Some answers

After going back to the books on ADHD and consulting some of the most recent studies done on the medication Hannah was switched to in January, I have no doubt whatsoever that at least some of her behavior is a result of the medication (Concerta). In addition, I found out that bullying has been linked to ADHD in children her age (though being bullied is often more likely the case). I should have mentioned in my previous post that this behavior, as far as we know, has been isolated to her relationship with one friend. We don't have any knowledge of her treating other kids like this, which is why the girl's mother thought, at first, that Hannah's behavior was a result of Hannah being so very comfortable in that friendship (i.e. "fighting like sisters" kind of thing).

We stopped giving Hannah her meds last Wednesday, and she still hasn't taken any medication. We've noticed a significant difference in her mood and behavior. She has been calmer, less oppositional, and generally less moody. Part of this could be a result of knowing that she was under closer scrutiny and that we were setting much tighter boundaries (i.e. she was in trouble). But, after getting advice from my dad, who also happens to be our pharmacist, we definitely think her medication should be changed. He identified a key ingredient in Concerta that affects some children (not the majority) in this way, and he recommended that we get her back on her old medication. She wasn't having any problems at all with the old meds, she just needed an increased dose because it had been over two years since she started it, she'd gained weight, etc. The pediatrician (NOT our regular one) who saw her in December suggested Concerta because it's the one the majority of his patients, he specializes in ADHD, and thus, it was his professional opinion that it would work well for her. I listened to him and agreed to the switch...and now here we are.

The good news is that all this research, in addition to meeting with Hannah's counselor, had resulted in some specific, concrete things Hubby and I can do to help Hannah be her best self. We're making a contract that outlines the consequences for violating house rules, etc. so that they are consistent and she always knows what to expect. We're implementing a rewards chart so that she sees when she's making progress and doing things well. We're looking for times when she does good, even with small things that would be considered "normal" responsibilities for an 11-yr old. She will be meeting with someone once we get back to the States to talk about ways she can cope with impulsivity and react to others who have ideas that are different from or opposed to hers. Without a doubt, this is going to take time, and it won't be easy. It's a nonstop effort, and we don't know if there will come a time when she stops being receptive. For now, though, we're letting her know that we love her and nothing she does will ever make us stop loving her. And, we're praying...for patience, guidance, wisdom, and strength. If you're the praying kind, feel free to throw one our way.