Pros/Cons of seeking ADHD diagnosis

[AndyJoy]

Forgive me if this subject has been talked about a lot before--I'm new to posting on this board.  I've done some searching, but I'd love it if anyone wanted to link similar threads for me to read further.

 

My son is about to turn 5 and from my layman's view definitely fits the criteria for ADHD.  I have suspected it for a long time, and there is a strong family tendency towards it.  Listening to my grandma's stories about my dad as a child sounds like either deja vu or prophecy :)  My sister was diagnosed as an adult (since the signs can be harder to spot in girls) and took medication for a while.  I've even begun to think lately that I have some signs of it as well, though I was much better at coping and meeting expectations in school.  Anyone who spends even a small amount of time around my son comments on his "moreness"; he's more energetic, more social, more wiggly, more talkative, more excitable, more distractable, more hyper-focused, more everything!  He is always "on" and consequently is incredibly exhausting.  He is bright and loving and sweet and helpful but SO.MUCH.WORK sometimes.

 

I'm wondering what others think about whether it is important/helpful to seek an offical diagnosis for a kid who I don't intend to enroll in brick-and-mortar school unless there is a major life change or compelling reason down the road.  Right now he is still pre-K and is in a once-a-week homeschool co-op class where I stay in the room and help keep him on task. 

 

I'm reading/researching and know there are differing views on the role of medication, diet, environment, etc. for helping with ADHD.  In 5 years we've intuitively figured out some things that just "fit" for him parenting-wise before even considering ADHD. I'd like to hear your experiences in this regard.  I'm interested in resources that empower parents to implement strategies at home.  There is so much out there I'm having trouble figuring out which resources might be the most helpful for us.  I will admit the thought of medication kind of wierds me out, but I won't completely discount the idea for the future, especially since he is still young and I don't know what he'll be like as he ages.

 

Any thoughts you'd like to share?

 

 

 

 

 

 

[Soror]

I didn't seek a diagnosis so much for the issues that are so often associated with ADHD, we accommodated well enough at home, so I figured it wasn't that big of a deal. However, what really steered me towards an eval was ds' memory and executive function issues. It became more and more clear that he would need accommodation to be successful with testing and school. I was providing some accommodation myself but (1) I wanted in writing what he needs for future testing and college and (2) I wanted/needed to know that I was not giving too much or too little. If I would have known sooner it would have saved me a lot of worry and stress and would have given me the info I needed about how to help him, instead of me just trying to figure it out on my own. We've not done meds, we may at some point. I loath the idea but when you see your kid struggle there are certainly worst options than pharmaceuticals.

[PeterPan]

Fwiw, I think it's really ironic that people in places I go tell me about how they suspect ADHD in their kids and never say BOO about my kid who probably will get an adhd label from the psych when we go in two weeks. 

 

Other things can cause the wiggles besides ADHD.  Not all kids who have ADHD *look* ADHD.  Other things can look like ADHD that AREN'T adhd.  It's possible to get the label (because it's a diagnosis of exclusion, meaning they gave up on labeling anything else and slapped it on) and NOT actually have it be the problem or the only problem.  Can we say how many people around here have gotten an initial adhd label when the problem was CAPD, aspergers, etc. etc.?  We have plenty here and I know some IRL.

 

Also, ADHD is NOT a behavioral disorder.  It involves EF delays that have serious ramifications for school work.  Getting proper evals is NOT about the meds and NOT about the label.  It's about learning how in the WORLD to work with what you've got in front of you.

 

Your ped can do the EF screening tool with you, which will give you a pretty good sense of whether he'd be likely to get an adhd label.  DON'T stop at the ped, because that doesn't help you become a better teacher!  You have to then get the full eval.  

 

So the real question is *when* to get the full eval, what kind of psych to use for the full eval, and how to know you've excluded other causes for the same symptoms.

