Friday, June 27, 2008

If It Walks Like a Duck

I went to a seminar the other night offered by Noah’s school. It was an invitation-only event for the parents of kids with “identifiable problems”. We certainly have a problem, I am not sure how identifiable it is.

For those of you in need of a catch-up, Noah’s kindergarten teacher thinks he should be tested for ADHD. We took the Connors Test for ADHD (One of many tests available, in which the parents answer questions and the teacher answers a different set of questions and it is scored). The teacher gave him a very high score and we here at home gave him a low one.
But then, the issues we have at home are different. At school it is hyperactivity and distracting other students. At home it is sudden bursts of anger, negative talk about himself, and sudden bursts of furious rudeness when a moment before he was a cheerful boy.

I got to spend a good 20 minutes talking with a therapist from the school system. The topic was supposed to be what to expect from therapy and how to find a therapist that is right for your child. We did talk about that, but also about his symptoms. We talked about his issues at school and when I said, “he just doesn’t exhibit that behavior at home”, she sighed and said that THAT phrase is one of the things you hear over and over again from the parents of a child that is later diagnosed as ADHD.

In the second session, which was actually about ADHD with a specialist, I brought up the idea that it could instead be early signs of bi-polar disorder as that would explain the mood swings and occasional depression we see at home as well as the bursts of creativity at home and the hyperactivity at school. They asked if I had B-P disorder in my family.


Does my husband?


Does anyone in my family have ADD? Yes, my brother and his son. Does anyone on my husband’s side have it? I thought I had heard that Michael's brother did, too.

Apparently both disorders are highly genetic.

I had a long talk with my brother yesterday who described to me what ADD feels like (he does not have the H=hyperactive) and also explained that his son, who was diagnosed around Noah’s age, was experiencing low self-esteem and depression symptoms, too. In fact, they concerned the psychiatrist more than the ADD did.


But still I persist in my doubts about Noah having ADHD. He does exhibit a few of the behaviors. But there is a good deal of symptoms he doesn’t exhibit. And a lot of the ones he does show COULD be chalked up to “being a boy” and lack of maturity. He is one of the youngest in his class.

But, geeez...
* The teacher believes he probably has it.
* The doctor who never met him but heard all about him agrees it’s likely he has it.
* “He doesn’t exhibit these symptoms at home” is a common thing said by parents of ADHD kids.
* My nephew had personality changes and low self esteem before diagnosis (which resolved after he finally went on medication after trying other methods for awhile).

* It is genetically passed on and seems to be in both our lines.

I guess I have moved from being on this side of the fence to being officially on the fence.

We got a referral for a great child psychiatrist who (thank heavens) is in our insurance network. He has been given accolades by his peers for being one of the best in his field in the county, and has been described as a very conservative doctor, who does not pass out ADHD diagnoses as if they were candy, like some doctors do.

There is a part of me that is actually hoping he has ADHD. If so, I will have an explanation for some bewildering and difficult behavior and therapies to treat it. If he doesn't have it, we may be dealing with something far fishier and difficult to pin down, to parent, and treat.

Until then, three more weeks of school until the end of Kindergarten.


Snowbird said...

I'm glad that you got to talk to Dave last night. I'm sure that helped. And,yes, Sam is a totally different young man today that he was 10 years ago. Very sure of himself and who he is.
ADD yes, but very much his own person now. I'm also happy that you have the name of a good child psychiatrist who hopefully will be able to give you some answers. I will be anxious to hear what he has to say.

Cindy said...

*hugs* That has to be so frustrating not knowing. I know you didn't ask for advice, but I would go with your gut. Don't let "professionals" put a label on your child you are not comfortable with. I'm not a big fan of "your child can't sit still, so he must have ADHD". I feel that diagnosis is much overused and that those who do truly suffer are merely just medicated. There are exceptions of course but I'm leary.

Also, for us about a year ago we were dealing with outbursts of anger and chose to cut out Red dye #40 out of Preston's diet. It really seemed to help. I have mommy friends that have done the same and swear by it. I have also heard the same with HFCS (high fructose corn syrup) but we have not felt it necessary to cut that out, we try to avoid it but not eliminate it. I have a few articles I can share related to these topics if you are interested. Again, all this is unsolicited so if you're already doing those or not interested, sorry.

I hope that I haven't come across as some fanatic or anti-ADHD. I've not personally been down that road, but wanted you to know I care.

Shama-Lama Mama said...

Hey Cindy,
No, of course I don't mind advice at all. That's kind of why I started this blog, to get some conversations going with family and friends.

I, too, am leary about the over-diagnosis of children. Luckily, the psychiatrist we were recommended is considered very conservative when it comes to ADHD and he might be able to identify if it is a different issue as well. He also will move to first grade in a couple months and I will have another teacher's opinion.

I had heard of the red dye issue in the past, and I will do some research into that. He eats so very little, I wonder if Lucky Charms is all I would have to cut out?

I am pretty easy-going, and not easily offended, so bring on the advice!

Anonymous said...

