Teacher Professor

February 2, 2010

Plan 173

Filed under: Twice-exceptional — Teacher Professor @ 5:06 pm

I blogged earlier about our search for a label for my son, and how we had rejected ADHD medications because they inhibit appetite, and with the issues we’ve had with eating, we were not even considering them.

My husband to the rescue.  (This is why my husband and I balance each other so well- when I’m overwhelmed, he does the research and gives me new “umph” to keep going).  He found that “traditional” ADHD medications- Ritalin, Adderal, etc. are not prescribed when a child has Tourette’s or Anxiety disorder and they all decrease appetite- Strike One, Strike Two and Striiiike Three- we are NOT going down the stimulant route!

But there is a new medication just approved for children in September 2009, guanfacine, sold under the drug name of  Intuniv, that (get this) helps ADHD, Tourette’s symptoms, anxiety, AND increases appetite!  Pretty much reads like a perfect medication for Ray… but I’m anxious about starting him on medication if there’s any other way…  Anyone out there with experience with this medication?

What I’m really wondering about is brain neurology.  The brain can only re-create an experience it has already had.  This is how kids learn to read- they see letters and hear the sounds and the brain has the experience of connecting the two things together.  A neurological synapse is formed and learning “happens”.  For some kids, they can form neurological synapses from one experience, other take many, many exposures, and others can never lay down that neurological pathway for some reason or another.  Once that neurologcal pathway is there, AND organized in a way that it is connected to something else, the brain can go back to it and recreate that experience.  When I teach this to my students, we play with Tinker Toys.  I give them time to “play” and then we talk about some connections are clear and simple and others go nowhere- just have arms sticking out in random places.  Other Tinker Toys contraptions are works of art that have moving parts where one part connects to and moves another.  This is a representation of the human brain.  Remember that old commercial of the fried egg “This is your brain on drugs?”  The reality would be a series of neurons that aren’t connected to each other- and other connections breaking.

Brain scans find that gifted kids have really fast synapses and really well-organized brains.  They can find the memories, the skills- the synapses- faster.  Kids with language processing issues have the words go to a part of the brain, where, for some reason or another, the synapses aren’t happening.  It’s a bit like a burned-out lightbulb. When language goes “there”, there is an electrical short and the synapses don’t happen.  When I teach someone with a language processing issue, I try to “work around” the problem.  The experiences of general education haven’t worked to turn on those electrical connections, so my job as a special education teacher is to find another way to access that area.  It’s a bit like having a dark corner in a room where a bulb has burned out.  I have to find and angle a different light in that direction to light it up.  All children can learn- but for some, you have to search for different “lights” or strategies to activate the reading/writing/talking.

Twice-exceptional children are particularly fascinating to me- they have very fast connections that are very creative in their wiring.  Their synapses aren’t just fast, but they connect very unusual things around the problematic areas.  They have often re-wired their brains.  For more on this, I highly recommend Thomas West’s book, In the Mind’s Eye.  And my son is so very twice-exceptional.  His verbal abilities- the joke, the insight, the story telling- often hide the fact that he can’t actually tell you what he’s feeling.  They can hide the fact that his attention just shifted onto something else and he can’t make a decision.  That he can read a story fluently at the fifth grade level, but not be able to tell you what it was about.  That he’s not eating.

So… in order for a kid to talk/calm/sleep/ learn- they have to EXPERIENCE that feeling.  Most kids simply have the experience randomly and it happens more easily with practice, but some kids, for some reason, don’t.  Here’s my child who HAS experienced calm and relaxation- but rarely.  I don’t think he has the neurological connections where he can find them. He can’t find those synapses that help him calm down.

Can medication help him “learn” how?  This is the question… Some medications stunt the growth of synapses so that the child can do something while ON medication, and not have the foggiest idea of how to access that process without the medication.  The synapses occur ONLY because of the medication.  But some do- and some people brains let them, and others don’t.

The one time I tried “magic mushrooms”, a hallucinogenic drug (in college and I was curious), it was a great experience that freaked me out because although I was seeing rainbows, I couldn’t choose to stop.  I was clearly not in control of this experience- the drug was.  But I loved the creativity and the feeling of being aware of so many things around me.  I still remember at one point when I was grooving on the loveliness of a petunia (the sheer perfection of the shape of the petals- how they ruffled to music, the vibrancy of the blue, the horror of the worm holes and the tremendous effort the flower took to overcome that worm and how that worm could not keep that flower down- but then we all have to die, don’t we?…) When I came out of it, I realized that although the drug had taken me somewhere, it was a place that I could go on my own.  But I could come back whenever I wanted.  And ever since then, there are moments when I will just sit and admire a rose every now and then… really and truly appreciate it.  The drug may have laid down the neurological connection, but it was one that I could find again.

