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Looking for some insight and some guidance from parents of or ADHD folks.
My son is 4 1/2, he's always been on the move, and been hyperactive, doesn't listen to some of our rules. His nursery school teacher suggested we have him evaluated. We saw an occupational therapist and the a child psychologist. The first doc says he's borderline for receiving assistance but based on her review he will not qualify. She thinks he has some fine motor skill development delay. However, he is extremely smart and is overcoming the problem. Psychologist did a 1 hour assessment. Also says he scores off the charts in smarts but has "classic" ADHD symptoms. Says we should see MD and put him on meds. A real shock to us and we are very concerned. We are not anti drug, but we do think drugs are often overprescribed and its the go to answer for many. Of course if he really needs it, we would put him on the meds but I am very unsure about it.
I've been researching, and from all the clinical descriptions of ADHD he has a few strong symptoms on the list but not too many. So I am not sure if he's just a tough boy to manage or if he has ADHD.
Here's the behaviors what I've observed, not in any particular order.
Based on many typical symptoms:
1. Does pay very good attention to details, although I only observed this with things he's interested in, not sure if he is attentive to things that are not of interest. But he does remember many things I say, things we do, things I would not expect a 4 YO to remember or notice.
2. Stays focused on things he likes, will pay hours on certain toys.
3. Can follow simple instructions but many times forget or ignore a routine such as don't run in the house or don't suck on fingers.
4. Can put together big puzzles on his own.
5. Sits still when watching TV, watching videos. Squirms at the dinner table, runs everywhere.
6. Seems oblivious to other people when he runs.
7. Talks a lot but not what I think is excessive, does interrupt often but will also sit quietly on occasion and just listen.
8. Temper is ok, not too many tantrums.
9. Loves to hug, 0 aggression.
10. Is impulsive.
11. Walks up to and starts talking to other kids, strangers.
12. Can do simple math.
So you may be seeing that he has several symptoms but other symptoms are quite the opposite of ADHD. I would think he would exhibit at least a low level of many of the symptoms but several items he does not do at all. I do not know if ADHD means you have a majority of the symptoms some stronger than others or if some symptoms can be non-existent and you can still have ADHD?
For instance he can spend quite a bit of time coloring or cutting things out but when he gets frustrated there is no tantrum? Sometimes he does tantrum over very minor offenses but there is always a cause. He does not just melt down for no reason. He does not fidgit when playing, all his moves are methodical and "normal" for the course of play. He does run everywhere and loves to flop on the ground.
When I ask he he knows not to run he says yes but he can't control himself.
He was sucking his fingers as a pacifier up until 2 weeks ago but had a big cut on one finger. The bandaid seems to have finally stopped the finger sucking. I would think if he could not control this he would start to suck the fingers then move them away as it would be more involuntary but I do not see that behavior, it seems to have been forgotten altogether.
So my question is this, can he "score" 8's and 9's on several symptoms and score 0 on many others and still have ADHD? Or would he score at least 3-4 on the majority of symptoms? Also if he has only 6 out of 20 symptoms, would that be considered ADHD?
Looking for some insight and some guidance from parents of or ADHD folks.
My son is 4 1/2, he's always been on the move, and been hyperactive, doesn't listen to some of our rules. His nursery school teacher suggested we have him evaluated. We saw an occupational therapist and the a child psychologist. The first doc says he's borderline for receiving assistance but based on her review he will not qualify. She thinks he has some fine motor skill development delay. However, he is extremely smart and is overcoming the problem. Psychologist did a 1 hour assessment. Also says he scores off the charts in smarts but has "classic" ADHD symptoms. Says we should see MD and put him on meds. A real shock to us and we are very concerned. We are not anti drug, but we do think drugs are often overprescribed and its the go to answer for many. Of course if he really needs it, we would put him on the meds but I am very unsure about it.
I've been researching, and from all the clinical descriptions of ADHD he has a few strong symptoms on the list but not too many. So I am not sure if he's just a tough boy to manage or if he has ADHD.
Here's the behaviors what I've observed, not in any particular order.
Based on many typical symptoms:
1. Does pay very good attention to details, although I only observed this with things he'sinterested in, not sure if he is attentive to things that are not of interest. But he does remember many things I say, things we do, things I would not expect a 4 YO to remember or notice.
