My sweetie

[jadasmeme]

I have a 5 year old daughter who has recently been "kicked out" of pre-school for aggression.  My husband & I have taken her to therapy and we are now trying medication (Concerta 36mg).  Nothing seems to be working and the aggression is worsening.  I love my baby girl and it is breaking my heart to see her so unhappy all the time.  We are doing everything that is recommended in therapy (behavior charts, ect) and still no progress.  She is a very friendly, outgoing & intelligent when she is behaving.  It was hard to put her on medicine and I honestly don't see any improvement, if anything the aggression has worsened.  What do you recommend?

[tejodouro]

Hi - 36mg of Concerta seems high for a 5 year old. Most docotors also do not start out with Concerta as the medicine for a 5 year old.  If you are still giving her the medicine, please talk to your doctor about the fact that this medicine maybe is not working. Maybe it is too high of a dosage or the wrong medicine.  If she is behaving at home, maybe you can consider a medicine that is not as lasting as Concerta.  At this age, you probably should only medicate her for school.  Concerta is a 12 hour medicine.  Many kids do not sleep well when on these type of long lasting meds.  You might be better off with a shorter acting medicine such as Metadate CD (8 hours only) or Ritalin and maybe a lower dosage.  At 5 years old, it is very hard to get the right medicine and doasage to work.  Make sure that you have a good doctor and you are communicating with him/her.  Be patient and give your child lots of positive rewards (verbal and otherwise). Make sure that she gets lots of sleep (over 10 hours), exercise outside, vitamins, fish oil (Omegas), and clean diet  (fresh food, not preservatives in the food and no artificial coloring).  I am not a doctor and this not an expert opnion.  Good luck.

[Kevin Kennedy, Ph.D.]

I recommend you continue with the help you have sought. It's not unusual for it to take some time to see progress. It may be that the straightforward limit setting and discipline are not adequate. Take a look at Lyn Clark's book SOS Help for Parents and see what you think.