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Old 01-22-2018, 06:52 PM
 
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Quote:
Originally Posted by townshend View Post
Late to the party, but I may be able to help. Not trying to pull rank, but I am a physician assistant who works in psychiatry, and have treated many adolescents and adults with ADHD. I could write a dissertation on the topic, but let me just make some salient points.

1) ADHD is a real disorder, not an imagined one. It has to do with focus primarily, caused by a lack of certain neurotransmitters (norepinephrine and dopamine) in certain portions of the brain.

2) ADHD = attention deficit hyperactive disorder. DSM 5 (diagnostic and statistical manual, 5th edition) classifies it into the following subtypes:
a) ADHD, primarily inattentive presentation
b) ADHD, primarily hyperactive presentation
c) ADHD, combined presentation

Note: all hyperactivity is not necessarily from ADHD, and the lack of hyperactivity doesn't mean an adolescent doesn't have ADHD. Hyperfocus does not "rule in" or "rule out" a diagnosis of ADHD. Male adolescents with ADHD can hyperfocus on video games for hours . . . but they can't focus on their school work and stay on task.

3) For diagnosis and possible treatment, go see a psychiatrist. PERIOD. They will have you fill out an "ADHD rating scale", which will screen for symptoms of ADHD (hyperactivity, inattention, impulsivity).

4) ADHD does not necessarily "go away" with age. I have diagnosed and treated adults in their 30s, 40s, and 50s who were never diagnosed as children. It is a serious disorder that is "usually" effectively treated if accurately diagnosed.

5) We don't "medicate" kids or believe every kids needs a pill. If the ADHD rating scale and a personal interview of child and parents creates a clinical suspicion that the child most likely has ADHD, then I will discuss treatment. Appropriate medications at an optimal dose do not change the personality of the child (i.e., they don't make your child a zombie). They don't "hotrod" his brain -- they do enable him to stay focused and not be so easily distracted.

6) Treatment consists of medications. Counselling is not very effective in helping with ADHD (counselling is very helpful for treating depression and anxiety). Naturopathy and alternative medicine don't work for ADHD.

7) Based on my clinical judgment and experience, I will select a medication, educate the parents and child on how to run a medication trial, in which the dose is "titrated to effect" until clear clinical benefit is evident (or abandon trial of side effects develop). This usually takes about one week, two at most. Continuation on the medication is only justified if clear clinical benefit is evident to child and/or parents. You may also witness increased frustration tolerance, and improved conversations with your child.

I hope this helps. Best wishes to you, Scott.
Excellent post and full of great information!
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Old 01-22-2018, 07:03 PM
 
Location: A Yankee in northeast TN
9,444 posts, read 13,311,699 times
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Quote:
Originally Posted by Magritte25 View Post
Excellent post and full of great information!
I agree, but do want to mention add that inour case insurance would not cover a psychiatrist without a referral from the pediatrician so it's not always an option to deal just with a psychiatrist. It was actually kind of a pain because every single visit to the psychiatrist had to be preceded by a visit to the pediatrician to get the referral.
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Old 01-22-2018, 07:27 PM
 
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No, not a psychiatrist. A psychologist. Pyshiatrists are for Meds.
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Old 01-22-2018, 07:46 PM
 
Location: A Yankee in northeast TN
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Originally Posted by G-fused View Post
No, not a psychiatrist. A psychologist. Pyshiatrists are for Meds.
I don't follow? ADHD doesn't require therapy, how does a psychologist fit into this? The testing? I think pediatricians are qualified to administer the questionnaires, my son never had to see a psychologist for ADHD reasons.
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Old 01-22-2018, 07:54 PM
 
Location: Austin
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Quote:
Originally Posted by G-fused View Post
A diagnosis wonít make their jobs easier, an IEP does.
Quote:
Originally Posted by Magritte25 View Post
Depends on how you look at it. For many teachers, IEPs make their job more difficult and a lot more work because of the accommodations that have to be made for each child. And many times our children aren't the only ones in a class with an IEP. Its a lot of work for one person to do.
In my school district, each of the schools groups the 504 kids into one class, if they can, or they're only in 2 classes. Depending on the grade, there is an aide in the morning and another (or the same one) in the afternoon. (I'm in a district with 5-7 classes per grade). The aides do a lot so the teachers can still have their main focus on teaching and not constantly having attention on the acting up.

