Morning struggles

Lucy, yes, he is definitely ADHD!! Not sure about red dye, although he does eat lots of ketchup. I don't give him cokes, so he doesn't get any caffeine. Haven't tried canned Ravioli, but guess I'll stay away from it!! He very rarely will even sit down to watch TV. It's a miracle that he watches cartoons before school, but he usually is pretty attentive then to the TV. I'm just learning about all this stuff. As I said, we just got him a little over a month ago, and I have never been around a true ADHD kid, so this has been an experience, to say the least. I've got the Barkley book, "Taking Charge of ADHD," and really am enjoying it. Just gotta make time to sit down and read it, as I've only started it. When they told us he had ADHD, my caseworker's response was, "They say that about all kids in foster care," and I didn't think much of it. I truly believed (boy, was I stupid!!) that ADHD was exaggerated and that children whose parents didn't keep their kids under control were just labeled that, as I'm sure most people think who aren't truly touched by this malady. Thanks for the input, and keep the ideas coming!! :D Cathy

Six year olds can be loud and playfu. Furthermore, your son is adjusting to your home and a bit of anxiety and fear or unsettledness is normal and to be expected. It takes time for a child to adjust...he's only six and his understanding of what this move and new home are all about are being seen through six-year old eyes and being understood by a six-year old heart and brain, both of which have experienced some degree of trauma and loss. So, I'd try to keep the morning as regular and predictable as possible. I'd suggest you try to get up before he does and go into his room and then wake him up. This may help him feel more comforted and secure...and calmer and less anxious! Another trick is to get up before he does and give him his medicine immediately. Since most of the ADHD meds begin working within 20 to 30 min, this can also help. Regards and congratulations.

Thanks for your suggestions, Dr. Art. I DO try to get up before him, but there have been a few days where he's got up at 5 a.m., and there is just no getting him to go back to bed. Once he's up, he's wired and ready to go. Normally, tho, he gets up between 6:30 and 7:00 a.m. He has to be at school at 8:00, so if he's not already up, I get him up by 7:00. I have also figured out I need to give him his meds as soon as he gets up, and I do. He has his first appointment with a therapist on 2/10 and I'm sure they will set him up with a psychiatrist at that time. I feel his meds need to be tweaked a bit. He's currently on Ritalin, Periactin (not sure why), clonidine and Zyprexa for aggression. That's what they told me, anyway. Yes, I know he's having a hard time adjusting, but all in all, I feel he's doing good. Complicating things are the fact that he has a brother a year older than him that used to help take care of him that was not able to be placed with us. He is in psychiatric hospital, as far as I know. He totally freaked out when his foster parents and the case worker started talking to him about being adopted. Apparently they were going to be adopted before and I believe both he and my son were abused in that situation and thankfully they eventually removed from that home, but I believe my son's brother was covinced he would be going back to that abusive situation again and that's why he freaked. Again, thanks so much for the input!! Cathy

ACK! I just read the pharmacy your child has been put on. My five year old was on a number of drugs when I took him. Hyperactivity is often way over medicated and overmedication can interfere with sleep and increase the hyperness. Get a good psychiatrist who won't just keep adding meds. Clonidine is a blood pressure me often given to hyper children. If it were my child, I would ask to have him worked off it as soon as possible. Zyprexa is a heavy duty adult antipsychotic medication not approved for children but often given to them in larger quantities then the adult dosages.it causes weight gain and has other possible long term side effects. Since you didn't see the behavior before he was medicated, I would ask to have that dosage decreased to to see if it's really a necessary med. Ritlin wears off in four hours. With true ADHD it works, but if the issue is something else, the meds are ineffective and the kids get really angry when it starts wearing off(often causeing them to be put on anti psych drugs). I've never heard of the other med, but I'd definately see if they can put you in touch with whoever perscribed it and find out why he's on it. In my experience, kids in fopster care are often over medicated because their behaviors in response to their unsettled environment cause mis diagnosis. Also, shen meds don't work, they often add more without subtracting what really isn't needed. I'm not a doctor so obviously I can't say what the case is with your son, but this needs to be discussed throughly with a qualified psychiatrist and I would, if it were one of my kids, suggest lessoning meds to be sure they're even effective. Even my ADHD kids mange without meds (I home school) with diet, exercise, and no TV/video. The older son has learned to notice when he feels "off" and will go running which is effective in clearing his head. Sorry for the rant, but I can't stand the way foster kids are medicated. Sometimes its needed, but other times its not. I'd also recommend you listen to Nancy Thomas audio tapes, just because your son's adopted older. They explain the thought process and trauma effects really well.

Lucy, thanks so much for the input. I think you are exactly right about the Ritalin. He gets it twice a day, first thing in the am and at noon. Usually around 11:00, he has an angry outburst, and usually again in the late afternoon around 4:00, so that sure fits. I have to sit down and make myself a list of all the questions/issues I want addressed to take with me on our evaluation with the therapist, and meds will be top on the list. Thanks again, Cathy

When you go to the doctor, if he/she agrees that ADHD is correctly diagnosed, ask about trying Concerta. It is a long lasting stimulant that only has to be given once a day. It seems to avoid the drastic ups and downs that so many kids experience on Ritalin. Good luck. (I do agree with lucyjoy that many kids in the system are overmedicated, and ADHD is a convenient catchall diagnosis.)

