from autism to ADHD

For the last 3 years, it seemed ds#1 had autism, he was on the spectrum, but barely.Well, at the end of last school year at his IEP meeting they said he was no longer on the spectrum, though barely.This year has been a struggle for him in school and abt. 2 weeks ago they asked me if I wanted to fill out some forms and have his teacher do the same to to see if he showed signs ADHD, of course I said yes.It all looks like he has ADHD, so I brought him to our Dr.'s office and she put him on vyvanse and the teacher has been writing notes letting me know how much better he is now doing.I've noticed it too a little, it's not as much as a struggle to get him to do his homework, he doesn't cry for the first 15 min. anymore.With all that being said I think he still needs to see someone else abt. this, am I right?What next steps should I take?Please, let me know anything that could help me help my son even more.I hate that he is only 6 and is now on meds. but it really seems to be helping.Is there anything else I should know?

When my son was in his first year of Kindergarten his teacher "suggested" that I get my son tested for ADHD so I naturally took him to his pediatrician.  The pediatrician basically had me to fill out a questionaire and gave me one for my son's teacher to fill out as well.  Once he compared the two he put my son on medication.  We had A LOT of side effects and went through SEVERAL meds so I eventually took my son off the meds.  All that started in 2006.  Now in 2009 we are basically back to square one with a NEW pediatrician who seems to know a lot more and do a lot better.  He got us a referral to a psychologist who is doing a full blown evaluation on my son.  This makes so much more sense to me than just the pediatrician looking over the questionaires filled out by mom/dad and teacher and then just putting the kid on medication.  I would say to get a referral ALONG WITH what you are already doing.  If the meds are working that is great.  Right now it seems like your son is doing better in school BUT...depending on his teacher, you never know if he's really doing better academically or if his better behavior makes it appear he is doing better.  Time will tell you the answer to that.  Unfortunately, we had to find out the hard way.  On the meds, my son was able to focus a lot better but that didn't mean he was focusing on the right things when he was at school.  We got a lot of "oh, he's doing sooo much better" notes only to find out with time that he was still academically struggling and being overlooked because his behavior was better.  So, the reason I would recommend you get a referral is so that your son is tested appropriately and you know where he stands right now academically and that will help you to be able to get the help he needs with the school system if your son ever does need it.  If he doesn't need the extra help later then that is great!...no harm done!  The evaluation that my son is going to have done is going to last a whole day from 8 a.m. to 4 p.m. with a mid-day break, however, when I took him for his initial visit with the psychologist they went ahead a started with him so add another hour or so to the full day.  I think this is going to give us a lot of information.  Oh, and whether you take him to be truly evaluated or not, keep a record of school reports...notes sent home by the teacher, progress reports, report cards...and anything else you think might be relevent down the road just in case your son may need further help.  You are your son's best advocate!  HTH!

This is only from my experience, so please take it for that.  :o)  We all have such different feelings on so much.  :o))

My son wasn't talking at 3.  (my ds was babbling up until the time he got his MMR vaccine, and then it went away)  When he was 2 we took him to a developmental psychiatrist to see if he might be autistic.  He is not... because of the speech issues, you might call him PDD-NOS, but he doesn't even really qualify for that.  Out of 30 symptoms my dr. looked for to diagnose ADHD, she could identify 30 and more. 

So, my ds has been on the medication since his 3rd birthday (highly unusualy).  I would do several things if your son is newly on medication.  1.)  I would request a cardiologist referral.  Stimulants are a FDA "Black box drug."  Which not to scare you because it is very very rare... but they have been found to cause cardiac problems and heart attacks and strokes in children who take them.  The vast majority of the deaths have been to children with (usually undiagnosed) cardiac issues.  For your peace of mind, I would go and let them do an echo (u/s of the heart... non invasive) and just make sure there is nothing there that could raise your ds's risk. 

2.)  I would also enroll him in Occupational Therapy.  ADHD goes right along with it.  THey find ways to help control it on their own.  It probably won't get him to where he doesn't need the medication (especially at first) but it will compliment the medication well.  I really believe that we could ALL use OT.  lol. 

3.)  FInd someone at the school, who's opinion you trust.  We have mainly had very good teachers.  However, there are some teachers out there, and we have had 1 of them, that don't care how drugged their kids are... as long as they are easier to deal with.  You need someone at school with your ds who can call and say... "You know, he seems a little like a zombie.  Cut back."  You want your ds to be able to sit still... not to be unable to do anything but sit still.  It will take time to find a perfect dose without side effects. 

4.) Monitor his sleep.  The drugs are stimulants and can keep the kids who take them awake.  It could make your ds have a difficult time sleeping and then have nightmares when he does.  Obviously a sleepy child, can not perform his best. 

5.)  Realize, that with the ADHD, he already feels "differently" then most of his friends.  Be very careful with his spirit.  (This comes from the mommy in me.)  You want to make him do the right things.  I am very strict with my ds.... BUT, these kids are just a tiny bit different... and you want to guard his little heart.  If he is telling you that he is having a hard time... look into tutoring, or work extra hard at home, or find something that can help.  I would also say just don't let your teacher just nag at him.  Tell her to get in touch with you and you can deal with any issues.  Sometimes, because the kids are up and down and moving around... teachers will just keep calling them out.  OVER AND OVER AND OVER.  which is hard to deal with for any child... especially for ours. 

6.)  Im guessing eating will become an issue for you, after a few months on the meds.  I have two words:  ENSURE PLUS!!  My ds is just never hungry on the meds.  I can get him to drink 2 of the Ensure Plus drinks a day and then not have to fight him so hard to eat.  I know he is getting enough vitamins and minerals... and so if I can only get him to eat Pizza.... so be it.  We feed him whenever he wants and whatever he wants.  lol. 

