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Suspecting ADD

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Please tell me your opinion. I am trying to build up the case with dh to have my 7 year old son evaluated. 


Here's what I am noticing/dealing with on a daily:


-Very short temper. He takes even the slightest comment personally and is yelling back right away and tries to stomp off to his room. "Why are you outside right now, you're supposed to be taking a shower?" and his answer is to get offended and scream, "You're always telling me we should play outside more and now I'm doing it!!"


-He easily gets in fights with even his good friends. People aren't being fair, no one wants to do what he wants, they are excluding him will say when really he is screaming and they are just trying to move away from him. 


-Daytime wetting. Not full on accidents, but he just forgets till he can barely get to the bathroom in time. So much laundry!


-I cannot teach him past 5 minutes without losing him. Handwriting practice is torture. He is doing good in math but only if we keep it short or he's on Prodigy.


-Constantly talks non stop, interrupts conversations all the time b/c he's going to forget what he wants to say.


-Huge distraction to other people working. He always needs to be in the room if I am working with my other two


I know he is bright, sweet and friendly, but recently all this stuff seems to be ramping up and getting in the way of that. 

Is 7 too young to tell, is it just a maturity issue? Could he be trying to be more independent from me (formally VERY clingy) and trying to assert himself?


Thanks, I needed to vent this out. 


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I'm not one to say. My ds was like that, and he has a diagnosis you didn't list and probably don't want to hear. "They're trying to move away from him" is probably your biggest clue, honestly. Whether ADHD is part of the picture or not, a psych can sort out. But I'd want to know what ELSE is going on, because more is going on. At the very least some social thinking and self-regulation issues.


For right now, I would stop with the why questions (which clearly aren't working), move to very clear expectations with follow-through and support, give prompts for expected behavior, follow through to make sure you always expect compliance for whatever you say, and log the bathroom incidents. You may need to start scheduled bathroom breaks.


Has he been to the ped for the bathroom issues? OT eval for sensory yet? You have a psych eval scheduled? And is he dry at night but not during the day? Or is he wet both?


And just as an observation, he's really on edge right now, in fright/flight a lot. That's why he's responding with screaming. It's your big clue that more is going on than just being bad. You want to get that calmed down with very clear expectations and more support. For me, I would have given a prompt like "Oh, you forgot to..." I wouldn't have asked why. Or join him in what he's doing, regain the connection (because obviously he wandered off and left your group plan), and once you have the connection back make an attempt to redirect him back to the plan.

Edited by OhElizabeth
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Right now, while you sort this all out, he may need a LOT of structure.  Like really structured with clearly laid out schedule and expectations and a routine that gets done at the same time every day so he can come to expect what is around the corner without having to remember/think it through.


Yes this could be ADHD.  Lots of kids with ADHD have poor impulse control and struggle with social skills, especially in the early years.  Their brains are moving too fast to notice the subtleties of other people's reactions.  It could also be other things.  Evaluations right now might help.  Depends on how good the evaluator is.  


I agree with OhE, he is in fight or flight mode and needs help with coping skills to deal with whatever frustrations are dragging him down.  Lots of structure and scaffolding plus you might consider looking at any social skills classes that might be available in your area while you look into evaluations.


Does he get any structured physical activity like swimming or jogging or something where it is more continuous for a set period of time?


By the way, when I say structure, I don't mean hand him a list of rules or a list of things to do.  I mean creating a supportive schedule that is predictable and you do your level best to follow every day.  He can have a list to see what is coming down the way but you are the one to positively implement the list.  Give him some choices if that helps but let the flow be mostly the same each day.  He may fight you on it at first but in the long run it may really help.  


For instance, maybe start the day with something that gets him moving every morning, then follow with a short lesson in something he doesn't like followed by a short lesson in math followed by 5-10 minutes of movement again.  Maybe a quick chore.  Every day.  Keep all lessons short for now, even if it is a good day, so he will come to trust that you won't just keep piling stuff on.  Make sure there is a finite end point.  


Keep his work area very simple and uncluttered.  It is very easy to get distracted and overstimulated.  Transitions can be hard, too.  


Have you read any books on ADHD/ADD?  

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Yes, there are a lot of ADHD flags, certainly enough to warrant an evaluation. OhE and OneStep gave excellent advice, I'd also recommend setting up a reward system to deal with both the temper issues and the schooling issues. We used pompoms in a jar for awhile, every compliance, finished subject, etc. warranted a pompom, and when the jar was full DD got a reward. Now we have a star reward chart for certain targeted behaviors...So if DD stays at the table eating, she gets a star for "Good Table Manners," if she gets dressed without getting distracted, doesn't interrupt, does homework independently, etc. she gets a star. 35 out of 40 stars a week earns her a reward. It's been hugely successful, and when she does interrupt or get up from the table, all I need to do is threaten to remove a star to get her back on track.


