Help with My 14 Yr Old Son - Anger Issues, Behavior, Grades, & ADHD

You are right about one thing, Medication alone is not the answer, and he needs a comprehensive plan that will include appropriate medical intervention that is right for him.

He sounds like so many ADHD kids I have worked with. First, I would get very detailed, comprehensive evaluation from a neuropschologist and begin working with a board certified child pschiatrist and a good cognitive behaviroral therapist. If you are depending on the school's version of his evaluation status, you could be in the dark about anything they chose not to expose, and you should absolutly never know less than they do and you should own the evaluation that includes his diagnosis. He will aways need more than the school will provide, they are only responsible for making him "functional" only obligated to provide "appropriate" educational services, and only required to show that he is making "some educational progress." I know that if you read IDEA, you get the impression that he is entitled to much more than this, and some schools provide more, but the legal standard is incredibly low, and you will want more than that for your son. Private serivices, therapy, toutoring, and medical intervention is essential if you want to see progress. Ask the school to provide all the recomendations from the neuropsychologist, and provide them yourself if they won't pony up. He needs as much help as you can get him as soon as you can get it.

The one thing that you should absolutly have at school is a behavior plan that stems from something called a Functional Behavioral Assessment. This will give you base lines for behavior and should not apply any subjective interpretations like "appropriate." This evaluation should simply say what the behaviors are, when they happen, how often they happen, what happened just prior to the behavior, and how long the behavior lasted. Then, the behavior should be dealt with in only possitive terms with only possitvie interventions and supports. This will be an uphill battle for you, I won't lie about that, and it may get worse in high school. Read about possitive behavioral interventions and Functional Behavorial Assessments at www.wrightslaw.com. This will be a huge resource for you.

Meds are an important part of the puzzel. If you did not find help for him with the prescriber you had before, look for a new one. He may be very difficult to prescribe for, and I have some advice for you if this is the case. If he needs to be seen every week for a while until you find what works, you may need to find a psychiatrist who is not on insurance at all. Find one who will spend the time you need to sort it out, it won't be cheap, but it will be worth it. You may be able to file for out of net work benefits or switch to an in network psychiatrist once you find the right meds. Meds work wonders when they are right, and they are important tools for kids to use so that they have full access to therapy, behaviroal intervention, and educational intervention.

If he is not reading at grade level, insist that he participate in an orton gillingham reading program, and do not take "no" for an answer. He does not have to qualify as LD or dyslexic to get this kind of intervention. Avoid things like fast forward or reading fluency programs that have kids reading the same book over and over again until they can read it well, this is not going to help him.

Good luck, remember, ADHD takes a multi factored approach, without one part of the treatment plan, you make all the others less effective.

M.

I know you don't think ADHD meds are an answer. I will just say this: There are several new ones or new forms of old ones on the market which might make a big difference for him and haven't been tried. Also, the teen years are a pressure cooker for a kid with ADHD. They are expected to constantly transition between things/subjects/concentrations, their hormones are making everything a roller coaster, and they all are going to fail at self control.

An ADHD kid is worst of all because they have gotten such an overwhelming volume of negative feedback by this point in their lives that they're mad as hell, lonely, feel singled out and hopeless about real success. All your methods will break down in the face of these added stresses to an already overstressed system if nothing can bring the stress to the system down somewhat. He was already running a marathon to get through his day, and now he's being asked to do it with a carnival fat man on his shoulders. It is crushing his spirit and making him angry. With very good reason.

He either needs a school situation that is unlike the normal constant transition nightmare of hormones and chaos and inconsistency, or he needs every helping tool available, like meds to get him through this stage of his life. There are school programs for at risk kids and ADHD kids if you can afford them or find them in your community.

But statistically meds offer him the best chance of not being a teen suicide victim.

If they were making him spaced out, his dose was wrong. Stimulants like ADDerall have a biphasic response. Many doctors don't spend the time to really find it. You initially start ramping up and you go through stages of extremely frustrating spaciness and then being able to see everything you fail at, but not fix it, and then trying to fix it, but not being able to really judge that well, and creating even more chaos. And then it seems almost like success falls back off intro frustrated spaciness and goes through this process again until you find the amount that actually works to make this possible.

If all you're getting is spaciness from him, it's a sign that his dose is high enough to stop the fidgeting and motion needs, but not enough to actually return him to alertness. If you have ever been extremely tired, and fidgeted to stay awake, you know this stage yourself. It was shortly before the need to fidget, where you were stupid tired and making dumb choices and slow to react like you were slogging through molasses to think. That's where the dose he was on returned him to. But it wasn't enough. If his dose is right, he should still be a bright and interesting kid. Your doctor failed you when you tried meds before. You need to understand it better, and help this kid find a right dose for him where he isn't in a fog.

