Our son is about 50 lbs. at age six and just went on an increased dosage of Concerta to 36 mg. (two 18 mg. tablets). It made all the difference in behavior problems during the first weeks of school this year.
What type of MD is handling the medication right now? Unfortunately, a psychologist can't do anything about medication but a psychiatrist can. You might shift the appointment so you can get the appropriate guidance. It may be time for a new medication or just an increase in the Concerta.
HI, and welcome
It sounds as if Concerta is not the right med for him, or he needs a larger dose. 18 and 27 mgs are in the lower range, and he may just need more. Alot of kids needs med tweaks frequently.
A child may HAVE ADHD, but it is not what they ARE. Never tell a child they ARE ADHD.
My son (7) is also on Concerta. Right now he is on 27 mg and is doing good. Towards the end of the school year last year, we had to up him to 36 mg and there was immediate improvement.
Oh, good grief, Concerta is NOT based on weight!!! It's based on effectiveness...honestly, that sounds about right to me for 10, that he might need more than 27 mg. Sounds like you're doing the right thing by taking him to a specialist.
Concerta worked *great* for my kid, until we maxed out & the top dose we could give him at that age was no longer effective (he was 10, I think, and it's 54, lest you be curious). We went to Focalin--same active ingredient, but more purified. The release profile is also different--Concerta basically gives you 3 spaced-out doses of the med, and Focalin only two, so it lasts less long. This is NOT a plus for my kid who seems to metabolize quickly!!
Anyhow, there are other classes of med too--though, to me, it sounds like he's responding fine to the ritalin class (Concerta, Focalin, etc, ), but that he needs more.
You said private school--but I think even private school kids have access to the public school testing programs? I know you can't do IEPs with your school or anything...anyhow: you might *also* want to get him evaluated for any kind of learning disability, basically as well as the ADHD. Can the school give no help, like a separate space for him to take his tests in, where it'll be quiet? Is he at least getting what they call "preferential seating"--so further away from distractions, possibly nearer the teacher? There really are a lot of subtle techniques teachers can use--my kid, even on effective meds, had lots of problems writing in 3rd & 4th & probably 5th grade--one thing his teachers would do is drop a little block on his desk every 5 minutes, just to get him back in--at one class, he was supposed to write a sentence for each block. It kept him from completely zoning out into his own world during writing time, and now, he's pretty competant (ON meds. OFF meds, it's a horror show, poor kid. And don't get me started on 7th grade homework & how I'm supposed to get the kid medicated for homework but also asleep at a rational hour...)
The "what med & how much" dance is, I'm afraid, fairly continuous. We seem to revisit it (but not necessarily increase meds) about every 6 months, specifically fall (school starting) & spring (sometime in March/April). It's been enough years now that I know the pattern, and my kid is, I hope, getting better at knowing when he needs more. But as we go higher & higher in Focalin dosage, I worry about what is NEXT--my pediatrician is excellent (and specializes in ADHD meds!), and tells me not to worry until we actually GET there, anything can happen with puberty anyhow, so why worry in advance ;}. Anyhow, I'm just trying to say, yeah, it's really awful & incredibly hard to detect when they need what (there is a MINT for someone who develops a little light that lights up when they need more meds) & then trying to tease ADHD out from personality & ability, blech. Hang in there, you CAN do this, you ARE doing the right thing by getting a more expert opinion, good for you!!!