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Advice needed: re: ADD medications

Discussion in 'Parents of Children with Type 1' started by txmom, Jan 20, 2012.

  1. txmom

    txmom Approved members

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    A little background first.....

    Son is 17 1/2, diagnosed T1D about 2 years ago.

    Junior in HS, plays golf and ice hockey, hoping to play golf in college.

    Grades: 6 a's, 2 B's.

    Does NO homework!!!!!

    I have been harping for about three years that the homework train is going to hit my son soon....so far it has not. He manages to get good grades while doing no homework and almost no reading.

    The psychologist at one of the local hospitals used to babysit for me when son was young and knows him quite well. She has suggested that he may have an executive function disorder (in the ADD spectrum). Apparently it is not uncommon for kids with this issue to be diagnosed in college when they finally hit a wall and being smart not longer makes up for the lack of work.

    As I start to focus on preparing him for college (teaching him to cook more, do his own laundry etc.) I am really aware of how much I still do for him that I did not do for my daughter at this age. Basically I am his personal secretary, keeping track of his "stuff" and nagging him to completion when things are critical.

    However, on the golf course he is unbelievably focused and organized. Apparently it is not uncommon for kids with this issue to have one or two things they focus on while all other tasks are sidelined.

    Since I am not looking for accommodation for him in college the psychologist recommends that we ask his doctor to prescribe some medication and see if makes a difference. She is not overly concerned that I get him tested and diagnosed if we are not looking for accommodation.

    Last night my son asked if we could try some medication as he was really struggling to read a 30 page assignment. If he is willing I think the time may be right to see if them makes a difference for him.

    My sense is that I should do this so we have some experience with the medications before he goes off to college. Many diagnosed in college have to work through finding the right medication on their own - I'd rather we find the right solution before he goes. I would like to try the meds soon to see if they have an impact and to help my son navigate any changes in the D care that may result.

    So, my questions are:

    1) Should I schedule an appointment with someone to get him diagnosed or just ask his regular doc to prescribe meds for us to try to see if they make a difference? Will a regular doc even prescribe these without a formal diagnosis?

    2) What is your experience with meds and the interaction with D?

    Thanks in advance for the help.
     
  2. selketine

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    Our regular pedi diagnosed my older son's ADD (not hyper but inattentive and it does affect his grades a lot unfortunately). She prescribed the meds and concerta works great for him. It does take away the mid-day appetite and some of dinner appetite so he is really hungry at night. He is 14 now and doesn't have diabetes - FYI.

    So are all of his homework grades an "F" and they don't count homework much or do they not count his homework at all? My son's low homework grades kill the rest of his grade. His report card looks like A, A, E, E, A, E, A, E, E , E, B, A, A, etc. (E is an "F" or a fail). This just kills me.:(
     
  3. Christopher

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    How long has he not done homework? I am thinking that the problems he is having with the assignments now may be because he is simply not used to doing it. It may take a while to get in the habit of doing assignments, but maybe the more he does it the better he will be at it. He has not been doing homework and has not been reading, so it is like a muscle that has not been used.

    I don't understand how he can get good grades and not do any of his homework assignments. Don't the teachers have an expectation that he turn those in?

    You have been enabling him all these years by choosing to be his "secretary" and doing the daily tasks for him. If you start to gradually back off and get him to start managing his own workload, etc. that may help him to see that he really can be independent, and successful.

    I am sure there is a lot of background that I am not aware of, and maybe trying medication is the right thing to do at this point. I just would try some of the other things first.

    I don't agree with the Psychologist about not getting him tested simply because you are not going to seek accommodations for him. You need to find out what really is going on here with him, not just some speculation by a Psychologist (no offense to psychologists!) :cwds:

    Good luck.
     
    Last edited: Jan 20, 2012
  4. lynn

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    I do not have any advice, just a story to tell you. I have four brothers. Two of them are "classic" ADD personalities. The younger of the two was diagnosed with ADD in the 80's and was the first in the school to be diagnosed. He had to be seen by a psychiatrist half-way regularly because the regular doctor wouldn't prescribe the meds for him. My mother fought for everything for him throughout his school years. She worked hard to get him the ideal seat location in the classroom. She had a folder that went back and forth daily from the teacher with the daily assignments. I don't remember all of the accommodations, to be honest. This guy is SMART!!! But he did awful in school and, after three different high school options (public, home, and christian) he dropped out. He now has a couple of kids and his daughter is just like him. The teachers have talked to my brother and sil about the possibility of ADD and they actually had her tested by a psychiatrist. She was diagnosed and given a prescription for concerta (I think). My brother refuses to give her the meds, saying that they will instead work with her the way she is made and allow her to learn how to thrive. He said that by giving her meds he feels like it's just giving her a crutch and an excuse to not do what she needs to do. She has a wonderful teacher this year and is making great progress in keeping track of things and completing assignments.

