View Full Version : Frustrated -- what does "working" look like? ADHD-I


descotes
03-25-14, 04:19 PM
Backstory:
My son (14) was diagnosed a few weeks back with ADHD-I. We were given tests to give to his teachers and for his father and I to fill out. Vanderbilt test?

Out of all of the tests that came back -- 4 teachers and his father and I -- mine was the only one that was "positive" for ADHD-I. He has every symptom. All the other tests were not saying that's what he had.

After a long conversation back and forth with his pediatrician about weather or not he really has ADHD-I he agreed to put him on Concerta 18mg. After a week of seeing no results he upped him to 27mg. I just spoke to him after another week of seeing "no results" and him feeling the same and him writing down wrong assignments, not meeting with his teachers, etc. and he told me that we can up him one more time to 36mg but if that doesn't do anything then that's when he starts questing the diagnosis and whether my son even really has ADHD-I or if it's just laziness. I know he has it because I have it. It's genetic!

Because it's not "H" I know it's harder to see a change but my son is saying he doesn't feel anything different and the behavior is still the same.

I'm so frustrated. I don't even know what to do.

zette93
03-25-14, 04:44 PM
Another possibility is that he has ADHD--I, but Concerta is not the right medication for him. In Russell Barkley's video (see my sig) he mentions that primarily inattentive tends to be less responsive to medication. There's even a subgroup he calls "slow cognitive tempo" that he speculated may someday be separated out into a different diagnosis.

You might try using the methods in Smart But Scattered to help your son in addition to trying another med.

zette93
03-25-14, 04:47 PM
I just spoke to him after another week of seeing "no results" and him feeling the same and him writing down wrong assignments, not meeting with his teachers, etc. and he told me that we can up him one more time to 36mg but if that doesn't do anything then that's when he starts questing the diagnosis and whether my son even really has ADHD-I or if it's just laziness. I know he has it because I have it. It's genetic!

Also, there have to be more options beyond "ADHD-I" and "just laziness". I'm thinking some combination of missing executive function skills (Smart But Scattered is good for teaching these) and possibly an undiagnosed learning disability? You might want to take him for psycho-educational testing (looking at things like working memory, visual perception, auditory discrimination, etc) if that hasn't been done yet.

dvdnvwls
03-25-14, 06:08 PM
"Medication working" looks like a noticeable reduction in the symptoms that you told the doctor about.

ADHD is largely genetic, but there's never a guarantee, and often the parent and the child will have different forms or different disorders altogether, if indeed they have any disorders.

TygerSan
03-25-14, 07:35 PM
Fwiw, I'm ADHD-Pi and Concerta didn't do much for me either, even at 54 mg. The amphetamine drugs worked better. It may just be that Concerta isn't the best med for him.

I think it's Barkley who suggests trying meds from both the methylphenidate (Ritalin) and the amphetamine class to see which provides the best symptom relief.

descotes
03-31-14, 02:17 PM
so now we're up to 36mg and I still don't know. He says he feels more focused in school and not daydreaming off in space. However, I know you said that it looks like a reduction in the symptoms I spoke to the Dr. about but that was things I see at home like missing homework, doing poorly on tests, being disorganized, not being social... I'm not seeing that change. Maybe because the medication has worn off by the time he gets home?

For example. He has to read a book a month and take a test on it. Last week I asked him about the book and he said he had a bit more to go and he'd have to read over the weekend -- as today is the 31st and is the deadline for his monthly quiz on the book. I asked him on Sunday if he had any homework to do and 1) lets say that if I didn't ask him he probably wouldn't have mentioned it OR done it and 2) he never mentioned the reading. So since I have ADHD-I as well and have way too much swimming around in my brain I forgot to ask him about the reading.

So when I woke up this morning after he had already gotten on the bus and was already at school I realized -- Crap he never read that book this weekend and he has to take the test TODAY. So he never mentioned the reading, didn't remember or idk.

Then I found out this afternoon -- he had gone to his friends house Sunday after he "finished" his homework --- that his friends mother had asked him something about the reading/test and she said to me after I told her he never read.. "no wonder he stuttered a bit when I mentioned it". So he did have a reminder, albeit not from me about the reading and he never mentioned it when he got home, nor did he read.

