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My STBAS was born positive for THC. I suspect his mom used cocaine too (she's my sister, I know a lot more about her than a usual FP) but don't have any proof of that.
Apparently drug-exposed kids commonly have frontal lobe deficiencies ... including impulse control. This is a HUGE problem for my STBAS. He's a smart kid and knows exactly what is expected of him. What he cannot do is think before he does something. I kept expecting it to get better with age (he's 5.5) but honestly he's not really any better now than he was two and a half years ago as far as sheer impulse control goes.
Today he got into major trouble on the bus today because of this, and was suspended from riding the bus. It is only a short suspension, but it will be a huge hassle for us (we both work full-time). It also means that the next time he acts up it will mean an even longer suspension. But I just feel totaly helpless what to do. Punishment does not help. It honestly isn't a genuine misbehavior ... I really don't think he CAN stop and think about what he is doing. It isn't until afterwards that he realizes he's not doing the right thing. The majority of the time he gets in trouble is because he's following the lead of another kid who starts misbehaving.
Not only that, but he has this weird "completion" complex too. He HAS to finish every action he takes, even if he's in the middle of getting in trouble for it. You tell him to stop doing something, and it's like he can't until he's finished with the action. Even if you're telling him over and over to STOP and you tell him he's going to lose a privilege AND you physically take the item away he's grabbing and clawing at it trying desperately to "finish". i'm not talking about finishing playing a video game or watching a TV show -- it's the very concrete actions. Like he has it in his head that he has to put 5 Legos together. If you just let him finish the 5 Legos he's fine, but if you try to make him stop at 4 Legos -- complete meltdown!! However, if you tell him to turn off the TV show he's in the middle of watching he is fine with that. I don't know much about OCD but I wonder if that is part of it.
So those two things together are probably 95% of his problems. The thing is ... what the heck do I do about it? Is there anything I can do to work with him on it? I am at a loss as to figure out how. I've Googled it but all the sites I've found with "practical" tips are all geared toward teaching toddlers not to wallop other kids with their toys.
We are in adoption limbo right now so we cannot start therapy yet, but as soon as adoption is finalized and he's on our insurance I plan on trying to find a therapist who specializes in ADHD to see if that will help (since impulse control is a part of ADHD as well). There are very few therapists here who take Medicaid, and it has to go through DHS for approval, so I don't even want to bother with that yet. He did go to a therapist for over a year but he didn't get anything out of it. She specialized in play therapy though and all she did was sit and watch him put together Lego kits. It was pretty much worthless. so hopefully with private insurance I can find a better therapist. But my insurance will not let me add him until we adopt.
Sorry for the novel ... any advice would be greatly appreciated!
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Okay I realize I wasn't entirely clear so I'll try to explain myself a little better...I definitely don't think continued impulse control issues are normal, I just said that in SOME kids it's not uncommon and that SOME kids grow out of it naturally while others don't. You are correct in talking about the frontal lobe, as it's part of the development process and SOME kids (drug exposed or not) don't always develop at the same rate.I definitely agree that if he is having issues with things that are dangerous or harmful, it needs to be addressed ASAP. If it is a non-understanding of the repercussions for his actions until after the fact, the problem COULD fix itself with just continued consistency or therapy/adhd meds could help. (At the very least it could speed things along.)When I mentioned meds, I was specifically referring to bipolar meds and children. NOT all meds. Bipolar meds are pretty hardcore narcotics. Anyway, I just wanted to make sure you don't think I was blowing it off, because that was NOT my intention. I totally sympathize with you! It is very very very frustrating when you see that something is "off" and nobody will listen!My little "practice" foster kiddo (I have him 50% of the time, mom has him 50% of the time) CLEARLY has significant speech and other delays and people have blown me off (including his own mother) when I try and point it out. I do NOT want to be one of "those people".
