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Is this ADD and how do I get it evaluated?


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DS10 can sometimes be really difficult to keep focused. It comes and goes as to the severity. Today it was painful.  His mind is everywhere but on the work. I am sitting right next to him saying okay, "so what is 7 x 8" or "what is 5-1" or what is "56 divided by 8" and there is a super long pause, he repeats what I said several times and eventually comes out with the answer.  This is not just a math thing though--it is every subject. He will tell me "I can't focus!" 

 

I just don't know what to do for him. I am already sitting right next to him working through the problems. He often will try to put off work. I do let him have short breaks during the regular school year. We are in summer session right now so we barely do any school at all.

 

He does test well--in the low 90s percentile on IOWA. He is smart. He just struggles so much to focus, but it varies a lot by the day.

 

He also has these weird aches and pains lately that seem to always correlate with doing school work or bedtime. It's hard for us not to think they are attempts to manipulate us since they are never ever consistent. Headaches, leg pain, arm pain, etc.  It's mind-boggling.  (BTW, just picked up a copy of The Manipulative Child from the library--not sure if that is him but going to read it.)

 

So we are going to the pediatrician tomorrow for a checkup.  What do I need to ask about?  

 

Up to this point I have just muddled through with this and we have survived, but if we have a lot of days like today, school is not going to go well at all. I'm really concerned about this need for me to go through each thing with him verbally--I don't know if that is the right thing to do or not.  I'm just trying to help recenter his focus. 

 

Other than more exercise, what else could I try?  Would eliminating screens more help? The boys play on the screens a lot (and dad is a gamer so we disagree heavily on screens).  

 

Sorry for the long post. I am just discouraged today. 

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There's actually evidence about screens/gaming increasing certain kinds of attention, and lots of people have had ADHD with no screen time or gaming. So if somebody is guilting you that the screen time is causing it, I'd move on from that. I *would* feel confident requiring an hour of red-faced a day. Some kind of movement, huffing with a sport, yardwork, treadmill, anything to where he's red in the face and really moving. 

 

Are you using the gaming as a motivator, like NO GAMING at all, no screens at all, till EVERYTHING on his list is complete? Are you using structure so the expectations are very clear? 

 

Yes, you can talk with the ped about it. The ped will have a screening tool. What you would like though is a referral to a psychologist for an actual eval. There's some stuff they could dig in on the testing that might explain things. For instance, he might have low processing speed. Sometimes just having a number for that is really helpful.

 

If you give him a small amount of caffeine, what happens? For some people that's a helpful indicator of how they *might* respond to meds. 

 

Yes, a ped can go through the process, diagnose, give meds. A good psych can also help you look for strengths, talk about ways it might be helpful to work together, identify weaknesses you don't realize, etc. STRUCTURE is going to be their biggest, biggest recommendation. There's also CBT, mindfulness, all sorts of stuff you can do. And to me it's all good, do it all, kwim? Not everyone responds well to meds, and not everyone wants to be on meds all the time. And the EF strategies and supports you learn can help some people function well enough that they don't need the meds or so that they're fine if, for whatever reason, they need to be off the meds. So it's good to be kind of "all of the above"... :)

 

His test scores may go up on meds. Just sayin.

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Thanks OhElizabeth.  I needed that encouragement.  I am still not sure that I want meds for him. I am also not sure at times that a chart along the lines of Smart but Scattered will help with the issues we were having today.  Sometimes a chart to track how long it takes him to get started would help, and I definitely need to revisit that.  I will definitely have to look into more exercise also. It definitely could not hurt.

 

I don't think we have ever given him caffeine. How much would that be and in what form?  We have caffeinated soda but it's full of sugar. Diet coke? Coffee with lots of sugar?  

 

Since it is summer I have not had the expectation of no screens until school is done but I was just thinking after I posted this that I might have to go there. 

 

Thanks again for the encouragement. I'm feeling really down about this for some reason today.

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What you describe could be ADHD. Or it could be a working memory issue. Or slow processing speed. Or any or all of the above. I agree that talking with your pediatrician is a good starting place.

