Jump to content

Menu

Bringing up possible ADHD concerns with ped. What to expect?


Recommended Posts

I'm usually posting about my oldest with ASD on these boards but I have a question concerning my younger ds now. Compared to my oldest, he has seemed pretty NT though I've always considered him VERY high energy. Over the past year or so, his energy levels, impulsiveness and tantrums have reached a point that I highly suspect ADHD. I have an appointment with our pediatrician to talk about my concerns this week.

I'm wanting to know from those who have BTDT will this appointment most likely lead to eval referrals and a long drawn out process or in more straight forward cases can the pediatrician go ahead and treat for ADHD? It has taken us years to figure things out with my oldest; I just want to prepare myself mentally if this will likely be a similar scenario. Thanks!

Link to comment
Share on other sites

The short answer is...some will go straight to a diagnosis (and med prescription), but this is why ADHD is overdiagnosed...The best pediatricians won't. 

 

The real question is, what is the BEST way to proceed? We highly suspected ADHD, but we wanted a full evaluation, so we could make sure there wasn't something else going on, or other comorbidities. Energy, impulsiveness and tantrums could be any number of things, and I wouldn't want to go straight to meds unless I knew for sure. (Even if I did know, I'd want to try other potential solutions first. And we did try, for over a year, and DD's behaviors did improve. She still had a hard time with schooling though, so we ended up deciding to try meds when we decided to start her in public school.)

  • Like 3
Link to comment
Share on other sites

The short answer is...some will go straight to a diagnosis (and med prescription), but this is why ADHD is overdiagnosed...The best pediatricians won't.

 

The real question is, what is the BEST way to proceed? We highly suspected ADHD, but we wanted a full evaluation, so we could make sure there wasn't something else going on, or other comorbidities. Energy, impulsiveness and tantrums could be any number of things, and I wouldn't want to go straight to meds unless I knew for sure. (Even if I did know, I'd want to try other potential solutions first. And we did try, for over a year, and DD's behaviors did improve. She still had a hard time with schooling though, so we ended up deciding to try meds when we decided to start her in public school.)

Yes, I do know this deep down...I'm just so very tired and honestly, when I get to the point that I'm bringing this up to the doctor, I'm pretty much at crisis point. I've already been giving him "accommodations" for lack of a better word and parenting with the possibility of ADHD in mind. I thought we could get by without more than that for him but it's becoming clear he needs more.

 

Thanks for sharing your experience. I know you are right, I just wish something could be easy!

Link to comment
Share on other sites

:grouphug: I'm sorry, I know. I can't imagine having my daughter as well as a young kid on the spectrum, I don't think I could do it. (We had a hard enough time with one loud, temperamental, incredibly hyperactive kid, which was one of the reasons we finally decided to try ps.)

 

We were lucky to find a neurologist who got us in within 2 months, tested and diagnosed in 3, although we didn't do meds for another year. There are also psychiatrists around here that will do Quotient testing, and they don't have waiting lists (although I don't know of any who take insurance.) It's worth looking around and getting on waiting lists as soon as possible, see what you might have in your area.

 

Have you had him try coffee? It's calming for many ADHD kids...We also used Suntheanine, which seemed to help a bit. Mindfulness and Zones of Regulation have been helpful for the tantrumming, it's worth looking into if you have the energy. But I know, it IS exhausting, more than most people will ever understand... :grouphug:

Link to comment
Share on other sites

Yes, he finishes off my coffee every morning and it does seem to help. I use Zones of Regulation with him as well since we were already using it with his brother. I'll look into Suntheanine, thanks!

 

Depending on where my ped refers us to I know the wait lists in our area can run several months out so I'm preparing myself to wait for quite awhile before we get any answers.

Link to comment
Share on other sites

WoolC, I hope that my post did not sound insensitive! I didn't mean for it to be. I was just sharing where we are at and acknowledging that it is hard. Meds are a personal/ family decision though, and what is best for each child and family will not be the same for another. This is why I never take a position for or against. I just share our experience.