 

There's a book ADHD Does Not Exist (I agree, idiotic title) that tries to go into all the OTHER things that can cause adhd symptoms.  I guess to me nothing you're saying sounds horrendous.  My boy looks very little different from the other kids in the classes he takes (other than being slower to learn the skills) and I've had him in classes almost every day at the Y for months now.  For energy and behavior, he's right there with the other wiggly boys, doing wiggly boy stuff.  There are different subtypes, yes.  (Impulsivity, hyperactivity, etc.)  Nuts, even gifted symptoms will overlap.  You yourself said he's bright.  No wonder he's fidgeting if he's in a typical preschool class.  Maybe he's BORED!  My 5 yo plays games marked for 8-10 yos and watches History Channel.  He's not going to have anything in common with a preschool or K5 class covering the letters, Arbor Day, and why we should save polar bears.  Frankly he finds things boring that my dd enjoyed at the same age.  So if you put him in a situation and get a particular behavior, is it adhd or boredom?  Definitely the latter, maybe both.  His auditory working memory is very poor.  Is that adhd (which will have overall EF deficits) or CAPD (more narrowly affecting auditory processing)?  

 

I'm just saying we can't answer those things for you or rub a ball.  I NEEDED the evals with my dd to teach her better and I did them way late.  If you actually think it's adhd, get a proper, full psychological eval to make sure.  Make sure there aren't *other* things going on.  There are some terrific interventions you can do (Interactive Metronome, Cogmed, etc. etc.).  

 

Btw, my dd's symptoms flare up when she doesn't wear her bifocal contacts.  You can even have symptoms caused by retained primitive reflexes.  It's not about the meds or the label.  It's about figuring out what's REALLY going on.  You can have symptoms caused by diet, food allergies, etc.  In fact, the more extreme the symptoms are, the more I'd be questioning biomedical and what else is going on.  Food can DEFINITELY make a difference.

 

With my ds, I'm getting evals as he turns 6 because that's the line for being able to run more tests.  I would do full evals younger if you had safety concerns.  (impulsivity making the child unsafe)  I think you're always wise to do evals rather than guess/wonder.  It's no fun to kick yourself later.  But meds at that age?  That would only be for safety in my book, but that's just me.  If you have other areas where the child is not hitting developmental norms, I'd definitely get them checked.  

 

If the child is showing issues with sensory, you could go ahead and get an OT eval.  (Many kids with adhd will benefit from OT.)  If there are speech or developmental delays, you could pursue those.  You can do metronome work and working memory work.  Just depends on what you're seeing.  You could even pursue neurofeedback, which is a tier 1 intervention for adhd and considered as effective as meds.  And it's PERMANENT!

[ZeeMommy]

OhElizabeth, I'm glad for your response to the OP.  I've been wondering about the pros and cons of a diagnosis for my DD 7.  There's enough of "somethings" going on with different areas of her behavior that make me lean toward some kind of ADD without the hyperactivity.  Mostly what shows up with her would probably be classified as impulse control and inattentiveness, little bit of the "fidgets" when I'm talking to her.  But other than diagnosis of amblyopia (lazy eye) and some vision therapy for that, there's no other obvious developmental/neurological problems, nothing that makes people gasp "my goodness, what's wrong with that child!"  Will know more about where she's at with schoolwork (educational development?) next month - have to do some kind of standardized test her in MN, will be doing the Peabody Individual Achievement Test.  DH and I each filled out the Vanderbilt Initial Assessment and discussed it with her pediatrician at her well child visit today.  Pediatrician did put in order for psychologist evaluation; will probably go that route but am trying to get more info settled in my mind so I know what to expect, what might be involved later on, etc.  Mostly I want to help her get the skills that will help her grow into the best possible person she can be; the only label I want her to have is her own sweet name! :) 

[PinkyandtheBrains.]

We waited on diagnosis until my child was well out of the normal age range for the ADHD type behaviors. At 5, much of it is still in the range of normal.

 

I do think diagnosis is helpful along the way, this is true for illness, disability and other issues. Once you know clearly what your are dealing with you can make a better informed plan of action.

