ADD/ADHD testing

[brynndolyn]

I have suspected for quite some time that my 7 yo DS (he'll be 8 in March) has some form of attention deficit disorder. We homeschool so I felt like that would give him some room to mature if it was just lack of maturity, and give him some grace to have extra play time etc. 

 

My husband is getting pretty fed up and would like to get him tested and possibly start medication, assuming of course that he does actually have this.

 

Throwing a wrench in this whole thing is the fact that I do not really care for our doctor, and have been considering getting a new one.  She seems to be somewhat anti homeschooling, and also anti breastfeeding past a certain age (I'm still nursing 15 month old DD and she has been saying that she should be switched to cow's milk for months now).  I assume the process would need to start with her, but if I get a new doctor and then say right off the bat hey, can you test my kid for ADD I feel like that would look bad.  Maybe I shouldn't be worried about this, I don't know.

 

Anyway. I thought maybe I'd talk things over a bit here and see if anyone has any thoughts. I've never done anything like this before, and I always second guess myself and think "Well maybe it's not as bad as I've made it out to be, maybe it's normal for his age" etc.

 

Looking at the different symptoms of things online he:

 

* Doesn't pay attention to detail or makes careless mistakes (especially with chores and copy work, skipping over lines, finishing only half of a word before moving on to the next word, etc.).  I do feel this is somewhat "normal" for his age.

 

* Doesn't stay on task (especially if it is something that takes more than 5-10 minutes, he will literally just stop and stare into space, fiddle with pencil, etc. He can sit there for 30 minutes or more doing literally nothing).

 

* Doesn't appear to be listening (won't look you in the eye when you're talking to him, constantly in motion)

 

* Doesn't follow instructions (for example, in a 3 step process he will complete 2 things and not do the other part, such as take sheets off bed, put clean sheets on bed, bring dirty sheets to laundry room he will forget to bring his sheets down to the laundry room. Or at night getting ready for bed he will put his pajamas on but forget to brush his teeth and go to the bathroom, getting distracted by the other kids, or by toys, or by just staring at the wall.) These are things he does weekly/daily, and he still needs constant reminders to make sure that every step is completed.

 

* Avoids or dislikes doing things that take effort or concentration (again, if they last longer than a few minutes, he'll just quit and move on to something else)

 

* Loses things - YES

 

* Forgetful and easily distracted - YES. Sometimes he literally has no idea what he was doing (for example, he was buttering his bread and started playing with the knife in the butter, and I asked him why he was doing that and he had no idea he was even doing it. Half the time he is in la la land and he either has no idea what he is/was doing or else he is a very good liar. I don't think he's lying though, he simply somehow can not remember what he was doing 5 minutes ago).

 

 

As far as the hyperactivity piece, the only things I really see are constant talking (including interrupting others, not taking turns in speaking with others) and being in constant motion.  It's hard for me to know if this is just manners/maturity that needs work or if it is a problem.  The other things listed I don't think are as applicable.

 

 

The biggest problems, to me, are his ability to be distracted by anything and everything and the times when he can't remember what he has been doing.  His tasks take him such a long time to do, it's frustrating for him as well as the rest of us who might be waiting on him. He is the one who takes the longest to get dressed, to get shoes and coat on, to do just about anything and everything because he moves soooo sloooowly and is distracted by every single thing he sees. DD5 and DS6 can do the exact same things that he does in half the time, with no adult assistance or reminders.

 

 

I have really mixed feelings about this.  As I've said, we've suspected for a while.  His younger brother (age 6) seems so much more responsible and reliable and I feel like as DS6 has matured it has kind of highlighted DS7's issues. And I say that with love, I try very hard not to compare them. DS7 has a lot of strengths, including being a natural leader, very very creative, he has wonderful number sense and has amazed me with the things he's learning in math (even things that I didn't teach him), and his language skills are off the chart.  He's amazing at art also, he's always thinking of crazy stuff to make.  He's clearly very bright, and I don't think I'm biased about that.

 

So, any thoughts on the new doctor or trying to pursue this with our current one, any feedback on any of the symptoms, etc.? Anybody BTDT?  I feel a tremendous amount of guilt about this and I do not know why. 

 

Sorry this is so long, you get a gold star if you've finished! :)

[kirstenhill]

You'll get more replies on this if you post it on the learning challenges forum. Even though all of what you are seeing isn't learning challenges per se, a lot of the people who frequent that part of the board have a lot of experience with all kinds of evals.

