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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.
As others have addressed, there are often comorbidities associated with ADHD and its subtypes. There's some overlap with ASD, which can be tricky when observing these traits and mannerisms. It was easier to see my son's (8) ASD traits after he was on meds and titrated up to the right dose. Conversational reciprocity, laser/narrow focus, struggles with communication and social interaction (understanding how conversations work), rigid and very black and white thinking, rules-based thinking (sometimes directed at other people), difficulty understanding other people's perspectives, needing concrete answers, trouble modulating voice, sensory-seeking, difficulty with change in routines, etc. It's a spectrum, so the traits and mannerisms can vary a lot. (my 11 year old also has ASD and it manifests differently in her in a lot of ways)
He has combined type ADHD. Meds made a huge difference in school and at home.
As others have addressed, there are often comorbidities associated with ADHD and its subtypes. There's some overlap with ASD, which can be tricky when observing these traits and mannerisms. It was easier to see my son's (8) ASD traits after he was on meds and titrated up to the right dose. Conversational reciprocity, laser/narrow focus, struggles with communication and social interaction (understanding how conversations work), rigid and very black and white thinking, rules-based thinking (sometimes directed at other people), difficulty understanding other people's perspectives, needing concrete answers, trouble modulating voice, sensory-seeking, difficulty with change in routines, etc. It's a spectrum, so the traits and mannerisms can vary a lot. (my 11 year old also has ASD and it manifests differently in her in a lot of ways)
He has combined type ADHD. Meds made a huge difference in school and at home.
Those comorbidities (and other reasons) are exactly why a psychologist is in the best position to notice and understand those tricky aspects. Psychiatrists are in the best position to prescribe appropriate meds in appropriate doses and to manage that and make changes. But for the most part, they are very lacking in as deep an understanding as psychologists with ensuring that the right thing is addressed and treated (i.e. making a good diagnosis). The risk of misdiagnosis is too high and can have severely detrimental consequences. It's just not worth taking the risk of having someone who is primarily tasked with medication management diagnose.
Changing behavior takes a deep understanding of the behavior to be changed. Psychologists are tasked with changing behavior (at least CBT oriented ones are).
.My wife of nearly 40 years has long identified with having ADHD by friends, family, educators, and medical professionals. She was often held in scorn by the nuns, who tried to discipline her in school, as she was forever moving. Although very intelligent, she was never much more than "B" student, and she attributes that to her own personal, unorthodox "ADHD specific" learning/studying/test-taking strategies that allowed her to learn. She became a teacher, and is/was among the best in our state, receiving many professional accolades including countless nominations for Pennsylvania teacher of the year for nearly 30 years. Her various principals would load her teaching roster with students having a history of learning difficulties annually, and she embraced the challenge to help her students maximize their learning potential. Although now retired, she still does volunteer instruction with at-risk learners. She has always utilized her personality (including her ADHD) to help students learn. She was the teacher never sitting at her desk, and her teaching lessons included frequent movement, much positive reinforcement, creative presentations, and acceptance of each child's individuality.
Her best recommendation to the parent of any child with ADHD/ADD/ODD/Autism would be to understand that conventional teaching methods (where students sit in their seats for extended periods of time, doing paper/pencil tasks, or continually listening to teachers instruct from the front of the classroom) are especially challenging for the ADHD learner. Your child may do best with the "unconventional" teacher, so become an advocate of such.
Our experiences aren't exactly the same but it's easy to tell that Mrs. T knows what she's talking about. And we got our kid baselined with neuropsych testing too. Good thing to do for the present and expecially the future.
I wish you and your kid the best Mrs. T.
Our experiences aren't exactly the same, but they are very similar. I left out the part where I feel like my son and I have somewhat of a strained relationship after all those years of pushing, pulling and hair tugging. It became very difficult to show affection towards him because I felt like I was incessantly frustrated and always in tears. His father died when he was six, so I was a single parent throughout most of his childhood. I now have a nine year old daughter, and the difference is like night and day. Parenting is never easy, but things are a lot more relaxed and enjoyable with her.
I appreciate your kind words. Parenting is THE most difficult job in the word. There is nothing like the responsibility of raising another human being in this dynamic world. I wish you the best with your child, as well.
I read your post and for a second that it was my wife posting. That pretty much sounds like my son. And literally just the other day my son was screened for ADHD and it looks like it may be that. Kid could be a genius if he could focus for more than 10 seconds.
Thank you for the responses. I am checking back on this thread every so often.
But, mainly combing through resources provided to me.
I really appreciate this community.
ADHD is tough. ADD by itself is less disruptive, but combined impulsive/hyperactive is the most difficult. The important thing is to get a solid diagnosis by a specialist, therapy where relevant, and meds if relevant. And good support/placement in school.
Under IDEA ADHD isn't a specific diagnosis, so it will come under OHI (Other Health Impaired) if looking for services. As mentioned before ODD doesn't qualify.
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.
Except there really isnt an ‘official’ diagnosis for ADD or ADHD or whatever they decide to call it a few years from now is there? There isn’t even a specific list of symptoms so you cant “rule in- rule out” anything can you? Also medications given to ‘treat’ this disorder are experimental themselves arent they? No-one really knows how, why or if they will work, one just throws one at a symptom and sees how well if works ( or doesn’t) right?
Not to throw dirt at your expertise but calling something a ‘real’ disorder doesn’t make it so. ADHD, at this time is a largely fluid and experimental diagnosis if we are being scientifically honest. Might explain the fact that while you insist that treatment involves medication, many diagnosed kids out there are coping without meds.