 

I agree with Nature Girl that the best doctors will not just hand out the meds. In our case, I made it clear to the ped that we are not considering meds and asked if she had any alternatives to recommend. We are pretty much doing what was on the list, at least whatever I have been comfortable trying. My son also has sensory issues, both my boys do, and that affects them during certain seasons and in certain situations. We also have some immune issues going on and there are links to that and the gut as well. For what it is worth, my 8 yr old goes through phases with hyperactivity. There are times when he is bouncy all day and you can come a few days later and he will appear like a different child. So, in our case, we take it for what it is and just cope. We are not dealing with aggression.

That's quite alright, I know everyone on the boards is coming from a different perspective regarding meds. I have actually been one of the most anti-meds people I know of in the past. I cringe to think of some of the things I said pre-kids!

 

Anyway, at this point my ds' impulsiveness, hyperactivity and occasional aggression has increased to the point that I can no longer send him to children's church or to extended family that used to watch him for me. Since I'm homeschooling I need to have that support system in place for my health. Meds were something I NEVER thought I would do, but at this point, if they will allow us to keep up the bare minimium in functioning as a family I'm willing to try.

Link to comment
Share on other sites

That's quite alright, I know everyone on the boards is coming from a different perspective regarding meds. I have actually been one of the most anti-meds people I know of in the past. I cringe to think of some of the things I said pre-kids!

 

Anyway, at this point my ds' impulsiveness, hyperactivity and occasional aggression has increased to the point that I can no longer send him to children's church or to extended family that used to watch him for me. Since I'm homeschooling I need to have that support system in place for my health. Meds were something I NEVER thought I would do, but at this point, if they will allow us to keep up the bare minimium in functioning as a family I'm willing to try.

 

 

Believe me, I was the exact same way before becoming a mom. (I may never have said it out loud, but I had definite opinions.) And even when DD7 was diagnosed, for months I said there was no way I would ever go there. I told myself it would be selfish to even consider it. But it all started to destroy me. I have my own health issues, needed a series of painful surgeries, and I was just starting to fall apart. This is the main reason we started her in ps (and so on meds), because I needed that break from her energy, and she LOVES it there.

 

I know it was the right choice. She's happier, our marriage/family is happier, she's made good friends for the first time in her life, and I know even if we do someday pull her back to hs we will probably keep her on meds...I watched her in the playground yesterday with a girl she knew from school, interacting in a way that never would have been possible beforehand, and I was filled with this joy...This is what parents of NT kids feel watching their kids! I no longer have to worry about her bolting, trying to retaliate against someone who's accidentally knocked into her, breaking down in tears because she can't climb something...

 

All this to say, don't ever feel bad about the choices you need to make. Know that in the end you're doing it not just for yourself, but for your family AND your son.

  • Like 1
Link to comment
Share on other sites

Believe me, I was the exact same way before becoming a mom. (I may never have said it out loud, but I had definite opinions.) And even when DD7 was diagnosed, for months I said there was no way I would ever go there. I told myself it would be selfish to even consider it. But it all started to destroy me. I have my own health issues, needed a series of painful surgeries, and I was just starting to fall apart. This is the main reason we started her in ps (and so on meds), because I needed that break from her energy, and she LOVES it there.

 

I know it was the right choice. She's happier, our marriage/family is happier, she's made good friends for the first time in her life, and I know even if we do someday pull her back to hs we will probably keep her on meds...I watched her in the playground yesterday with a girl she knew from school, interacting in a way that never would have been possible beforehand, and I was filled with this joy...This is what parents of NT kids feel watching their kids! I no longer have to worry about her bolting, trying to retaliate against someone who's accidentally knocked into her, breaking down in tears because she can't climb something...

 

All this to say, don't ever feel bad about the choices you need to make. Know that in the end you're doing it not just for yourself, but for your family AND your son.

Thanks for sharing! This is what I'm hoping for with my son. If meds could even get us to a point where he could be more receptive to learning coping strategies and such I'd be thrilled!