Several people here recommended Kazdin's Everyday Parenting Toolkit, which describes this method. It was a life-changer for us.

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Oh, another thing that helped here was an apprenticeship for chores.  While a lot of what the kids were expected to do seemed simple and I knew they had done them before and knew how, what I had thought was more laziness in their pushback on chores was really Executive function issues, feeling overwhelmed and getting easily distracted.


I started over.  We started an apprenticeship for each child.  We worked on ONE chore for each child, different ones, so they weren't in competition.  I explained that I had taught them badly.  Yes, I put it on my shoulders.  I explained that we were starting an apprenticeship or training program so I could help them to be more successful with house maintenance (I did not call them chores but house maintenance and emphasized we all worked on house maintenance as a team).  I showed them how (even if they already knew) and I talked through WHY I do things  a certain way.  Is it just cause that is how I like it or something required for functionality or safety reasons?  If it is just my personal preference can they do things a bit differently when they do it?  I let them know.  Then they do it with me the next time.  Lots of support, scaffolding, praise.  Then they do it with me watching and giving support. No negative comments or visible frustration or micromanaging/nagging on my part or expecting them to do it on their own or even remember when.  Only specific, targeted, positive feedback with lots of scaffolding.  Then they do it on their own for quite a while with me nearby each time they do it to offer more scaffolding and feedback as needed.  We did this for everything until they had the procedural and muscle memory down.  Once they could do the chore successfully every time and usually remembered to do it on their own they got a certificate and we had a mini party.  Seems ridiculous for things like emptying the dishwasher or doing laundry but it absolutely turned things around and now they don't complain about chores.  Once one was mastered we moved on to the next one.  And so on.  


Now, if one needs a distraction, something physical and I need a chore done, I know I can just ask and they almost always just get up and do it.  

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This sounds very, very much like my son - from the short temper to the misreading cues of children around him to the daytime wetting.


He has other behaviors (namely, stimming and some repetitive speech) that led us for an evaluation for ASD. 


While at that evaluation (2 years ago, so he was only 4), our neuropsych also highlighted some potential attention issues to keep in mind for the future. It surprised me that the attention aspect was part of his Dx, only because it wasn't on my radar at all. 


So, perhaps it's ADHD? Or perhaps it's other neurological issues? Definitely worth a check-in with your doctor.


For us, what has worked (lately...it's a moving target):


school work: breaking pieces into small chunks; working while eating; cycling through topics - practice a piano song, do some math practice, read a book, play another piano piece. 


attitude: keeping blood sugars stable (lots and lots of fats, eating all the time); lots of free movement time (trampoline to the rescue!); ignoring many of the activities that would have been a "no" for his older siblings (constantly eating with hands, not utensils); giving very specific directions (pick up THIS game and put HERE; now pick up THIS TOY and put HERE). 


behavior with others: reminding him over and over and over that his first disagreement with someone can't be a shouted "no"

Usually, when he's screaming with others, it's because he's way overstimulated or his blood sugar has crashed. 


He hears so much negative talk from me (you wet your pants AGAIN!?!?!?!?!?), from his siblings (STOP YELLING AT ME!!!), and himself, so any steps I can do to keep that negative talk from arising is really helpful for him and us all. Giving him discrete tasks he can finish with success is part of that; intervening before he goes nuclear on his siblings also helps. 


Good luck, mama! It's hard to see our guys suffering so much.

Edited by fdrinca
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Oh yes, as fdrinka said, lots of praise! That's part of the Kazdin method, and a general technique for ADHD kids, and really, really helps to shape the positive behaviors. It seems like ADD kids glory in praise even more than neurotypical kids.


When they're misbehaving (like your example of playing rather than taking a shower) what I've found most effective is to get down on my knees so I can look into DD's eyes, at her level rather than towering over her, put a hand on her shoulder and say calmly, "I really need you to come inside now and take a shower." She'll almost always comply. Any frustration they hear (and believe me, I know how hard it is to keep from being frustrated!) will just echo inside them and make them angry/frustrated back, they feed on it, it raises dopamine! I do a lot of deep breathing to try to keep myself from raising my voice. I'm not always successful, but when I'm not, I always regret it because it comes right back at me as defiance/silliness/ramping up of behaviors.

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