View Full Version : Need advice about son, also Intuniv


heybabalou
12-16-14, 09:38 PM
My son is 7 years old and in second grade. He has PDD NOS (or the DSM 5 equivalent) and AD/HD, and he most likely has ODD as well, although hasn't been diagnosed with it yet. He also seems anxious at times. He has an IEP and is in an inclusion program at his elementary school, so he is in general education 90% with extra support in the classroom. He has been on Adderall XR 20 mg for over a year and has made a lot of improvements. He also started a 10 mg Adderall IR booster in the afternoons recently and that has been really helpful with homework. However, he is having behavioral problems at school, including arguing and sometimes even hitting teachers. He has problems with defiance at home as well. We do have a behavior chart we use at school and home. We are looking for a therapist to work with to make a more comprehensive behavior plan, and we are hoping we can find a person who can work with him on his anxiety also. We have questions about whether his school placement is the right one for him, but we are trying to make it work. I am looking for suggestions from others who might have kids with similar issues. I am also interested if others have had experience with the medication Intuniv given in addition to a stimulant, and whether it seemed to help with behavior problems such as aggression and defiance. Thanks!

sarahsweets
12-17-14, 05:26 AM
to me it sounds like he would do better in a self contained classroom environment.

Tmoney
12-17-14, 09:17 AM
I do not have the knowledge to speak on the specifics of the medication mentioned, but I have worked with kids who are physically aggressive when aggravated. As young as 4 years old.

One of the behavior programs we used was giving them a healthy acceptable way to express that frustration. It could be hitting a pillow, kicking a ball, even crumbling paper or scribbling on paper.
Then when the time was right we would sit and talk about what actually made them angry to the point where they felt they needed to hit or hurt someone else. We would always ask them how they would feel if someone got mad and hit or hurt them.

I would always remind the kids that it is okay to get angry but it is never okay to hurt someone because you are angry. Never!

So we give them alternatives so they can hopefully make better choices. One of the most important parts of this behavior modification is that when they do make a good choice when they are angry you make as big a deal about it as possible! Praise praise praise, and tell everyone who interacts with him to do the same. I'm sure he can use a dose of positivity!

When we have had success with this we have had this same child start to help and work with other kids who get angry and lash out. The results are amazing on how supervised peer pressure can help!

I was an angry kid who wouldn't hesitate to throw fists when I was angry. I also like praise and I wanted to please my caretakers. I didn't actually want to hurt others, I wasn't a mean kid, I just didn't have the capacity to control my emotions when I was angry! I needed a safe acceptable outlet for my anger! There was no time out when I was a kid and I can assure you time out would have only made matters worse!

Whenever you tell a kid what he can't do make sure to tell him something he can do! Empower him, hold him accountable, reward success!

I wish good things for you!

MrsMoMo
12-17-14, 11:47 AM
My son is also 7 years old and in Grade 2. He has been on Adderall since he was diagnosed just before he turned 6. He has been on 15mg XR. My son also has mild anxiety but not significant enough for a diagnosis. He has also started to show signs of aggression this year and was in a couple of fights at school (granted for the most part he was just standing up for himself). He has been getting easily frustrated in class and sometimes has to leave to cool down. I found him giving attitude, moody, irritable most days and he has started to feel down on himself, sometimes saying bad things about himself (like "everyone thinks I'm stupid" -- and he is actually gifted academically). Very recently he was in a funk at school and told his teacher he wanted to kill himself. He has never said ANYTHING like that before. I was shocked and upset. I made an appointment with our doctor which was yesterday. But as it happens, on Monday, our son was given his pill but left it on the counter accidentally. When I came home from work, I realized right away how happy he was. He said he had a great day at school. He was laughing and skipping around. He said he felt like himself again and was confident and happy all day - the anxiety was gone too. So we decided to stop giving him Adderall which I was planning to do after meeting with the doctor anyways, and was realizing at that point that the behaviours I was struggling with were largely due to the medication. I hadn't realized how miserable he became on Adderall. And it did sort of creep up on us and became a new normal. I'd somehow forgotten that before taking this (it has been almost 2 years) that he was a happy, sweet, confident boy because it happened so gradually.

