2E ADD/ADHD Resources?

[TKDmom]

Can you point me towards threads/resources about ADD/ ADHD? 

 

My youngest has always made me a little crazy. She's ridiculously intelligent, remembers everything, and throws lots of temper tantrums. She finally drove me to seek out an amazing child psychologist in our area. She started administering the WISC this week. Last week, after spending some time getting to know dd, the therapist asked me about dd's attention span (or lack thereof). I had never noticed that anything unusual about dd's attention span, because she can focus so intently when she is doing something she likes and because she has an amazing memory. Plus she's the youngest--of course her attention span and impulse control are lower than my other kids'. Also, when she decides to do something, it *must* happen, and she doesn't give up. But I've been talking with friends who have coached her in a math club and in Odyssey of the Mind, and they commented that she's all over the place. I've actually slowed down to really notice her behavior...and I think she may have the attention span of a piece of lint, with about the same amount of impulse control. She has a habit of asking me questions, then interrupting me to ask another (or the same) question. And she always wants to go, go, go. I've been exhausted since she was born. 

 

Anyway, I've never spent much time on this board. I don't really know where to look for info or what to expect if she does come back with a 2e diagnosis. Help?

[kbutton]

These are some good resources.

 

https://www.understood.org/en --great all around site. They sometimes have webinars and things.

http://www.amazon.com/gp/product/B005D7D57K/ref=dp-kindle-redirect?ie=UTF8&btkr=1 --great book on breaking down skills in the areas that are weak and teaching new habits, etc.

http://www.amazon.com/Syndrome-Autism-Spectrum-Tourettes-Anxiety/dp/1849059675

http://www.amazon.com/Different-Minds-Children-Asperger-Syndrome/dp/1853029645/ref=sr_1_1?s=books&ie=UTF8&qid=1461805258&sr=1-1&keywords=different+minds

 

The last one is more about academics, and it's dry but good (I have a kiddo with ASD and ADHD, and she tackles the nuances of that).

 

There is talk in the gifted community about overexcitabilities and things like that. Some people feel very strongly that a lot of kids with ADHD have OE instead. I don't personally think they are mutually exclusive. It is possible to want to weep over beauty every time you hear Ave Maria (OE) and also not be able to find your coffee because you put the mug on top of the fridge when the phone rang (potentially ADHD if this is par for the course). 

 

ADHD is all about EF (and some about hyperactivity or inattention). If you look up information on EF, it's not an all or nothing deal--there are areas where kids can have really disabling trouble with some EF skills and good EF skills in other areas. Like anything else, it's at least partially defined by how much of a difference it makes in your functioning in life. And like all skills, you can hone them and learn what the limitations of your own abilities are, work with it, and learn how to stave off mishaps when you can't compensate for a skill deficit. 

[PeterPan]

What do you want to change?  I think when you know that, you'll know when you have the answer.   ;)  I mean, not to be trite, but if you're ok with her energy and it's not interfering, then obviously meds aren't your top priority.  You're going to get some pretty serious opinions as soon as that diagnosis comes, so you might as well start really thinking it through.  You're going to hear people saying you're actually harming your kid NOT to put them on meds.  You'll have other people telling you she doesn't need them because she homeschools, magical homeschools...

 

I say it's really hard to solve a problem you haven't identified.  I also think gymnastics and OT can help an astonishing amount.  I'm not saying they cure anything, but they can tone it down a fuzz.  The sensory input and energy drain are good, but also they work a lot on attention, controlling the impulsivity, etc.  It's just good on a lot of levels.  I keep my ds in a lot.  Actually right now he does gymnastics 3 days a week, Crossfit 2 days a week, and swims 1 day a week.  I forgot, your kids do TKD, yes?  Does this one?  Does it have good sensory input?  Something with more impact maybe.  Gymnastics...

 

Oh, threads?  You want books?  The Explosive Child by Green is what you're wanting.  Also Holloway's Superparenting ADHD.  

 

Another thought is to pursue CBT and get somebody to do Social Thinking materials with her.  Then she could harness that strong cognitive to build some awareness of how her actions are affecting others.  It's not developmentally typical to be ready to be *accountable* for the material at this age (that's more like 3rd grade), but she would be ready to be more *aware* and to notice.  Zones of Regulation, Social Behavior Mapping, Incredible Flexible You...  Incredible Flexible You would be age-appropriate.  Although it doesn't look like it from the young titles and art, probably the topics would, of themselves, be enough to let you work through most of the inappropriate behavior she's happening right now.  Even though it might be ADHD, that doesn't mean she can't bring cognitive to bear on it, kwim?  We can use a blended approach.  In fact, the research is showing that CBT *before* meds actually gets a better result than meds alone or meds with later CBT.  

 

The Zones of Reg would be on the older end for her but it would get you going.  They more recommend 5 Point Scale for this age.  Social Behavior Mapping (like buying the book) is actually overkill for this age, but the *concept* can be started.  It's included in the red Social Thinking main book by Winner.  You'd get a lot of mileage out of it.  As Winner says, don't *assume* kids don't have these holes just because they're smart.  It's actually *more* likely that they have the holes.  If she was noticing the effect her behavior has on others in those classes and clubs, she would modify her behavior or be embarrassed.  So no matter what you call it, you're wanting to up that observation, that noticing.  