2. Stays focused on things he likes, will pay hours on certain toys.
3. Can follow simple instructions but many times forget or ignore a routine such as don't run in the house or don't suck on fingers.
4. Can put together big puzzles on his own.
5. Sits still when watching TV, watching videos. Squirms at the dinner table, runs everywhere.
6 Seems oblivious to other people when he runs.
7. Talks a lot but not what I think is excessive, does interrupt often but will also sit quietly on occasion and just listen.
8. Temper is ok, not too many tantrums.
9. Loves to hug, 0 aggression.
10. Is impulsive.
11. Walks up to and starts talking to other kids, strangers.
12. Can do simple math.
So you may be seeing that he has several symptoms but other symptoms are quite the opposite of ADHD. I would think he would exhibit at least a low level of many of the symptoms but several items he does not do at all. I do not know if ADHD means you have a majority of the symptoms some stronger than others or if some symptoms can be non-existent and you can still have ADHD?
For instance he can spend quite a bit of time coloring or cutting things out but when he gets frustrated there is no tantrum? Sometimes he does tantrum over very minor offenses but there is always a cause. He does not just melt down for no reason. He does not fidgit when playing, all his moves are methodical and "normal" for the course of play. He does run everywhere and loves to flop on the ground.
When I ask he he knows not to run he says yes but he can't control himself.
He was sucking his fingers as a pacifier up until 2 weeks ago but had a big cut on one finger. The bandaid seems to have finally stopped the finger sucking. I would think if he could not control this he would start to suck the fingers then move them away as it would be more involuntary but I do not see that behavior, it seems to have been forgotten altogether.
So my question is this, can he "score" 8's and 9's on several symptoms and score 0 on many others and still have ADHD? Or would he score at least 3-4 on the majority of symptoms? Also if he has only 6 out of 20 symptoms, would that be considered ADHD?
Any insight would be very helpful. Thanks!!
I high lighted a number of things. It seems that he can sustain attention (or become fixated) in things that he is interested in such as playing with a favorite toy or watching videos but not in areas that he has less of an interest in doing such as sitting at the table during mealtime or being careful of other people if he is running. That is pretty typical for a child with ADHD.
It has been my experience, as a teacher, that yes, a child can score 8's and 9's on several/many symptoms and score very low on other symptoms and still have ADHD.
Share the reports with your doctor and see what he/she recommends. They know your child much better than someone who just assessed him once. Perhaps the pediatrician may suggest additional assessments.
BTW, a child can be extremely bright and still have ADHD, so the fact that he can do simple math or big puzzles does not make a difference in his diagnosis (although, it is great that he can do those things).
It sounds like your son might have it. Remember, someone has to have enough symptoms to meet the diagnostic threshold, but doesn't have to have a particular set of symptoms.
He's definitely is a smart kid with a lot of strengths. If he loves to run, then you need to develop that strength. Take him to the park and let him simply run. You'll probably need to wear him out too... I say that with kindness. It sounds like you have an athlete on your hands.
At four, I would be very hesitant to put him on meds. I would also start researching your options for kindergarten and see if there is a class that truly incorporates movement, music and the arts. Too many kindergartens are turning into little academic factories and are no longer a place for kids to explore and learn social skills through the arts, play and movement.
If he does get a diagnosis, you may be able to get accommodations through a Section 504 plan. For example, he might be assigned to a corner desk on the side or at the back of the room and be allowed to work standing up... without having to ask permission. This way he can move instead of having to sit in a chair and think about not moving so he doesn't get in trouble, which will make it difficult to think about the work he's supposed to be doing.
Good luck and props to you for trying to get information that will help you and your son.
Looking for some insight and some guidance from parents of or ADHD folks.
My son is 4 1/2, he's always been on the move, and been hyperactive, doesn't listen to some of our rules. His nursery school teacher suggested we have him evaluated. We saw an occupational therapist and the a child psychologist. The first doc says he's borderline for receiving assistance but based on her review he will not qualify. She thinks he has some fine motor skill development delay. However, he is extremely smart and is overcoming the problem. Psychologist did a 1 hour assessment. Also says he scores off the charts in smarts but has "classic" ADHD symptoms. Says we should see MD and put him on meds. A real shock to us and we are very concerned. We are not anti drug, but we do think drugs are often overprescribed and its the go to answer for many. Of course if he really needs it, we would put him on the meds but I am very unsure about it.