[PeterPan]

OhElizabeth, I'm glad for your response to the OP.  I've been wondering about the pros and cons of a diagnosis for my DD 7.  There's enough of "somethings" going on with different areas of her behavior that make me lean toward some kind of ADD without the hyperactivity.  Mostly what shows up with her would probably be classified as impulse control and inattentiveness, little bit of the "fidgets" when I'm talking to her.  But other than diagnosis of amblyopia (lazy eye) and some vision therapy for that, there's no other obvious developmental/neurological problems, nothing that makes people gasp "my goodness, what's wrong with that child!"  Will know more about where she's at with schoolwork (educational development?) next month - have to do some kind of standardized test her in MN, will be doing the Peabody Individual Achievement Test.  DH and I each filled out the Vanderbilt Initial Assessment and discussed it with her pediatrician at her well child visit today.  Pediatrician did put in order for psychologist evaluation; will probably go that route but am trying to get more info settled in my mind so I know what to expect, what might be involved later on, etc.  Mostly I want to help her get the skills that will help her grow into the best possible person she can be; the only label I want her to have is her own sweet name!  :)

That's a pretty common thing with people I talk with, not wanting labels.  People have a lot of reasons for that and I'm saying you're not the only one.  I'll be straight though and encourage you to get over it.  It's not about the label.  Evals are to help you teach her better and work with her better.  Labels are your business what you do with them.  You don't have to tell people.  

 

I'll flip this.  Your child will come to a point where *she* will realize she's different and *she* will want the words.  And when that child asks, you want the RIGHT words, not things like: I'm stupid, I can't learn, I'm dumb.  I'm much rather have the correct label and be done with it.  Just another perspective.

 

Even ADHD subtype inattentive will have a hyperactive component.  You might just be missing it.  You could also miss on what the label actually is.  You're very wise to get a thorough psychological eval, especially when your ped is encouraging you to.  

 

Keep posting on LC if you want support, want to talk about the numbers you get and what to DO with them, etc.  Good luck on your evals.  :)

[ZeeMommy]

That's a pretty common thing with people I talk with, not wanting labels.  People have a lot of reasons for that and I'm saying you're not the only one.  I'll be straight though and encourage you to get over it.  It's not about the label.  Evals are to help you teach her better and work with her better.  Labels are your business what you do with them.  You don't have to tell people.  

 

I'll flip this.  Your child will come to a point where *she* will realize she's different and *she* will want the words.  And when that child asks, you want the RIGHT words, not things like: I'm stupid, I can't learn, I'm dumb.  I'm much rather have the correct label and be done with it.  Just another perspective.

 

Even ADHD subtype inattentive will have a hyperactive component.  You might just be missing it.  You could also miss on what the label actually is.  You're very wise to get a thorough psychological eval, especially when your ped is encouraging you to.  

 

Keep posting on LC if you want support, want to talk about the numbers you get and what to DO with them, etc.  Good luck on your evals.   :)

 

Thanks!  I will! 

 

[AndyJoy]

Fwiw, I think it's really ironic that people in places I go tell me about how they suspect ADHD in their kids and never say BOO about my kid who probably will get an adhd label from the psych when we go in two weeks.

 

Other things can cause the wiggles besides ADHD. Not all kids who have ADHD *look* ADHD. Other things can look like ADHD that AREN'T adhd. It's possible to get the label (because it's a diagnosis of exclusion, meaning they gave up on labeling anything else and slapped it on) and NOT actually have it be the problem or the only problem. Can we say how many people around here have gotten an initial adhd label when the problem was CAPD, aspergers, etc. etc.? We have plenty here and I know some IRL.

 

Also, ADHD is NOT a behavioral disorder. It involves EF delays that have serious ramifications for school work. Getting proper evals is NOT about the meds and NOT about the label. It's about learning how in the WORLD to work with what you've got in front of you.