    My older brother was never diagnosed with ADD. Anybody with any knowledge of it only has to spend a short time around him before they are joking that he has ADD. This brother was coached about time management and staying on task as he grew. He also is very smart. He graduated high school near the top of his class. Teachers saw his smarts and rode his butt if he fell behind on his assignments. He is currently a Lt. Col. in the Army and just got back from heading up the withdrawal of U.S. troops in Iraq.

    My feelings on meds, with the experiences of my brothers and the many kids I've known over the years (I've taught Sunday school and homeschool groups for almost twenty years) there are obviously some kids who benefit greatly from medication. I just look around and wonder how many, with a little more work, could thrive without it.
     
  5. txmom

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    Thanks for the insight and advice everyone....

    Here is the deal on homework......his grades do go up and down as a result of not doing his homework however he is the master and getting a 97 on tests so he maintains overall very high grades. He also has a very good memory and can often dash off a worksheet with very little effort (or understanding).

    I feel like I have had my head in the sand a bit about this issue - because his grades were good I was not overly concerned although I have been overly frustrated at times.

    I am working to remove myself from the role of secretary and have started leaving many things undone so he will suffer the consequences, however I have a little guilt about this. I wonder if it is truly a neuroprocessing issue or a lazy issue, it is hard to nag when in the back of your head you are wondering if he just can't wrap his brain around it.

    I agree that he needs to learn study skills and thought this would naturally happen as the work got more difficult. Since he is still doing quite well in school I am concerned that he will hit the wall in college when he doesn't have a support structure to manage through it.

    He is a little bit ingenious when he really needs to study something he records the information then listens to the audio while he shoots hockey pucks in the driveway. I used to make him come in the house and sit at the table to study - but I have quizzed him on the driveway material and he can usually repeat it to me with about a 98% accuracy (again, he has a very good memory).

    Thanks again for the insights on others that may have had similar struggles.
     
  6. Lakeman

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    I don't know how much of this will apply but if you are like me you like to see what options are out there.

    My son has tics and there is a correlation between kids with tics and kids with ADD. The meds for tics have side effects that make them not worth taking for him since his tics are not all that bad. Instead we started some vitamins and minerals that were specifically recommended for tics. However, what we noticed is that his schoolwork and homework improved dramatically in exactly the ways one would see if he had ADD. In fact, it has made us wonder if he does not have undiagnosed ADD.

    Anyway, just fyi here is what is working for his tics and what makes a big improvement in his ability to focus and make far fewer mistakes on his homework:

    50 mg 5-HTP (which is also the main ingredient in a product called "Calm Advantage" which is marketed for ADD)

    500 mg Niacin

    400 mg Magnesium

    Allergy medication (singulair)

    B Complex to balance out the Niacin

    Zinc to balance out the Magnesium

    The first four on the list each contribute noticibly to his improvement in both tics and ability to concentrate. If at any time one of them is skipped we do see more tics and more mistakes on homework and more difficulty concentrating. There is a much longer list of things that could be tried. These are just what works for us. If you google Bonnie Grimaldi you will find what looks like a typical internet hype for expensive products that would never work (though I think she is genuine and charges what she needs to). If you look up the ingredients in her products that are listed on a forum for people with tics you can buy whatever you want through whatever source you want. That list is about 30 products long and you can include whatever works for you. I picked the items we use because we already had some of them in the house, they were not expensive, they were safe and easy to take. The way I see it in a country where a huge percentage of people are deficient in zinc or magnesium for example it can't hurt to try in moderation.

    Good luck and best wishes.
     
  7. txmom

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    Lakeman....

    Thanks for the information - I will definately do a little research in this arena as I don't know much on the subject.

    What I've learned today is that I know very little about ADD including the effects of diet, treatment options etc. I'll be reading a lot this weekend.
     