I've been researching, and from all the clinical descriptions of ADHD he has a few strong symptoms on the list but not too many. So I am not sure if he's just a tough boy to manage or if he has ADHD.
Here's the behaviors what I've observed, not in any particular order.
Based on many typical symptoms:
1. Does pay very good attention to details, although I only observed this with things he's interested in, not sure if he is attentive to things that are not of interest. But he does remember many things I say, things we do, things I would not expect a 4 YO to remember or notice.
2. Stays focused on things he likes, will pay hours on certain toys.
3. Can follow simple instructions but many times forget or ignore a routine such as don't run in the house or don't suck on fingers.
4. Can put together big puzzles on his own.
5. Sits still when watching TV, watching videos. Squirms at the dinner table, runs everywhere.
6. Seems oblivious to other people when he runs.
7. Talks a lot but not what I think is excessive, does interrupt often but will also sit quietly on occasion and just listen.
8. Temper is ok, not too many tantrums.
9. Loves to hug, 0 aggression.
10. Is impulsive.
11. Walks up to and starts talking to other kids, strangers.
12. Can do simple math.
So you may be seeing that he has several symptoms but other symptoms are quite the opposite of ADHD. I would think he would exhibit at least a low level of many of the symptoms but several items he does not do at all. I do not know if ADHD means you have a majority of the symptoms some stronger than others or if some symptoms can be non-existent and you can still have ADHD?
For instance he can spend quite a bit of time coloring or cutting things out but when he gets frustrated there is no tantrum? Sometimes he does tantrum over very minor offenses but there is always a cause. He does not just melt down for no reason. He does not fidgit when playing, all his moves are methodical and "normal" for the course of play. He does run everywhere and loves to flop on the ground.
When I ask he he knows not to run he says yes but he can't control himself.
He was sucking his fingers as a pacifier up until 2 weeks ago but had a big cut on one finger. The bandaid seems to have finally stopped the finger sucking. I would think if he could not control this he would start to suck the fingers then move them away as it would be more involuntary but I do not see that behavior, it seems to have been forgotten altogether.
So my question is this, can he "score" 8's and 9's on several symptoms and score 0 on many others and still have ADHD? Or would he score at least 3-4 on the majority of symptoms? Also if he has only 6 out of 20 symptoms, would that be considered ADHD?
Any insight would be very helpful. Thanks!!
Take him to a qualified physician and have him examined again for a second opinion.
There is no one here who can tell you if your son has or doesn't have or could be considered ADHD.
Just because they may have experience with it does not mean they can diagnose anything for you.
Both of my kids have an ADHD diagnosis. There are two main types of ADHD, the hyperactive type and the inattentive type. If they have some symptoms from each bucket but not enough in one bucket to call it one type or the other, then they get what my daughter got, which is ADHD - not otherwise specified. Basically, she has some of the symptoms, but it's not totally clear cut. Is this what your diagnosis said too? As my daughter has gotten older, we feel that both of my kids are more on the inattentive side though.
My older daughter is almost 9. She has a 504 in school and her ADHD is handled well by behavioral interventions (using a reward system, using a timer, sitting on a ball, having fewer people around her in class, sitting in the hallway if necessary) and she does not take medication. She was diagnosed by a psychologist after about 2 hours of testing.
My younger daughter is almost 6 and has an IEP in school. We are currently considering medication for her. Our doctor said that the general guidelines are to try behavioral interventions first, especially if the child is under 6. Once the child is 6, they are more likely to recommend medications though. She was diagnosed by a psychologist after 2 days of extensive testing. She was getting more testing for various learning difficulties, not just for ADHD testing.
He COULD very well have ADHD based on those symptoms. At 4 1/2 though, I think that's a bit early to start medicating.
I was undiagnosed for my entire childhood (I have fairly severe ADD) and it caused me a lot of difficulties. However, I don't think I needed to be medicated as a kid - I just needed strategies to keep me on track and to understand that my brain worked a bit differently. Half of my frustration came from the fact that I had no idea how to calm my brain down and that I didn't learn things the way other children did. I still excelled academically.
Get as close to a definitive diagnosis as you can. Then read up up on ADD/ADHD. Start implementing strategies for dealing with it at home and see how things fall into line for him.
