ago. We were going ONLY with accommodations in the classroom and behavior therapy and dietary changes. We would have stayed where we were, however DS came to us and said he just could not do it anymore. He asked for more help (Note: he was working so hard to keep it together during the school day, He simply could not function anymore). DS is combination type (hyper and innatentive--mostly innatentive at school though). I have to say, meds have so far made a HUGE difference.
    Heather

    DS 2004
    DD 2007

  9. #9
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    egoldber is offline Black Diamond level (25,000+ posts)
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    Default

    We sought out a dx with a psychiatrist when we saw her really suffering with self-esteem issues. On the verge of being depressed. The constant corrections in behavior (calm down, pay attention, etc.) at school and at home were really taking a toll on her. She was struggling to do what typical kids could do seemingly without effort. Socially the behaviors were also affecting her.
    This pretty much sums it up for us as well. DD's diagnosis is not ADHD, but the anxiety and impulse control issues were making things very hard for her. I made the call when I watched her at a school function meant to be fun, struggling so hard to hold herself together. We started the process for a referral to a psychiatrist soon after.

    But at that point we had had her in therapy for a long time (over a year) and tried as many other avenues as we felt were feasible for us and her before medication. She was also older, 4th grade, and I knew that vs. her peers she was quite delayed vs. just being a little immature.
    Beth, mom to older DD (8/01) and younger DD (10/06) and always missing Leah (4/22 - 5/1/05)

  10. #10
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    Thanks everyone!

    Catherine

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