Is this ADHD, SPD or something else???

[ssruckman]

Our ds, age 9, has been diagnosed with SPD, ADHD, dysgraphia and anxiety. He is currently taking Straterra and we are doing as much OT at home for SPD as we can. He has frequent sensory breaks and uses a lot of tools to help with the SPD.

 

He is struggling so much with his schoolwork, we are both frustrated and almost in tears daily. I try to keep mine from him, but yesterday, it all came to a head. He has been refusing to do his work some days, and I will give him a chance to get himself together and come back to complete his work. Yesterday, he refused, sat staring and not answering me. My husband set a timer for 10 minutes for him to get it together and work. At 9 minutes, he began to tear up his papers, which is when I got angry and told him he wasn't going to do that. He began kicking and hitting me, yelling. This is totally new. He has done this to some extent with his brother, but never an adult. My husband held him and he calmed down, went to his room. He told my husband that he felt like he couldn't do the work, it was too hard, so he just wasn't going to try. He is doing 2nd grade math, he was on lesson 5 of Intermediate Language Lessons, doing modified work, lots of oral lessons. He can't memorize anything. He reads for history, does science with our co-op, does half a page of handwriting-cursive, is practicing keyboarding. After the incident yesterday, I got his grammar and writing books out from last year, and we proceeded with those, dropping the ILL book, and he did better. Still, the math is difficult for him, he does one page a day, and it seems like nothing is clicking.

 

My question is, does this all jive??? I am wondering if ADHD can cause such delays with learning. He is paying attention fairly well, and I let him fidget with things and jump on the mini trampoline when the lessons allow. He will begin testing for CAPD next week because he takes so long to answer oral questions, has difficulty following oral directions, and can't keep up if the conversation is going to quickly.

 

He has had testing with a psychologist. I can't find the result to save my life. I am thinking of having a neuropsych eval to try to figure this out.

 

Any ideas? Help!

[MomatHWTK]

Do you know if there was any LD/IQ type testing or just behavioral? ADHD can impact processing speed, but I *think* they can be separate issues as well.

 

While considering your options, you might want to do some research into how to maneuver through these blocks. Ecalating will just lead to a meltdown, in my unfortunately extensive experience. It may also be that as he gets older he needs additional medications to cope with the huge changes going on hormonally and mentally.

 

I wouldn't hesitate to get another consult and ask for more support from your physician(s).

[Mandamom]

Yes, this can be from the ADHD, SPD, memory issues, or something else that might be going on. Anxiety is only going to make it more stressful for him.

 

Definitely investigate an full-fledged evaluation to find out what is going on.

 

At this point escalation of wills is only going to set up a negative learning experience for him which will last longer than that one assignment not being completed.

 

Math: does he have one-to-one correspondence, can he sequence orally. . Can you give him the placement test for the math program you are using and see which level he can do by himself and still pass? If he's at first grade math than that's where you need to work until you can get him caught up.

 

Work with manipulatives until he understands. See if he can work through them without the manipulatives. The next day, if he needs the manipulatives again, that's okay because with memory issues this is going to be normal.

 

I was working with an 8 year old yesterday and she was really upset because she just "lost"how to subtract with regrouping even though she's been doing it for months. We just pulled out the manipulatives and she ended up having fun. She developed confidence and so next time I see her if we need to do more manipulatives we'll do them again.

Edited August 25, 2012 by Mandamom

[RPDwifey2819]

I don't have a lot to add to what the others have metioned but this:

 

1: How long has he been on Strattera? My DS had a violent reaction to it.

 

2: Would changing his curriculum be an option?

 

My DS has all of those DX'es. However, I have abandoned all the typical curriculum resources from the last 2 years and have adapted to his learning needs with other options- Math U See, Real Science 4 Kids, Draw Write Now- a change from Singapore, Standard phonics program, copy work. (I didn't have a science curriculum before but as he is in tune to it, I chose to keep him engaged in learning by adding it in)

 

I also have changed our diet. I FINALLY took gluten out of his diet and have noticed real positive changes. I also added in TriEnza, a digestive enzyme to help him digest the food proteins that may be affecting him but I haven't identified yet.

[Tiramisu]

Have you read The Explosive Child? Yeah, the title seems pretty negative, but there is great insight in this book about kids with low frustration tolerance. You may see the frustrations come out in hitting and yelling or it can be internalized. It does give great suggestions about how to avoid putting these kids into situations where they are bound to get frustrated, and giving them a constructive way out when they get there so their self-esteem is preserved--without okaying the behavior, if you KWIM. It is actually about discipline based on an understanding of the inner workings of some children. I remember a very wise pre-school teacher telling me about one dd, she has a very strong physical response, and how I should never put her against a wall without providing a way out. That's the kind of awareness that's in the book.

