Post by aworriedmom on Jul 6, 2008 7:57:55 GMT -5
We are just starting to get in the results of very thorough private learnign evals on 16 year old DS. AMong other medical and learnign issues, he has ADD-in. Although I don't know the exact numbers yet, the evaluator told me he is very bright with "painfully slow processing." This is not a surprise to me, since a little more than a year ago, he had WISC IV done by another private evaluator and his PSI was 75 (about 16th percentile), which was almost 50 points below his VS IQ. This pulled his FSIQ down to 106, solidly in normal range. Natually, school District felt there was no educational impact, so we have been in battle ever since (I have posted educational questions on Millermom's educational board---you are all so patient and supportive over there to help me, plus the help you give here, too. I am so grateful!!!). In prep. for DP filing, the evals were all repeated (grueling for DS, but he did it with full cooperation like a real trooper).
My question is: He has been on Vyvanse, 30 mg (lowest dose manufactured) since February, and he took the testing while on Vyvanse (at evaluators recommendation). One thing I am wondering is if those of you more experience than I with ADD than I am have seen any change in your child's processing while on stimulants. DO the meds that increase neurotransmitters then speed up neuronal synaptic activity, thus speeding up processing? Or od the meds work by filtering other "noise" so the child can focus better but no change in processing speed?
For us, if meds are to really work, this is an aspect of his ADD that we would want help with. Otherwise, how can DS ever hold his own in a fast pace HS and college classroom (I know---accommodations but that battle has been the fight of a lifetime for us.)?
A bit more summary of his medication history---we started with Concerta in Aug of 2007, gradually got up to 54, then I think 72 mgs, and on each dose, he had tics, stomach aches and bad side effects after he had been on the does for 10 days-2 weeks. We then tried Focalin XR (no effect, but low dose was used), then Adderall XR--the latter up to I think 30 mgs for a brief time. Adderall at frist seemed to work, but gradually good effects just wore off and the higher dose just took his emotion away.
Then we switched neuropsychs to this very well know doc for our area, and he right away switched DS to Vyvanse. I must admit, Vyvanse is mych smoother, no evening wear off crankiness, but it takes DS about 1 1/2 hours to kick in in morning (doctor doesn't believe this, he says literature says it works fast). DS says it helps him some, I would say it does help, but not like a miracle or anything. Most help in improving alertness. We did a brief increase to 60 mgs, and DS started picking at his head, so we were swtiched back to 30 mgs. DS thinks that 30 mgs Vyvanse doesn't helpa s much as it used to. When it wears off, he is ravenously hungry but still alert. DS has, at times, noticed that if he takes the Vyvanse later in the morning (like on a Saturday), it keeps him up. Other times, this has not been an issue.
One thing the doctors are considering is that DS has sluggish cognitive temp. If so, some of these kids respond to no stims at all, some to low dose stims only.
He has NEVER been tried on any short acting stim, either methyphendate or amphetamine derivatives. Since it is summer, wouldn't it make sense to give this a try to first determine if any stims help him at all before jumping right into the extended release forms? I have been through 2 different neuropsychs, and neither wants to even discuss regular acting stims.
To complicate the assessment, DS is on wellbutrin and zoloft for depression (which occurred due to his bad grades in school and years of the teachers and lately SPED staff criticizing him for being accountable for his slow written output). DO the antidepressants slow down processing?
We see the doctor Tuesday for a med check and my gut feeling is that the Vyvanse is too low. According to the med literature, most adults end up on at least 70 mgs Vyvanse, and DS is a big guy. I am thinking to ask doc for a trial of 50 mg Vyvanse, and also for an alternative stim to use for DS on summer days when he wants to sleep in, like all teens, and take meds late so that he can still have some support of the summer school classes he is taking.
As always, many, many thanks for your wisdom and support!
My question is: He has been on Vyvanse, 30 mg (lowest dose manufactured) since February, and he took the testing while on Vyvanse (at evaluators recommendation). One thing I am wondering is if those of you more experience than I with ADD than I am have seen any change in your child's processing while on stimulants. DO the meds that increase neurotransmitters then speed up neuronal synaptic activity, thus speeding up processing? Or od the meds work by filtering other "noise" so the child can focus better but no change in processing speed?
For us, if meds are to really work, this is an aspect of his ADD that we would want help with. Otherwise, how can DS ever hold his own in a fast pace HS and college classroom (I know---accommodations but that battle has been the fight of a lifetime for us.)?
A bit more summary of his medication history---we started with Concerta in Aug of 2007, gradually got up to 54, then I think 72 mgs, and on each dose, he had tics, stomach aches and bad side effects after he had been on the does for 10 days-2 weeks. We then tried Focalin XR (no effect, but low dose was used), then Adderall XR--the latter up to I think 30 mgs for a brief time. Adderall at frist seemed to work, but gradually good effects just wore off and the higher dose just took his emotion away.
Then we switched neuropsychs to this very well know doc for our area, and he right away switched DS to Vyvanse. I must admit, Vyvanse is mych smoother, no evening wear off crankiness, but it takes DS about 1 1/2 hours to kick in in morning (doctor doesn't believe this, he says literature says it works fast). DS says it helps him some, I would say it does help, but not like a miracle or anything. Most help in improving alertness. We did a brief increase to 60 mgs, and DS started picking at his head, so we were swtiched back to 30 mgs. DS thinks that 30 mgs Vyvanse doesn't helpa s much as it used to. When it wears off, he is ravenously hungry but still alert. DS has, at times, noticed that if he takes the Vyvanse later in the morning (like on a Saturday), it keeps him up. Other times, this has not been an issue.
One thing the doctors are considering is that DS has sluggish cognitive temp. If so, some of these kids respond to no stims at all, some to low dose stims only.
He has NEVER been tried on any short acting stim, either methyphendate or amphetamine derivatives. Since it is summer, wouldn't it make sense to give this a try to first determine if any stims help him at all before jumping right into the extended release forms? I have been through 2 different neuropsychs, and neither wants to even discuss regular acting stims.
To complicate the assessment, DS is on wellbutrin and zoloft for depression (which occurred due to his bad grades in school and years of the teachers and lately SPED staff criticizing him for being accountable for his slow written output). DO the antidepressants slow down processing?
We see the doctor Tuesday for a med check and my gut feeling is that the Vyvanse is too low. According to the med literature, most adults end up on at least 70 mgs Vyvanse, and DS is a big guy. I am thinking to ask doc for a trial of 50 mg Vyvanse, and also for an alternative stim to use for DS on summer days when he wants to sleep in, like all teens, and take meds late so that he can still have some support of the summer school classes he is taking.
As always, many, many thanks for your wisdom and support!
