DC at 5 was on red during kindergarten more days than not. He was asked not to come back to a summer camp mid-week. In 1st and 2nd, he got 2s and a 1 in citizenship, emails and calls from the teacher, we had meetings. A psychologist diagnosed him with ADHD and recommended meds but the pediatrician recommended waiting. We waited.

Then there was covid.

In 6th grade, it was re-entry year and pretty disastrous. In middle school, DC was diagnosed with ASD and ADHD by a different psychologist, and really started figuring things out. He finally had figured out the rules, and how to follow them. There were some missed assignments here or there, but post-covid the school wasn't concerned.

High school has gone well. DS is disorganized but doing fine. There is the occasional impulsive mistake but they are infrequent and involve normal sorts of things.

Yes, DS had behavioral issues in ES and they improved without medication. There was some white-knuckling, especially in lower ES, but by upper ES, things were beginning to smooth out.

I would really encourage you to try medication. The difficulty that some kids feel trying so hard to manage themselves without it is incredible, and I truly don’t understand why people would not to give their child all the help they could. It’s sad how some unmedicated kids struggle so much and get negative messages all day at school about themselves.

Anonymous wrote:OP at what age was the formal evaluation? What's your screen time, play date frequency, parenting consistency, and exercise/outdoor time like?

DC was 6 for eval. During school year about 45 mins a day of tv after school, maybe an 1-2 hours on weekend mornings. No other regular access to screens. Play date frequency varies but generally some sort of social interactions with other kids once a week, though sometimes it is just taking DC to a popular playground. We try to be consistent but are not perfect. Outside/exercise time also varies based largely in what DC requests/will tolerate. This week about 6 hours a day at an outdoor daycamp. During school year, some days just recess and walking to and from school.

OP at what age was the formal evaluation? What's your screen time, play date frequency, parenting consistency, and exercise/outdoor time like?

No. Could not have attended preschool or school without medication. Got better around grade 6, when we accidentally forgot to medicate a couple times on Saturday activities, and worst we got was him saying that the coaches were complaining about how wired and out of control he was. But prior to that, was physical and could not be around other kids in any settings. Our only alternative would have been homeschool.

Now at sleep away summer camp for sn kids as 13 year old, and we actually reduced his adhd meds this summer to the lowest possible dose and haven’t gotten a call home to come get him (but did get a call that he was annoying other kids and one of them punch ds - so obv his adhd was still an issue, even if the call was about the other kid).

But age 4-12 meds were non negotiable.

My DS had a lot of anger and emotional problems at age 8. He did therapy and we eliminated all screens. They were real trigger for him. He’s a teen now and on screens plenty and can handle it. Not sure what was going on back then, maybe a big time of brain growth?

He does show signs of adhd but not enough to interrupt his grades/social life and he’s never mentioned a problem. But if he asked for meds or we felt like he needed it to succeed, we would consider it.

My sons has had difficulty in school settings since he was 3, but he only started getting high reactive and aggressive at closer to age 5.

We do medicate - my son is on several meds. But he also does therapies and I recommend the book “finally focused” by James greenblatt. I am looking into mineral and iron deficiencies that could be exacerbating his adhd and we’ve already seen an improvement just by starting magnesium, which most adhd kids are deficient in.

Medication, therapy and time/maturity have helped some. I don’t think my son would be in a mainstream classroom or learning much without medication. But I hope one day we are less dependent on it.

Honestly it depends what tradeoffs you're willing to make to avoid medication, and what you consider to be "success". Willing to homeschool, or willing to pay for private, willing to have limited choice of camps? Many people are fine with that, but for some it's a difficult tradeoff. Impact on siblings, friendships (at eight, behavior like this will start to really affect friendships), stress on the family as a whole. Only you can decide, OP, what's worth it to avoid medication. It's a very individual question.

I've seen a lot of families delay medication until their kid was really struggling socially and pretty miserable trying to get by in mainstream settings. The only time I've seen it go differently was a kid who had an atypical presentation of ASD, was face-blind so everyone had to adjust for that, and he received a ton of social skills coaching that addressed his skill gap. With a few years maturity he was in a better place. And one other kid who was having mini seizures that frightened him, but then they medicated for that. For most, in my experience, other interventions can help, at great effort to the family, but medication has the most oomph.

Anonymous wrote:Define “success”. Do you mean noticeable improvement? Zero issues? Environment can be critical. Many kids do much better with tiny class sizes, environments with less stimulation (facing their desk against a blank wall, in a quiet room, for example, for some tasks), hands on, active assignments, and frequent opportunities for physical activity (such as sports). Doing this means optimizing an environment for the kid, while reducing the kinds of factors and interactions associated with behavioral issues for that particular child. The ideal plan would involve working on the behavioral concerns and eventually returning the kid to a mainstream environment.

So, progress is possible, but there are huge pluses and minuses that go along with decisions like these.

All of this. It's very kid-specific but you're also finding the healthiest way to pass the time while they mature.

No. They improved with a combination of meds, environment change, and age.

Define “success”. Do you mean noticeable improvement? Zero issues? Environment can be critical. Many kids do much better with tiny class sizes, environments with less stimulation (facing their desk against a blank wall, in a quiet room, for example, for some tasks), hands on, active assignments, and frequent opportunities for physical activity (such as sports). Doing this means optimizing an environment for the kid, while reducing the kinds of factors and interactions associated with behavioral issues for that particular child. The ideal plan would involve working on the behavioral concerns and eventually returning the kid to a mainstream environment.

So, progress is possible, but there are huge pluses and minuses that go along with decisions like these.

I would try to zero in on the reasons for the emotional regulation and the hitting, and work on those specifically.

Have you had a behavioral eval?

We didn’t medicate because my xDH refused and I wasn’t willing to get a court order. Around the end of 6th grade he started to mature and be able to control himself better. It was very rough going and I think the only reason he did not get placed in a different school is because DCPS has few options and he actually was not the most disturbed kid in school.

if it was just me I definitely would have tried ADHD meds. I am more ambivalent about SSRIs.

My 8yo DC has struggled with behavioral issues since Pre-K. Had a formal eval, but no diagnosis. We have done play therapy and parent training. Things improved a bit in school but we have been kicked out of two summer camps for hitting this summer. Emotional regulation is our big issue. No one has recommended medication, but the play therapist has said DC has a lot of ADHD characteristics. Most of the success stories I know about with ADHD or other behavioral issues seem to be paired with medication.

Has anyone had success without medication? If so, what worked?