[ssruckman]

The psychologist did IQ testing, should have been the whole 9 yards, it was done over 2 days, 3 hours each day. She had to guess at his IQ because he kept having meltdowns during the testing. This was last summer, at age 8. She called them anxiety attacks. It sounds similar to what he does when he is overwhelmed with what he is asked to do with his schoolwork.

 

He has worked up to this level in math, using MEP math. We have tried every math program there is, this is the one he has tolerated the best. He worked through Life of Fred Elementary Series up to the last quarter of Edgewood, when he hit a wall and didn't want to finish. He very much wants to do his work on his own, but feels better if I am close if he has to write anything. He hates to work on the computer, so that is out. Reading to learn is great for him, I have no problems with him if I hand him a book and tell him to read a chapter, and he wants to write his own stuff, without me checking or editing.

 

He does have one to one correspondence, he understands addition and subtraction, but he can't memorize the facts. I'm okay with that. I get the executive functioning issues, but is this all EF??? It seems so much worse, like there is really something very wrong.

 

We are careful with what he eats, but he doesn't eat much. His diet is very self restricted. If it weren't for PB&J, he would starve, and sometimes he won't even eat that. But I don't let him eat junk, it is what the family is eating, PB&J, or nothing. We don't use processed foods, but taking gluten out would be a nightmare.

 

His curriculum is not normal, it is very adapted, he writes one sentence a day using a word from Vocabulary Cartoons, one page from math, a few lines in a cursive writing workbook, read a chapter out of M.B. Synge history book, and a page or two out of Get it Right for grammar. He takes science at co-op, and they do their thing there, no homework, just fun. I am putting keyboarding on the back burner. We do bible together as a family. I dropped Intermediate Language Lessons after yesterday's fiasco.

 

I will read The Explosive Child. I understand about needing an out, and I try to give him one. This came out of nowhere. He doesn't talk a lot, so I don't know how to figure out what he is going through. It is all so frustrating. His pediatrician does not understand any of this, and is no help at all. We have tried several other ADHD meds, and they had weird side effects. Straterra has been fine, in fact, it is sort of hard to tell that he is on it, except for the fact that we lowered the dosage once, and realized that was a bad idea. He has been on it for 9 months or so.

 

I think I will schedule the neuropsych appointment as soon as we can afford it. Why does it all have to be so expensive???

[RPDwifey2819]

Sounds like you are doing all you can for him academically. ((hugs)) That has to be hard to see him struggle and be so frustrated. :(

 

I have a friend who read The Explosive Child- twice- and the methods in it have worked wonders for her DD. I really is a very good book.

 

Just a thought-- sometimes kids who are very self limiting in foods do so b/c of the negative association with food from the early days. We don't always have a visible outward sign of food allergies or intolerences. Celiac disease is one of these that can cause strange food habits and even food aversions. It can also lead to what appears to be ADHD, SPD, and ODD. I never realized it in my self until I got another medical dx... but I have been gluten intolerent for years. I can tell immediately when I have been glutened- yes, I have a stomach ache- but, I also get very rage-y and explosive :(

 

I'm not saying that he has Celiac or that he has food allergies.... but from what you describe with his eating, there may be a connection.

 

Best wishes to you and your DS!! I hope the best for you both.

[Guest JenBiren]

Our son is 15 now and your description fits him pretty well at age 8-12. He is diagnosed with ADHD and we had him do a full diagnostic. It was expensive, but we still use that darned document every chance we get with providers and its wonderful. We learned so much about how he processes information (slowly) and that his brain moves quickly, so as a friend of mine described her similar son, its like having a High-speed brain on a DSL line. Very frustrating! Our son's anxiety and frustrations have been greatly reduced as the years have gone by and he is better able to control himself. He does take medication (Focalin xr, Hydroxizine for anxiety- not an SSRI- and Abilify for mood management. All of them are on minimum dosages now.

 

Our son's frustrations have greatly reduced since pulling him from ps last year- but actually I credit our (his parents) ability to control our own anxiety a large part of it. We have listened to Kirk Marin's "Celebrating Calm" (http://celebratecalm.com) series and boy has it helped us work with our son and calm the stress and anxiety amongst us all. it's not diagnosis-specific, its more about working with kids who are "not so compliant" ;) and cause parents to worry about their kids and their own abilities with them. I can't recommend it more.

 

I can recommend figuring out how to pay for the most deeply detailed evaluation. We went to a family therapy center in our town in NC and had a Phd doctor evaluate our son over a few days. Everything he said came true- even the subjects he would do well in. Kind of spooky, actually.

 

Hang in there- bad days happen. Our son has them still and thankfully they are much less often now. (well, I haven't started assigning him papers yet...)

Edited August 25, 2012 by JenBiren