 

Your ped can do the EF screening tool with you, which will give you a pretty good sense of whether he'd be likely to get an adhd label. DON'T stop at the ped, because that doesn't help you become a better teacher! You have to then get the full eval.

 

So the real question is *when* to get the full eval, what kind of psych to use for the full eval, and how to know you've excluded other causes for the same symptoms.

 

There's a book ADHD Does Not Exist (I agree, idiotic title) that tries to go into all the OTHER things that can cause adhd symptoms. I guess to me nothing you're saying sounds horrendous. My boy looks very little different from the other kids in the classes he takes (other than being slower to learn the skills) and I've had him in classes almost every day at the Y for months now. For energy and behavior, he's right there with the other wiggly boys, doing wiggly boy stuff. There are different subtypes, yes. (Impulsivity, hyperactivity, etc.) Nuts, even gifted symptoms will overlap. You yourself said he's bright. No wonder he's fidgeting if he's in a typical preschool class. Maybe he's BORED! My 5 yo plays games marked for 8-10 yos and watches History Channel. He's not going to have anything in common with a preschool or K5 class covering the letters, Arbor Day, and why we should save polar bears. Frankly he finds things boring that my dd enjoyed at the same age. So if you put him in a situation and get a particular behavior, is it adhd or boredom? Definitely the latter, maybe both. His auditory working memory is very poor. Is that adhd (which will have overall EF deficits) or CAPD (more narrowly affecting auditory processing)?

 

I'm just saying we can't answer those things for you or rub a ball. I NEEDED the evals with my dd to teach her better and I did them way late. If you actually think it's adhd, get a proper, full psychological eval to make sure. Make sure there aren't *other* things going on. There are some terrific interventions you can do (Interactive Metronome, Cogmed, etc. etc.).

 

Btw, my dd's symptoms flare up when she doesn't wear her bifocal contacts. You can even have symptoms caused by retained primitive reflexes. It's not about the meds or the label. It's about figuring out what's REALLY going on. You can have symptoms caused by diet, food allergies, etc. In fact, the more extreme the symptoms are, the more I'd be questioning biomedical and what else is going on. Food can DEFINITELY make a difference.

 

With my ds, I'm getting evals as he turns 6 because that's the line for being able to run more tests. I would do full evals younger if you had safety concerns. (impulsivity making the child unsafe) I think you're always wise to do evals rather than guess/wonder. It's no fun to kick yourself later. But meds at that age? That would only be for safety in my book, but that's just me. If you have other areas where the child is not hitting developmental norms, I'd definitely get them checked.

 

If the child is showing issues with sensory, you could go ahead and get an OT eval. (Many kids with adhd will benefit from OT.) If there are speech or developmental delays, you could pursue those. You can do metronome work and working memory work. Just depends on what you're seeing. You could even pursue neurofeedback, which is a tier 1 intervention for adhd and considered as effective as meds. And it's PERMANENT!

Wow, lots here, thanks! Your third paragraph is exactly my thinking. I'm a pragmatist so what really matters to me is figuring out how to help my kid function in the world given all the societal rules, expectations, etc. he doesn't mesh with naturally at this point. I want to know how to best teach him. I've seen the dysfunction of my dad/sister caused by untreated/recognized ADHD and want to spare him that. I've also been kind of shocked to discover from all my reading that *I* probably have ADHD as well, but present differently than they did. I fit most of the criteria for a "masking" undiagnosed girl.

 

I don't think his wiggliness/talkativeness is just typical for his age. We socialize with a LOT of families, and no one else comes close. We tried an organized t-ball group last year and it was impossibly difficult for him to focus. Part of the problem was the coach and his larger size interferring with age-appropriate expectations, but all rhe other kids in the group were able to adapt in a way that my son couldn't, so I pulled him out.

 

He seems to be almost physically pained by situations where he is expected to be still and/or quiet for any length of time. He can get weepy when asked nicely to be quiet for a minute and insists he can't and it makes him sad. The constant stream of questions come pouring out so fluidly he doesn't seem to need to think or breathe to between them.