I have a relative who has three boys, at least one of whom is probably ADHD. Everything runs very orderly in their household though because they pay a lot of attention to keeping their kids on a schedule, and when a tantrum or meltdown is in the offing they are prompt with the time outs. They make the boys stop and think through a situation before running in pell mell.
Either way, I would provide more structure and routine, with set outlets built in to your day for his excess energy and need for distraction. Teach him also how to calm his brain down - breathing exercises, meditation, whatever.
And ADD/ADHD is weird - we're either super-coordinated or total klutzes. I'd get him some therapy for his motor skills and teach him about accepting physical limitations to a certain degree. Inability to control my focus means I have a hard time with bicycles and skates and whatnot. I trip over stuff, walk into things, fall down. And boys tend to be more reckless, so he could hurt himself. Martial arts might be a good past-time for dealing with this.
He's only 4 though, so he could be a different kid in a year, lol.
Since it was the preschool that recommended the evaluation I would want to know how many other children in the school she has recommended be tested for ADHD and exactly what her educational background is. I know if she's been teaching for awhile she might recognize a child that is more active, etc. but I would still want this information.
Honestly, your description of your son sounded like a 4 year old that is perfectly normal to me. They run. They are more focused on what interests them. Talks a lot (my daughter talked nonstop at that age).
I would talk to his doctor and watch him for awhile. See how he responds in kindergarten.
One question for you--how does he respond to clothing textures? My oldest nephew is ADD. He always had difficulties with tags on clothing and socks. This was one of his symptoms and fairly common.
Have you heard any one else besides your son's teacher suggest ADHD? How long has he been in this nursery school program? How long has he been with this particular teacher? What are the demands of that setting? How long has he had to adapt to the routine?
It could be that he is transitioning into the routines of the setting. He may not be used to having to sit still and pay attention to something he didn't select himself. Sometimes it takes kids awhile to adjust to those types of demands.
I would observe him in the setting to see how different it is from other settings he has been in to date. Four years old is really young to commit to ADHD medication without behavioral intervention first. But it could be that he just needs a bit of time to adjust to the demands of the setting.
I'll chime in with our story. My son is currently 9 and in 3rd grade.
When DS was just 5 (seriously like a week after his birthday) he received an ADHD diagnosis as well. He's very hyper and impulsive and at 5 it seemed like he may have a few attention issues too. We tried medication briefly after the teacher talked us into it. It did little to help.
Here's what's happened since. DS was even more fully evaluated later on that same year and given an IQ test which came back very high. By the end of kindergarten he had become super academic, skipping levels in both reading and math and totally engrossed in school work. As long as he had work to do he was fine. PE, recess, waiting in line remained a problem, social skills also were a little off.
In first grade DS was diagnosed with a tic disorder, we now lightly medicate for that. This year we sent him to a private school with a program for gifted kids. We still have issues with impulse issues particularly in PE, recess, and waiting in line but none are super serious. He has zero attention issues, is super organized, and a good time manager.
So would he still qualify for an ADHD diagnosis? We don't know. He definitely still struggles with impulsivity and social skills. We do our best to manage these issues and even if we wanted to medicate for it there aren't any good medications for impulse control. On the other hand he's a really neat, organized, straight A student so not really the picture of an ADHD child.
I share because your son sounds a little like ours. I would personally hold off on the medication for a couple years and see how he develops. Best of luck.
Eta: my son never had tantrums either. And I would give up on trying to get him to stop running in the house and sucking on his fingers, hyper kids need to put that energy somewhere. My 9yr old still runs everywhere, I think he'll be running in his college dorm
Several people mentioned that their children run a lot.
I'll share a tip that worked wonders for one of my former students with severe ADHD and the parent did not want to try medication. He woke up early every morning with an enormous amount of energy.
So every day before & after school she had her child run laps around the outside of the house for about 15 or so minutes (or if it was raining or too snowy he would run/walk fast up and down the stairs in their house). This was not punishment. it was for him to "use up" his extra energy and it also helped him fall asleep much better at night time. He called it "practicing for the Olympics" and absolutely loved it.
I've also had students run the perimeter of the playground continuously for the entire recess time, by their choice not because they were told to do it.
I am certainly not saying that this works for all children with ADHD but for some children it works very well and helps them sit quieter and focus better at times when that is important.
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