They diagnosed my son at age 4 as having ADD and it was the same thing; he did not display the symptoms at home. The psych was the same; after 15 minutes talking with my son, he proceeded to write 3 prescriptions.I just couldn't do it. The diagnosis just didn't sit well with me.We took him to Kennedy Kreiger for extensive evaluation and it was determined that no, he is not ADD but rather, he was bored. His IQ was way off the charts and gifted classes were established and put into place for him. This may or may not be the case with yours but regardless,sometimes it is far to easy for professionals to assume.
He is a perfectly content, well adjusted student now. In his case, the problem was that they didn't know what else to do so they assumed.
It's a long hard road but you are right, having an accurate diagnosis, whatever that may be, is far better than being in limbo and unable to help your little guy because you just don't know what he needs.
Good luck and I know that everything will work out; just hang in there.

Shama-Lama Mama said...

Yeah, I have said that if the doctor just chats with him and calls it ADHD, I am not gonna believe it. I know there are lots of tests out there (none conclusive). I want him to take a few of those to see how he does.

Noah is really smart. One of the reasons he disturbs the other kids is he always understands the lesson the first time and then makes noise. He finishes early sometimes, and starts chatting. So, yeah, boredom is a possibility.

I will decide how much weight I give the doctor's diagnosis until I see how he comes to it.

Michael says that sometimes ADD is diagnosed by giving the meds. If they respond, that's what it was.

The meds turned out to be a great thing for my nephew. He was acurately diagnosed.

gpc said...

They put my daughter on meds 20+ years ago and it did not go well. But, although apparently no one knew it at the time, even a bad reaction provides diagnostic information. They have learned a lot since then, but the human brain is still mostly mystery. As you seem to do with every 'surprise' in parenting, you and Michael are exploring this in an open minded, rational way. I think Noah is in good hands, and I hope you have answers that help you all soon.

Robin said...

I came here today via WW and saw this post and wanted to send out a virtual hand to hold. That time when you know "something" is wrong but don't yet know what it is or what it means can be a frightening, lonely place. Good for you for facing things head on and searching out as much help and information as you can. My own daughter's issues are at the same time both similar and different to your son's, but that sense of standing on the edge of a cliff is universal. Whatever you and your son are facing, you are not alone.

After over 18 months of in-depth evaluations and nearly that long in treatment (psychologist, speech therapy and now O/T as well) we're seeing tremendous progress. The earlier you catch things the easier they are to deal with.

Hang in there.

Anonymous said...

I found your blog through another blog, etc...

I have worked in early childhood education world for well over 10 years. I do not have all the answers and am not qualified to offer a diagnosis, even if Noah were in my classroom. I do have a lot of experience with young children and work with lots of people who have more experience I learn from everyday. I am writing based on my experience and information I've gleaned from others.

A portion of what I'm about to write you may already know. If so, I apologize for the repeat.

I can verify 100% that diet can be a huge impact on a child's behavior. Sometimes an undiagnosed allergy or sensitivity to something in the environment or food can have dramatic impact on a little body. I've seen some unbelievable changes when a child's diet is altered, usually to a more natural, less processed foods diet.

Sometimes mineral or other deficiencies can cause behavior changes. Traditional blood and other tests don't always check for them though. Some MD's and DO's specialize in figuring these things out without a Rx.

The behavior changes can happen quickly or take over a month to display themselves when the diet is changed. Still, the change is dramatic.

The drugs they give for ADHD are often the same class as cocaine and should be carefully considered.

If Noah is bored a lot in school you may want to consider a Montessori school. The environment is much calmer overall than a traditional classroom. I've seen remarkable things happen when a child changes to that type of setting. Many offer "contract learning" where children are given tasks based on individual abilities and interests. This avoids them running out of things to do.

It is somewhat like a traditional education special education classroom in that each child has their own IEP (Individual Education Plan) with his/her own goals. Personally, I think every child needs one of these, not just those with a "diagnosis".

Most Montessori programs offer multi-age/grade rooms. The advantage is kids keep the same teacher for more than one school year and kids can move on to higher level tasks without changing classrooms (being pulled out). Kids are encouraged to keep learning on their own, not rely on a teacher to provide the answer on the board. The teacher is a facilitator rather than answer provider.

I am not Montessori teacher or certified in it or worked in an official Montessori classroom. I'm just giving you an overview of my experience and observations after working with some Montessori teachers in different settings. Maria Montessori has written some very good books that may be of interest to you. There is also a lot of information online about it.

The most important thing is that Noah has supportive parents and extended family ready to help him and not stay in denial that an issue exists for their own comfort. You all can/will make it through this. You will find the right answers and someday this trying time will be a distant memory.

Stick with the professionals that respect you and fit with your family's style and personal belief system. Don't give up, they do exist and can help.

Best of luck for some quick resolution...

Anonymous said...

Funny she should mention Montessori; that's where we had my son and he absolutely loved it and flourished. Our "problems" began when he had to go to public school.
Hope all is well and I am off to email you!!

Gumby said...

here's hoping things get figured out sooner than later.

Katrina Stonoff said...

Two things:
1. My pediatrician has warned us that extremely bright children who are bored can manifest just like ADD (as, indeed, mannequin said).

2. She also said the final diagnosis is, as you mentioned, to put the child on Ritalin. But you'd know immediately if it works, so if he doesn't have ADD, it would only need to be one dose. That seemed crazy to me, but then my sister's son was diagnosed with ADD, and that was exactly her experience. Within a few hours, he was a completely different child. My pediatrician also said (and my sister concurred) that if it really is ADD, you'll be grateful for the diagnosis because you'll be pulling out your hair trying to figure out what's wrong.

It doesn't sound like you're pulling out your hair, though, so I don't know that I'd be quick to try the Ritalin.

Good luck.