  • Like 1
Link to comment
Share on other sites

All this to say, don't ever feel bad about the choices you need to make. Know that in the end you're doing it not just for yourself, but for your family AND your son.

Just one thing I want to say here though! This also applies to those of us that make the decision not to medicate, for our own reasons. We are not selfish people, inconsiderate of our kids' needs, as we are sometimes made out to be. We just make different choices, based on our own situation and child, and our own family's needs. Sadly, that is not always considered by some on this board!

Edited by Guest
Link to comment
Share on other sites

Just one thing I want to say here though! This also applies to those of us that make the decision not to medicate, for our own reasons. We are not selfish people, inconsiderate of our kids' needs, as we are sometimes made out to be. We just make different choices, based on our own situation and child, and our own family's needs. Sadly, that is not always considered by some on this board!

 

 

Of course, Marie! We all think of our kids first, and make the choices we feel deep down are best for them, and of course what's best can differ wildly, just as children differ wildly. I never meant to suggest otherwise, was just trying to help WoolC find peace with whatever decisions she makes.

Link to comment
Share on other sites

Of course, Marie! We all think of our kids first, and make the choices we feel deep down are best for them, and of course what's best can differ wildly, just as children differ wildly. I never meant to suggest otherwise, was just trying to help WoolC find peace with whatever decisions she makes.

Nature Girl, I didn't mean that about you. I knew why you said what you did, just like I appreciate and respect other people's choices, although they may differ from my own. It was just a general point I was trying to make, on a theme I often notice on here.

Edited by Guest
Link to comment
Share on other sites

Meds have changed our lives. He can finally slow down and is now receptive to intervention and can learn. Meds have not made him a zombie. . . actually we can finally see who he really is. . . a sweet, loving, kind hearted, funny little boy. I was VERY anti meds. . . VERY! I am thankful for all the went on before in my journey that got me to the place where I was ready to learn and consider things outside my paradigm.

  • Like 2
Link to comment
Share on other sites

Meds have changed our lives. He can finally slow down and is now receptive to intervention and can learn. Meds have not made him a zombie. . . actually we can finally see who he really is. . . a sweet, loving, kind hearted, funny little boy. I was VERY anti meds. . . VERY! I am thankful for all the went on before in my journey that got me to the place where I was ready to learn and consider things outside my paradigm.

Thank you for sharing! I need all the encouragement I can get!

Link to comment
Share on other sites

I think it's good to be open to considering all of the options. And then you take time to consider them and make the best decision for your son and your family.

 

Meds have also been a very good thing here, and I was also against them at first. We actually had three different evaluations -- counseling psychologist, pediatric psychiatrist, and pediatrician -- all of which confirmed ADHD, before we began meds. We were also meeting with the counselor, learning calming techniques from our OT, and getting mindfulness recommendations from the pediatrician, in addition to the pharmaceutical approach.

 

At that time DS was nine, turning ten, and things had reached a tipping point. I realized that we needed outside help.

 

Link to comment
Share on other sites

About what to expect from the pediatrician. Be prepared for them to be doubtful about the ADHD. I hope that doesn't happen, and that you have a doctor who will really listen, but I can happen. It happened to me. Our pediatrician brushed me off. In the nicest possible way, but still a brush off. I think his natural tendency was to soothe the concerns of moms by saying that behaviors are not out of the norm.

 

He was actually very interested in human behavior and was a believer in doing personality type screenings, so that parents could understand the behavior of their children better. He also had a "parent coach" on staff who led parenting seminars. He was really interested in helping parents connect with their kids. But I think he had a kind of mindset that parents benefit from training, and that after that, the child behaviors get better, because parents understand their kids better.

 

I like that approach really. But it got in the way of him being able to see that sometimes it was not ALWAYS "parents need to learn a different way," but "child has some problems to address."