 

He is impulsive, but not dangerously so. Most of his impulsivity is swinging arms wildly, spinning or running in close quarters, verbal barrage/interrupting, throwing random objects up above his head, doing something random and immediately regretting it, etc. When he was younger he was more prone to running away, fearless climbing, etc. but we curbed that and he has a healthy respect for heights (without any ER visits, thank goodness!)

 

"Academics" have not been an issue yet as his formal sit-down instruction time has been minor since he's technically pre-K. He is bright and picks up concepts and vocabulary so quickly I haven't needed to "make" him focus for long. He just absorbs things and seems to make big leaps with little formal teaching so far. He is probably a bit "behind" on scissor/coloring/letter formation compared to some of his peers. I haven't really pushed it yet.

 

While his vocabulary/sentence structure is advanced, he does have some pronunciation issues that might be atypical for his age. I was planning to ask his pediatrician at his well-check next month. He doesn't have the "obvious" sensory issues with food or clothing (in fact he will eat or wear most anything happily) but he does crave motion/spinning, crushing hugs, is a bit clumsy, doesn't realize how much force he is exerting, and has a high pain tolerance which I know can be sensory issues.

 

Thank you for your advice. You gave me a lot to think about and discuss with dh. I suspect we will get a full evaluation at some point. One of my questions was whether that would give me some answers to how to better help/teach him and it sounds like it would.

[PeterPan]

On my phone, but yes OT eval and sooner rather than later. The ped can run EF and spectrum screening tools. Ask him to. Don't assume ADHD and gloss other explanations or possible mix of explanations.

[Storygirl]

AndyJoy, I totally agree with the suggestion to get an OT evaluation. Sensory issues go both ways, with sensory avoiders and sensory seekers. Your description of your son sounds very much like a sensory seeker, and OT can be a big help.

 

We didn't seek an ADHD diagnosis for DS10 until this year, although we always thought he had it. As homeschoolers, we just accommodated, until we decided to look into medication. I will say that managing DS's behavior has taken a toll on ME. Now that we are getting help, I regret not doing it sooner. I have no regrets about having DS diagnosed. He actually has multiple issues, and, I'm not going to lie -- there is some emotion that comes with getting a diagnosis for your child, even if you know it is coming. I felt (and feel) sadness and grief as well as relief. So it's not easy, but getting answers is ultimately helpful and worth it, so that I can help my child be the best himself that he can be.

[SandyKC]

When he was younger he was more prone to running away, fearless climbing, etc. but we curbed that and he has a healthy respect for heights (without any ER visits, thank goodness!)

 ROTFLOL at that comment.. Fearless climbing, running, flipping, etc., however we garnished a Frequent Visitor's card to the ER!  DS had a high tolerance for pain to go with his fearless energy, which was not a good combination.  On the bright side (maybe), when he put his teeth through his bottom lip, he just sat there and let the doc sew his lip back together.  Gruesome and unbelievable.. I had to let my DH handle that one!

 

Pros and Cons for evaluating, you ask?

 

Pros:

1. You find out if your child actually has ADHD.
2. You find out the severity and type of ADHD.
3. You will learn which specific cognitive or executive functions are weaknesses for your child.
4. You can then use precise solutions to remediate the specific weaknesses your child has.
5. You can look at the results and determine your child's learning strengths and build those up.
6. You can follow the recommendations of the NP as to how best to teach your child.
7. You can get an early start on any additional Learning Disabilities (and there are often multiple issues) rather than waiting until your child is struggling and falling behind.
8. You will have early documentation of learning disabilities, which is helpful when you want/need to seek testing accommodations later on.
9. Depending upon the presence of and severity of your child's ADHD, you can better gauge whether medication might work better than non-medicated management.
10. You can get a diagnosis and keep the results private to yourself--no one else need know your child has even been evaluated.
11. Having your child evaluated will give you a better understanding of your child's neurology, which often leads to more effective parenting and education.