  8. Lakeman

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    Regardless of the cause the day will come when he will have to take care of these things himself one way or another. It may mean hiring someone to do these things or learning to find a way to do them but he will have to be responsible. If you suddenly stop helping one day it will be harder than if you withdrawal slowly. If he has ever done one of these then it means that he has the ability to do that thing. Following through consistently will be the trick. I am sure he is very smart and can find ways to accommodate, cope, or remediate his own needs.

    P.s. I can relate to your son a bit since when I was in school I was bright enough to get by doing the least possible and still get good grades. The day did come when I needed to learn to work hard and diligently on projects to get them done. I doubt I was or am ADD but I did not learn to apply myself until much later in life. I am still much more of a visionary and leader than a detail oriented follow through kind of guy. He will find his way in life and will find his niche that works for him.
     
    Last edited: Jan 20, 2012
  9. 3kidlets

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    Bonnie Grimaldi is my hero! When my son was in 1st grade (6 years ago), he had very bad eye tics, shoulder shrugging, etc. I found her supplements on line and started im on them. Within 3 days they were gone. Prior to this episode, he had them the year before. The lasted several months. They would slow down and then come back full force. But it took a good 5 months before they were gone. However, the supplements stopped them in their tracks. I kept him on the supplements for 3 years before I finally took him off. Luckily, they have not come back. I'm hoping for him, it was an age thing and he has outgrown them. But you are right, you don't have to buy her product. YOu can pick and chose the supplements you want to use and buy them at the store.
    Coincidentally, at this time I was also getting a lot of phone calls home from his teacher. Mostly about focus. When he started on the supplements, that improved as well.
    There is a lot to be said for magnesium. My son swims with a girl who has terrible migraines - pretty much daily. She is working with a neurologist and is on a lot of medications to try and control them, but the dr. recently put her on magnesium as well. There is evidence that magnesium deficiency contributes to migraines.
     
  10. Christopher

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    But being successful in school is not just about getting good grades. It is also about learning the work ethic and skills you will need to progress further in higher education (and life).

    I don't think you should feel guilty about leaving things left undone, as long as you make sure he has the skills and the clear expectations to do those things himself.

    I agree with your concern about him "hitting the wall" in college. He needs to have the support and be prepared for the things he is going to be expected to do. Hoping that he will just do it is setting him up for failure, so I hope you set things up for him.

    A good memory is great but what is just as important is the comprehension piece.

    Does he have any other symptoms of ADD, besides having trouble (not sure what that means) with the 30 page assignment? I guess I still feel like he has gone for 3 (4, 5?) years not doing homework and not learning good study habits. Now that he is trying to do those things, he is having trouble, which is understandable. But I am not sure I would jump right into ADD without a lot of other evidence.

    You have a tough situation on your hands, I wish you luck.
     
  11. txmom

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    Hey Chris....you are right, it is a tough problem. There are some subjects that he comprehends very well, others he skims the surface enough to get by. He has a great math brain and can do very complex equations without ever writing anything down, he loses points for not showing his work but usually gets the answer correct.

    If left on his own he will read for about 20 minutes then start to watch the clock and lose comprehension. He is very well behaved at school and none of his teachers have ever said he doesn't pay attention.

    I have 18 months left for some intense training (before he is off to college) - maybe its me that needs some therapy regarding how to go about this. I think I'll start with short but mandatory study sessions and slowly increase the timeframe until he is doing a similar amount of homework as his peers.

    Any other behavior modification suggestions would be appreciated.

    Thanks again for jumping in and not asking why I haven't addressed this sooner - believe me, I'm asking myself that question right now.
     
  12. MommaKat

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    20 minutes may be all that he can devote to a session at a time. It may help, when you have mandatory study times, to honor that as his sustained cognitive focus window, and build in brain breaks. They don't have to be more than a few minutes long - but can be very, very necessary if that's the way your brain is wired.

    I'm still tutoring this year, even though I'm not in the classroom. I have a mom who started out requesting a two hour tutoring session, and I advocated for 45 mintues - two twenty minute lessons split by a 5 m conversation with my tutees parents. I've struggled to get her to go shorter than one hour, and finally this last month she agreed to try it. Amazingly, (to the parents, not myself) their daughter is now getting substantially higher grades. When we study beyond our brain's ability to focus and process, our brain shuts down and everything stuck in working memory is lost - so the entire study session becomes a waste.

