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QueenBee
06-03-2011, 08:39 PM
I need advice!
How important do you think having an ADHD evaluation is?

I am looking at having my youngest (7) evaluated and I am confident - oh so confident - at the diagnosis - ADHD. Specifically, I am confident that she will fit into this category:

"... the Predominantly Hyperactive-Impulsive Type. For these individuals sustaining attention is not their major difficulty, but controlling their actions, thoughts, and
movement is."

Her lack of impulse control is beginning to be a REAL problem. I don't know how to handle it as she is getting older and bigger. Whatever I'm doing clearly isn't working. I feel like I've tried all the suggestions from the many books, articles, etc. She is easier in many ways than when she was 3 and 4, but in other ways it is more difficult as the lack of control is different (e.g., instead of cutting our curtains to pieces as she did when she is 3 she is stealing little things from stores at age 7 - even though she "knows" better she simply has no impulse control). I worry that this will lead to bigger problems as she gets bigger and bigger.

At the same time, I'm not sure what I think I will gain with having her officially diagnosed. I'm not pro-medication (I'm certainly not anti-medication either) although I'm starting to think we may end needing something if I can't figure out how to help her without it. I'm not sure how having an official diagnosis will affect her long-term - how will it affect her medical insurance as she gets older?

Has anyone been in this position? What did you decide? Any advice to pass along? books? etc.? I'm at my wits end. This is such a different type of ADHD - it's not that she won't sit in her chair, etc., b/c that is honestly the least of my concerns at this point although she is hyperactive... I'm so torn. Argh.

Sorry this is so long!!

AddlepatedMonkeyMama
06-03-2011, 09:56 PM
My son was diagnosed--if you can call a 20-minute conversation with his pediatrician a "diagnosis"--with ADHD about a year ago. I think he's the combined type, both inattentive and hyperative/impulsive (lucky us). Medication does help with impulsive behavior, but it can have unwanted side effects. Have you been reading the thread that Batgirl started about that?

The best thing we've found for the impulsive behavior is to have an immediate, consistent consequence such as a timeout or a small fine (your daughter might respond to something different). Eventually, the cause-and-effect connection seems to rewire his brain and he remembers not to do those things. Doing this has helped with infractions such as name-calling (at parents) and taking change off my husband's dresser. It is important that we stay calm and give the punishment without emotion or lecturing. For destructive behaviors, we've told him that he will have to pay for any damage he causes, even if it means cancelling one of his activities (we've never had to actually do this, but the boy loves his money and the threat is enough to make him think twice about it). I still have to watch him like a hawk, so I can intervene when he's about to something impulsive like drop a sizable rock on his sister's head. He keeps me on my toes, that's for sure.

The book that inspired this approach was "Transforming the Difficult Child" by Howard Glasser. Overall, I didn't really like the book. It's poorly written and and he seems to work from the premise that kids misbehave because they find it entertaining to watch their parents blow their tops. He's also very anti-medication. But I did glean a few very good tips that have helped with the impulsive behavior and defiance. He also has a point system that we used for a while (the novelty wore off after a while, so we stopped). You make a chart of positive behaviors (completing chores, being kind to siblings, using good manners, etc.) and award points at the end of each day. The points can be used to "buy" certain activities or privledges such as watching TV, playing video games, going out for ice cream, etc.

MarkInMD
06-03-2011, 10:31 PM
I think we've got one ADD (Hurricane) and one ADHD (Tornado) on our hands. Hurricane is very scatterbrained when it comes to completing a task (they both are, really, but H is older, so it's more noticeable), and Tornado's impulse control and short fuse are definitely issues. For the next two weeks we're building up (hopefully) to a "No Fits" Party for T. He can't lose control or he won't get his party at the end of that time. We can do that with him because quite frankly, he's only that way with us, which is the highly annoying part. In his PS setting, with grandparents, other kids, etc., he's one of the easiest kids to get along with. At home, totally different. So he has some control over it. We just need him to prove that he can with us. If he can, then we'll have a better idea that his problems aren't too severe compared to others. If not, then we might go the diagnosis route.

As for Hurricane, we've had discussions with him about the possibilities of medication to help him concentrate, because it's really starting to affect his abilities to do the things he needs to do. For example, in his karate class, he's getting to the advanced levels, and his slowness on the uptake is starting to show. He knows the techniques, but he starts looking around the room to see what others are doing, whether it's connected to his activity or not, and then boom! What he was supposed to do has passed right by him and he looks like a fool. For school, he gets sidetracked so easily into tangential conversations that it's maddening to try to accomplish certain subjects with him. However, he really doesn't want to take any meds, and I would rather he didn't either, but I have to say: he's going to have a tough row to hoe if he can't pull it together on his own.