My son has been exposed to methamphetamine both in the womb and after second hand exposure. He displays impulse control problems as well. Interestingly, he was exposed less than my daughter, who has much less severe of problems. I think that neglect has a huge effect on children and their emotional health. My son is 4 1/2. Recently, I discovered he only "hears" about 1/4 of what we say. I have begun checking to make sure he hears what we expect of him. We go over expected behavior before going anywhere. If behavior is not what is expected, consequences happen, then we discuss what should have happened. We also ask him if he needs a cool down time if he's spiraling out of control. He sometimes says yes, and goes to his room to chill for a couple of minutes. I don't know what's going to happen when he goes to school...I think he may need to be medicated to function properly. I won't hesitate.
My oldest son had mild ADHD. We were able to manage it by strict schedules, physical activity, rules, plenty of sleep, good diet, and organization and support. He is encouraging me to use meds if need be for my son. He had such a hard time growing up. Don't hesitate medicating if your son needs it.
I could have written your post as well!
My STBAD is almost 6 and she is ADHD as well as a few other acronyms and she IS medicated and still has horrible impulse control (as well as defiance and other issues)
Im so glad to hear someone else talk about the "has to finish the act" behavior! I really thought she was the only one. Its like once she has the thought to do something..even when she is getting told not to, she has to complete the action regardless of the consequence. She takes it one step farther too... if caught ABOUT to do something and told to stop, she starts looking for something else to do to get in trouble!
Her Teacher and I talk almost daily about her behavior. Most days she is "OK", but at least once or twice a week she ends up with a sad face, usually for not listening and doing something she "knows" is wrong.
Her trend is going in the direction of more sad faces. Her meds were increased a few months ago and she was great for a few weeks(per the Teacher- they were increased before we had her) so I dont know if she needs another increase or what. I know what ADHD meds do, but I dont have much knowledge of doses, as far as what is considered high/low. Her Neurologist appt isnt for 3 more months (thats who does her meds) but she has a Ped appt on Monday and I hope to talk about increase/changing meds and see what other options there are. It may be that theres another med that will work better for her.
We do not know what she was exposed to in utero, as they were only slightly on DSS radar at the time of her birth, so she wasnt tested. I am starting to lean towards alcohol though..... she really does not learn from one day to the next...no form of "parenting style" makes any difference!
She can be such a joy and so much fun as well, but we are so beat down from her battles sometimes it is hard to remmeber that.
Sorry...didnt mean to vent... but wanted to tell you that you are NOT ALONE with that behavior, and I know how discerning it it.(and frustrating!)
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You post sounded very familiar to me, too! My son is 5 and his behaviors are very similar. We did an evaluation and I learned the term "dysregulation." For some reason, that has helped me a lot! I've come to recognize moments when he is "dysregulated" and moments when he's okay. When he's in those moments, there is a tense, frenetic energy about him. He's like a volcano about to erupt. Being interrupted, or being in a very stimulating environment, or being tired, hearing a "no" - almost anyting can lead to a huge meltdown. I also notice other things - it's much harder for him to focus and complete a task and when I talk to him, unless I'm looking him in the eye and right up close, he often won't respond right away. It's like his brain just can't focus.
We put a lot of energy on prevention and have spent a huge amount of time talking to him about self-calming techniques like quiet time and breathing. In quiet moments, we talk to him about his triggers. (It's hard for you to stop what you are doing and change your plan.) He just started therapy. He does seem to be much better lately. But I have a friend with a son who is very similar (same age) and they have started ADHD meds - which have helped enormously. So I would definitley be willing to go there if he needs it. I used to think it was my "last resort." I'm not so sure anymore. I'm willing to do whatever is going to help him function. He starts kindergarten next year, and I'd rather not go back to cringing every day when I pick him up, wondering what he did today! After about 3 weeks of calm, we had a rough weekend this weekend and the contrast made me realize just how not normal all of this is! Even though I knew it was hard, it was eye-opening to see it fresh after a break of several weeks of relative calm.