    I've also used techniques like encouraging students with ADD to walk, fiddle with a stress ball, gently bounce or rock on an exercise ball while they read. They actually need the motion to enhance comprehension. It's basically providing two independent pathways to the same stored information in the brain, and the more pathways, the easier the info is to retrieve. I have an entire list of strategies that I send home to parents. I'll look for it, and if you want it, pm me your email and I can send you a copy.

    Just keep in mind that sustained cognitive effort needs to be built over time, just like any form of exercise. If you go too fast too soon, he'll fizzle out and resent the process even more.
     
  13. Helenmomofsporty13yearold

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    You are describing myself as you describe your son. I was always the top of my class and never got into trouble. I had a photographic memory so I did not need to study. I also have a logical enough brain to comprehend or figure things out. I only figured out I have ADD last year after relating to someone else's story (who is extremely intelligent and successful, btw) . As an adult all that is needed to diagnose it is to fill out a symptom checklist you can get on-line from any respected site like this one

    http://www.hcp.med.harvard.edu/ncs/ftpdir/adhd/18 Question ADHD-ASRS-v1-1.pdf

    Menopause has taken its toll on the photographic memory, so I am really noticing ADD's effects, now. I used to self-medicate with nicotine, coffee and diet coke for most of my life, not realizing that I was, and wondering why I had such a hard time quitting. Finally quitting smoking and then nicotine gum has really let the ADD shine.

    I have been trying the meds, but suffer too many of the side effects to stay on them. The person I mentioned above has had tremendous success with dexedrine and coaching from the USA's top ADD coach. I have been taking Fish Oil Supplements for years and take a calcium supplement that has magnesium in it, though my naturopath recently cut back on the dosage for other reasons. I have recently tried an ADD coach and am trying neuro-feedback with no noticeable improvement yet. The coach is $200 bucks an hour, so I have only gone twice so far.

    I did not have any trouble studying at college, university or for my professional designation. We can do anything with a gun to our heads. I could not study in advance of exams, but last minute cramming was my specialty. I have met several university students lately who have told me that "everyone uses ritalin to study nowadays"...an exaggeration I am sure but it seems med students, etc. are using it to focus.

    I read a great book recently that describes ADD so well. The author is a doctor and journalist who has it and his kids have it. I saw myself as the daughter, student, wife and mother with ADD. It explains a lot.

    http://www.randomhouse.ca/catalog/display.pperl?isbn=9780676972597

    In the right professions, persons with ADD can excel. The book explains that persons with ADD can think outside the box and this has allowed so many to be so successful.

    I do not think ADD should be ignored. I wish someone had told me earlier that I had it. Your son has already asked you for help.
     
  14. Style mom

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    What would be the harm in having him tested? That way you know if you're dealing with an actual diagnosis or just, well, laziness, and you can act appropriately. Would you even be able to find a doctor willing to just prescribe medication without a diagnosis?
     
  15. Christopher

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    I am not here to judge, and (I know it is hard) but you shouldn't judge yourself either. We can all look back at things and think, why didn't I do something about it sooner (dx diabetes, for me personally, is a good example).

    I think your plan sounds good. Maybe you could even look into one of those "learning centers" like Kumon or Sylvan to help him build some habits. And I also think you should still have him tested, just to be certain.

    I am really concerned about how Danielle is going to do in college. Heck, I still need to deal with High School first!! :eek:
     
  16. TheFormerLantusFiend

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    I don't know much about ADD meds.

    I did extremely little homework before college. I still can't exactly say why, but it was a very strong aversion.

    I had two years of homeschooling (really more like unschooling) between being in a school with teachers and being in college, but I was still really aprehensive about the homework deal.

    College was easier than high school or elementary school. I did put some effort into avoiding classes where papers counted for large parts of the grade (and especially classes where one paper was a large part of the grade) and there were many papers I missed, but I got As on almost all of my tests, had perfect attendence if you don't count excused absences, participated in class, did most of the homework, and in the end I graduated near the top of my class.
    I did not enjoy my years in college, but I think that had at least as much to do with my life outside of school.

    P.S. Reading was not a problem for me, just focusing and writing about anything outside of class.
     
  17. swimmom

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    The book "Lost, Late and Unprepared" might be interesting reading for you.

    My daughter uses the Daytrana patch (it's a slow release Ritalin patch). The medication does not go through her digestive system, so no issues with appetite suppression, etc. and no rebound issues.

    My high school senior decided to quit taking his ADHD meds this year and has mostly done fine without them. He knew he would need to exert more self discipline, which isn't always his strong suit. He's finding strategies that work for him.
     

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