So these are the things I wanted to help with the ADHD meds and it doesn't seem to me that they're doing anything. Any thoughts or help would be welcomed.

dvdnvwls
03-31-14, 02:41 PM
He needs help to learn how to not have way too much swimming around in his brain. Tricks of how to get by when you have ADHD. The tricks that "regular people" use are generally not much good.

descotes
03-31-14, 03:31 PM
Well I have ADHD-I too and I have too much swimming around in my brain and haven't figured it out yet and I'm 43. Not sure I'd be the best help.

dvdnvwls
03-31-14, 03:51 PM
Well I have ADHD-I too and I have too much swimming around in my brain and haven't figured it out yet and I'm 43. Not sure I'd be the best help.
Not saying it's you who helps him, just saying what's needed.

Fuzzy12
03-31-14, 04:05 PM
Basing a diagnosis on whether someone responds to a particular medication or not is a very lazy practice I believe.

Even if concerta doesn't work for your son there are other stimulants and other treatment options that he can try. And as mentioned above sometimes the effect of the meds is very subtle and can go unnoticed behind habits that have been picked up after years of undiagnosed adhd. I'd give it some more time. Even woth meds it's unlikely that anyone guess immediately from being fairly non functional to fully functional

Having said that just because you have adhd it doesn't mean that your son has it too though it increases the probability. Adhd symptoms occur on a spectrum and everyone falls somewhere on this spectrum. You are right. It's not just adhd I or lazy.

Maybe in addition to meds some behavioural adhd specific therapy might help.

messyme
04-01-14, 11:45 AM
Out of all of the tests that came back -- 4 teachers and his father and I -- mine was the only one that was "positive" for ADHD-I. He has every symptom. All the other tests were not saying that's what he had.

After a long conversation back and forth with his pediatrician about weather or not he really has ADHD-I he agreed to put him on Concerta 18mg.

Do you mean that four teachers and his father and you all filled out questionnaires and according to all of them (except yours) he does not have ADHD-PI, but according to yours he does? If so, I'm very surprised that the doctor would diagnose a boy with ADHD based on just his mother's answers.

I don't think not doing homework points to ADHD. If you talked to middle/high school teachers at an average high school, I think you'd find that most 14-year-old boys are quite irresponsible about doing homework/studying, for different reasons. I'm not saying your son doesn't have ADHD or that he's lazy, but I think not doing homework etc. is actually the norm at that age. And I'm not saying that's not a problem, but I just think it's very normal and there are many possible reasons for it.

I think that if the four teachers don't think your son has symptoms of ADHD, it might be a good idea to take that into consideration. They deal with teenagers every day and are able to compare your son to hundreds of other kids his age. There might be some "symptoms" as you describe, but as I said if they're normal for that age, the teachers are comparing your son to other students and are saying that compared to them, he's about the same.

Another thing to think about -- most teenagers don't get enough sleep (they need about 9-10 hours a night, every night, around the same time). A lack of sleep could have an effect on your son's behaviour.

Have you talked to your son's teachers? Maybe they could give suggestions about how to help him become better organized. Whether or not your son has ADHD, he could benefit from the same kinds of strategies used by people with ADHD.

By the way, my son is 8 and his diagnosis is also ADHD-PI. I didn't see much difference with his medication, but his teacher definitely did at school. Even though my son's ADHD is mild and primarily inattentive, every year teachers would talk about attention problems.

descotes
04-02-14, 11:34 AM
Do you mean that four teachers and his father and you all filled out questionnaires and according to all of them (except yours) he does not have ADHD-PI, but according to yours he does? If so, I'm very surprised that the doctor would diagnose a boy with ADHD based on just his mother's answers.

I don't think not doing homework points to ADHD. If you talked to middle/high school teachers at an average high school, I think you'd find that most 14-year-old boys are quite irresponsible about doing homework/studying, for different reasons. I'm not saying your son doesn't have ADHD or that he's lazy, but I think not doing homework etc. is actually the norm at that age. And I'm not saying that's not a problem, but I just think it's very normal and there are many possible reasons for it.

