[kamamsm]

Hi everyone-- We are adopting a boy & girl with adhd. They are both on alot of meds (clonidine/adderall/tripetol/seroquell/eskalith) the last two I'm sure I spelled incorrectly.
They have lots of energy and don't look you in the eye. Both kids have been through so much. I'm trying to figure out what's adhd behavior and what's from their circumstance. Could anyone tell me anything about these meds and well -- any advice in general? Things to look for, how to help the kids, how to manage etc?
Thanks so much!!

[aMarylandfamily]

The medications that you have inquired on are definitely hefty ones for any child. Without upsetting you - can I inquire as to whether or not you have histories, especialy psychological ones on these kids? If not you may wish to attain same and even speak with the physician (hopefully a psychiatrist) prescribing these.

Trileptal, Seroquil and the last one you mentioned are mood stabilizers ... often prescribed for the dianosis of bi-polar and/or multiple personality disorder vs. just ADHD/ADD. Clonidine is a blood pressure lowering agent which is often prescribed in combination with one or all of those three to address the anger, explosiveness that accompany related outbursts/tantrums. Adderall (ritalin) is prescribed for the ADHD/ADD and has proven very successful with many kids ... major concern with this is that the afternoon dosage is smaller than the morning one as it can cause major insomnia. My major question here (after having personal experience with Concerta (Ritalin), Clonidine and Trileptal combination would be if any aggressiveness led to this treatment plan of action.

Please know the above information is not to scare you - just to advise you to find out exactly what each med is prescribed for ... what caused the determination of it/their need. If adjusted correctly (and as children grow it will need readjusting) it can allow a child with these symptoms/diagnosis to lead a very normal life. The hardest part is monitoring it and knowing if a history for "onset" is present for either child ... it will make a difference in long term needs (medication and counseling) and will effect daily life at times.

Hope this helps ... send more questions and I'll be glad to give you advice - as I always write though - this advice is for information - some of it may apply, some not but will provide wisdom and ammunition in decisions if ever needed.

[kamamsm]

Thank you so much! You didn't frighten me, but I am now more wary. I will definitely try to learn much more about their histories ( we are in visitation now). It is important to make informed decisions for the children and for our family ( we have kids in the home now).

[lucyjoy]

If the kids are taking all these meds and are still displaying the behaviors, I bet ADHD is not the correct diagnosis. Normally, there is a major difference on and off the meds. I agree with trying to talk to the psychiatrists who perscribed the meds to find out why. None of my kids every needed any of the large amount of medication they were on. I do have two that needed something entirely different, but noone would know as they were walking pharmacies. Not looking you in the eye is an attachment or trauma behavior, not an ADHD behavior(this does not mean they have attachment disorder, just an issue-however, with all those meds, I'd want an evaluation for RAD). Most kids in foster care are diagnosed ADHD and put on meds. They may or may jnot actually have it. Can you talk to the former foster family? They often have better insite to the child's actual needs and behaviors.

[kamamsm]

We have a call in to the sw. We can & will speak with the foster families. I want to thank you all-- This is serious--being informed is very important. At stake is whether or not these are the right children for our family, as well as are we right for them. We know what we can parent - but we need real information to judge correctly. We have one adopted child who is doing so well- we must guard his progress. Please think of us, as today is a day trip with the children.

[Dr. Art]

You definately need to get a detailed accounting of their history. My guess is that they have significant histories of maltreatment, and, if so, are a high risk of having Reactive Attachment Disorder. You may want to get your own assessment by a licensed mental health professional who is trained and experienced in treating adopted and foster children and who meets the criteria to be a registered clinician of The Association for the Treatment and Training in the Attachment of Children .

Generally, children who really have ADHD respond well to medication...if that is not happening, then you need to get a reevaluation. The third and fourth meds are usually prescribed for children with mood disorders, such as Bipolar I Disorder. You might want to take a look at the book The Bipolar Child.

regards

[kamamsm]

I wanted to update you because you were all so kind, answering my question specifically. I thank you, too, because the info you gave may have saved these children from being incorrectly medicated. The Dr who medicated them did not give a specific diagnosis, only adhd. We requested and are receiving a change in Doctors, as well as a complete pysch evaluation for both kids.
Whether or not these are the kids for us- they are now going to get the correct diagnosis and proper meds if any.

[Dr. Art]

It is vital that the new therapist be a registered clinician of ATTACh or meet those qualifications if you are to get a competant and thorough evaluation and, then, the correct treatment. A general child therapist, social worker, psychologist, etc. won't be able to give you what your family needs and deserves.

regards