ADHD

[Belle]

Does anyone have experiences with ADHD that they'd be willing to share (PM me if you prefer?)? I am constantly debating with myself whether my son is just highly strung and very energetic, or whether it's something more. have spoken to the health visitor about it but the help on offer in Southwark is quite general - parenting courses etc - so am not quite sure what I'd do to get a diagnosis/support. It may on the other hand just be that I've done a bad job of instilling any disclipine, so maybe am subconsciously making excuses! But I'd be interested to hear people's stories nonetheless.

[Fuschia]

Might be worth seeing the gp?

Child no 1 was referred by school to sunshine house re possible dyspraxia

After he was dx with hyper mobility etc I took twin 2 to the gp for similar and she was referred to a paediatrician, quite easily.

I would check with the gp that the hv is correct about the lack of help. Does he go to nursery? How old is he?

[Belle]

3 and a quarter. He goes to nursery some mornings, they acknowledge he's a handful but we haven't seriously discussed anything more yet. Mind you as he's only there for half a day at at time, although they see some tantrums I'm not sure they see the full gamut that I do. My mum's a teacher and agrees he can be extreme but doesn't think as yet it's necessarilly ADHD. Think will go and talk to a sympathetic GP.

It's been making me question next steps re nursery/preschool - Goose Green nursery say their ratio is something like 1:11 which I gather is normal for school nursery, am sure it's fine for most kids but not sure how he'd cope give some of his meltdowns.

[Otta]

Definitely speak to a GP. It will take an experienced specialist to diognose at that age.

[Fuschia]

There is such a wide range of normal. There may be some issue of communication Or behaviour that becomes properly apparent later on or it may just be his personality. I tend to think even a part time nursery would have picked it up if it was very obvious.

Hope a sympathetic gp can refer you to an expert to look into it further

X

[Saffron]

My brother has profound ADD, and he was not correctly diagnosed until he was in his teens. Sadly this has caused many problems for our family. Correct diagnosis and medication has helped my brother some. I truly believe that had he been diagnosed earlier, he would not have fallen into many of the behavioural habits that cause him problems now as an adult.

That being said, 3 1/4 is FAR too young to properly diagnose ADD/ADHD, in my experience. Three watchwords for ADD/ADHD behaviour are inattentive, hyperactive, and impulsive. Most very young children can be easily distracted, have rounds of hyperactivity, and display various shades of impulsivity. However, by age 4 or 5, when most other children are displaying the ability to control their behaviour, settle down, and pay attention for longer periods, then the ADD/ADHD affected child begins to stand out from peers.

I would still press to see and expert if you're concerned, but don't expect to receive a clear cut diagnosis. Even an expert may want to see your child several times over the next 1-2 years before accurately making any diagnosis.

The question about nursery ratios is an interesting one. Even if your child does not have ADHD or any other clinical issues, he may just be a normal but very lively child. If you think your child would benefit from a different style of nursery school, it's worth asking different facilities what they offer and how they cope with "high need" children.

You sound like a very attentive parent. Don't be fobbed off by others who don't see the same behavioural issues to which you've become aware. I'm sure there must be more help on offer. It's definitely worth seeing a *sympathetic* GP.

[charlottep]

The other thing about ADHD (in addition to the markers that Saffron has pointed out) is hyper-focus. Often on very random things. So in addition to seeing the inattentive and hyperactive behaviour, you'd probably see one or two things that your boy is absolutely engaged by (maybe to the point of compulsion). My husband's family has a history of ADHD and the markers are very clear in my mind, although i agree that at your son's age it will be hard to walk away with a diagnosis. There is a very good chance that he's just very spirited. Despite our family history, I have resovled that my boy is spirited as although he can be a bit manic he is not exhibiting the other very specific traits i have seen in this condition. PM me if you want more information, I've spent a LOT of time sitting down with consultants (not for my son) specialising in this condition.

[helena handbasket]

Hi Belle! I thought I'd share my experience as my boy always sounds to be your son, a couple of years ahead.

As you know, my son has always been what I would consider textbook "spirited"..... but when he started school this year he just seemed so immature compared to the other kids. It seemed like the others had learned some level of control that mine hadn't. He didn't stand out at all in pre-school three months earlier, they were all hyper then. But he couldn't go with the school routines without a fight and then he'd just have these monster melt-downs if things didn't go his way.

He is the youngest boy in the class, so statistically 20x more likely to be referred for assessment than the oldest girl, but hey that's another story.