Cons:

1. It's expensive.
2. You may not get results you feel you can work with.

At your DS' age, there will be fewer of the cognitive development tests that can be administered with solid results.  There are tests for younger kids, but not as many.  A lot of the evaluation instruments have lower age limits of 8 or 9, so you might get a more limited eval now, and still need a more comprehensive eval later.

 

On the topic of meds, we didn't want to go there and didn't for years.  When my DS was a senior in high school and turned 18, he flat out told us he wanted to see if meds helped.  The first day he took them, he said, "MOM! We should have done this a LONG time ago!"  I felt guilty that my DS had struggled to get his school work done all those years, but at the same time, we did not want to give him meds at a young age.

 

Since ADHD is a brain chemistry imbalance, there are things we can do to help improve the brain chemistry, but the quickest and most consistent option is meds when a child has clinical ADHD resulting from the brain chemistry imbalance. 

 

So, depending upon how easy or difficult you currently find your DS to work with academically, and given his age, you might want to consider going with the flow for now.  When academics become a bigger issue, when more reading and writing are part of your DS' day, then you might want to go for an eval.

 

Just my thoughts, for what they're worth.

[kbutton]

Sounds like ADHD, sensory processing disorder, and giftedness are all possibly in the mix. I definitely encourage you to get a full evaluation so that someone has a bead on the full picture, and not just on pieces. It could change your life. I wish we'd know what to do much earlier than when we intervened. Don't be scared by what-ifs. If you are not comfortable with what comes out, sit on it, think about it, breathe, think about whether the evaluator has a point or not, ask questions about how they came a conclusion if you think they are way off (either dismissing issues or a diagnosis that seems too severe), and then regroup. You have time for additional evals down the road if the first one fails to explain things top to bottom--some kids need time for all their issues to surface to get the whole picture. 

 

I think you said pre-K. They have preschool IQ tests. The ones that start at six are considered more accurate, and age 6 is a great time. So, if your child is really close to six, you might get on a waiting list so that you can eval as soon as he turns six. If you have a ways to go, I recommend that you just get it done asap. 

 

You mention that he's sad he can't hold still. Some kids are oblivious to the majority of their issues at this age or at least don't fret about them. If he's aware, then he needs the security of having a game plan, and an evaluation can get you there. I do know some people that did meds very early (preschool), and it was life-changing. We're just starting them at 10, and if we'd been able to settle some of our concerns earlier, we'd have considered them earlier. Now that we've tried them, I wish it had been sooner. But, everyone has different levels of coping ability, and some people can take a lot before they are strained. We also wanted to be sure nothing else was missed, and then we had concerns about side effects (anxiety was a real possibility in our case that seems to have not materialized--we are dealing with ASD as well).

 

HTH. It sounds like you are going into things with your eyes wide open--that's awesome and a great place to be.

[AndyJoy]

Thank you all! I'm thinking it's time to get the ball rolling. I don't want to just sit around if something can help him now. I'm so used to him it seems like it's no big deal sometimes but then when I step back as an outsider and consider I think I need some help helping him. He is just so all-over-the-place. For now most people who treach/watch him smile and comment on how bright and fun and active he is but it is going to be a lot less cute and more crippling soon.

 

So when I talk to the pediatrician, what should I say/ask? Unfortunately we've had no continuity of pediatricians so he's never actually seen this one before, though my daughter has. They both have well-checks with her this month. What phrasing would you recommended? Should I try to talk to her without DS in the room?

[merry gardens]

Perhaps I'm the lone dissenter.  I have not pursued ADHD diagnosis.  We have a diagnosis of dyslexia for one and a diagnosis of auditory processing for another.  Both may have ADHD, but I don't officially know that. Why haven't I pursued a diagnosis?  Well, because I believe the range of "normal" behavior is far wider than many believe.  It's not that I doubt the existence of ADHD, it's just that I think people are far too quick to diagnosis childish behavior as "abnormal."  I looked up the stats before posting and the CDC says that in 2011, 11% of children were diagnosed with ADHD and boys at a rate of 13.2% compared to 5.6% for girls. As the mother of four boys (well, 2 are now men) I'm particularly concerned with how the number of boys being diagnosed with ADHD is 2-3 times greater than the number of girls. I think there is something wrong with a society that thinks there is something wrong with >13% of its boys. 