We try things like charts as AMM has said, but unfortunately we're not able to be terribly consistent with it because of our wacky evening schedules most of the week. But when we have implemented it, it's worked quite well. Might be worth a try. I think it's not as important to have a diagnosis as it is to recognize what works for you guys and what triggers the negative behaviors. Diagnosis would only be necessary if you absolutely have to go the meds route.

Batgirl
06-04-2011, 12:59 AM
I'm always in favor of getting more information. A diagnosis might be helpful if your pediatrician is knowledgable. You'll have a chance to confirm that it is ADHD and not something else that looks similar and you can have a frank discussion about medication. When I spoke to my doctor, her opinion was that you need to take a multi-pronged approach--you need start medication, behavioural modification, and a modified diet simultaneously to be successful in treating it. This was HER opinion; we've only just started working on my son's adhd in a concerted way, so I haven't formed my own opinion yet. One book I've found helpful is called Parenting Children with ADHD by Vincent Monastra, He gives tips for medication, behaviour and diet. I've found the book to be very readable and practical and it described my son's behaviours to a T, which was an enormous relief. I also second AddlepatedMonkeyMama with regards to dealing with the impulsive behaviour. That approach has been very effective for us as well.

I also wanted to say that I've never been very good about maintaining behaviour charts and Monastra sets out an approach in his book called "Work Before Play" that is much easier to implement for those folks (like me) who aren't terribly organized themselves and need something more flexible.

Busygoddess
06-04-2011, 07:39 AM
When it comes to ADHD, here's my thought: If you are planning on getting professional help - meds and/or therapy - get an official diagnosis. As long as you are trying to deal with it on your own, just do research - books, websites, pick brains of other parents of kids with ADHD - and treat it as though they do have it.

Both my kids have combination-type ADHD. I knew from very early on that they both had it. We don't bother to get an official diagnosis until we feel the need for meds or other outside help. I have combination-type ADHD & my dh has inattentive-type ADHD. We do our best to work with them until it becomes obvious that we will need more than that.

We've dealt with the stealing issues with my dd. Although, she has never stolen from a store (not to my knowledge, anyway). She has stolen food (entire jars of peanut butter, anything sweet, bread, etc.), she has raided nmy jewelry box, she has stolen from grandparents. It got so bad that we had to put locks on the fridge, the pantry, & my bedroom. Nothing we tried (with or without therapy) really helped (though her stealing issues were partly from her Bipolar). Age seems to have been what helped (hitting puberty often helps ADHD symptoms). In your situation, I would take her in for a diagnosis. Therapy & behavior modification may work well for her.

If you decide to get an official diagnosis, you should take her to a child psychiatrist or child psychologist, preferably one that is used to working with children with ADHD. Most physicians & pediatricians are not actually qualified to diagnose ADHD (though many of them will diagnose it & prescribe meds for it anyway). Not all Drs will push meds. The child psychiatrist we see prefers to use meds as a last resort. Before choosing a psychiatrist, ask some questions about how they treat ADHD - if they automatically prescribe meds or prefer to try other methods first.

My dd is on meds for her ADHD & her Bipolar, because right now she needs them. My ds is not on meds for his ADHD, because (for now anyway) we are doing well without it. So, it really depends on the child & situation.

Eileen
06-04-2011, 08:57 AM
I think, if your insurance covers it, it can't hurt to get an evaluation done. It can be a little scary, if getting a diagnosis like that might be upsetting to you, it's really not so bad. I found the evaluation very helpful and was able to gain some insight into my dd's behavior. Yes, she has ADHD, but they also found that she has a mild auditory processing disorder which explained some of it. Some other stuff too, and the upshot is that we decided to try a non-stimulant adhd med. But, if we had decided not to, that would have been fine too. I think an evaluation is great because I believe that the more complete your information is, the better position you're in to make decisions.

QueenBee
06-04-2011, 10:16 AM
Thank you all so much - you've already given me lots to think about, and it is good to hear from people that understand. Some of my friends have kids with ADD/ADHD but don't homeschool so it's a different game all together. I will definitely be asking some preliminary questions when I call - I think I will bring her in. Our pediatrician recommended it two years ago (when she was only 5) and she passed an initially screening by the psych. department at our local childrens' hospital, but I took her off the list. I recently found a child psych. practice closer to our house so I think I'll call there. I guess I'm sort of one that avoid medical involvement for whatever reason, but I agree about getting more information. I will be looking at reading the above-mentioned books - the one I've read that I enjoyed was Living With Intensity, but that isn't a book about how to cope practically... Anyway, thank you all!!!!!! This is the best forum!!!

