Discipline

[wisegirl70]

I have a 12 year old son.  He has been diagnosed with ADHD and Asperger Syndrome.  I am at my wits end trying to deal with him.  He is lazy, he refuses to do work, cries all the time, and his anger is so out of control, I can't explain it.  I have looked and looked trying to find help. I am exhausted with this.  I have disciplined him (taking privledges away) as the Dr.s say, but it does NOT faze him at all.  He doesn't care.  He is taking Strattera (just started today was on Ritalin 2 tabs 3 X a day), Risperdal (2 1/2 tabs of 2 mg a day), 1 tab clonodine, and 1 40 mg. celexa.  My question is are these meds o.k. to be taken together.  I have asked his Dr. and she says yes, then others have told me that he is taking too much. I know you don't know his history, but could this medication be affecting he behavior?  I would love any suggestions.  As he is getting older, his temper is getting worse.  He has 2 sisters @ home and 1 brother.  (all of whom he instigates fights with daily)  Please help!!!!!  Wendy

[Kevin Kennedy, Ph.D.]

Yes, the medications you mention can be taken simultaneously. Strattera is not like the Ritalin he was taking previously. Strattera is a non-stimulant medication and an alternative to the standard stimulant medications generally employed to treat symptoms of ADHD. It targets the neurotransmitter called norepinephrine. You may find that the Ritalin, particularly since he was taking a short-acting preparation several times daily, was contributing to his mood problems. The Risperdal, Celexa and Clonidine should be helpful in ameliorating some of his anger. You might want to check with his doctor to see if he/she has considered employing a mood stabilizer, maybe instead of the Celexa (or in addition to it). Also, consult with a behavioral specialist to design a program of behavior management. Reliance on privileges as an incentive may be useful in a general sense, but you may have to amend the particular ways you implement the plan. As they say, 'the devil is in the details'.

[wellthen]

You may also want to get involved with Children's Services. They are tapped in to so many resources (support groups, seminars for ADHD, aspergers, in-home support, etc.) It's must be difficult if your doing this without assistance.

As for psycotropic meds. I suggest that you keep a journal on the child's behaviors for the peditrition or primary doctor taking his case. This may help in the future to get him on the right combinations of medication.

Instigating is most certainly one of the traits of aspergers however it's also a trait in many children with or without aspergers.

[ilovrose]

May not help you but we have what we call a chore chart for our son.  It has everything on it from brushing his teeth to shoe tieing.  The important things like home work, turning in home work, making his bed, loading the dishwasher, getting along with sibelings.... all has points.  

If the task earns 20 points then he gets 10 of those points for doing the task without attitude, behavior problems, and half for doing it right.  Half the points for performing and half for attitude.  

The points he earns M-F are for priveleges that weekend and those earned S-S determine what he gets to do for the week days.  We advise our son other than food/water, bed, roof, medical attention, and school we have no further obligations.  He has to earn priveleges.  And everything is a privelege so he'd better earn them.


The chart is posted on our refrig.  Where he can view it anytime.

Then the real magic for our son is that if he has something he wants (video game, controller, basketball, friend over for sleep over) we build in some of that to be earned over 4-8 weeks.  He knows how many points he has to earn to get what he wants.  Puts him in control.  And I no longer feel like a warden.  

We always make the points he has to earn realistic...we sort of figure out how many things have to be done for a satisfactory day and times that by the number of days to earn the reward and that's the number of points he has to earn.  (Now I don't explain my reasoning on the points to him and he never has asked).  If fighting with brothers and sisters is a major issue then put more points on it.  And perhaps break it down to specifics...like in the car, or watching t.v., at the table, maybe by child where he earns points or looses if he gets along with and list each child.  Address the problems head on.  Just be sure that he doesn't have to be perfect of earn/win something he really wants in the not to distant future.

The first week is hell.  Just don't yell once the chart is on the refrig.  Either he has earned the points or he hasnt'.  When he wants to do something just go to the chart.  IF he has the points he get to do it (like watch t.v.) or not.  Once he gets the idea it cut and dried this should reduce the hassles, yelling, frustration, pulling of hair, etc...

The first 30 days our son just knew he could never earn the 2,000 points we required to have 2 friends over for a sleep over. He had to earn the point 5 days before the proposed sleep over so we could get the other kids invited.  He was so excited when he realized, 7 days before the date certain, that if he just keep it up in two days he not only had the points for the sleep over but had earned enough for a thrid boy to come over, pizza and rent a movie.  That made a believer out of him.  You should of heard him on the phone telling his best friend he earned 2847 points (or whatever it really was) and all that he got with those points.  

This works so well that some of my son's friends have had their parents call me because they want their parents to put this chart in their home.  Why?  Because there is none of this maybe, or when we have the more money, or we'll see when it comes friday, on things my son wants.  If he performs the rewards are preset... thus he often gets more than his peers.  Our family life is much much easier.

One thing to remember...don't banish him from anything that will mean that you are punished.  IF the family goes to the movies once a month and you want it to be a family thing then that isn't on the list of things he earns or looses.  Or if you have to give up to much to remove something then leave it as an item not effected positive or negative by his performance.  There are plenty of rewards when you realize that everything is a privelege.


Medicine has it's place.  Our son is on his meds and will continue to be.  But this chore chart has really made a difference in our quality of family life.  Less fights, less repeating and repeating, less of everything...if you live through the first week.

Frankly such a chart will help any family with kids but those of us with challenging situations often find the results impact our lives so much more.

Hope this helps.

[colep_2003]

my answer is this ADHD stuff is a load of ****...  it just means you have a extera sturborn son, Medicans dont help...  it even gives the kid a reason to get away with things...  I would try to make his life unconfortable...i suggest, staying home till he makes a behavoral change in himself...