Disturbing behavior from our son.

Having a child with ADHD makes mornings a trying time in our household.  Especially coupled with taking 10 days of antibiotics for strep throat.  Every morning and evening for the past 6 days has been the same mantra.  Take the pills, have you taken the pills, this is taking too long!!!!!  I've tried every trick in the book from rewards to taking away treasured toys and nothing works.

Today we're going for a Medicine checkup.  He's been on Metadate CD for almost a year now.  Things have been going well up until the last few months.   His concentration and behavior in class is sprialing downward.   I'm hoping a change in dosage will help.  

Recently Jake has started using a pencil to dig into his hands.  His palms are covered with little puncture marks.  I'm struggling to not shut down and spiral into despair. 

Bob and I have sat him down several times to try and figure out the cause.  We've told him he's not in trouble and we're not angry with him, but are concerned about him hurting himself.  When asked how it feels when he does this, he says it feels kind of good. 

He tell two different stories of why; one is that no one listens to him and the other is that he does it when he doesn't get his way.  Bob caught him picking at his hands last night when he we wouldn't let Jake sleep in our room.  Bob discussed it with him and asked if he's doing it for attention and he admitted to this.   But he's only 7 so who know how much of what he says is what he thinks we want to hear and how much is the truth.

I'm hoping the Doctor can shed some light on the situation.  I'm trying not to panic until I hear what she has to say. 

He's come so far in the past year, made many improvements in his school work and at home, but lately he's become argumentative and rude.  He trys to be a goofball for attention but doesn't understand that the things he says sometimes are inappropriate and hurtful.   He's not following directions and appears not to hear us when we ask him questions.   I know some of these things are typical 7 year old things but it's hard not to become frustrated and keep our patience. 

He's always had some social issues; i.e. not knowing when he's too close or listening when people ask him not to hug or to let go.  Social cues are hard for him to understand.  

I'll post more when I have some definitive answers later.