I am a huge proponent of ADHD meds! I have had custody of my niece for almost 4 years now. She is ADD, ADHD, ODD and BiPolar. She has been helped tremendously by Concerta and Lexapro. It does not make her zone out- infact it helps her concentrate and stay focused so well that her grades and behavior have improved dramatically! She and I would be lost without her medication. She too was very aggressive and had an "I don't care" attitude. There were times at was at my wits end with her and she couldn't stand the way she acted at times. It seemed she was always grounded and getting into trouble. Finally we had her tested and she was able to get on medication- it has been a God-send for both of us. She has made new friends, her school work gets completed (most of the time- hey she's still a teenager! LOL).
Personally I feel you should consider getting Zack into counseling to help him deal with the felings he has towards his birth mother and also consider trying medications again. I don't mean to be too harsh, but his behavior may only worsen if it is allowed to continue this way. He can not hit other people and you do want this to escalate to actual fighting! He has anger built up and needs a way to get it out- try therapy and maybe karate or some other form to help him release. GOOD LUCK!!

I'm also a big proponent of ADHD medication. It really is targeted to this condition and can give amazing, life-changing results. If he was too subdued and not himself either the dosage was too high or that medication wasn't right. In the past five years, you'll be amazed at all of the other medication options that have entered the market. Make sure you're dealing with an expert like a psychiatrist or neuropsychologist (not a pediatrician) who is extremely familiar with all of the options and can start off with a low dosage and work up to what is just right for your son.

He isn't doing what he's doing voluntarily and that's the hardest part to accept and deal with. The aggressive/angry behavior is due to lack of impulse control -- he thinks it, he does it. We went through this with our son. He's a sweet boy but just couldn't think through his actions first. It's not intentional. That doesn't mean there aren't consequences for the poor actions, but it forces you to think through those consequences and have some empathy, too.

Now that our son is on medication, he's thriving at school and at home (at least, when the meds are active ... when they're not is another story). His teachers see him for how smart he is, not for his bad behavior. He's focused, happy, friendly and pleasant to be around. You wouldn't know he has ADHD and it's pretty severe when he's not on medication. He isn't sedated or zombie-like in any way -- in fact, he's still full of energy and spunk. It's just in the normal range.

Please do rethink medications. Also consider a behavioral therapist, as well, to work through some of his issues and relearn appropriate actions. The combination of the two can work wonders.

Have you considered counseling for him? Maybe he needs a "disinterested non-judgmental" 3rd party just to talk to. If he has anger issues, he is burying something that he doesn't want or feel like he can discuss with you and your husband, or guidance at school. Since you said yourself that his birth mom put him through a lot, maybe he needs someone he feels like he can talk openly with about it. No matter how much you love him and have cared for him (you AND your husband), no child will feel like he can tell you what he is thinking/feeling about his other parent. What he has to say or feels about that other person will be couched in consideration for how it might make YOU feel. Has he had an opportunity to talk with someone "outside" ?

HI D.-

I was a Nanny for many years and I worked with a family who had children with ADD/ADHD. We started medication too, but found the same issues and stopped them. We knew we needed to manage symptoms, and that's when I started my quest to understand ADD/ADHD and the medication free treatments. Today I'm a parent coach working with families, in part, with medication free treatments for their child's ADD/ADHD.

First, what are you feeding your son? As I'm sure you know, diet for the ADD/ADHD child is important. I encourage a diet high in protein, brain food, and eliminate as many preservatives and artificial flavors/colorings as possible. Many kids see huge benefits is focus and control by this simple change.

You’re not the only family who have difficulties moving from grade school to middle/high schools. Most middle/high schools focus on making kids responsible for their actions, less hand holding, which means the support the ADD/ADHD child was use to is gone. It’s a good time to teach organizational skills, which we all need. I like the idea of electronic organizers, and enter reminders, to do’s and assignment due dates in one location. Outlook was very helpful when I was working full time and going to college half time. I was able to stay on top of assignments and keep my mind straight.

To help with the organizational skills, it may be time to review the IEP. You may want to talk about adding organizational assistance to the plan, or having the teachers send you the class syllabus/assignment due dates.

I have a few great books for you:
Taming the Dragon in Your Child by Meg Eastman
Healing ADD, the Break Through Program That Allow You To See an Heal the 6 Types of ADD by Daniel Amen
The Explosive Child by Ross Green
The Organized Student by Donna Goldberg & Jennifer Zwiebel
The ADHD Parenting Handbook by Colleen Alexander- Roberts
The Complete IEP Guide, How to Advocate for your Special Education Child by Lawrence Siegel

I’ve read all of these and they are great for various reasons.

I hope it helps.