CCMom
06-14-2011, 08:46 PM
Hi. I'm going to go post an intro in a minute, but wanted to post my thought here before I forgot. My daughter is 8 and I'm certain would be diagnosed with ADD/ADHD if tested. She also has a variety of other issues. At this point we've chosen to forgo ADHD testing for her since we wouldn't do medication at this point. We just work. On ways to help her focus better and adapt our educational-style to best fit her needs. I can't say it's been easy and there are days where I have to walk away because I get so frustrated with her inability to focus.

What has helped? Style-wise, I've dramatically reduced the amount of "sit down and do work" schooling that we do. As we just started our new school year I've created an artist-based, Charlotte Mason-esque plan that is mostly reading and discussing subjects and lots of field trips. We do sit down math because she really needs more help in that area. In addition, we've started supplements for her. Fish oil seems to really help even out her brain and theanine helps her anxiety. We have also given her phosphatidyl serine. It seems to help with focus some. (I have ADD-esque issues also and the phosphatidyl serine seems to help me.)

Two books I really, really like are "Superparenting for ADD" and "The Gift of ADD". They both offer support for the idea of treating ADD as a gift and not a disability. The Superparenting book is by two M.D.s and really changed my way of thinking. It's still difficult, but I really try to look at the positive attributes about how her brain works and how to encourage those areas.

QueenBee
06-15-2011, 09:14 AM
Thank you, CCMom! I appreciate the response and the insight. I have not read either of those books. And I haven't heard of phosphatidyl serine so I'll look it up. We did give her an Omega supplement for a while and I didn't notice a difference, but perhaps I didn't give her enough. It's worth trying again anyway!
Thanks again!

Scoobymummy
06-22-2011, 09:51 PM
Just wrote a looong response and managed to delete it. Argh. I'll start over.

I'm not a big fan of labels. We've gone through our share of them....Spirited, Sensory Processing Disorder, ADHD, Learning Disabled.... In the last couple of years, we've discovered that ds has an autoimmune disease which definitely affects his ability to cope - so is it ADD or the autoimmune problems at play?

I think as a homeschooler, in the end it doesn't matter. He is who he is - a unique individual who thinks differently from the norm. Here's another label for you - a right brain learner. It gets a little closer to the reality and is a bit less negative, so I generally use that one. He thinks predominately with the right side of his brain. Being RB brings many gifts, as I'm sure you've seen with your child. He's creative and innovative. He sees things differently from the rest of the world. It also brings with it emotional and behavioural challenges. These kids are intense and spirited. They are easily frustrated. They can't sit still. They need to move to learn. But are they flawed? I don't think so. They're just different from the norm (as were a lot of really gifted people).

In our home we spend a lot of time figuring out how to cope in the world. For example, when ds was smaller he had to learn that yelling at his friends when he got frustrated wasn't OK, so in a quiet moment we figured out what would work better. Initially, he would tell me we needed to leave. As he matured, he started finding a quiet corner to read or would take a walk to centre himself. Now he'll ask to speak to me privately if he needs guidance. Helping them navigate their emotions is really important. It's been a long bumpy road with lots of ups and downs, but at the age of 10 he's really become a delightful child.

Homeschooling is the perfect environment for these kids. You can structure your life around their rhythms. One thing I discovered through talking with other moms is that these kids have their own developmental stages. They don't seem ready to read until between 8 and 10. They don't write until between 11 and 13. That's not to say that they're delayed. They develop a lot of other skills earlier (for my ds it was higher level thinking skills, oral skills). These aren't 'sit down and do curriculum' kids. These are the kids that will lead YOU - that will show you when they are ready to learn a specific skill.

Some resources that really helped me are:

http://applestars.homeschooljournal.net/2010/03/12/timeframes-challenges-and-disabilities/

http://www.throwingmarshmallows.com/home/more-purpose-driven-adhd.html

http://groups.yahoo.com/group/homeschoolingcreatively/

Books:

The Spirited Child (Mary Kurzcinka)
The Explosive Child (Ross Green)
Right-Brained Children in a Left-Brained World (Jeffrey Freed)

The Spirited Child by Mary Kurcinka

I hope that helps. Parenting these children is really challenging but so incredibly rewarding.