 

Now there very well may be good reasons to pursue an ADHD diagnosis, but some people being diagnosed as having ADHD at young ages may have something else going on--either in addition to or instead of ADHD.  If my son who has dyslexia was in school, I'm certain that someone would want to give him a diagnosis of ADHD. In learning all that I've learned about dyslexia, I've seen it's fairly common for dyslexia to get missed because the child's school problems are blamed on ADHD, (which can occur in conjunction with dyslexia but doesn't always.)  Similarly with my son who has an auditory processing disorder--he mishears what was said to him due to background noise frequently--and that can look like an attention problem.  Now, both of those boys might still have ADHD--but if you go to a doctor, especially one who is not familiar with all the various learning disorders, you could come away with a diagnosis of ADHD when what they could really use help in some other area.

 

The behavior modification techniques that are frequently recommended for ADHD can be used by parents without a diagnosis.  Many of them, like consistency and regular outside play time, simply look like good parenting.  Good organization which can help students with ADHD can be taught to our children--with explicit instruction if necessary--without needing a diagnosis.  Drinks like coffee or cocoa can be given to a child before school without needing a doctor's permission. There is so much that can be done to help children without needing that ADHD label. 

 

If you are going to ask your pediatrician about this, I would suggest that you ask your pediatrician for a referral to someone who can sort out ADHD from all the various other things that could be mistaken for ADHD.

 

 

[Storygirl]

I both agree and disagree with you, Merry Gardens. I've long thought that children can be misdiagnosed for ADHD and that many are medicated who don't need to be. When we had DS diagnosed, a psychologist who had been working with him for a year, his pediatrician who has know him his whole life, and a psychiatrist who specializes in ADHD all concurred that he had it. We also had the opinion of a classroom teacher who screened him for entrance to a private school (which he did not end up attending). Each of them used different screening tools and tests to get to his or her conclusion. I'm guessing that most people do not have that number of people chiming in on a diagnosis. But we found it helpful to have the diagnosis multiple times over. It did not take us multiple times for us to agree that he has it, by the way. We always suspected that. But the multiple diagnoses gave us peace about our decision to try medication.

 

The psychiatrist, by the way, did the most perfunctory screening of all of them before offering us a prescription. Our pediatrician and psychologist both mentioned that psychiatrists prescribe quickly. "That's just what they do," they both told me. This quickness to medicate could account for the kids who end up being misdiagnosed and/or incorrectly medicated. Many of the screening tools are subjective reporting by the parent and teacher. That's not to say that they necessarily produce inaccurate results, but when DH and I were filling them out, we sat together and hashed out some of the answers. Would our answers have been slightly different on a different day? Probably. Not different enough in our case to end up with a different diagnosis (DS's ADHD is severe, not borderline in any way), but we would not have come up with completely identical answers if we had done the testing more than once.  The questionnaires are subjective, not objective. These tests also have a teacher portion, meant to be filled out by the classroom teacher. Any child whose behavior is disruptive to the classroom or hard to manage may be tagged by the teacher in these kind of screening tools as having symptoms of ADHD. It is true that more than one thing can cause a child to have issues that LOOK like ADHD, but if the parent checklist and the teacher checklist both indicated ADHD, the psychiatrist is most likely going to diagnose ADHD. They are not experts in things like sensory disorders or processing issues which can appear to be ADHD but be something completely different. Our psychiatrist was looking for evidence of ADHD and not looking to get a whole picture of everything going on with DS (he has a ton more than just ADHD).