 

Once we brought him the diagnosis from the psychs, he was on board and was a great help and actually managed the meds for us. But he didn't see it at first. I've heard other stories like ours, so I just wanted to say...be prepared to be insistent that this is not in the range of normal issues. Maybe make a list of behaviors that you see and how often they happen and how diligent parenting isn't making the problems better. If he or she tries to soothe things over and brush it off, be insistent. I am a nonconfrontational person, so I wouldn't argue or insist but just leave the office with a sigh, feeling misunderstood.

 

And I loved our doctor! He is a great and well-respected pediatrician. But we still had a hard time making him a believer.

 

Your doctor hopefully won't respond in that kind of way, but be prepared.

  • Like 3
Link to comment
Share on other sites

Some pediatricians, to answer one of your questions, will run their own screening tools to check for ADHD and will treat it themselves. Others will refer it out to a pysch. The screening usually involves filing out a behavior checklist and having a teacher do one as well. Some providers have access to a computer program called Quotient or another one called TOVA. They test attention and impulsivity and generate a report. Our pediatrician liked to use the Quotient both to diagnose and also to see how effective the meds were (he would run it multiple times). He happened to own the machine himself.

  • Like 1
Link to comment
Share on other sites

About what to expect from the pediatrician. Be prepared for them to be doubtful about the ADHD. I hope that doesn't happen, and that you have a doctor who will really listen, but I can happen. It happened to me. Our pediatrician brushed me off. In the nicest possible way, but still a brush off. I think his natural tendency was to soothe the concerns of moms by saying that behaviors are not out of the norm.

 

He was actually very interested in human behavior and was a believer in doing personality type screenings, so that parents could understand the behavior of their children better. He also had a "parent coach" on staff who led parenting seminars. He was really interested in helping parents connect with their kids. But I think he had a kind of mindset that parents benefit from training, and that after that, the child behaviors get better, because parents understand their kids better.

 

I like that approach really. But it got in the way of him being able to see that sometimes it was not ALWAYS "parents need to learn a different way," but "child has some problems to address."

 

Once we brought him the diagnosis from the psychs, he was on board and was a great help and actually managed the meds for us. But he didn't see it at first. I've heard other stories like ours, so I just wanted to say...be prepared to be insistent that this is not in the range of normal issues. Maybe make a list of behaviors that you see and how often they happen and how diligent parenting isn't making the problems better. If he or she tries to soothe things over and brush it off, be insistent. I am a nonconfrontational person, so I wouldn't argue or insist but just leave the office with a sigh, feeling misunderstood.

 

And I loved our doctor! He is a great and well-respected pediatrician. But we still had a hard time making him a believer.

 

Your doctor hopefully won't respond in that kind of way, but be prepared.

Thankfully our ped is the same that took our concerns about my older son seriously, so I think she will be proactive with this. I am worried because she is pretty anti-homeschooling so I'm bracing myself for why don't you put these kids in school kind of comments. She has offered meds for my oldest though we declined since we're seeing steady progress in my older son without it.

I believe my pediatricians office has a pretty standard procedure for behavior related appointments so I'm halfway expecting them to diagnose, but I wanted to hear if anyone else had gone that route or if full evals are pretty standard for this. Thanks for sharing how things worked for your family!

 

My internet is out today so I'm replying on mu phone, please excuse any typos!

  • Like 1
Link to comment
Share on other sites

I had the appointment today. Our pediatrician used the Vanderbilt rating scale for ADHD and we received the diagnosis today. I did get a long speech about how I need to put him into public school so that he can learn to "conform socially instead of imitating his autistic brother" which I promptly disregarded. I seriously need to find a homeschool friendly doctor who also takes my concerns seriously! Now I just have to be brave enough to start the meds with him tomorrow morning.

  • Like 3
Link to comment
Share on other sites

Our doc used the Vanderbilt too. Don't be afraid of trying meds. They can make all the difference in the world. Just be patient and don't expect the med to make all his behavior go away. The meds get him in a place so he can learn NEW ways to handle himself. And he will. But they won't MAKE him behave. That takes work. Hope it goes well.

  • Like 1
Link to comment
Share on other sites

So far so good. Thanks for checking in everyone!