But some drugs inhibit the formation of synapses.  Heroin, for example (I don’t know personally- I’ve just read and I hear about on Celebrity Rehab with Dr. Drew) gives the person an amazingly good feeling where they feel powerful and happy and on top of the world.  So good, in fact, that when they come down, the body physically craves that feeling again (interesting note- very similar chemicals are released when you are first blindly, passionately in love with someone).  “You’ve lost that loving feeling” is a biological chemical let-down.  BUT, with heroin, the brain can’t find that feeling again, and that synapse is close to burning out, to be forever lost.  So, the person takes more and more heroin, trying to re-create that high feeling, only to keep losing it, bit by bit.  My husband and I just have to take a weekend to ourselves to get that feeling again because those neurological tracks are there- just lost amidst the day-to-day grind.  But some drugs- the addictive ones- are the ones that destroy synapses, not create them…

The same day that I learned about guanfacine (which for some horrible reason reminds me of the word “guano”- which is bat poop), I was listening to Oprah Radio on XM Radio on a long drive.  Dr. Laura Berman had a meditation expert on her show, who was extolling the virtues of meditation for adolescents, especially since meditation can reconfigure the brain.  I had read a few months ago how Buddhist monks have the best-organized brains- brain scans have shown how their brain operate far more effectively than most of us.  Their synapses are logical, clear and rarely stressful.

But my son has a VERY difficult time paying attention to meditate.  Plus, he’s seven- not the ideal age to understand what meditation can do.  It’s like trying to catch a butterfly when I’ve tried to teach him how in the past.

So here’s my medication/meditation plan.  We were thinking about introducing him to this medication (if doctor approves and teachers see it as necessary, etc.) and as he comes down from it, reminding him of what he felt like on it.  See if we can “trigger” that memory.  Introduce him to meditation when he’s experiencing calm.  And when he hits puberty (which messes with medication, etc.) wean him off and focus on meditation as a strategy, using the skills he’s learned over the next few years.

At least, that’s the plan today.  We’ve learned that with our kids, the plan may have to change.  Tomorrow, or next month- things may happen to change the plan.  We’ve had lots of plans change since they were born…

But this is Plan #173 and I’m hopeful.


  1. Came over here from MOM-NOS to answer your question; I’m not a health care professional, just another mom with a kid whose profile is somewhat similar to yours, and who has been taking guanfacine (aka Tenex) for 3 years now.

    Intuniv must be the new version I’ve heard about: they took this old drug — originally used to lower blood pressure, but since replaced by newer hypertension medications — and made a time-released version and gave it a fancy new name. As I understand it, some kids couldn’t take the old version because it lowered their blood pressure too much, too fast, and the new version doesn’t, because, needless to say, it’s time-released. Also, this way the drug company makes more money because this version is back under patent — the old version is very cheap, and made by a number of different companies. But I digress.

    Our doctor insists that it’s a rather mild drug. A bad analogy might be aspirin, yes it works but if you really want to wallop huge pain, you need something stronger. But if aspirin is all you need, great, consider yourself lucky. Which is what we do.

    Good Luck!

    Comment by Another mom — February 3, 2010 @ 9:52 am | Reply

  2. Thank you sooo much for your insight- I had read and read up on it, but wanted to know what it was like with REAL kids. Sounds like a possibility… and I LIKE the mild concept! I appreciate your coming over!


    Comment by profmother — February 3, 2010 @ 1:00 pm | Reply

  3. You’re welcome. If you end up giving your kid guanfacine and it doesn’t work the way you hoped it would, you can always call the doctor and say you want to stop (it doesn’t help everyone). It’s not a course of antibiotics, where if you don’t finish the whole bottle, you screw things up. It’s an experiment and you and the doctor are coresearchers.

    Comment by Another mom — February 3, 2010 @ 3:17 pm | Reply

  4. Good to know… I know that some meds like Effexor or Paxil, you can’t stop without some severe withdrawals. About how long did your child take it before you saw results? I’m sure it varies, but I’m just curious…


    Comment by profmother — February 3, 2010 @ 4:03 pm | Reply

  5. I can’t remember how long it took, that would probably be complicated by the fact that we started with a very low dose and worked our way up. We’ve tried out several different medications over the years and I vaguely remember that at one point we were cutting one set of pills in half (don’t think you could do that with a time-released version) in order to make the stair-steps up as graduated as they could be. But I’d guess we’d settled on the Tenex dose in less than a month.

    I’m under the impression that people who have to be weaned off their medications have generally been taking fairly significant amounts for significant periods of time. One of the attention medications we tried we scuttled after one tiny dose, it made my kid very OCDish (you can never know what any of these medications is going to do until you try them, which is why it is good to go gradually). Of course, we called the doctor immediately.

    Which brings me to my final suggestion (the next few days are very busy for me): When you are figuring out medications, it helps to have a doctor who returns calls quickly. We dropped one because she didn’t, in favor of one at our local chidlren’s hospital, because there’s always someone to answer the phone there.

    Comment by Another mom — February 4, 2010 @ 9:28 am | Reply

  6. Thanks for the advice- good to know! Our appointment isn’t for a while, so we’re charting right now… baseline data. And investigating options… I’m always open to Plan #174.

    Comment by profmother — February 4, 2010 @ 11:01 am | Reply

  7. Tinker Toys…fond memories of the summer. I needed that stimulation so very badly until my caffiene kicked in. I miss you!

    Comment by Tara Long — February 10, 2010 @ 9:17 am | Reply

  8. I miss you too! 🙂 Glad that the Tinker Toys made sense!

    Comment by profmother — February 10, 2010 @ 9:38 am | Reply

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