One thing that I was reminded of this morning that I wanted to ask you all about since our kids seem to have similar issues....AS does show signs of having forethought and understanding consequences. He can tell you what the rules are and what happens if you don't follow them, but that doesn't mean he always does. But he also seemingly purposely makes poor choices. Like last year, we were at a playdate. He pulled a seed pod off one of the plants (already a big no-no) and said, "Look Mommy! It looks like peas!" I agreed that it LOOKED like peas, but emphasized that it was NOT PEAS and that WE CAN'T EAT THOSE. He questioned me a few times about it, and I told him it wasn't food and could be poisonous. Then I explained that "poisonous" means it could kill you, or at least make you very sick, etc. and that it's not good for your body and WE SHOULD NOT EAT THEM. Not 5 minutes later, his friend (who I am sure is going to be diagnosed with ADHD as soon as he hits kindergarten) comes and tells me AS ate the seed, maybe even two of them. ARGH. We called poison control, and bottom line, AS was sick for a whole week, unable to eat b/c the pain in his stomach was so bad, and yet.... He still continued to ask about various plants and whether we can eat them. I did my best not to freak out on him, but he just couldn't get it off his mind that he wanted to eat random plants.Fast forward to this school year... There's a kid in a different class who is apparently kind of a "problem" in terms of rough play, being generally "not nice" and using pushing, shoving, and hitting as his favorite means of communication. AS is actually attracted to kids like this. There was some sort of incident at the beginning of the year that really upset him but I never was able to get the whole story from him. I ended up telling him he has a choice of who to play with and he shouldn't play with kids who behave that way for a whole host of reasons. Which we discussed, at length (his choice) several times. Last night at bedtime, he said, "I hope I don't see R at school tomorrow." I said, "If you don't want to play with him, then just don't. Stay away from him." He then reinforced that he knows what to say to kids he doesn't feel like playing with, etc. This morning, on the way to school, he says he's going to play with this kid. I told him it's his choice.... OMG, really??? WHY does he think this is a good idea? This kid has hurt him, hurt other kids, done dangerous things (like throwing a full water bottle at another kid, hitting him in the stomach), basically SCARES him, and yet he is planning to seek him out.Is this "normal" kid behavior or is this part of the neurological disconnect? It drives me crazy. He can tell me what the "right" choice is, but then doesn't make it.
Three of my kids have ADHD diagnoses. A lot of what you are saying does sound like common ADHD associated behaviors. A lot of people are against medicating kids with ADHD - I am not one of those people. The impulse control is the result of hormonal/ chemical imbalance. People who do not have ADHD have bodies which produce hormones which help regulate impulsive behavior. ADHD kids bodies do not produce these hormones or do not produce enough of the hormone to be effective.
When people say that ADHD meds are 'drugging' the child to make their behavior more manageable I immediately know that this person does not live with a child or person with ADHD and see what they go through. The lack of impulse control causes social difficulties in peer settings, academic settings and causes low self esteem because the kids often see themselves as bad because they are getting in trouble all the time. People wouldn't deny medication to a child whose body didn't produce insulin and therefore was diabetic so I never understood why people are so willing to deny medication to an ADHD child. The medications require regular doctor's visits and checkups so as long as their blood work comes back ok and their check ups come back good then I say don't hesitate to ask the pediatrician about possible medications that might be appropriate for your child.
Since you asked about specific meds, my nephew is on procentra, a liquid form of dextramphetamine (similar to dexadrine). It is easy for him to take (being a liquid) and seems to wear off quickly and not have long lasting effects. However, because it is not extended release, we have to have a second dose dispensed at school during the day so he can keep his hands to himself in after care.From info I have gathered from other ADHD parents, getting meds (type and dose) perfect is trial and error, and has to be reviewed approximately annually as kids grow out of a med type or dose.
