You might want to have him checked for bi polar. Not to add any new meds he is taking but I would see a new physchiatrist and get a second opinion. Its so hard knowing how to handle children with problems these days. It really seems that all doctors want to do is hand out drugs. But get a second opinion and ask the doctor if your grandson might be bi polar. Good luck.
We are in the same boat all most. My daughter is ADD and she has been taking same dosage of Metadate for over 5 yrs I think. She does not see a physchiatrist cause our insurance says " Since she is not a threat to herself, hitts herslf , harms herself there is no need for those services." There are days that she drives myself and my husband nuts with the attitute, screaming, yelling, back talking, and sometimes what you are going through. She has a learniing disability as well. What we do is let her act out to a point then have her sit down in a certain area in the house to have her calm down for a few minutes then either myself or my husband would go and sit with her and talk with her and ask " What brought on that out brust or made you so mad all of a sudden?" The area we put her in is what we like to call " The Calm Down Area" where there are things that she likes to play with, color, or just simply do. We put her there so that she can calm dowm and do what she likes to do while thinking about what she just did before talking with us about it.
My son is also ADHD...His behaviors worsened when he was in 2nd grade...As any parent we want to beleive that our children will grow out of it. So I held off. The teacher told me that he was not what you would call a curtain climber. When I went in to meet with her...she had a baggy full of things that he was chewing on during class and was very negative speaking about my son. Whenever I mentioned that I could have him evaluated by an outside psychologist and get a referral from my doctor she did not feel that it was necessary. When he got to 5th grade, he was out of control. Getting kicked out of class, poking a people, really rude and name called a lot, kicked off the bus, referrals 2-3x a week and he threatened to hit the teacher. The school psychologist then decided to listen to me and had an evaluation done... He was a terror at home as well. I could not get him to do his homework and bedtime was a struggle every night and it was even worse getting him up for school in the morning because he would not sleep at night until like you said, 3-4 hours after bedtime. I went to the doctor and she sent us for blood work to make sure Zach did not have any unknown health problems. She then perscribed him Aderrall XR 5 mg (2 pills a day) 1 in the morning and 1 at lunchtime. His behaviors were still happening. She slowly gave him more mgs. He never started taking 2 -20 mg Adderall capsules until he was a teenager about 12. His weight and body changed so the 1-20 mg wasn't working. He is 16 years old and still takes 2-20 mg pills in the morning now before school. When Zach took the 1 pill at lunchtime, kids in the school found out and were harassing him about his medication. I also through my son Zach and his friends found out that the teachers centered him out in front of the class which caused him to act out. Some of the teachers were also talking in the class about his meds. We never talk about his medication in front of him or around his friends. It is a very touchy situation with him. I tried Stratera and Concerta and he was an animal on both. Taking the 2 Aderall 20mgs...you could not ask for a better kid. He is very calm and respectful and does well in school. He has an 80 average this marking period. If he skips his meds 1 day....Beleive me you will know it within 1 hour. I am not a doctor by no means but it seems as though he is taking too many meds. When Zach was younger and even now when he misbehaves...I take his most precious treasures.....I have taken his tv, xbox 360, not allowed to hang with friends or have friends over. He also put a whole in our hall when he was angry. He told me that I made him do it...because I made him mad(he wnted his own way)He was made to help repair it. I would seek a psychiatrist on the outside of school. I am not sure how they run things where you are from but here...they come and get te kid out of class. He may not like his friends see him go to counseling. My son went to counseling as well and I discontinued it as he as angry about it and did not want kids to see him leave class with the COUNSELOR. I also would tell your family doctor that you would like a referral to have your grand son evaluated outside of the school. On the outside of school they do a much thorough evaluation. I spoke to my doctor about Zach's sleeping problems. I told her that I do not want a drug to help his sleep. She told me to get Malatonin for him. You can buy it at walmart. It is so cheap and now he goes to sleep as he should. My friends son is on 6-8 pills a day.... which is crazy. I don't know how he functions, he is only 12. I hope all of this helps....Please let me know if you have any other questions that I can help you with or if this helped a little. What are the other 2 medications that he takes besides Adderal? Have a great day....Dont give up....I know it's discouraging.
I also forgot to mention that Melatonin is a natural herb and you can get it in the pharmacy section.
could i ask a question what do you do if he becomes agressive do you tell him off like a normal child and send him to his room to cool down or do you let him be noughty because i have a huge problem with my stepson and his mother a few days ago my stepson was verry violent towards his dad and was sent to his room to cool down for a while he is 11 years old so he dose understand things . he sent a nasty message to his mum saying he wishes his dad gets stabbed in the heart athousand times this made his mother think that we were putting him in danger so the mother became verry agressive too she started to really get personal with me and my partner the next morning she came to the house thinking that we were going to be reasnoble with her after everything she said about us what do you think of the situation and how would you cope with somthing like that bear in miend that his perants will not put him on mediaction they just let him behave in an unacseptable way all the time
I have done a lot of research in ADHD, ODD, OCD, and Bi-Polar Children and they will become more disruptive if the discipline is not carefully developed (it's a process)
What happens is usually there is so much inner tension because of the lack of ability to process stimuli around them, and they will turn inward and more staunchly hold their ground. At this point the child is unable to translate what's happening to anything but building tension until they explode. They see the tension in your face and they hear "blah, blah, blah".
The best way to start is to sit down (or have the parents sit down with) the child and explain that they understand that there is a lot of anger and hurt going on in the childs head and that's ok. Also observe the child and figure out what his triggers are, so you can help him identify and avoid them. Make sure you tell the child that it is OK to feel this way, but there are ways to relief the pressure in his head other than acting out the dangerous behavior.
Ask him very calmly, get down to his eye level "You seem very upset. What are you so upset about?" and just listen. You'll be suprised at how badly they just want to be heard.
Medication does make it a little easier, but there are ways to do it without. Check out some books on Parenting the ADHD child and there are discipline techniques that work. (Time outs dont! A better option is to hand him a vaccuum and have him vaccuum a room or two--this will help dispell the anger through physical movement