 

I loved our pediatrician, but he liked to offer other explanations, I think to reassure me that my kids were really okay and that I shouldn't worry. So it took longer for him to come around and see that there were underlying issues. I only mention this so that you can be prepared that if your doctor suggests that you are an overly concerned parent with a typical child, that you can be firm in disagreeing and saying that you really see a problem and want to look into it.

 

I'm sorry it's so frustrating. Believe me, I've been there, and I get it.

 

DS12 even does the fake injury thing. A lot. Or he has a real injury but exaggerates the pain. It's tough, because it's hard to say that someone is not feeling pain! But we have reason to believe that exaggeration is happening. He's been doing this suspicious injury thing on and off for almost two years, now. It's not always the same complaint, and sometimes there is actually something minor that is wrong. But he over reacts. It's a hard thing to address, because we want to be sympathetic to real problems. But we don't want to encourage this behavior if it is attention-seeking. In DS's case, I wouldn't think it is manipulation, but it is likely attention-seeking, which I see as two different things.

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It's been a long time since I looked at Smart But Scattered. What chart? 360Thinking has some really good info on time management for ADHD, etc. They just did a webinar that was really good. Structure goes WAY BEYOND a chart. Checklists, calendars, knowing the plan, working the plan, creating structures that help you work the plan, clear expectations. 

 

It takes a lot of WORK on your part to set up structure, but the more you point into it, the more it will pay off. You'll have to teach him how to work within the structure, but increased structure, very clear expectations can make a huge difference.

 

For the caffeine, you can google for charts that show you dosing. They sell it in tablets at the store (No Doz), and a very small amount can give you an effect that is *roughly* like meds. Meds work more parts of the brain, don't go up and down like the caffeine, etc., but still it could give you some sense. 

 

I always schooled through the summer with my dd too, but to me if you're there to work you're there to work. Have the amount be small but defined, with very clear expectations, and it gets done before this time and before any screens or they lose all screens for the whole day.

 

Right now you're in that weird window where people go I'm not sure, I wish it wasn't this way, wish we could do without, etc. etc. Nothing is changing. He is who he is. You could maybe get his eyes checked and find some developmental vision problems, do some VT, and get a small bump in EF (executive function). It could happen. He could have a growth spurt. He could have retained reflexes that you could get identified, treat, and get integrated. But he is who he is. 

 

So sometime between now and 7th, 8th, 9th, you're probably gonna pull the trigger. At this point he is SAYING it's an issue and asking for help. You know it's an issue. So my one bit of advice is don't look back with regrets. Once you hit that point where he knows, you know, and you're hitting walls that are like wow, we can't get over this without help and it's not working, it's time. 

 

If you want other things to do first, sure, there are things. Metronome work can help improve midline issues, target the EF portion of the brain, etc. VT can bump EF. Those things really could help! But it's doubtful they would help enough that you'd be going wow, we no longer need meds! Kwim? 

 

All the strategies for EF, doing VT, metronome work, etc. etc. are things you can do ON TOP of the meds. It's not like meds preclude anything else. That 360 Thinking would be FABULOUS paired with meds. Structure is ESSENTIAL, even with meds. They're going to need to use their tools and strategies, work on their self-regulation. He's going to have to make choices for himself. You're not going to be there forever going ok Johnny, do your math before you play PlayStation, kwim? LOL

 

How much are you trying to get him to do for school work each day over the summer? Is it so much or is it that he drags it out? 

 

Caffeine reduces Attention Deficit Hyperactivity Disorder (ADHD) - DrClydeWilson's NUTRITION BLOG

 

That's the article I used with my dd. I'm not a doctor and that's not medical advice. I'm just saying what *I* did. The thing about the doses he suggests is that they're LOW, way low, and they're something you can do while isolating away the sugar, food colorings, etc. in pop. The half life of caffeine is only about 4 hours, so they're something that you can take, have work, and then have wear off. 

 

Fwiw, the half life of stimulant meds for ADHD is also very short. That's why they do time-released meds for kids. So you're talking something that is in and out pretty quickly. Something like prescription anti-depressants, that women take very commonly, have a MUCH longer half-life in the body, how long they take. It's something you can think about as you make your choice, that this is not a long-term choice. It's just a choice.