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My guy is taking Adderall. He is on a low dose of 5 mg once a day (although we had an older foster child that was on 20 mg twice a day so it may increase as he gets older). Its a capsule that we can open and put the medicine into a spoonful of yogurt or applesauce for him. We are happy with it because its a low dosage and it helps Buggy slow down and think but it doesnt change his personality at all.
My STBAD is on Focalin. 10 mg daily in the morning. She burns through it in about 6 hours tops, although it is labled as UP to 8 hours. She has been in trouble 2 times this week already (note from Teacher) and also in afterschool (and shes only there about 1 hour).
We have the non XR for afterschool but Ive only used it a few times. It does help tremendously for Homework and activities.
Im calling her Doc in the morning to see what we can do to improve her focus and behavior at school... not sure if that mean a higher dose or change of meds, or giving her a booster AT school instead of after. Too many more incidents and she will be kicked out of afterschool, so we gotta do something.
Ive heard that Concerta is a 12 hour medication. My son was on it 10 years ago for a short while for ADD and itKILLED his appetite. Since his was ADD not ADHD it just wasnt worth it to medicate and see him not eat... We were able to get him organized in school and he had an AWESOME Teacher the next year that taught him lots of skills to help him stay focused. Focalin does not have that affect for us, so I hope an increase will help rather than switching meds around.
Oh- and some people say that the ADHD meds keep their kids from sleeping. Mine was taking Clonidine and I hated it...didnt really work all that well after the fist few days and made her groggy the next day. Her Ped. said to try Melatonin. WOW. It REALLY works! Bedtime is no longer a battle and its one less "medication" I have to give her! (they are chewable strawberry and she loves it)
Anyhow...Focalin is considered a "big dog" in the ADHD meds, but like all the rest of them, it tends to stop working after a while. It is apparently an abused drug and highly restricted/regulated. Im not sure any of the others are like that...
I used to be one of those " Im not drugging my kid" parents too. Them I met Rose! Until you live with one of the trully ADHD kids 24/7 and see the struggle THEY go through as well as the whole rest of the family, and classroom, and teammates, etc, you really cannot judge parents for giving their kids medication.
It's not that I am against meds ... it's that ADHD meds are very over-prescribed. I have friends who have taken their kids to the doctor over some minor concern and the doctor immediately starts handing out jugs of Ritalin. So I do not want to go down that route unless it is truly necessary. A good doctor will not do meds unless there are truly necessary, but I don't have a good doctor yet ... still waiting for adoption finalization so I can put him on our insurance. Medicaid providers here are not very good and I think the Medicaid patients tend to get blown off.
someone compared it to insulin ... but it's not really the same. A doctor is not going to just hand out insulin because a kid complains about headaches, they are going to actually evaluate for diabetes. And insulin does not have the kind of serious side effects that these ADD meds have. I understand the rationale -- that ultimately the meds are crucial to a child's well-being -- but it really isn't the same scenario.
Again, I'm not against meds as long as they're used properly and are genuinely needed. That's entirely likely with my STBAS, but I can't go that route until he is on my insurance.
irq11
My STBAS was born positive for THC. I suspect his mom used cocaine too (she's my sister, I know a lot more about her than a usual FP) but don't have any proof of that.
Apparently drug-exposed kids commonly have frontal lobe deficiencies ... including impulse control. This is a HUGE problem for my STBAS. He's a smart kid and knows exactly what is expected of him. What he cannot do is think before he does something. I kept expecting it to get better with age (he's 5.5) but honestly he's not really any better now than he was two and a half years ago as far as sheer impulse control goes.
Today he got into major trouble on the bus today because of this, and was suspended from riding the bus. It is only a short suspension, but it will be a huge hassle for us (we both work full-time). It also means that the next time he acts up it will mean an even longer suspension. But I just feel totaly helpless what to do. Punishment does not help. It honestly isn't a genuine misbehavior ... I really don't think he CAN stop and think about what he is doing. It isn't until afterwards that he realizes he's not doing the right thing.
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irq11
thanks, mommy2fiveplus...:D