Thanks, Georgia Mom. I will ask about Concerta. I've also been told by a friend that Wilbutrn (sp?) is quite effective. Anybody had experience with it?? Cathy

Welbutrin is an antidepressant and not and ADHD drug. My child had a bad reaction to it, but that was probably do to his other problems and antidepressants were not what he needed. Adderal is also a longer lasting drug and did not have the side affect ridlin had. I think the biggest thing is to let the psychiatrist know your concerns about possible misdiagnosis or unclear info resulting in possible unnecessary meds. You have to be clear, because some docs like to just keep medicating more. Unless the child really needs meds, that won't help. Each kid is different. My only concern was the amount of meds and the unclearness of the info you were provided and the side effects the meds can have. All my kids came here way overmedicated on all the wrong stuff. Just make some notes for the doc on your obserations, what his records say or don't say and any concerns you have about what the medications are.

I was told Ritalin and the clonidine were for the ADHD, Zyprexa was for hyperagression and the Periactin (cyproheptadine) was to stimulate his appetite, as he is very thin. On 1/24, he was 43 3/4 inches tall and 41 1/4 pounds. I, of course, received basic information from the pharmacy on possible side effects, but I didn't read them in detail. Shame on me, I know, but I do have a Nurses' medication reference book and looked up all his meds and glanced over the side effects. I will definitey thoroughly discuss each med with the psychiatrist. Thanks again! Cathy

It is vital you have your child seen by a child psychiatrist who has significant experience and training working with foster and adopted children and children who have been maltreated. First or all, you do want to have that person review all previous evals and then reach her/his own conclusions regarding diagnosis. There are lots of excellent meds for ADHD, if your child has ADHD. Which medication is best depends on lots of factors and really isn't something I'd want to outline here, not being a physician and not knowting anything about your child. Wellbutrin is a frequently presecribed medication for ADHD when there is a history of, or concerns about, tics or stuttering as stimulants can cause tics and stuttering or make it worse. Wellbrutrin is also used for ADHD in teens and adults when there is a concern about substance abuse as stimulants can be abused but not Wellbutrin. Furthermore, many maltreated children look like they have ADHD and have: ADHD, Bipolar Disorder, Sensory-Integration disorder, etc....so a good doc is important to make a good diagnosis. Good luck and be sure to get a good doc.

I agree that most are over medicated. We have recently (within the past 4 months) adopted a sibling group of 3. Ages 5,6, and 7. They came to us on multiple meds, over the first 2-3 weeks we have been able to reduce the meds to one tablet a day of Aderal XR a day for the oldest and the rest are off all meds and are doing well. Of course their PCP helped with this. The oldest has ADHD and the medication help this, however over the the last 1-2 months we have been able to go medication free on the weekends without very much problems even on Sundays in church. The biggest area we are dealing with is the RAD with all three.

I am VERY cautions about diagnosing children who have RAD with ADHD as ADHD is often misdiagnosed in such children. The symptoms of RAD often overlap with ADHD. In addition, maltreated children often have Sensory-Integration Disorders that mimic ADHD. If a child seems to do well without meds, you may want to consider gettng a competant evaluation. Probably over 50% of the children we see in my group have a previous diagnosis of ADHD that is incorrect...the diagnosis was usually made by a competant mental health provider who had little experience evaluating and treating adopted and foster children and who had no training evaluating and treating attachment disorders.

Hi - Just a thought, but would it help to have your son brush his teeth in the kitchen while you are making his breakfast? Then the two of you could talk and you might also have him help with breakfast. It would a good learning experience and a chance to listen to him and give some feedback. It could make him really feel special - just the two of you. Tovi

hi there, im no expert, but with our 7 yr old, we think he has ADHD. He doesnt fit into the RAD catergory, but he was dx with it when he was removed from his birth mom at the age of 4. He was also dx with PTSD and ADHD. his mother was bipolar, so now ive been reading some stuff on children with bipolar, who the hell knows whats wrong with him. but were scheduled for an appt soon. we had a neuro psych appt last week, and i wasnt happy with the doctor. It seemed she didnt know anything about adoption, when she asked for his records from the hospital he was hospitalized in when he was four, i told we didnt have it and i didnt even know what hospital it was. She then told me "well, theres nothing i can do, i cant beliieve you dont have those records." anyway, i left very disheartened. we need help with our seven yr old...AHHH!! but i have him scheduled with an adoption unit at childrens hospital in Mass. where we live, where they specialize in adoption/foster kids. But, like alzwys, we have to wait another couple of months. Well, now that i got that off my chest. what we have found, is NO TV in the morning. I try my best to wake up by 5 so i can sit, have my coffee, make their lunches for camp, and take care of all those things before they get up. The 7 yr old never has to be waken up, hes usually up at 6am every morning. when he does get up earlier, i would put him in our bed and have him sleep with us. he usually fell asleep. he usually gets up scared, he runs out of his room and into ours asking "can i get up now?" the poor thing. but when he falls asleep again, i get up and continue with the routine, which is....the minute he gets up, i sit him down at the breakfast table and start to feed him, then he get his vitamin, goes in the bathroom and brushes his teeth, then i take him in his room and dress him (he wont dress himself yet, he still cant sit still long enough, but thats a whole other issue.) then i put his suntan lotion and then when his brother gets up (he has to be waken up every morning, i do the same thing) we are learning as we go along on what works. BUt once the rountine is down, and this goes with the nightime too, it seems to go smoother. But it diffulcult, we try to be two steps ahead of him at all times, which sometimes were not. anyway, thats what seems to be working with us. dadfor2

Unfortuantely, the early years are an important part of a neuro psych exam. She should have been able to ask you or the state for background info. She does sound a bit uninformed or maybe just lazy.