 

But that all depends on what you're wanting to target/work on.  If teaching her is no biggee but her behavior in those sessions is a problem, then Social Thinking materials would help.  If you're having a hard time teaching her, then more structure and possibly meds.  The meds can help self-regulation, and of course OT and the Social Thinking materials can improve self-regulation.  So just depends on your goals.

Edited April 28, 2016 by OhElizabeth

[TKDmom]

What do you want to change? 

 

Right now, I'm just trying to figure out what ADD or ADHD looks like and how it's different than OEs in a gifted child. I've always assumed she just had big OEs, and maybe that's all it is. But maybe it's more. She definitely has anxiety, perfectionism, and  a lot of negative self-talk. Her energy is exhausting for me because she wants 24/7 undivided attention from everyone. 

 

I'm not interested in meds at this point, but I think CBT could be very helpful. She can be easy to teach (when she wants to) but mostly her behaviors interfere with everything. In the past, I've sent her to school so I could teach my older kids. But she will have to be at home for at least another year. Even without external circumstances, I think this is the time I need to be helping her to learn some self-regulation at home. 

 

Right now her only physical outlet is the trampoline in the backyard. We've done gymnastics, dance, and TKD for a semester at a time, but she's very resistant to change (or anything that's not her idea at that moment). Getting her out the door to go to activities is a herculean effort. She's screams the whole way to class that she won't go and she's quitting and it's too hard. I have to drag her into class and leave before she runs back out the door. But then she throws a fit when it's time to go home. I just registered DS10 for a new gymnastics class and she threw a tantrum when she found out he gets to go to gymnastics without her. But I'm not interested in paying money to have a big fight with her every week. 

 

 

I really like the therapist I have found, and I'm confident she will be able to help us. At the same time I want to do some research on my own so I have some idea of what to look for and what sot of behaviors and thoughts would be important to report to the therapist as she evaluates dd.

Edited April 28, 2016 by TKDmom

[camino]

My son, who is 10 and 2E (ADHD, Generalized Anxiety, and Dysgraphia), was a bit like your daughter at that age, especially with transitions. And so intense all the time! Therapy was incredibly helpful, especially the parent part where I learned how to manage him for lack of a better word. For my son, having a very consistent routine and being forewarned about all transitions, was incredibly helpful. At first my husband vacillated between slight annoyance at having to "prep" my son for everything--truly everything, all day long--and skepticism that something so simple would work. But it was shockingly and immediately helpful. For example, we would discuss how child is going to take X class, starting in a few weeks. We'd mention it calmly but in a positive way, regularly, for the following two weeks, possibly with inclusion of a small built-in reward (like, on the way home we'll stop and have a snack, etc). Then on the day of: In a couple of hours, we go to the first class! Ten minute warning, then Do it, even if it's kicking and screaming. I think that anxiety is a huge part of resistance to transitions and the knowledge of what's coming is extremely reassuring. We had to work so, so hard to get my son to do his favorite sport but now he is completely hooked and it is a huge part of his social life and a great source of joy and self-esteem. At age 10, he still is not a fan of surprises but handles them so, so much better. And the little transitions that used to be so hard are nothing!

 

By the way, my son also hyperfocuses and has an amazing memory. I do think they are features of his ADHD, that have negatives and huge positives. It is great to be able to talk about both. The wonderful part about homeschooling a child like him is that, despite his severe challenges, he has true passions and interests. Sometimes WW2, sometimes Minecraft, and so on... all can be channelled into a home school lesson. I agree with OhElizabeth that homeschooling is not magical, and we have to work hard at it as parents, but I do think there is no better way to work with 2E children and meet them at their (confusing! ever-evolving! surprisingly advanced and surprisingly delayed!) level. 

 

Best of luck!

[PeterPan]

You won't like it, but my ds was doing that and his diagnosis pushed over to ASD.  I think you're right to be bringing in someone to work on behaviors.  Make sure you're telling all these things to the psych and talk through all the explanations. There's some of this that rolls and becomes more obvious over time.  Right now you think oh it's just such and such, and as the behaviors *don't* fade and in fact pick up with the level of expected behaviors, then comes the diagnosis.  It's also a lot of the same interventions, no matter what they call it (generalized anxiety, ADHD, ASD, etc.). 

 

So no, I'd be wanting some behavioral help so that she can make transitions and go to a class.  She should have an OT eval, definitely.  OT issues are super common no matter whether they go ADHD or ASD or whatever right now.  Super common.  And a super good OT should have training in Zones of Regulation and things you can do at home too.  It would be complementary to your behaviorist or therapist work.  

 

Ok, now I'll rabbit trail.  For my ds, some of the refusals were because there were things going on he couldn't put into words.  So you might investigate that way as well.  It might be a combo of things.  Why is she saying the class is too hard?  Is she low tone? Does she fatigue?  Is the motor planning complex for her?  Is the amount of noise a lot for her to handle AND have expected behavior?  

