discipline

Has your daughter received counselling? Behavioral therapy might be helpful.

Andrea

I am concerned whever I see a child on so many different meds. My son had most of the same issues, but they were all secondary to the ADHD and symptoms lessened with time. We did, however, find that the dosage had to be increased. You don’t say her age or size. My son is 11 and weighs 61 pounds (genetically meant to be thin) and takes 30mg of Adderall XR. I have had people question the dosage but that is what works.

Also, as a teacher (and parent) of ADHD children, even the ones that you would normally not even realize has ADHD have been “off the wall” since the week before Thanksgiving. Changes in routine, excitement, lack of regular sleep patterns, etc. can all contribute to behavior problems in these kids, just think of how the general population behaves at this time of year. Suicides increase and depressions become more pronounced.

Behavior mod may help, it invloves a shift from punishment to rewards…i.e. if she can make it through 24 hours without hitting her sister, she can watch TV the next day. It works better with these kids to have a reward to work for than a punishment. example: my son regularly forgot things for his homework and would have to pay me 50 cents to drive hi back to school-I could have bought a Beamer by the end of 3rd grade. For fourth grade we made a deal in which for every 10 days (in a row) that he rememberred all of his materials, I would take him to lunch at Burger King during the school lunch period. This worked wonders-he is now in Middle School, dealing with a locker and 3 teachers and no incentive program anymore. He forgot something once (last week) this year.

Hi Katies Mom,
How old is Katie. My daughter also has ADHD diagnosed just about 2 months ago. She doesn’t act out like that with pushing and stuff but we are seeing a therapist. I do agree with Beverly but it really depends on her age. My daughter is almost five and our therapist says they have to have punishment at that moment because little ones have no concept of time. I was taking TV away for 3 days because of behavior but that didn’t work either. My daughter is now on Focalin 5 mg and is doing better in school and home. She is 40 pounds. Not everyday is good at school but for the most part they see a big difference in our daughter. It seems when she is on the med she listens better but as soon as it wears off your telling her 3 to 4 times to do something ( pick up room, etc) . Is your daughter on pills everyday and thru weekend. I know some people take kids off for weekend. At least for ADHD. Let me hear from you. Bye the way our 5 step visual chart consists of 1. Verbal warning and we actually have a face with mouth open. 2. Time out 3 minutes in chair with a visual chair. 3. Nose in corner 3 minutes with visual of a nose in the corner. 4. Time out in bedroom for 5 minutes with a visual of a bed and 5. Spanking. It has worked for us. You have to stay consistent. They usually get it but if your daughter is much older than mine I would talk to therapist and let them give you some ideas on some behavior techniques.

Thanks for the input. We have tried counseling, but it was not very successful. Katie would talk to the therapist, but instantly forget what they discussed the minute she got in the car to come home. She is 11, tall for her age and weighs about 85 lbs. We have been searching for help since she was diagnosed in the second grade. She is now in fifth grade, with an IEP and accomodations in a regular classroom. She works closely with the LD teacher. They have few discipline problems at school. I give her medication at home on the weekends, trying to make life a little easier for the rest of her family, but doesn’t seem to do much good. I think that I am going to have to start looking for another counselor. We live in a small town in a rural area. There are not a lot of resources for kids with problems.

There are no medications that can make any child follow the rules all of the time and at one time or another brothers and sisters do end up giving a really good push to their sibling. My father who has a very quiet personality threw a pitchfork at his brother once…

Your daughter’s behaviors sound like they’re born in the moment. They’re impulses she follows through on. Time out and groundings can’t control impulses. Medications sometimes can and perhaps some adjustments can be made in her medication if you share your frustrations with her prescribing physician.

What’s also true is that if your daughter is depressed and axious, all things become even the more problematic. The behavior of depressed and anxious children can be born of the anxiety that propels them or the sorrow. I’d try approaching those issues as a means of helping her to not give in to her impulses. Also try giving her some strategies to cope with the frustration she feels in certain moments - count to ten or count to five. Step back, don’t hit but you can yell kind of thing.

This is a difficult issue. Are you connected to any of the good support groups like CHADD? Their experienced parents may have great insight for you. Consider finding a local chapter of CHADD to see what help they could be.

Good luck.

I just did a search of our insurance companies’ doctor find looking for a psychologist or psychiatrist, even a counselor for my daughter and found not one listing for our area. I also looked up CHADD’s website and the closest CHADD group is two hours away. It looks like I’m going to have to take on my insurance company (again) to find help for my daughter. I am also currently reading Dr. Silver’s book “Advice to Parents on ADHD”. It’s giving me a lot of insight on issues I need to discuss with Katie’s medical doctor. Every time I tell her that I think that the Adderall XR is not helping, she dismisses my concerns. She is trying to treat the anxiety and depression (with the Zoloft and Clonidine)instead of treating the ADHD and maybe that would take care of the anxiety and depression.

I highly recommend “The Explosive Child” by Dr. Ross Greene. His approach to helping these kids become more flexible and tolerant and less explosive is very humane. He points out that all the “back end”, after-the-fact punishments rarely work with these kids, and gives strategies adults can use to teach the skills these kids don’t have. It’s not like she’s purposely behaving this way — few children choose to make themselves and those around them miserable if they can help it.

OK so your daughter is the same age as my son and 24 pounds heavier. What is the dosage that she is on of the Adderall XR?? If you feel that the therapist is treating the other issues, that very often coexist with the ADHD, but moe often are caused by the ADHD, maybe a change in therapists would be a thought. If may be that someone else agrees or disagrees, it is hard to tell from here what the whole picture is but a therapist cannot treat only part of the picture.