Anyway... I am pretty sure you were not hoping for all of this.  Im sorry.  It was just really hard to start medicating my ds too.  So I kind of have a list of things in my head that bothered me and that we had to work through.  lol. 

HUGS!!

Grl4Bekah:

Which not to scare you because it is very very rare... but they have been found to cause cardiac problems and heart attacks and strokes in children who take them.

Agreed! Vyvanse is about the same as Adderall in the way that they are both stimulants and when my ds was taking Adderall XR he started complaining of his "heart hurting" so I immediately took him off of it.  I had reserves about giving my ds meds, especially so young because of the side effects.  Do your homework on any and all ADHD medications.  You may be surprised what you learn. 

Grl4Bekah:

2.)  I would also enroll him in Occupational Therapy.  ADHD goes right along with it.  THey find ways to help control it on their own.  It probably won't get him to where he doesn't need the medication (especially at first) but it will compliment the medication well.  I really believe that we could ALL use OT.  lol. 

Agreed and good point!  This is something I need to talk to my ds's dr. about.  I really believe this would help him so much....and I think we could ALL use OT too, lol..

Grl4Bekah:

3.)  FInd someone at the school, who's opinion you trust.  We have mainly had very good teachers.  However, there are some teachers out there, and we have had 1 of them, that don't care how drugged their kids are... as long as they are easier to deal with.  You need someone at school with your ds who can call and say... "You know, he seems a little like a zombie.  Cut back."  You want your ds to be able to sit still... not to be unable to do anything but sit still.  It will take time to find a perfect dose without side effects. 

I have to strongly agree with this!  This is the experience we had with my ds's first teacher.  We kept getting notes that he was doing so much better but he really was not.  His behavior was better suited to her standards.  I originally wasn't medicating my son on the weekends so that he would have a break from it but then I decided I should so I could see what was going on at school with him and sure enough that opened a big can of worms!

Grl4Bekah:

4.) Monitor his sleep.  The drugs are stimulants and can keep the kids who take them awake.  It could make your ds have a difficult time sleeping and then have nightmares when he does.  Obviously a sleepy child, can not perform his best.

Yes!  We had problems in the sleep department too!  There would be times when he wouldn't go to sleep until after midnight.  That was tough!

Grl4Bekah:

6.)  Im guessing eating will become an issue for you, after a few months on the meds.

Agreed!  Eating was a big issue for us.  The worst was when my ds was taking Strattera.  He got to where he didn't want to eat AT ALL. 

Grl4Bekah:

Anyway... I am pretty sure you were not hoping for all of this.  Im sorry.  It was just really hard to start medicating my ds too.

Me too.  Having my ds start meds was soooo hard for me!  I cried A LOT.  To see him change from my little boy to this little person that the school wanted/needed him to be was soooo hard for me.  I really struggled with this.  So much so that I ended up completely taking him off medication.  Now, though, I am considering trying it again because of some of our circumstances but reading through all of this brings back so many memories and makes me wonder why I would consider medicating again and how on earth could I do it to him.....it's a tough decision to make!

Sorry, I am not trying to take over your post.  Grl4Bekah brought up some very very good points that I wanted to agree with to let you know that it's common to go through the things she mentioned as well.  Also, I am not trying to scare you either.  If you have anymore questions or concerns you can always talk to us here and you are always more than welcome to pm me.   

Thanks ladies for all the advice and support.I knew abt. one of the side effects was not eating as much, but that seems to be ok for now, but she did have me make an apt. at the time to go back in 2 weeks (which will be Monday) to check on his weight.I have noticed that a couple time now that he has have trouble sleeping, so I'll ask her abt. that.He did have OT for the last 3 years, but they stopped it after he wasn't on the spectrum anymore, so hopefully he'll be able to get that again.He still has speech and APE (I think that's it).I'm very well connected with the school and my son.The teacher knows we are trying to help him and she seemed concerned abt. him and is watching out for him in class.She had noticed a difference and I see it too.He has the lowest dosage for that med., so he isn't in the zombie like mode, which I was concerned abt.It wears off throughout the day, so he still tends to not really want to do his homework, but he seems to understand and do it better then before, I think it had helped him alot with focusing more, so that he does do better on his tests, but still failing them, but we knew that would still probably happen.Thanks again, I'm glad to know I have others to lean on and help guide me through this.If I have any other ?'s I'll be sure to ask.

One more thing...I am reading a book called Understanding Attention Deficit Hyperactivity Disorder by L. Susan Buttross, MD, FAAP and so far it seems to have a wealth of information in it concerning ADHD.  I have read a few other books about ADHD and this one I am reading now seems to be the best and it's not a very long book to read.  If you are interested it's a really good book!  It has a Copyright 2007 so it's a fairly new book too.  I would love to hear updates of your son and I have high hopes for him  He's lucky to have you as his mom!

Thanks for that info on the book, I will check it out.I also was reading on the internet that some have used omega 3 and it has has worked, have any of you tried this?

We have never tried Omega 3.  That book goes into detail about traditional and non-traditional treatments so you would probably be interested in that part of the book as well.  My ds hasn't been medicated in a little over a year but I may very well decide to medicate again soon.  I am sooo undecided as to which route to go, yk?!  Either way, I am going to try to get him some behavioral or psychotherapy!

update : had an EKG done and bloodwork and all came back normal, so I'm a little more ok with the meds.He also has another appt. in a couple weeks just to check up to make sure he is ok on the meds. still. ETA : Do you think the EKG is just as good as the ECHO?I told her my concerns and this is what she went with and I didn't know the difference between the two.