I brought the boys up to see Sarge at Active Healing for their first full re-evaluation which he does every 4 months. There were some improvements in certain things which was very good to see. I look forward to reading his full report.
Harry has been having a rough time lately. I asked him how he was feeling on his new dosage of Concerta (we went from 18/27mg to 36mg at Xmas). He had previously reported he felt better, but now he said he feels worse. We decided to try just 18mg the next day and he said he felt better. We've stayed with that dose for the last few days and he seems to feel better. Because it has been wearing off more obviously in the afternoon and he has been having a hard time doing his homework without it, we added in a 5mg booster of short-acting Ritalin after school the last couple of days. It seems to work really well, he stays calmer and did his homework much more easily.
I have been in touch with the pediatrician about these things and he agreed with the change. I also asked him about trying something for Harry's anxiety which seems to be affecting him more and more. I don't like adding another medication, but maybe something to help get him over this rough patch. I'm waiting to hear back from the doctor, hopefully today.
Harry's teacher asked me if I would come in and observe him in class. That can't be good... I am going to do that next week, I'm not sure what she expects me to see. I'm starting to think I should ask the school to do a full core evaluation for him. Maybe his difficulties are coming from a measurable learning disability and he was able to compensate for it until now (now that the work is getting more difficult). I'm not sure his teacher knows much about all this, it's only her 3rd year teaching. Maybe she's never had a 2e kid before. If it can be clearly shown and documented maybe he can move to an IEP and we can get him more accomodations.
Tom has been taking his new adhd medication for 2 weeks and while his PT and I don't really see much difference, his teacher reports an improvement in his ability to stay in his seat and focus a little better. I'm glad there's an improvement, but still hope for more. Thankfully there have been no adverse effects. The neurologist said to increase the dose so we will try that tomorrow.
Tom will have more school testing done in another week and we will hopefully discover more about his learning difficulties and get him more help. Maybe he can benefit from special ed at this point, I don't know. I wonder at what point do kids qualify for an aide in the classroom? I think I've heard of an aide being shared between a few kids, I'm not sure. I wonder how he would do with someone keeping him on track.
Things have been rough for a few weeks, but hopefully are starting to turn around now.
Friday, January 28, 2011
Tuesday, January 18, 2011
January update
It's been a while since I posted, I've been feeling a little overwhelmed. We are following the NR program and seeing some improvements in their forms. I feel guilty because we are only averaging therapy about 4 times a week, instead of daily. Although they don't actively fight it, they do moan and groan. Doing the work with them (especially Tom) is so frustrating for me, sometimes I just can't muster the energy. We will see Sarge at the end of the month for a re-evaluation and program update. I need to shake off this funk and get motivated again.
We are having difficulties with Harry's teacher and team at school. He hates school and his work is sloppy and careless. He is so bright, but can't seem to utilize it (classic dysgraphia). I don't think his teacher 'gets' him at all and she seems unwilling to bend her teaching agenda to accommodate him. With his input they are creating a school contract which I think will be helpful.
After seeing the pediatrician just before Xmas we increased Harry's Concerta dose with positive results. In the Dr's office he was unable to sit still and focus and was (literally!) climbing the wall. I didn't realize he was still so impulsive on medication, but he seems calmer and says he feels better on the higher dose.
He also shows a lot of anxiety symptoms which I worry about. Sarge believes this will be greatly relieved once we get to work on integrating the Moro reflex. We have to hang in there until he's ready for that work, but I have high hopes for improvements once we get there.
I met with Tom's teacher and she told me how he is struggling academically in class. He is very sweet and has lots of friends, but he avoids work whenever possible. The little stinker even had some of his classmates doing his worksheets for him! His work and penmanship especially has taken a nosedive since the Xmas break. She sees a lot of inattention and adhd symptoms and we're seeing a lot of this at home, too. The teacher wants to have more tests done to see if he can start receiving special ed. It makes me sad that he needs it, but glad to get him whatever help we can. She can see that he is bright and doesn't think he'll need it forever, just until he is able to work on his own. In my opinion, he is very smart, but just can't seem to easily access or output the information. How sad and frustrating for him.