 

Also, does he mow or use equipment? Is he going to learn to drive in a few years? The accident rates for unmedicated ADHD are *very* high, much higher than for the non-ADHD population. It's a really serious issue, because driving requires processing speed, responding to situations, controlling their impulsivity... It might be that thing where you go ok, drivers ed is 15, and we KNOW we want to pull the trigger then, might as well pull it now, kwim?

 

Couple more options for you. There's something called an Educational Therapist. You can hire one and let them help you, help him with strategies for structure and how to work together. Sometimes they're called Executive Function Coaches. Or a psych doing CBT will serve a similar purpose. They're trying to harness the dc's meta-cognitive, his ability to THINK about his thinking and realizing the choices he's making. It's good stuff, and you can pursue that with meds or without meds.

 

If you're on the line, one thing you could consider is just flat out asking your dc what he prefers. Like you could tell him your list of options you've found, explain that you could pursue the strategies by themselves, pursue them along with meds, do the caffeine first, etc., and just see what he thinks. I'm not really a child-decides kinda person for major decisions (where he goes to school, etc.), but I really felt like it was my dc's body, my dc's buy-in, and that my dc had to have some say in the choice. If it's a young child, you make the choice for them. But just putting it on the table let's them express the amount of frustration they feel, which can help you feel better about whatever direction you're going, kwim? And for the long-run, BUY-IN is where this is at. You are not going to give him meds and have it just POOF and all go away. He's clearly very bright! He needs to understand and be making choices that use his strategies and help him achieve his goals.

 

 

 

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So for Smart But Scattered if you are having trouble with task initiation you might make a chart and the child would get a "star" for every time they started within x minutes of being instructed to do so. Five stars might equal a reward, or twenty, or whatever. Gradually you increase the amount of stars required for reward until you eliminate the reward. That's the general idea.  The trouble is, I am dealing with more than one EF defecit. It's not impossible to do a chart for this though.

 

First impressions from reading The Manipulative Child is that it will be helpful. I am definitely dealing with some of that and it is rooted in my being inconsistent and/or soft with him. I need to really look at my own behaviors and how they may be exasperating the situation.

 

This summer I have been a mess on expectations. I have had too much on my plate and as a result I have been awful about structure and consistency. I know that is A LOT of the problem.  I get distracted with this other thing and instead of staying after him to do his reading or whatever he gets on his iPad and I am not noticing.

 

So as far as what we do in the summer: reading (30 min), Latin (either quizlet for 15 min or one page of the LfC Reader), Math (about a half hour either going over a lesson or workbook, etc.), and piano (about 10-15 minutes a day).   Technically we are supposed to be doing typing but it has not happened yet.  =)  He can definitely stretch all this out into a full day. However, if he has proper motivation he can do it quickly (e.g. you can go play with friend x). However, the day I posted he was having some major brain fog. I think that "not wanting to do school" and "brain fog" are not always concurrent issues. So I need to navigate both if that makes sense.

 

For now I have made an appt with a counselor through the pediatrician to talk about attention issues, executive skills, etc. and what I might need to do differently, etc.  If those don't work, we can go from there.

 

I also am trying to think of practical things that might help like relocating him when he is working at the kitchen table and his brother is playing and in view (brother finishes work quickly and is often done first). 

 

I will also look into the metronome thing you mentioned, and do some research on the caffeine. I also need to get him started on a regular exercise regime since we have not been consistently at the pool or park this summer.  Maybe we can at least do morning walks.

 

Anyway, thanks so much for the encouragement. I think I have some decent first steps planned and that makes me feel a bit better. 

 

I'm not sure I answered all your comments but I share your view that it is best to deal with it now than to deal with a greater mess at grade 7 or 8.  Fortunately his issues are not pervasive. He does well in co-op and at church. So I think once I get the lax parenting side tackled, and improve the environment he is working in, I think those attempts to improve executive skills are going to bear fruit.  We may still need "more" help later.

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Ok, I can just try to remember and share how I worked with my dd at that age. First, I'm not some really strong, uber-organized, awesome EF kinda person either. So my first gig is always that I don't make rules or a list or a plan I can't enforce. Like if I'm not going to enforce the command, the list, whatever, I don't even give it in the first place.