I think that if the four teachers don't think your son has symptoms of ADHD, it might be a good idea to take that into consideration. They deal with teenagers every day and are able to compare your son to hundreds of other kids his age. There might be some "symptoms" as you describe, but as I said if they're normal for that age, the teachers are comparing your son to other students and are saying that compared to them, he's about the same.

Another thing to think about -- most teenagers don't get enough sleep (they need about 9-10 hours a night, every night, around the same time). A lack of sleep could have an effect on your son's behaviour.

Have you talked to your son's teachers? Maybe they could give suggestions about how to help him become better organized. Whether or not your son has ADHD, he could benefit from the same kinds of strategies used by people with ADHD.

By the way, my son is 8 and his diagnosis is also ADHD-PI. I didn't see much difference with his medication, but his teacher definitely did at school. Even though my son's ADHD is mild and primarily inattentive, every year teachers would talk about attention problems.
We've been hearing about focus problems for years as well. It mostly came in the form of him coming home and not being able to do his homework because he was in la-la land during the lesson of that day and had no idea what to do for his homework. Or him having a test and failing it because he didn't know the material. He may look like he's focused in school -- which is what I believe the teachers think -- but he's not getting any of the information the teachers are saying.

We had Ryan tested for auditory processing in 4th grade because I hadn't really delved into ADHD-I at that point. What we were seeing then was when we'd study at home for a test, we'd say (for example) -- the sky is blue, the sky is blue, the sky is blue. What color is the sky? And he'd look at you and be like -- for real -- I don't know. We'd be like really??????? As a parent it was extremely frustrating. We got him a 504 and yes even as his doctor said because he's 14 he has developed learned to cope with it just as I did when I went through school failing all my classes because I wasn't diagnosed as I should have been when I was in school.

His teachers may not see anything but I can tell you this. When I see A's a B's for the first time all year on the grade portal for my son, I am optimistic that he was diagnosed correctly and that even though I many not see it in some behaviors at home that in school he is more focused and doing better which was the main reason for getting him officially diagnosed and getting him on medications in the first place.

messyme
04-03-14, 08:18 AM
We've been hearing about focus problems for years as well. It mostly came in the form of him coming home and not being able to do his homework because he was in la-la land during the lesson of that day and had no idea what to do for his homework. Or him having a test and failing it because he didn't know the material. He may look like he's focused in school -- which is what I believe the teachers think -- but he's not getting any of the information the teachers are saying.

We had Ryan tested for auditory processing in 4th grade because I hadn't really delved into ADHD-I at that point. What we were seeing then was when we'd study at home for a test, we'd say (for example) -- the sky is blue, the sky is blue, the sky is blue. What color is the sky? And he'd look at you and be like -- for real -- I don't know. We'd be like really??????? As a parent it was extremely frustrating. We got him a 504 and yes even as his doctor said because he's 14 he has developed learned to cope with it just as I did when I went through school failing all my classes because I wasn't diagnosed as I should have been when I was in school.

His teachers may not see anything but I can tell you this. When I see A's a B's for the first time all year on the grade portal for my son, I am optimistic that he was diagnosed correctly and that even though I many not see it in some behaviors at home that in school he is more focused and doing better which was the main reason for getting him officially diagnosed and getting him on medications in the first place.

Well then it looks like you answered your own questions! :)

Timberline
05-15-14, 11:19 AM
Hi- my 10 YO daughter was diagnosed with ADD in Dec., and I had a hard time with the diagnosis.
She was VERY difficult to wake up, quite surly especially in the mornings, would bring home math homework and stare off into space instead of doing it, resist and complain about everything. She was impulsive and had NO friends. Every year at school, her teacher had to seat her away from her peers, because she couldn't quit disturbing the others.

We started with Daytrana (ritalin patch), but she had a tendency to pick at her face while on that, and then we started Vyvanse. Once we got the dose right, she's generally easier to get along with, happier, does math assignments while still at school, and HAS MADE FRIENDS with girls at school. Her grades improved, impulsive behavior is reduced a lot, her memory is better, but she still isn't interested in getting organized. These results came for a girl who RESISTED the idea of taking medicine at all.

So that is our definition of "working". It isn't perfect, but it is a great improvement.
HTH. T-Line

LynneC
05-15-14, 01:26 PM
So that is our definition of "working". It isn't perfect, but it is a great improvement.
Yes, yes, yes! :)