Anyway, after a lot of pressure from his school we have been to a Developmental Paediatrician as well as forking out huge cash for a private psych assessment. I just didn't want to wait for "the system" to figure it out, because as a teacher I've seen kids slip through too often (as Saffron mentioned).

Soooo, they assess for developmental disorders in sort of process of elimination. Asperger's and ADHD can be very similar, so we first ruled out a spectrum disorder. We have ended up with a diagnosis of ADHD for now, as it seems to address what he's doing in the classroom and provides him with appropriate support to his business.

BUT... he has tested as really gifted (99th percentile in a couple of areas), and there's a trait theory called Dabrowsky's Excitabilities that applies to gifted children. It resembles ADHD. In a couple of years we will absolutely reassess.

I don't think there's anything you can do until around five, because they are so immature anyway. What I would have done differently is sent him to a much more knowledgeable pre-school, so we might have been able to prepare better. We honestly thought that he was fine (but hard work). No easy answers I'm afraid. PM me if you want to know more, I'd be happy to share.

[helena handbasket]

I just re-read your post and wanted to comment about the discipline bit... as much as I don't love my child having a clinical diagnosis, there's something validating about knowing that I have worked bloody hard all these years and I couldn't have done better. He actually really is harder than the other children, just as I've been saying since day one! I know you have felt that way too, and I think it's just something you know instinctively as a parent. There's a long list of people I'd like to flip the bird at over the hard times they have given me over the years, but of course I'm wayyyy too mature for that:))

[Belle]

aw thankyou forum! reassuring as always. And thanks for the PMs too.

Reading these responses makes me think about perhaps putting off looking for a label/diagnosis for a couple of years, and focusing on getting his preschooling right instead. And I take on board that some kids are just spirited, and he may be just that.

HH - funnily enough I nearly put in the subject header 'Helena are you out there' as had a feeling you'd have both personal/professional insight to share on this! I agree, in some ways there would be some validation in knowing my gut feeling that he is more extreme than many others is right. Also, and without sounding like an annoying overly indulgent mum, I do sometimes feel that he is not in control of his behaviour, and it's less about naughtiness and more that he really has lost it and actually is scaring himself - yet I end up apologising for him and doing him down to others, which isn't necessarily the right thing to do. As such, Saffron's point about comforting the child once they've passed into the emotional stage and the anger has burned out is a good one, and one of the v few approaches i am having any luck with.

Thanks again for all the advice & PMs.

[bluesuperted]

Hi Belle, I think your approach above sounds really sensible, I don't know much (yet) about ADHD but I am about to start a PhD in the subject from October (in relation to language impairment but I will have to do a lot of reading about ADHD first of all) so if I can be of any help in future let me know.

x

[helena handbasket]

Belle my Spidey senses must have been tingling! I only take a peek once in a while these days, for nostalgia.

[cuppa tea]

I have similar thoughts myself (mostly during the challenging moments) with my own child. He's just turned 5.

Personally I don't necessarily think that rushing to have a diagnosis is all that helpful for a child. Children are all so individual that there will be so many variations within a 'disorder'. Once the child has a label you tend to see the label and not the child and their specific needs. Another problem with having a diagnosis, is that the children can feel that there is something wrong with them and this can create other problems. I think a diagnosis can be helpful for a parent in some ways. Other parents and teachers can be really unforgiving. It is always assumed that it's a parenting problem, a 'lack of disciple problem'. I've heard this ad nauseum. When I read the symptoms for ADHD they don't make sense to me, they seem to contradict each other....another reason I personally haven't gone down that route. It's a 'disorder' that suddenly becomes significant in school/nursery/formal setting where structure and compliance are very important. Some kids just don't fit into that, and have more complicated needs, but instead of changing the school it's assumed that it's easier to change the child :(

[Saffron]

Yes, diagnosis can be a double-edged sword if not subsequently managed sympathetically. Also, you're quite right to suggest that the perspective on whether or not something is a disorder is in fact partially attributable to society's view on what is "normal". See my previous post on ADD/ADHD here http://www.eastdulwichforum.co.uk/forum/read.php?29,854520,854530#msg-854530

[cuppa tea]

That's an interesting thread Saffron. Sort of also makes me think of why the more 'conventional' ways of parenting my son have never worked very well. It doesn't create the right environment for him to thrive, or get to the root of any problems. The things that seem to help are more of a 'working with' approach. The firmer discipline is just a vicious cycle and perpetuates the problem. In a school context, that 'normal' and 'average' are what is easiest for the institution...but not necessarily helpful in later life. I also don't understand how anyone can tell where a personality stops and a disorder begins, particularly with ADHD. Never mind the million different ways parents raise their children. Misdiagnosis must be rife!