 

We're trying Quillavant XR. I'm not sure what I was expecting but he's totally himself, his usual fun personality except CALM. It's actually really weird because we've all gotten so used to him bouncing off the walls constantly. He sat through our morning read aloud for the first time and had incredible focus during his seat work. I'm most surprised by how he's playing today. He builds with legos all day, usually creatively because he doesn't like to look for specific pieces to follow lego instructions. Today he tracked down all of the pieces to a bionicle figure that have been missing for months and built it all on his own! That's huge for him to set out on a task like that and carry it out without giving up!

  • Like 3
Link to comment
Share on other sites

Just one thing I want to say here though! This also applies to those of us that make the decision not to medicate, for our own reasons. We are not selfish people, inconsiderate of our kids' needs, as we are sometimes made out to be. We just make different choices, based on our own situation and child, and our own family's needs. Sadly, that is not always considered by some on this board!

I have two children with ADHD. One is medicated and one isn't. Where does that leave me? Am I good mom or selfish and inconsiderate?

 

😂

 

I'm guessing most of us are doing the very best we can to make informed responsible decisions. That makes us all good moms no matter where we fall in the medicate/don't medicate camps. I don't know who these "some" are, but who needs them?

  • Like 2
Link to comment
Share on other sites

it honestly depends upon your ped.  some are great - some not so much.  mine . . . to whom I had been taking kids for 25 years at the time . . . shut me down, put me off and completely discounted everything I had to say. :ohmy: I was utterly flabbergasted by it.  he then had a ranting fit :chillpill: about how he couldn't exam him because dudeling wouldnt' stand on the scale and he didn't know his weight.  (if you picked him up to put him on it, he'd pick up his feet.  if you told him to stand on it - he's splay himself across the floor.  he did that from the very first time someone tried to weigh him standing up as opposed to a baby scale.  only in the last year or so has he been willing to actually stand on one without a struggle.  he's 12.)  so, he was more angry about the non-cooperation than he was concerned that the movement of the scale freaked him out to such an extent.

 

needless to say - :auto:  I haven't seen him since.   I was able to get him into the university's child development center for an extensive eval.  (asd, anxiety, some adhd, some ocd,  odd - which really wasn't ever addressed in tx.)  later with a slp - capd. 

now, we're scheduling with a ped neuro for another adhd eval.  (and hopefully addressing the odd as well :toetap05: .)  but I just got the referral for that yesterday.

 

I would rec a diagnosis by someone other than a ped. get the referral.   you want someone who knows more about it than the ped.

I once attended a lecture by a dr who runs an adhd clinic.  the ONLY kids who came were kids whose ped had diagnosed them as adhd. . . .  only half actually had adhd.

  • Like 1
Link to comment
Share on other sites

 

I would rec a diagnosis by someone other than a ped. get the referral.   you want someone who knows more about it than the ped.

I once attended a lecture by a dr who runs an adhd clinic.  the ONLY kids who came were kids whose ped had diagnosed them as adhd. . . .  only half actually had adhd.

 

 

Wow...That's flabbergasting, and terrifying. Because that's probably the way the majority of people, especially those who haven't self-educated on ADHD beforehand, are diagnosed. 

 

The book ADHD Does Not Exist is excellent...It agrees ADHD does exist, of course, but shows many other issues that might be behind behaviors. And...some kids are just over-energetic, but completely neurotypical. 

  • Like 1
Link to comment
Share on other sites

 

 

Depending on where my ped refers us to I know the wait lists in our area can run several months out so I'm preparing myself to wait for quite awhile before we get any answers.

 

yes - and call every couple weeks or so.  the child dev center put us on the waiting list and said they'd call.  they never did - so I ended up having to call them just to remind them I was here, waiting.

he had the full battery.   psychology, audiolgy (though if i'd know their's was barely more than a basic hearing screen . . I wouldn't have done it.  i wanted a capd screen.), slp, nutrition, OT/PT, and a couple others.  on two different days - it was hours. and exhausting.  then dh and I went back to meet with the team for the results.