To OP, you may have to go with your gut on this one and there’s nothing wrong with testing... at the very least you get to rule out other issues and learn more about your kid. If he is diagnosed with ADHD its best to understand that the diagnosis itself a ‘best guess’ of a particular doctor based on certain feedback not a definite one like ‘yes you definitely have a malignant tumor’ or ‘yes you are definitely schizophrenic’.
The medications will be guesswork too. Some kids are doing badly enough that even this is an acceptable path to take to alleviate their symptoms. You will need to ask yourself if your kids situation really is bad enough for that kind of ( largely experimental) intervention and if there’s absolutely nothing else you can do. There’s also no arguing the influence of money in this whole discussion either. Entire business have cropped up around ADHD and other disorders so vet everyone’s stake in it carefully.
As you can tell i’m not an an advocate of routine prescription of psychotropic medication to children. But i do understand situations where it may come to that. Think hard about this on your child’s behalf and above all go with your gut...even if your gut does say he needs medical intervention. Sometimes thats all you can do.
Except there really isnt an ‘official’ diagnosis for ADD or ADHD or whatever they decide to call it a few years from now is there? There isn’t even a specific list of symptoms so you cant “rule in- rule out” anything can you? Also medications given to ‘treat’ this disorder are experimental themselves arent they? No-one really knows how, why or if they will work, one just throws one at a symptom and sees how well if works ( or doesn’t) right?
Not to throw dirt at your expertise but calling something a ‘real’ disorder doesn’t make it so. ADHD, at this time is a largely fluid and experimental diagnosis if we are being scientifically honest. Might explain the fact that while you insist that treatment involves medication, many diagnosed kids out there are coping without meds.
To OP, you may have to go with your gut on this one and there’s nothing wrong with testing... at the very least you get to rule out other issues and learn more about your kid. If he is diagnosed with ADHD its best to understand that the diagnosis itself a ‘best guess’ of a particular doctor based on certain feedback not a definite one like ‘yes you definitely have a malignant tumor’ or ‘yes you are definitely schizophrenic’.
The medications will be guesswork too. Some kids are doing badly enough that even this is an acceptable path to take to alleviate their symptoms. You will need to ask yourself if your kids situation really is bad enough for that kind of ( largely experimental) intervention and if there’s absolutely nothing else you can do. There’s also no arguing the influence of money in this whole discussion either. Entire business have cropped up around ADHD and other disorders so vet everyone’s stake in it carefully.
As you can tell i’m not an an advocate of routine prescription of psychotropic medication to children. But i do understand situations where it may come to that. Think hard about this on your child’s behalf and above all go with your gut...even if your gut does say he needs medical intervention. Sometimes thats all you can do.
Did you know that many people with schizophrenia and disassociative personality disorders opt out of taking medications and do quite well? Would you say, using your logic, that those diagnoses are "largely fluid and experimental"?
To add to scientific honesty, there are brain scans which show a definitive difference in the brains of NT people and those with ADHD disorders. Many children, like my son, have flourished with small doses of medications like Concerta. His self reporting on his internal struggles being alleviated with the medicine means something and he's one of thousands of people with the diagnosis who've improved with the use of medicine.
I do not think medicine can or will work for everyone.
I await the day I see arguments about how money influences the diagnoses of such issues as diabetes, bad eyesight, etc.
Did you know that many people with schizophrenia and disassociative personality disorders opt out of taking medications and do quite well? Would you say, using your logic, that those diagnoses are "largely fluid and experimental"?
To add to scientific honesty, there are brain scans which show a definitive difference in the brains of NT people and those with ADHD disorders. Many children, like my son, have flourished with small doses of medications like Concerta. His self reporting on his internal struggles being alleviated with the medicine means something and he's one of thousands of people with the diagnosis who've improved with the use of medicine.
I do not think medicine can or will work for everyone.
I await the day I see arguments about how money influences the diagnoses of such issues as diabetes, bad eyesight, etc.
A schizophrenia diagnosis is not an ‘is he-isn’t he’ situation. Its pretty well defined and has been for eons. Brains scans? There is a difference in the brains of:
Smart people vs Imbeciles
Alcoholics vs Non- Drinkers
People in love vs People not in love
Angry vs Calm people
Comatose vs Alert people
Hungry vs Full people
Criminals vs Law abiding citizens
And the list goes on. A ’different’ brain scan in isolation is proof of nothing. All it shows is a certain part of the brain’s activity. A difference in that activity does not always equal a diagnosis. Brains change over time in both size and activity. Not all people everywhere diagnosed with ADHD/ ADD show the same( or lack of) brain activity. There’s nothing ‘definite’ about the differences that are seen which is why they are still heavily researched.
The medicine your son gets alleviates his symptoms but do nothing about the underlying cause. What is up to you as a parent is to decide whether alleviation of symptoms so your son can function given the risks and downsides of taking such medication for a long time is worth it. That isnt any different than taking any other medication except that none of these medications have been tested for long term (or lifetime?) use in children and no-one can tell you exactly what changes they may cause (and in some cases how they work) over time without cracking some skulls open and doing lengthy double blind studies.... on children.
Nobody can argue your decision on that as it is very personal and one would have to know your child. But that does not change the fact that unlike diabetes, ADHD is largely a work in progress as opposed to a clearly defined condition with clearly defined symptoms and a clearly defined treatment. And as long as that is the case, parents and providers should be very cautious about embracing it as a diagnosis. Doesnt seem like much of that is occurring. Physicians seem far more cautious prescribing cold medicines.
There’s money influence in pharmaceuticals period. This isn’t limited to psychotropic meds or mental illness.
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