[helena handbasket]

Cuppa Tea, seriously? If everyone is assuming it's a parenting or discipline problem, then obviously there would be no thought to thoroughly examine the child to see what is going on, hence no diagnosis. The whole point of going the diagnostic route is to see if there are other explanations for the behavior. I don't think very many people are "in a rush" to have their young child diagnosed with anything. That's silly (and actually a bit insulting if I think about it). Nobody goes seeking help for invisible problems. But when behavior is causing problems, looking for answers is the right thing to do. If those answers lead to a diagnosis that helps your child get support, then how is that a problem? When your child's behavior is perceived as bad but you don't believe they can control it, you need to advocate for your child. The school can't accommodate your child if they don't understand the behavior. And if your child is having behavior problems in the classroom then guess what? The other children already know.

As it is, my child will now have the best access to resources available. We now know his strengths and weak areas and can work with the school to make sure his needs are met appropriately. This is worth more than gold to me.

As a middle school teacher,I don't know how many students I've taught who have clearly slipped through the system undiagnosed, and it's not something I would wish for my child. But to each his own I guess.

[helena handbasket]

Have read your link Saffron. Interesting.

Well first of all, I won't be drugging my child. I will work with the school to write a good IPP (individialized program plan) suitable to his needs. At home we have a good rhythm already. I will probably stop saying "you never listen!" though :-$.

Secondly, the assessment was incredibly thorough, including sleep and sinus issues. These people are not amateurs.

Finally, tantrums aren't what I felt were the deciding factor. My son literally can't be still. I don't just mean fidgeting, he constantly seems to have the need to move (even when still, if that makes any sense), and I felt strongly that there was a psychomotor drive in him that I don't see in others. I thought honestly about how busy he's always been, I mean really driven, and I did a huge amount of research to understand the difference between personality and clinically significant traits. That's where "normal behavior" ends and a person starts to fit into a group (label, whatever you ned to call it).

Now the need to do his "happy dance" at inappropriate times is written into his plan and an accepted part of his personality, as it should be.

[cuppa tea]

I wasn't out to insult anyone...I'm talking about my own son and referring to the OP's child who is only just 3. Not yet school age and still very young. I wasn't saying the problems are invisible....I was suggesting that outside of the school environment, the more specific needs of certain children can be met more easily. School is part of the problem.

You've done a 'huge amount of reasearch' and are clearly an advocate for your child. That's great! Some people do not have the capability to do that, or communicate and work with a school. That's a worry I think.

[Saffron]

It's important to keep an open mind about both diagnosis and treatment.

It's often difficult even for a patient to know where her own symptoms end and her personality begins. As previous posters have suggested, diagnosis is often a case of excluding other problems, whether physical or behavioural. Do hold in mind however, that there are very specific criteria for any diagnosis, and that psychiatrists and psychologists have trained for many years as specialists in their fields to help identify and treat such problems to improve the quality of life for patients and their families.

Many children will benefit from behavioural intervention alone, but a few will require something more. If at some point physicians believe that drug treatment would be advantageous for a child with ADD/ADHD, then it's important not to dismiss drug treatment out-of-hand.

Belle, you seem like you're actually pretty well on top of things with your son. Seeking support from other parents, whether or not your son is ever dianosed with any disorder, is brilliant. I hope it helps you and your little one find new coping strategies. xx

[Belle]

I'm resurrecting this thread because I'm more than a year on and am still (at times) wondering about this. Son is now nearly 4 1/2, goes to school nursery & starts reception in September. Following this thread last year I did as I think I posted I would, a kind of 'watch and wait' strategy, plus started him last Sept at school nursery which he settled into very quickly and was largely successful. however we seem in the last few months to have moved into another really difficult phase, and for the first time the descriptors of ADHD are really making sense, particularly the 'impulsiveness' strand. There are times when he literally can't seem to stop himself doing something, and often this involves something highly dangerous. So that might be - scooting in front of a moving car, because i've specifically said not to - running on the road in the same scenario - breaking things almost compulsively - and most recently, hitting/pushing which hasn't been a very regular feature of his behaviour till now. Basically all that energy he's always had is starting to turn a bit aggressive which really concerns me. I have tried the whole spectrum in terms of disclipine - time out, carrot and stick, reward chart, removing favoured toys, removing promised treats etc, promising rewards for good behaviour - but it is as though he is possessed and utterly beyoned reason at times. And nursery, who have up until now insisted he gets along well there, have started saying he's not listening, playing up, quite hyper etc. I'm not looking for labels but I am looking for context. I did a few searches online and found other parents with v similar (and same age) children which is kind of making me feel this is not necessarily about my crap parenting! So to that end, Helena (if you're there), cuppatea, charlotte and BST I'd really value yours and anyone else's personal and professional experiences!

