The medication trial has been ongoing. When 5 mg of Ritalin had no effect, we bumped it to 7.5 and then 10 mg, still with no results. This week we switched to Adderall, but started back at 5 mg. (And though my friend Moi suggests we should try Strattera, Bud's doctor wants to try the medications with a longer track record with younger children first.) It has been difficult to gauge the results, however, because Bud has not been sleeping and it is taking a terrible toll on him.
Ever since the Daylight Savings time switch Bud has had trouble falling asleep at night, a phenomenon that is very common in kids with autism. Though we've blocked all light from his windows and he is physically exhausted, he simply can't wind down at the end of the day. We start the bedtime routine around 7:00 p.m. and it's usually sometime around 10:30 - 11:00 p.m. when he finally falls asleep. Then he's up bright and early in the morning, with dark purple circles under his eyes.
Though this has been going on for weeks, Bud had been managing surprisingly well until it was time to make a transition at school. His preschool program ended, and his summer services began. As transitions go, this one was minor: same classroom, same staff, same daily routine... just a few new kids whom he doesn't know. But he's been completely unable to cope. When I picked him up yesterday, the staff looked heartbroken. He'd had a terrible day. He wouldn't let them come near him. He wouldn't talk, except to use perseverative scripting. He wouldn't engage with any people or activities. He wouldn't do any of the sensory activities that usually help focus him (swinging, stomping, bouncing, etc.) And he looked utterly exhausted. (But bless his heart, when I asked him how school was he told me he had fun.)
I called his pediatrician in a panic. She had resisted giving him anything for sleep while we were trying out other medications, but I told her I'd rather suspend the Adderall trial to let this poor child get some rest. She told me to stick with the Adderall, and try giving Bud 1 mg of Melatonin before bed.
It was magic.
Bud was asleep by 7:45, and though he woke briefly a couple of times and called out to me, he slept until 7:00 a.m. And best of all, he had a great day at school today. So now the real trial with Adderall begins. Stay tuned.