R. Magby

i can really feel what your son is going through. I grew up ADD/ADHD as a child and at 29 i still sometimes struggle with it. It's hard to see everyone else pretty much doing what they are supposed to do and not get into trouble. You want to do what's right but there is trully a little voice in your head that urges you to do the stupid things that you know are wrong. My mother tried meds for me when i was younger( ritalin-that was pretty much the only thing back in the 80's) and she quickly took me off because of the way I was when i was one them). She said i just wasn't myself. I had brushes with the law, Was almost deemed incorigable by the courts( my mom took me) ran away from home, the only thing i wasn't was sexually active so i didn't bring any babies home or caught anything. It was hard for me, my mom, and my stepfather( i really gave him the flux). But i know you may not want to hear this but he may have to bump his own head to really get the picture. I almost wore my mother out but she never gave up on me. everything she old me i thought she was being mean and just didn't understand. but i think that as long as you and your husband continue to love and try to find ways to support him he will be alright. now I 'm so glad my parents did everything they did for me. i may not have liked it then but i appreciate it now. ADHD is a true battle within self. And it's VERY discouraging when you know you have this disorder that you sometimes have no control over.and you have to have it to really understand what i'm talking about. I think that you are doing an EXCELLENT job of trying to cope witih him and making him feel good about himself. Keep up the good work and keep searching for answers. and just work with him.. he will be greatful when he's older. good luck!

Hi D.,

At age 14, a lot of what you can do depends on what he is willing to participate in. You sound like you have a handle on your home and that's wonderful. I also know boys are different. I know there are environmental things that affect the attitude and the ADHD. My daughter was diagnosed at seven and we were able to remove the diagnosis with some environmental and nutritional changes. The environmental changes you can do. The nutritional ones will depend on how agreeable he is. Even if he's with his birth mother semi-regularly the benefits he gets at home will help him while he's gone.

If you think this may be an option for you or you just want to talk, let me know. I can walk you through what we did and some experience I have with a friend's son as well.

God bless,

M.

"I had to explain to him the other night that the only responsibility that dad & I have is to give him food, a bed, clothes and somewhere to live. " - You forgot to tell him you only have to until he's 18. It's a limited time offer deal which might be extended if he goes to and graduates collage. If collage is not in his future, then maybe the Army might be. I'm sure there are more than a few recruiters who would be willing to talk to him now with an eye for getting him prepared for when they can sign him up. It's a perfectly good place to learn some life skills and a career.

Have you tried or thought of counseling? It might help him and a trained counselor might be able to teach him coping techniques and help you to help him.
He sounds like a good kid with issues already, and his biological mom sure doesn't help the situation. An "objective" person to talk to might help.

My son also has ADHD (he also has PDD-NOS, which is sort of like high-functioning autism), Tourettes, and sensory issues. He has an IEP and luckily his school is phenomenal at working with us to bring out the best in him. He tried Adderall when he was much younger and it turned him into a zombie, then he tried Tenex (which was GREAT!) and was on that for many years. Recently, his tics started acting up and his neurologist wanted to lower his Tenex dosage and try Strattera. OMG! What a mistake! My easy going son turned into the most aggressive, mean child EVER! "Good morning, sweetie!" "Shuddup and get away from me!!!" The attitude and backtalk was unacceptable! So we immediately took him off the Strattera. Now we're trying a new form of guanfacine (which is the generic for Tenex) called Intuniv. It's an extended release form of Tenex, so we knew he wouldn't have any side effects from it. For the last few years, I though the "H" part of ADHD was gone because we just didn't see ANY hyperactivity. Well, as part of switching to Intuniv, we had to start him on the lowest dosage, taking him way down from what he'd been on. This is just in the last week, BTW, so we're going through this right now. Anyway, his hyperactivity is off the charts right now with this low dose. He's holding it together at school, but when he comes home, omigosh, bouncy, bouncy, bouncy chatterbox! I'm not worried, though, because I fully expect as we up his dosage each week to the amount he was using before, we'll see some real improvement. Intuniv apparently just came out in Oct or Nov '09, so it's new on the market. There are so many ADHD meds out there right now. It sounds like your son might be at the point where he'd really benefit from another try. Unfortunately, it's all trial and error with the meds and what he used when he was younger must not have been right for him. But giving up on meds altogether is also not good, I think. If you're doing everything you can to help him and nothing's working, perhaps it's time for another visit to the neurologist or psychiatrist. It's just one more tool at his disposal to help him succeed. Good luck!

You sound like a great parent. Talk to Zack occasionally about his feelings about his mother. Obviously, that is huge for him, even though you are a great mom to him.

Some kids are not scholars. There is no simple solution for your problem, as I've seen with many kids over the years. I'd keep the bar pretty low scholastically, while setting him up for success in anything he actually excels at, and praising him a lot where he does succeed and put in effort.

The thing I would really focus on at this point is turning in the work, not the quality of or the grade for that work. As long as he does it. Good luck with it.