[Belle]

and saffron too!

[fapl]

Hi Belle, I have similar aged boy and am in the same situation as you :-)

Very difficult, seems more difficult than other kids his age, but what exactly is normal? My son is at a really fab preschool, I raised my concerns a few months ago, they spent the last few months observing him and recently sat me down and suggested it may be worthwhile referring him to a paed. for an assessment. (the preschool have in no way suggested any possible label, I am the one that thinks he screams ADHD diagnosis).

My brother was diagnosed ADHD and there is something about the diagnosis that does not sit comfortably with me. I have been completeing a course on coursera https://www.coursera.org/course/adhd (universities from around the world, but mainly US, put college courses on line for people to study for free), to try and educate myself as to the current mainstream medical opinions on the disorder. The lack of answers as to cause and why treatment options work/don't work leaves me with not much confidence in the medical profession. I just don't think meds seem like the right long term solution. They are a solution for getting kids through the school day perhaps, which does probably mean a lot to some people, but things would have to be really bad for me to ever consider it (and I do not intend for things to ever get that bad). Even sending parents on parenting courses etc. what about when children are in other environments where people have not had specific training to deal with ADHD type behaviours?

I have just started reading about a few alternative therapies. I read a book "Is that my child" http://www.amazon.co.uk/That-Child-Dyspraxia-Tourettes-Childhood/dp/0753510642 and a lot of it had some resonance to me (although you can see from the amazon reviews his opinions polarise people, he is not a medical doctor, he is a chiropractor, and some things he talks about has no scientific basis, but as far as I am concerned the scientists do not have the answers anyway). Basically he combines a few different ideas, the main one being diet and nutrition is really important, he recommends omega and other mineral supplements to help with brain development, and also specific physical and computer based visual exercises to help underactive areas of the brain develop.

Reading up on these alternative views, I do believe there is a high chance my son with ADHD behaviours may have trouble with visual and auditory processing. Basically his brain may be having trouble distinguishing the various sounds around him and does not know what to filter out. He can definitely hear, but often does not seem to listen and it can be difficult for me to get his attention. You can google auditory integration training or Tomatis. Also, visually he often has trouble seeing things under his nose and he is proving to be more clumsy than his peers, even though he walked form 11 months so from an early age I thought he had advanced gross motor skills.

Here is a private OT practise (I know nothing about them other than their website, but it illustrates the kind of things I am talking about) http://www.hemispheres.org.uk/ that offers various different treatments, both auditory and physical exercises. I am looking into various treatments (not done anything yet) as I think at worst, we will waste some time and money, and at best we may really tackle some of my sons issues and boost his brain in a meaningful way so he can manage his own behaviour better (not just external methods of parents/teachers etc. trying to manage him, and meds only work for the time they are active in the body). Might all be a bit woo for some...

Martial arts are also supposed to be good. That sort of ties up with the whole physical exercise developing the brain thing so that makes sense to me.

Richard Branson, Justin Timberlake, Will Smith and loads of other successful people who have been diagnosed ADHD, so as long as I ensure my son has high self esteem and does not fall in with the wrong crowd, I am not worried long term, but I think the school years will be difficult.

That was long.

[helena handbasket]

Hi Belle! Funny how I manage to catch this in the rare event I poke around here.

Well, where do I start. First I have no idea how I feel about the concept of ADHD, if it exists, what it is...... I do start to wonder about any "disorder" that seems to include so much of the population, particularly whatever the numbers are... 5? 10 % of little boys? A cluster of traits, often ambiguous and often at the mercy of the objectivity of the observer. Having been through the process, there is a scary amount of room for confusion and assumptions, and "best guesses". I've spent a full year now trying to understand. Here's what I have learned:

It's been a real rabbit hole, frankly. I was of the opinion that my son was difficult but normal. I still mostly believe that, although I do see him still doing things the others have largely outgrown. He still gets upset and frustrated easily, he sometimes can't stop moving/rolling etc at carpet time but can sit for ages if the assignment is appealing, and just generally seems younger than the others. Is that enough? Who knows.