After talking with the teacher I contacted the neurologist who we saw in Nov and are scheduled to see again in May. I asked him about a possible medication trial for Tom and we went in to see him last week. He agreed that we have been conservative so far and a med trial is a sensible option. Tom cannot swallow pills (I have tried working with him on it, but it seems to be a sensory problem he just can't handle) so the Dr wrote a Rx for Metadate. You can open the capsule and sprinkle the little beads on food. He has done very well taking it with a spoonful of yogurt.
The first day at home I noticed a subtle overall calming of his body. His teacher had a great report after his first day on medication:
"There was a marked difference in Tom today. I gave a math test at the end of the day and he was able to follow along. His handwriting was also neater. Tom still had his toys in his hands but he handled them better. He aso participated in a discussion about Venn diagrams. I'm interested to see how he does with guided reading on Tuesday."
I was really happy to hear this and can't wait to hear another report after a couple more days at school, however I didn't really see much behavior improvement this past weekend. After my recent experience with Harry's medication I wonder how do you find that "sweet spot" where you get the most benefit from medication without the negatives? I am supposed to report back to the neurologist after a week and I am going to ask him this.
I am sad that we have to take the next step to medication with Tom, but he is just not able to succeed in school at this point in time and it may make a big difference. My hope is that medication (for both boys) will just be a crutch until the NR therapy resolves their issues and they no longer need it.
We are having difficulties with Harry's teacher and team at school. He hates school and his work is sloppy and careless. He is so bright, but can't seem to utilize it (classic dysgraphia). I don't think his teacher 'gets' him at all and she seems unwilling to bend her teaching agenda to accommodate him. With his input they are creating a school contract which I think will be helpful.
After seeing the pediatrician just before Xmas we increased Harry's Concerta dose with positive results. In the Dr's office he was unable to sit still and focus and was (literally!) climbing the wall. I didn't realize he was still so impulsive on medication, but he seems calmer and says he feels better on the higher dose.
He also shows a lot of anxiety symptoms which I worry about. Sarge believes this will be greatly relieved once we get to work on integrating the Moro reflex. We have to hang in there until he's ready for that work, but I have high hopes for improvements once we get there.
I met with Tom's teacher and she told me how he is struggling academically in class. He is very sweet and has lots of friends, but he avoids work whenever possible. The little stinker even had some of his classmates doing his worksheets for him! His work and penmanship especially has taken a nosedive since the Xmas break. She sees a lot of inattention and adhd symptoms and we're seeing a lot of this at home, too. The teacher wants to have more tests done to see if he can start receiving special ed. It makes me sad that he needs it, but glad to get him whatever help we can. She can see that he is bright and doesn't think he'll need it forever, just until he is able to work on his own. In my opinion, he is very smart, but just can't seem to easily access or output the information. How sad and frustrating for him.
After talking with the teacher I contacted the neurologist who we saw in Nov and are scheduled to see again in May. I asked him about a possible medication trial for Tom and we went in to see him last week. He agreed that we have been conservative so far and a med trial is a sensible option. Tom cannot swallow pills (I have tried working with him on it, but it seems to be a sensory problem he just can't handle) so the Dr wrote a Rx for Metadate. You can open the capsule and sprinkle the little beads on food. He has done very well taking it with a spoonful of yogurt.
The first day at home I noticed a subtle overall calming of his body. His teacher had a great report after his first day on medication:
"There was a marked difference in Tom today. I gave a math test at the end of the day and he was able to follow along. His handwriting was also neater. Tom still had his toys in his hands but he handled them better. He aso participated in a discussion about Venn diagrams. I'm interested to see how he does with guided reading on Tuesday."
I was really happy to hear this and can't wait to hear another report after a couple more days at school, however I didn't really see much behavior improvement this past weekend. After my recent experience with Harry's medication I wonder how do you find that "sweet spot" where you get the most benefit from medication without the negatives? I am supposed to report back to the neurologist after a week and I am going to ask him this.
I am sad that we have to take the next step to medication with Tom, but he is just not able to succeed in school at this point in time and it may make a big difference. My hope is that medication (for both boys) will just be a crutch until the NR therapy resolves their issues and they no longer need it.
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