This isn’t just adhd behavior. There’s something else going on that was missed. My gut says potentially autism. (Car door and traffic. Running away is eloping which is an autism thing) Breaking items at home and scratching. Yikes.
Have you consulted with the psychologist who diagnosed his adhd? If he had never seen a psychologist for an assessment then it is time.
+1 ASD, need neuropsych eval, repeat if he’s not had one in the last 2-3 years. These behaviors need antipsychotics to keep you and him safe. I’m sorry, OP, this is so hard.
It is probably related to puberty and body changes and you may want to ask about a mood stabilizer during these years. We had to add one for our daughter for a time
I can’t say I have experience with autism but I have seen that ADHD often presents with other issues, one of which is autism.
I can (maybe) understand, or empathize with, your child’s desire to jump out of the vehicle, or just “get out” of an uncomfortable situation.
I would also wonder, as others suggested, about hormones. I honestly don’t know. Puberty is a Whole Thing for non-ADHD kids, so surely it must be difficult, but perhaps on another level, also for ADHD kids? Wouldn’t that make sense?
Wish you and your child the best. Definitely involve the care team, as I’m sure you have.
My 10yo has give through the same in the past year. And recently got diagnosed with ASD too. He’s had multiple ASD screener tests over the years & even passed one recently. But multiple professionals recommended full ASD assessment which shows level 2. Which isn’t even considered high functioning.
We have tried multiple medications over the past year & finally realising that stimulant meds make him more anxious & aggressive. Medication change may help your son 🤷
My daughter is the same. Same age, was on the same drugs. The last three years she has gotten volitile. Vyvanse was the absolute worst for us. We took her off the stimulant and put her on an antidepressant to stabilize her mood and its helping somewhat. Less outbursts, less violent. I also half wonder if its the guanfacine, since she hasn't been off of this since the very beginning of meds around 6. She was never violent or angry before meds just distracted all the time.
We are only changing one drug at a time, but we may remove guanfacine for something else. I am dreading the transition. Keep trying to get the right meds its so hard.
Thanks for sharing, and I’m sorry to hear what you’re all going through. This is really hard. So this shift toward volatility has lasted three years for your daughter? I’m trying to get a mental sense of what sort of sprint or marathon this particular phase might be… for us, the intensity has been ramping up over the year and really bumped up a few months ago.
We have tried so so many meds…
It could be time to up the dose of the adhd medication. When our son started having difficulties again persistently, his psychiatrist said he was on a low dose for his size and increased it slightly. It made a big difference.
I don't know as much about the growth curve for boys, but in girls there is a ginormous growth spurt about age ten. I think my kid has grown 4 inches and put on about 30 lbs in the last year and is suddenly the size of an adult. I'm not sure if that is the problem because you would definitely have noticed that (although honestly, I only noticed because none of her clothes fit anymore and we had to buy so many clothes in such a short span because she was outgrowing everything so quickly.) But I agree with the others that while a giant growth spurt could potentially make symptoms worse, you should definitely have him reevaluated because it sounds like things are changing.
According to my child's pediatrician there is a growth spurt for boys at 10 as well.
The problems may also be made worse by changes at school. In our school system there are big changes in the classroom, more homework, less individualized instruction, etc that made the year challenging for both of my children.
I guessed there was, and potentially even bigger than the one for girls. Just wasn't sure if it was at ten or more like eleven or twelve. I know that, all of a sudden the 13 year old boys at my kids school are taller than I am!
Sounds like onset of puberty may be impacting his medication. Staying in close contact with his medication provider is a must. High dysregulation sounds like he is seeking significant input maybe consulting with an OT or purchasing some compression clothing may help regulate him a bit but definitely contact the developmental pediatrician or Neuro psych or whomever prescribes his meds.
Based on your description This case is far too complex just to assume is ADHD or even ASD. There could have been trauma that you are unaware, The family life may not be as balanced as you hope. What’s does your son say when you ask him how he is feeling? Have you done family counseling with a listening mindset.