 

slp's won't screen for capd until a child is at least seven.   they have to cooperate.  it consists of two parts - a *very* thorough hearing test to rule out an organic problem - then the capd screen.  both appoints are at least an hour.

 

 

 

We use CBT style strategies (mindfulness is also part of CBT). Usually, spring is the hardest time for us. My boy's activity level changes with the seasons. He has no problem focusing on his passions though. Neither of my two do! So we do what we can while we are waiting for their new evals at the autism center. We will decide on therapies after the evals but meds is not an option we are considering, now or in the near future. My 13 yr old has no problem getting his school work done. He can keep up just fine. The 8 year old I can focus but have to be there to keep him on task and I anticipate it will be this way for several years to come. Once school gets done, I cope with the rest. I pray for strength daily :)

 

Hope you find the best solution for your family :grouphug:

 

what can you tell me about the cbt? what is it aimed at helping?  how does that work with your asd child?

 

  • Like 1
Link to comment
Share on other sites

Wow...That's flabbergasting, and terrifying. Because that's probably the way the majority of people, especially those who haven't self-educated on ADHD beforehand, are diagnosed. 

 

The book ADHD Does Not Exist is excellent...It agrees ADHD does exist, of course, but shows many other issues that might be behind behaviors. And...some kids are just over-energetic, but completely neurotypical. 

 

capd has many overlapping tendencies with adhd, asd, dyslexia, etc.

there are three kinds of capd.

Link to comment
Share on other sites

Wanted to update to say that it looks like the side effects are outweighing the benefits on the quillivant. I gave him a half dose today but still having issues with no appetite, no sleep, extreme irritability and rigidity that is out of character for my son, etc. We're discontinuing for now and heeding advice to get on the wait list for full evals before trying anything else. I did read the ADHD Doesn't Exist book yesterday from my library overdrive account, thanks for the recommendation nature girl! I was able to rule out most of the other possible explanations provided in that book but I will still feel better working with someone who specializes in ADHD as we figure out how to proceed.

Link to comment
Share on other sites

Ugh, I'm sorry. We had to go through 3 meds (and 2-3 dosages for each) before we found the perfect fit. It could be that amphetamines work better for him, or even a different methylphenidate. (We had minor emotional issues with Focalin, which we don't see with Concerta.)

 

Regardless, the full eval will put your mind at ease, so I think it's great that you're getting it. (If you find a neurologist or psychiatrist with ADHD experience, they'll also have more finesse in tweaking meds.)

Link to comment
Share on other sites

Talk to the doctor. It took several months and trying many meds before we found the right one at the right dosage.

 

For DS, the "right' one happens to be not quite as effective as one of the others we tried, but it has fewer side effects.

 

Appetite suppression has been an issue for DS, but we have found ways to work around it. He isn't often hungry for lunch but will eat twice as much in the evenings and will often eat his lunch after school (he is enrolled in school).

 

Also, there are options for taking a short acting version of some meds that will wear off by lunchtime, allowing the child to eat. Then they can have a second dose for the afternoon.

 

It's worth reporting back to the doctor and seeing what else they can try. There are options out there.

  • Like 1
Link to comment
Share on other sites

Talk to the doctor. It took several months and trying many meds before we found the right one at the right dosage.

 

For DS, the "right' one happens to be not quite as effective as one of the others we tried, but it has fewer side effects.

 

Appetite suppression has been an issue for DS, but we have found ways to work around it. He isn't often hungry for lunch but will eat twice as much in the evenings and will often eat his lunch after school (he is enrolled in school).

 

Also, there are options for taking a short acting version of some meds that will wear off by lunchtime, allowing the child to eat. Then they can have a second dose for the afternoon.

 

It's worth reporting back to the doctor and seeing what else they can try. There are options out there.

I'm definitely calling the doctor tomorrow, if nothing else I want his reaction documented. Feeling a little wary about trying anything else just yet, but I'll discuss the options with our pediatrician.

  • Like 1
Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...