What I was saying in my earlier posts, is that the school wanted me to get a diagnosis so they could not only medicate, but have an aide in the class to help keep him calm. His brain runs fast, so he gets frustrated at the slow pace teachers have to go in order to accommodate all students, so many times, his paper is crumpled up on the floor across the room (or flown in the shape of an airplane) because he finished it before she even completed the lesson. Aides can help occupy his time a little better, but alas, he was found not to have ADHD and they can't do 504 services for ODD.
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Old 01-23-2018, 04:15 AM
 
27,993 posts, read 19,619,705 times
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Quote:
Originally Posted by DubbleT View Post
I agree, but do want to mention add that inour case insurance would not cover a psychiatrist without a referral from the pediatrician so it's not always an option to deal just with a psychiatrist. It was actually kind of a pain because every single visit to the psychiatrist had to be preceded by a visit to the pediatrician to get the referral.
Oh that is a pain!
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Old 01-23-2018, 07:44 AM
 
5,008 posts, read 4,814,987 times
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Quote:
Originally Posted by DubbleT View Post
I don't follow? ADHD doesn't require therapy, how does a psychologist fit into this? The testing? I think pediatricians are qualified to administer the questionnaires, my son never had to see a psychologist for ADHD reasons.
No, kids don't need to see psychologists for ADHD reasons. They should though.

A psychiatrist is an MD that took a couple Psych classes. That's it. A qualified child psychologist has a much deeper understanding of ADHD and is better at diagnosing and determining a plan of care. If that plan includes meds, which it often does, a psychiatrist should be sought to collaborate with the psychologist. Psychologists study and focus on the mental aspect of care, psychiatrists study and focus on the medication aspect; it's symbiotic.

I'm surprised you think ADHD doesn't require therapy. Of course it does. And depending on the severity and any comorbidities, therapy may be more important than meds and have a better affect. I'd argue that most any kid on meds should be in therapy too to learn cognitive skills and strategies that can help to move him/her off meds and generally improve their ability to function well. It's of supreme importance.
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Old 01-23-2018, 07:51 AM
 
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Quote:
Originally Posted by FalconheadWest View Post
In my school district, each of the schools groups the 504 kids into one class, if they can, or they're only in 2 classes. Depending on the grade, there is an aide in the morning and another (or the same one) in the afternoon. (I'm in a district with 5-7 classes per grade). The aides do a lot so the teachers can still have their main focus on teaching and not constantly having attention on the acting up.

What I was saying in my earlier posts, is that the school wanted me to get a diagnosis so they could not only medicate, but have an aide in the class to help keep him calm. His brain runs fast, so he gets frustrated at the slow pace teachers have to go in order to accommodate all students, so many times, his paper is crumpled up on the floor across the room (or flown in the shape of an airplane) because he finished it before she even completed the lesson. Aides can help occupy his time a little better, but alas, he was found not to have ADHD and they can't do 504 services for ODD.
That's how it works here. The goal is to keep the kids in the standard classroom but there is a room just for them when they need it. And an aide assigned who is usually in the standard class to help. My kid has benefited from that and so have his teachers.
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Old 01-23-2018, 07:51 AM
 
Location: Raleigh, NC
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Wow, thank you for the responses. As mentioned, I have a very basic understanding so I definitely appreciate the resources offered.

My son is 9. He is not hyper-active (physically) but he is excitable - we constantly have to remind him to use his "inside voice" (level) and he often cuts into conversations. Unprofessionally, I've been told that he has so much on his mind, he HAS to get it out, for fear of forgetting or losing his chance to say what's on his mind.

Grade-wise, he does well as school; but, that comes with working with the elder kids in afterschool care and us parents checking his work. Again, talking about laser focused - he can be determined enough to work on a Lego model for an hour. But, getting him to sit down and quiz him on an upcoming test is a challenge. The questions might include compare & contrast - where he writes down four single words. This is where I question his motivation. Getting him to read something that doesn't interest him is a challenge, as well.

This was the type of information I was looking for. I will start with his pediatrician and go from there. I want to thank every one who was willing to share their personal experiences and allow me to gain a better understanding. I wish all of you the very best on your continued, challenging journeys.
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Old 01-23-2018, 08:51 AM
 
174 posts, read 89,586 times
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Quote:
Originally Posted by Kibbiekat View Post
My experience has been that the school/teachers will not recommend testing (except maybe in the most extreme cases), you have to ask for it; They will test, but not diagnose. I expressed concern to our pediatrician, and wasn't really given any advice at all, let alone a diagnosis. After I finally got private testing done and a diagnosis, I went to the pediatrician for meds. There I was given the questionnaire for parents and for teachers. We've used it when going on and off or switching meds, but not to get a diagnosis.

Maybe I didn't ask the right questions, or maybe I wasn't persistent enough. I don't know. I got the most help from other moms who had already been through it.

In Texas, a licensed physician has to diagnose ADHD. It can't be done by the school, though the school will likely need to gather input for the doctor. We've also been told that we can't even say that a child has ADHD because then we are diagnosing them. I'm sure other states may differ on who can diagnose it, but perhaps this is also the legal requirement in your state.

As for the OP, I'd recommend you talk to a doctor about it.
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