 

Gymnastics has been so overwhelmingly positive for us, I'd encourage you to consider putting her back in it and in it enough that she can get the calming effect and actually get better at it.  Like not just one night a week but 3 times a week.  Gymnastics is now a strong calming force for my ds because it has SO much sensory input.  But it wasn't that way initially.  

 

Fwiw, they just put in my ds' IEP that the expectation for a 7 yo was to be able to participate for 30 minutes in something he wasn't really interested in when provided with supports.  With my ds I get sort of caught up in a time warp and don't really realize what's expected, what could be expected, because I'm just so used to thinking he can't get there.  The school, for his IEP, goes well let's give him more supports and get him there.  It challenges me to have that perspective.

Edited April 28, 2016 by OhElizabeth

[Targhee]

I have three kids who are 2e ADHD (one with additional LD).  And all three flavors - inattentive, combined, and hyperactive.  What ADHD looks like in each is a bit different.  Add in personality, and behaviors related to gender and birth order, and it is really difficult to generalize what 2e ADHD looks like.  I think universally for my ADHD kids executive functions are pretty low - especially follow-through, task persistence (in non hyper-focused things), materials management, and following multi-step directions, time management... 

 

I wouldn't spend too long trying to diagnose ADHD on my own.  I would get a professional evaluation.

 

Teasing out what is what can be quite difficult. But you may be dealing with something you haven't even considered - ASD or LDs or other things - and that is why I'd just go straight to evaluations.

[kbutton]

Big side note here...

 

This is not a "You should do meds" line; it's a disclaimer in case anyone who is thinking through their options has heard bad press.  I wanted to tell you that ADHD meds helped my son's anxiety. You hear lots of stories about how stimulant meds can boost anxiety, and that is not always the case. I am sure it has to do with what the cause of the anxiety is, but my son can DO so much more and think so much more clearly that the boost in competence decreased his anxiety. I know not everyone would have the same results, but if anyone is specifically concerned about stimulants and anxiety, it's not a cut and dry equation where stimulants always increase anxiety. 

 

So, do what you think is best for your child, but do ask questions instead of believing everything [bad] you hear, not just about meds, but about other options as well. :-) 

[SarahW]

Big side note here...

 

This is not a "You should do meds" line; it's a disclaimer in case anyone who is thinking through their options has heard bad press.  I wanted to tell you that ADHD meds helped my son's anxiety. You hear lots of stories about how stimulant meds can boost anxiety, and that is not always the case. I am sure it has to do with what the cause of the anxiety is, but my son can DO so much more and think so much more clearly that the boost in competence decreased his anxiety. I know not everyone would have the same results, but if anyone is specifically concerned about stimulants and anxiety, it's not a cut and dry equation where stimulants always increase anxiety. 

 

So, do what you think is best for your child, but do ask questions instead of believing everything [bad] you hear, not just about meds, but about other options as well. :-) 

 

 

Interesting.

 

Gets me thinking....DH, who is ADHD inattentive, has anxiety issues. Problem is, every SSRI he's been prescribed has come with really bad side effects (total fogginess, lethargy, etc). It gets me wondering if stimulants would help him overall in his case. 

 

Likewise, because of DH's problems with SSRI's I've been wary of eventually trying meds for DS. But maybe...?

[kbutton]

Interesting.

 

Gets me thinking....DH, who is ADHD inattentive, has anxiety issues. Problem is, every SSRI he's been prescribed has come with really bad side effects (total fogginess, lethargy, etc). It gets me wondering if stimulants would help him overall in his case. 

 

Likewise, because of DH's problems with SSRI's I've been wary of eventually trying meds for DS. But maybe...?

 

It may be worth a conversation. Best wishes if you decide to investigate that. :-)

 

I think the ADDitude folks recently had some kind of webinar on either depression or anxiety that is "really ADHD." I didn't check it out, but you might want to look it up. 

[TKDmom]

I have three kids who are 2e ADHD (one with additional LD). And all three flavors - inattentive, combined, and hyperactive. What ADHD looks like in each is a bit different. Add in personality, and behaviors related to gender and birth order, and it is really difficult to generalize what 2e ADHD looks like. I think universally for my ADHD kids executive functions are pretty low - especially follow-through, task persistence (in non hyper-focused things), materials management, and following multi-step directions, time management...

 

I wouldn't spend too long trying to diagnose ADHD on my own. I would get a professional evaluation.

 

Teasing out what is what can be quite difficult. But you may be dealing with something you haven't even considered - ASD or LDs or other things - and that is why I'd just go straight to evaluations.

Interesting. As I've started researching, I discovered a description of ADHD in teens that sounds exactly like dd14. I've always assumed she was just flaky and intolerant of sibling noise. I might learn some ways to help her focus during this process.

 

We are in the process of evaluation for dd6. The therapist is the one who brought up her attention span. ADHD wasn't even on my radar before that. I just want to research some too. I like to know what doctors are talking about when I talk to them. :)