 

Having a thorough screening by a psychologist in addition to or instead of a psychiatrist's evaluation could be helpful for some people, because a psychologist cannot prescribe medication and is therefore more likely to consider a wider range of ways to address the issues. Someone who wants to pursue the idea of medication can always follow up with a medical doctor who can prescribe.

 

So I guess that is where I agree with Merry Gardens. People can be misdiagnosed. True. Some kids are just active and wiggly and don't learn well while trying to sit still in a traditional classroom but lack true ADHD. What I disagree with is the idea that ADHD looks like "childish behavior." My other three children act childish all the time.  They are wiggly and interrupt me and have a hard time sitting still and would rather run around the room than sit at a table and do schoolwork. They act like normal children. DS10's behavior is something completely different and complex.

[PeterPan]

Perhaps I'm the lone dissenter.  I have not pursued ADHD diagnosis.  We have a diagnosis of dyslexia for one and a diagnosis of auditory processing for another.  Both may have ADHD, but I don't officially know that. Why haven't I pursued a diagnosis?  Well, because I believe the range of "normal" behavior is far wider than many believe...  

I'm not disagreeing with anything you said, but how did they get the dyslexia and APD labels without getting the EF screening as well? And as part of full evals for dyslexia and APD, you'd have gotten IQ testing, info on EF, working memory, processing speed, blah blah, right? So if a mom *only* suspected ADHD and merely *assumed* without ever getting ANY eval, she'd never have the benefit of that process of learning about EF, working memory, processing speed, motor control automaticity, finding out she assumed the wrong label (haha), etc.   :)

 

To me the benefit was in the learning process, not the label.  If you go through a ped for a adhd label, you totally miss that learning process.  So if in Merry's case she's saying she had psych evals, found what she needed to be able to teach them better, and then it was a question of going back to a ped for a label to get meds, well of course that's her business.  That's just a behavioral question.  But adhd (the crap label they dump on everything after they exclude the other labels that they don't really fully have sorted out genetically and absolutely anyway) itself, by itself, even as a dumping ground label, causes SO many issues with how they learn and process, it sure is nice to know how in the WORLD the child's brain is working and what in the world to do to connect with them.  It's not *just* behavior and it *does* affect learning, even without an LD diagnosed.

 

I only nitpick on that and flip it like that (to a situation with no LD but yes ADHD) because every so often we get people coming through lamenting xyz going on in their teaching and they have NO CLUE it connects to the supposedly behavioral label their ped gave them so blithely after that questionnaire.  (I agree on the questionnaires btw, totally variable.  I've filled them out a ton and they vary with what's bugging you.)  

 

I think if you want help on how to teach your kid, you have to get the help and hang the nasty DSM.  And if you just want meds and no help teaching, you could have gotten that through the ped for a whole lot less money or skipped and done those alternative things, as Merry said.  Or read that laughably titled ADHD Does Not Exist book and gone through all the things that overlap.  But it is NOT invalid to want help for teaching a child who presents the differences of ADHD.  In our house, caffeine just makes her tired, doesn't cut it.  She has struggled to find a dose that helped without making things worse.  She lives au natural at this point.   :D

[mamabear2three]

I have to say from my very limited experience with agonizing over whether to test, the testing process, the results and various suggestions on how to manage symptoms, simply knowing is huge.

 

Suspecting is one thing, but knowing took so much pressure off of me! Suddenly I realized so many of the parenting struggles were not me, but something entirely separate going on in her brain.

 

I was glad to finally hear all the professionals (doctors, psychs' etc.) be finally supportive of my choice to homeschool, instead of telling me that all my problems would go away if I just put her in a classroom. 

 

Regardless of your chosen path to deal with any diagnosis, I'm a huge advocate of KNOWING... knowledge is power, and will give you the tools you need as the parent to make informed decisions on behalf of your child.

[Storygirl]

 

 

Regardless of your chosen path to deal with any diagnosis, I'm a huge advocate of KNOWING... knowledge is power, and will give you the tools you need as the parent to make informed decisions on behalf of your child.

 

Absolutely agree!!