 

What you probably want to check on first is what requirements and coverage your insurance has. I could have skipped talking to our primary care doc all together before scheduling an evaluation for all the insurance company cared. No referral required. I did talk to our doc to ask for suggestions on where to fo for an eval, but she turned out not to be very helpful in that regard (I found better testing options by googling than what she was aware of).

 

A full neuropsych eval is what is going to give you the most complete information. But if your insurance won't cover it, it is a lot to pay out of pocket. If you post on the Learning Challenges board, I am sure the other people who post there can talk you through other options as well.

 

You might have a long wait for a neuropsych eval - our wait time from when I made the appointment was six months (well, we still have about a month left to wait).

 

If you do need a primary care doc referral for insurance or just want to talk with someone about what you are seeing, I wouldn't hesitate to try a new doc. But instead of saying, "I am worried he has ADHD", you could lead with "I have developmental and educational concerns". And after sharing your concerns if the doctor does not suggest ADHD, then ask if he/she thinks it is a possibility. Some primary care docs (I've heard) will give a prescription for meds just based on an office visit, but ours said she doesn't do that and definitely suggested we get testing for DS6 based on what we are seeing in him.

Edited December 22, 2015 by kirstenhill

[Lady Florida.]

Ds was diagnosed at a young age (6yo). I taught exceptional ed. and dealt with kids with ADHD yet didn't really see it in my own kid. For a long time I thought it was that he was an only child (brother is 20 yrs. older) of older parents. I sent him to preschool hoping that would help.

 

We started with his pediatrician, though in our case the pedi was involved in some national studies on ADHD so he was quite knowledgeable. It's better really to go with a psychiatrist (or psychologist but they can't prescribe meds unless you live in NM or AZ). If you don't really want to deal with this doctor, but don't want to switch before the dx, can you get a referral? Or if your insurance doesn't require a referral can you just choose a psych doctor on your own?

 

The behaviors you describe sound like ADHD without much of the impulse control issues. I've often said it should be called ADID - Attention Deficit Impulse Disorder - because that's a bigger issue than hyperactivity. Interrupting and blurting out stuff is common, as is inability to follow multi-step instructions. And pretty much everything you listed.

 

Kids with ADHD are often bright and that can actually be a problem. They're bright enough to fake their way through some lessons, but the stuff they need to remember isn't sticking. When they reach around 3rd or 4th grade it becomes harder because then they need to call on the knowledge they didn't actually learn, but faked. Working memory is where they have a lot of trouble too.

 

Medication isn't the end of the world and it's not always the first thing you'd start with. If you were diagnosed with say, high cholesterol, your doctor might start you out with dietary and lifestyle changes before prescribing medicine. The same might be true (depending on the severity) with someone diagnosed with ADHD, be it a child or adult. And if he ends up needing medication, it will be because it can help him. We were amazed at the difference in ds once he got the right meds at the right dose (expect some adjustments and possibly having to try more than one). We went to a festival we had been going to for years, and ds always flitted from one display to another. The first time he went on medication he could actually stay in one place and watch (they were pioneer demonstrations so he was interested). He actually enjoyed it more when he was able to focus.

 

Another thing to consider about a diagnosis is college. If he has a dx he can get accommodations if necessary. I know people who for years refused to have their kids diagnosed, and they are now struggling in college. Ds is able to take tests in a quiet place and access classroom notes online. Accommodations will vary based on need, but if there's a diagnosis they can have them in place.

 

The tricky part with homeschooling is that there should be several situations where the behaviors occur including social situations, and at least 3 people need to fill out the forms. Dh and I filled ours out without consulting with each other. Ds at the time was also taking outside lessons, so I asked that instructor to fill one out for him. I haven't paid attention to the changes made in DSM 5 but I don't think much changed for younger children. IIRC, most of the changes are for adolescents and adults.

 

This was not only my area when I was a teacher, but I've done extensive research once I became the mother of someone with ADHD. Feel free to PM me with questions or concerns.

[Carrie12345]

We went straight to a child psych for my dd. I've never found primaries to be very helpful with neuro issues.

 

The simple act of homeschooling has certainly made many things easier for dd, but we always revisit the medication conversation a few times a year.  Being able to control the environment isn't an all-encompassing solution to wonky brains for everyone.  Even as a sahm, I have periods where I need to be medicated in order to function appropriately.  (Meaning, years on and years off.  Not sporadic self-medicating!)

[oneangelwaiting]

Thank you guys!  I will post on the learning challenges board as well, thanks for the suggestion. I didn't even think about that board. :)

[PeterPan]

moved to LC.  :)

 

Edited December 23, 2015 by OhElizabeth