I made the mistake of enrolling him in a very academically high achieving school, which I thought might provide some structure etc. but has actually been the worst for him. It's a highly controlled environment where sitting quietly and just following directions is highly valued, and I thought it was hard to find flaw in that. Honestly it's completely broken him. I felt very pressured into having him assessed, and am of two minds about the whole thing. I felt that at least having a diagnosis would get him classroom support...... it didn't.

I am now of the opinion that his difficult temperament was a problem for his teacher, who honestly was cold and detached with him. He's very shy and sensitive, and I believe in my gut that this was what caused him anxiety, which led to him avoiding a lot of classroom activities, which was interpreted as defiance and inattention. See where I'm going with this? I recently spoke to another psychologist (she did not assess him) who suggested it sounds like gifted/anxiety (which can look like adhd), and sounds more likely to me. I have no idea. Nobody does. And that is where the diagnostic criteria falls short.

Anyway, we have done all of the recommendations. We did a course of OT (slow your engine down strategies), play therapy (the therapist felt that he was age appropriate and a high sequential thinker) and he then suggested we try group therapy to see if a social dynamic would bring out the problems. It didn't- they said he was great! The computer based stuff (CogMed) requires him to sit for long periods of time and tolerate boredom (ironically) and is very expensive. We didn't do it.

We also do the omega's and magnesium (this as powder in juice or epsom salts in bath). We tried elimination diets (particularly gluten) but saw no difference. Obviously we don't load him with processed foods or dyes, so pretty sure diet is not an issue. We're strict about sleep. I stand by my aversion to medication, certainly at this age. I'm not interested in chemically altering his developing brain just to keep him in that school. Maybe later, when he can at least articulate how he feels. Plus I've sat through too many depressing support meetings with people who spend the evening discussing side effects and the horrors of trial and error. No thanks.

Sooooo, what's left is school environment, which we are leaving at the end of the year. He has really come along and has made great progress (even at school), but he's also a year older so I wonder how much if it is down to TIME? I feel that what we really need is stop it all, and just let him develop at his pace without all of this crazy. We've come up with a somewhat radical solution (pm me if you want), but it's still pretty frustrating that it has come to this. There are some really great books out there that discuss our exact situation.

Sorry! All this and no answer for you, Belle. I guess what I would do is really find a school program that is willing to listen to you and work with you. Do a bit of networking to find out how each school handles these issues..... some schools are more assessment happy than others. Some need to "fix", and others are better skilled at working through it. A gentle, patient teacher may just get him through, at least until you both agree it's more than just "being him". I know, you don't exactly have the luxury of shopping for schools.

The shit of it is, there's no good answer.

cuppatea, this is absolutely true, and scary: You've done a 'huge amount of reasearch' and are clearly an advocate for your child. That's great! Some people do not have the capability to do that, or communicate and work with a school. That's a worry I think.

[helena handbasket]

Sorry, you totally have it right here. When I responded last year I was reeling from the stress of everything.

cuppa tea Wrote:

-------------------------------------------------------

> That's an interesting thread Saffron. Sort of also

> makes me think of why the more 'conventional' ways

> of parenting my son have never worked very well.

> It doesn't create the right environment for him to

> thrive, or get to the root of any problems. The

> things that seem to help are more of a 'working

> with' approach. The firmer discipline is just a

> vicious cycle and perpetuates the problem. In a

> school context, that 'normal' and 'average' are

> what is easiest for the institution...but not

> necessarily helpful in later life. I also don't

> understand how anyone can tell where a personality

> stops and a disorder begins, particularly with

> ADHD. Never mind the million different ways

> parents raise their children. Misdiagnosis must be

> rife!

[Saffron]

Belle, has your son been for any recent professional assessments? As far as I understand, the concensus on medication for very young children is that it's a treatment option of last resort, so at this point your son should be being assessed to see what type of behvioural-based intervention would be helpful. He needs a psychological "toolbox" of coping skills as much as you do. That way you and your son can try to work with eachother, even though he's very young, rather than you feeling like the disciplining is all down to you and then doubting yourself. If that makes sense? xx