So he has been more unfocused these last few days, sillier, fidgety, but I will take that over what was happening to him. He's taking a break of a few days to a week or two off meds and in the meantime our doctor, consulting with some specialists in ADHD children will help us find an alternative. It's not uncommon that amphetamines (Adderall) can bring out anxiety - and if a child already has some anxiety, Adderall can make it a lot worse. This was our case for sure. I have a few things in mind to discuss with the doctors - Focalin, Intuniv, Strattera. Although the side-effects of Strattera concern me and it seems to be a longer and more severe list than that of Adderall.

tripleE
12-19-14, 11:04 AM
^^ what MrsMoMo said.

Our daughter - 11 y/o - took Dexedrine last fall. While not the same as Adderall, it is in the same family of ADHD medications. We found it allowed her to intensely focus, but it also increased her anxiety almost immediately. She also had irritable behaviour that creeped up on us - we didn't notice until she stopped taking Dexedrine due to weight loss that she was all of a sudden much happier.

She has been taking Intuniv for quite a while now - I think since early last spring. It worked well for her at first, then after a while we needed to add a low dose of Biphentin (in the Ritalin/methylphenidate family) and more recently we have had to increase the dose of Intuniv.

ccom5100
12-31-14, 03:13 AM
When we first tried a stimulant for my grandson, it made him very aggressive. We took him off of it and the dr put him on Tenex (short acting version of Intuniv). A few years later, when he entered high school and was finding it very difficult to focus and his impulsivity was ramping up, we tried the stimulant again. The combination of the stimulant and tenex was perfect. Each one seemed to cancel out any undesirable side effects of the other; his grades improved, and so did his behavior in school.

zette93
12-31-14, 10:05 AM
My son is 7 years old and in second grade. He has PDD NOS (or the DSM 5 equivalent) and AD/HD, and he most likely has ODD as well, although hasn't been diagnosed with it yet. He also seems anxious at times. He has an IEP and is in an inclusion program at his elementary school, so he is in general education 90% with extra support in the classroom. He has been on Adderall XR 20 mg for over a year and has made a lot of improvements. He also started a 10 mg Adderall IR booster in the afternoons recently and that has been really helpful with homework. However, he is having behavioral problems at school, including arguing and sometimes even hitting teachers. He has problems with defiance at home as well. We do have a behavior chart we use at school and home. We are looking for a therapist to work with to make a more comprehensive behavior plan, and we are hoping we can find a person who can work with him on his anxiety also. We have questions about whether his school placement is the right one for him, but we are trying to make it work. I am looking for suggestions from others who might have kids with similar issues. I am also interested if others have had experience with the medication Intuniv given in addition to a stimulant, and whether it seemed to help with behavior problems such as aggression and defiance. Thanks!

My son was very similar -- Aspergers, ADHD, unrecognized dyslexia, behavior issues that became more and more extreme the longer he was in general ed. Adderall and Intuniv helped somewhat, and we also tried Rispersal, but ultimately the solution was getting him into a program specifically for kids with AS.

Forget behavior charts and rewards. What he needs is help solving the problems that are leading to the maladaptive behavior. If a kid is acting out because he is continually frustrated, the solution isn't to reward and praise him for handling frustration better. It is to find the causes of the frustration and fix it.

Check out the book Lost at School by Ross W Greene, and the videos in the parent tour section of his website, LivesInTheBalance

heybabalou
02-03-15, 07:36 PM
Thanks for the feedback! Things have improved since we started the Zones of Regulation with him. The doc prescribed a tiny bit of clonidine to try in the late afternoon to see if that helps with some of the irritability which seems to increase defiant behavior.