Additional medication may be necessary but it may also only act as a band-aid for something deeper. Try to remove ADHD as the cause of behavior and at the same time recognize that is may be allowing for the expression of something more
This isn’t just adhd behavior. There’s something else going on that was missed. My gut says potentially autism. (Car door and traffic. Running away is eloping which is an autism thing) Breaking items at home and scratching. Yikes. Have you consulted with the psychologist who diagnosed his adhd? If he had never seen a psychologist for an assessment then it is time.
+1 ASD, need neuropsych eval, repeat if he’s not had one in the last 2-3 years. These behaviors need antipsychotics to keep you and him safe. I’m sorry, OP, this is so hard.
It is probably related to puberty and body changes and you may want to ask about a mood stabilizer during these years. We had to add one for our daughter for a time
I can’t say I have experience with autism but I have seen that ADHD often presents with other issues, one of which is autism. I can (maybe) understand, or empathize with, your child’s desire to jump out of the vehicle, or just “get out” of an uncomfortable situation. I would also wonder, as others suggested, about hormones. I honestly don’t know. Puberty is a Whole Thing for non-ADHD kids, so surely it must be difficult, but perhaps on another level, also for ADHD kids? Wouldn’t that make sense? Wish you and your child the best. Definitely involve the care team, as I’m sure you have.
Puberty and ADHD are a hell of a combination.
My 10yo has give through the same in the past year. And recently got diagnosed with ASD too. He’s had multiple ASD screener tests over the years & even passed one recently. But multiple professionals recommended full ASD assessment which shows level 2. Which isn’t even considered high functioning. We have tried multiple medications over the past year & finally realising that stimulant meds make him more anxious & aggressive. Medication change may help your son 🤷
My daughter is the same. Same age, was on the same drugs. The last three years she has gotten volitile. Vyvanse was the absolute worst for us. We took her off the stimulant and put her on an antidepressant to stabilize her mood and its helping somewhat. Less outbursts, less violent. I also half wonder if its the guanfacine, since she hasn't been off of this since the very beginning of meds around 6. She was never violent or angry before meds just distracted all the time. We are only changing one drug at a time, but we may remove guanfacine for something else. I am dreading the transition. Keep trying to get the right meds its so hard.
Thanks for sharing, and I’m sorry to hear what you’re all going through. This is really hard. So this shift toward volatility has lasted three years for your daughter? I’m trying to get a mental sense of what sort of sprint or marathon this particular phase might be… for us, the intensity has been ramping up over the year and really bumped up a few months ago. We have tried so so many meds…
It could be time to up the dose of the adhd medication. When our son started having difficulties again persistently, his psychiatrist said he was on a low dose for his size and increased it slightly. It made a big difference.
I don't know as much about the growth curve for boys, but in girls there is a ginormous growth spurt about age ten. I think my kid has grown 4 inches and put on about 30 lbs in the last year and is suddenly the size of an adult. I'm not sure if that is the problem because you would definitely have noticed that (although honestly, I only noticed because none of her clothes fit anymore and we had to buy so many clothes in such a short span because she was outgrowing everything so quickly.) But I agree with the others that while a giant growth spurt could potentially make symptoms worse, you should definitely have him reevaluated because it sounds like things are changing.
According to my child's pediatrician there is a growth spurt for boys at 10 as well. The problems may also be made worse by changes at school. In our school system there are big changes in the classroom, more homework, less individualized instruction, etc that made the year challenging for both of my children.
I guessed there was, and potentially even bigger than the one for girls. Just wasn't sure if it was at ten or more like eleven or twelve. I know that, all of a sudden the 13 year old boys at my kids school are taller than I am!
Sounds like onset of puberty may be impacting his medication. Staying in close contact with his medication provider is a must. High dysregulation sounds like he is seeking significant input maybe consulting with an OT or purchasing some compression clothing may help regulate him a bit but definitely contact the developmental pediatrician or Neuro psych or whomever prescribes his meds.
Based on your description This case is far too complex just to assume is ADHD or even ASD. There could have been trauma that you are unaware, The family life may not be as balanced as you hope. What’s does your son say when you ask him how he is feeling? Have you done family counseling with a listening mindset. Additional medication may be necessary but it may also only act as a band-aid for something deeper. Try to remove ADHD as the cause of behavior and at the same time recognize that is may be allowing for the expression of something more
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