ADHD kids and adults are very often depressed, how would anyone feel when they are the one who is disrupting the class, the one who the kids don’t want to play with because they “have to have their way”, the one who is in terminal time-out at home, the adult who cannot keep a marriage together becasue their inattentive behavior is seen as a lack of caring?? My son went through 2 years of therapy and behavior mod, with a Mom who has a degree in Child Psych swearing he had ADHD. They wanted to treat the “depression adn anger issues” of my divorce. Baloney (wish I could say a stronger word here but…)-after 2 years and 2 different therapists, I was finally given the go-ahead to see a Child Psych who specialized in ADHD. It took her one visit to his school (before he had met her so she would be ignored), a phone conference with his teacher, the profiles filled out by myself, the teacher, my son’s father, and his stepfather, and then a session with him to say DUH!!!

The therapists do seem to want to find another answer and make ADHD almost the last resort these days. Keep working at it, the right balance will come with time and patience. When I look at my son now I cannot believe the changes that have occured over the last 5 years since he started meds. He couldn’t read at the end of first grade, and is now working in a gifted pull-out program. He hasn’t had to have a 504 since 3rd grade. But I had to be the Mommy from ____ in order to get him what he needed. He still has “those days” in which I wish I could put him back, but those are occuring less frequently and occur more at times when changes occur….holidays, the start of the school year, the end of the school year, staying up late, etc.

There is a light at the end of the tunnel, becasue you are working to get her there. You are not just sitting back and taking a passive stance. That alone will help her more than anything.

Katie is on 10 mgs. of Adderall XR in the morning and 10 mgs. at noon. She seems to metabolize medicine faster than they should be and the XR was not lasting until the end of the school day. She is also taking 75 mgs. Zoloft and .05 mgs. Clonidine. The Zoloft has definitely helped with her depression and anxiety and the Clonidine has helped with her OCD. These medications have not been prescribed by a psychologist, but a pediatrician who specializes in ADHD. She is the one who seems to be focusing on the anxiety and depression. She told me that we can’t medicate Katie to normal. I have told her that I don’t think that the Adderall is helping that much, just from observing Katie at home. But this year her school started the fifth grade changing classes. She now has four teachers and none of them can tell me if they think the medication is helping. I’ve asked. They say that sometimes she is not on task or out of her seat, but so are others in the class and they are not seeing it as a problem. With her accomodations and the help from the LD teacher and a tutor after school twice a week, she is holding her own academically. But she has NO friends and she seems to always be in trouble at home because she has no social skills and no impulse control. She is also very immature, she often acts younger than her 8 year old sister. She argues with her father and me constantly and cannot transition from one thing to another at all. We can warn her that we are eating dinner in 5-10 minutes to give her time to transition from whatever she is doing and we will still have to physically remove her to the dinner table. As I said we have tried therapy and it didn’t help, but I have had other parents tell me that sometimes you just have to keep looking until you find the right therapist. Unfortunately in our area, there are not a lot of choices.

Thanks, Rover. I have heard of the book before, but have never read it. It seems like I’m am constantly reading something new to try to find answers. I will definitely get this book.

Did you ever talk to your daughter about this to find out what is going on when she acts impulsively? I have done this with my son.

He states he doesn’t want to do things like this but sometimes he just can’t seem to stop himself. I have been able to help him help himself.

For him some of this hinged on his sensory integration needs which I really needed to get a handle on. He is really much better and he now will go ride his bike to let off some steam rather than acting out. He can feel it coming on and will seek out the activity he needs to help him gain control.
Extra protein in his diet also seems to help. He notices this and asks for it.

It has become second nature to him and really isn’t much of an issue anymore.

I just wanted to say that your message about discipline is right on target.
I have enough books on discipline and ADHD to open a library but
one thing I have learned over the years of raising my 12 year old son with ADHD
is that what works for kids with ADHD regarding discipline is very different than with kids without it.The whole issue with ADHD is impulse control and rewards work much better for my son, and I believe all kids with ADHD.

I also wanted to say that my son has had trouble falling asleep and wakes in the night for 3-4 years and we finally realized it is a anxiety problem .
We are going to a therapist and trying zoloft.
For a long time we thought it was either the Adderral XR lasting too long or wearing off and making him hyper.
We just started the zoloft but we’ll see.

Just a note that my son is on Adderral XR 40 mgs. in the morning
It has just recently changed from 30 mg. because his grades and schoolwork were slipping.It is better now with the 40 mg.
I think he needed more with puberty and adolscence.
He also has a fast metabolism
Maybe 10 and 10 isn’t enough for your daughter to help her.

Anne B-
How much does your son weigh? I have been trying to tell Katie’s doctor that either we needed to increase the dosage or try a different med, because what we’re doing isn’t working. When I give Katie medicine on the weekend I can’t tell a difference when she’s on it and when she’s off as far as her ADHD symptoms go. I feel like I’m giving her a medication that is just passing through her system with no affect at all.

Katie also has always had trouble falling asleep. We have finally gotten that problem mostly under control. She takes her Zoloft and Clonidine about 1/2 hr. before bed. And we do our best to stay on the same schedule, weekdays and weekend. She needs a lot of sleep, so it’s lights out for her at 8:30. And we send her to her room at 8:00, so that she can get ready and have ten or 15 minutes to read before lights out. It seems to help her unwind.

I’m with Anne that the doasge may be too low. Also the second dose in the afternoon may be causing her sleeplessness. A higher dose in the morning and no afternoon dose may be more beneficial.