Thursday, June 12, 2014


The biggest battle we have had in all Logan's medical issues is, without a doubt, managing behaviors. Logan is predisposed to having issues with ADHD because of his disorder. Now, before I start a war on the opinions of ADHD, I know that there are many opinions on the validity of diagnosing ADHD and even more on the treatment of it.  As someone who works in schools and has a child who struggles with behaviors, I attest that it is a very real problem.  While I do agree that people may jump to that diagnosis very quickly, and medicate as an "easy fix" without trying other interventions, I also believe that there are valid cases that require such interventions for the benefit of the child.

Best attempts at sitting still
I never, in a million years, thought I would say that with as much confidence as I do.  A little background: as a child I struggled in school.  I was diagnosed with ADD and put on medication to help support my education.  I hated it.  It's difficult to explain, but I just didn't feel quite myself while on it.  Once I was old enough to compensate for my weaknesses, I stopped taking it.  I swore I did not want that for my kids.

Then I became a school-based speech therapist.  I began working with kids who were the textbook examples of what ADHD looks like.  These kids can't control themselves or their actions.  I know it sounds silly to say.  Who can't control their own actions?  It's easy, right?  Well, you don't believe it until you really see it. It is truly indescribable and sad to see them battling so much within themselves.

What he can do in about 90 seconds
But it's fun to play with the blinds
4AM make-overs (not pictured: Logan and the cat)
Finally Logan came along.  In the last 2 years, Logan has developed hyperactivity and attention based behaviors that have severely impacted his life.  I know he's only 4, and these things are expected of someone his age, but it goes beyond that of a typical pre-schooler.  He truly lacks impulse control and does things that are inappropriate, destructive, or down right dangerous.  He knows right from wrong.  He can tell you the things that he should not do.  But he can not stop himself from doing them.  A highlight of some of his more common and most often repeated actions : pulling the fire alarm at school, drawing on the walls/furniture, drawing on the cat, dancing naked at school, throwing things in the toilet, stealing things (constantly), throwing tantrum, attempting to play with dangerous items (scissors, knives, razors, lighters, etc.), walking/running away in public, running into the street, peeing on himself, pooping on the bathroom floor, general destructive behavior. If left unattended, Logan can destroy a room in about 90 seconds.

In addition to the behaviors, Logan is unable to sit and attend in order to learn new information. He can pick an activity and before he even has a chance to start that activity, he has moved on to another.  This can happen in rapid succession until he has either found the rare object that can hold his attention or he runs out of options.  At school, unless the teacher is sitting with him one-on-one, he can't participate and even then it's a struggle. I have overheard teachers at his school (on multiple occasions) refuse to allow him to be a part of their classroom. As a mother, it breaks my heart.

Finally there is the developing aggression. Yelling, screaming, tantruming, aggressive backtalk, hitting/kicking, crying.  All at the drop of a hat.

Logan started taking a low dose Ritalin a few months ago and for awhile we saw a great change.  Once we played around with the dose, we found that the behaviors decreased and his attention increased.  He was finally able to participate in class activities.  He wasn't initiating destructive behaviors (as much).  He was easily redirect to appropriate behavior.  About a month ago, the medication started to not work as well.  His morning dose continues to give him some benefit for a brief amount of time, but his afternoon dose has no effect.  We started to receive reports of behaviors coming back at school and we certainly saw it for ourselves at home.

 We have spoken at length about finding another option.  Different medication?  Stronger dose? Extended release?  Who knows.  Before we can discuss another plan, Logan has to be cleared by Cardiology.  These medications can cause your heart to race or exacerbate existing heart problems.  Since my family, including myself, has a history of cardiac issues, Logan will require a thorough work-up before they feel comfortable changing he prescription.   Once he is cleared, we will continue to work on a plan to best support Logan.

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