 

Next, listening to your scenario, I think I'd be willing to tighten it up *and* say you know it has to be done under xyz parameters because those are more convenient for *me*. It doesn't always have to be just what is convenient for the dc. You have needs in this too.

 

My dc are 9.5 years apart, which you would think would have been gloriously easy. Instead it was awful and quickly became a nightmare. I ended up giving dd a private office, which is tricky to manage. It can quickly devolve into 1600 pinterest pins, if you kwim...  However if you *happen* to have adjacent rooms where you could sit between and monitor both kids, it could be an option. Or, if you have a room you could put dividers in, like maybe a physical divider or whatever, then both boys could work. If the younger finishes earlier, he would just leave. 

 

My dd found it really frustrating to work with the distraction of my ds. It worked much better to separate them. I definitely think you're on the right track trying to get him a less distracting work environment. Kitchen table (high traffic) with brother running around is pretty rough.

 

 

This summer I have been a mess on expectations. I have had too much on my plate and as a result I have been awful about structure and consistency. I know that is A LOT of the problem.  I get distracted with this other thing and instead of staying after him to do his reading or whatever he gets on his iPad and I am not noticing.

 

What works for me is to have checkpoints and set a timer. So if you assign something and need to walk away, you can set the timer on your phone for the amount of time you were thinking, then check him. I do that for EVERYTHING. I don't even walk away from the stove without setting a timer, I kid you not! I just have no memory, and things happen. So timers work for me. On my iphone I just swipe up, tap the clock icon, roll to the number of minutes, and boom. I also use the ALARMS on my phone a lot. 

 

If you go to that 360Thinking Webinar they show you how to help your dc estimate how long the task will take, set a midpoint goal, and set a timer to remind them to see where they're at. It's good stuff! The webinar came with pdf files you can download or you can just jot the notation on his paper. It's something he'd need supports to do at first, but it's the kind of stuff people who specialize in EF are doing with kids. I'm having my dd learn this before she goes away to college. 

 

Ipad. Ok, he needs the ipad for his school work? He's still at an age where you can passcode lock this. So you could problem solve here. With my ds, during the day his kindle fire is locked so that only audiobooks work. The kindle has better parental controls than the ipad, so I can specify what categories are blocked and what aren't. So I get that you have a problem, but you might have to solve it by putting on a passcode. You could structure in some earned motivators if you want, but some kids are hard to motivate, sigh. It sounds like he really kicks it in gear when he has an overall reason, like something he's going to next. That's something I used to do with my dd. Like we'd put ice skating at noon, so she knew she needed to get around and get certain things done to be able to go. So I think that's really smart if you're giving him things to look forward to so he's motivated to get it done!

 

The Mary Poppins days are SO my dd, oh my. It's the ADHD. Yesterday they were fine, but today the wind blows and your kid is gone, no chance of work. Mary Poppins days, sigh. And, I hate to say it, but meds solve that. I've seen some REALLY REALLY severely ADHD kids have Mary Poppins days in spite of lots of meds, but that was specific to that kid. For your kid, for my kid, that can resolve. But I hear you that it's exasperating. It's not your imagination. Now it *can* be part of a pattern. Like with my dd we used to work really hard one day and then have her WIPED the next.

 

How is he doing with that latin? My dd is quite smart and her brain is facile, but the processing speed necessary to do the latin really, well I used to say it made smoke come out her ears. If he's giving you pushback, you might just drop it. Kids with ADHD sometimes struggle significantly with foreign languages. If your ds is struggling at all, you would be really, really, really wise to put your energy into a language he's likely to stay with through three years of high school credit. Like start doing Muzzy or something. Or start doing a high school program but do it really, really slowly. That way you can give him credit for spanish 1 or whatever in 8th, spanish 2 in 9th, and so on. 

 

It's not that you have to do that. I'm just throwing that out there. You're saying you're seeing lots of things. That processing speed really bogs down some kids. If it's a problem, you can have alternatives.

 

I don't know, you're saying you're a lax parent, but are you really? You're saying he does well in co-op and at church. I doubt you're a lax parent. I think he has ADHD and can't put everything into words that he's feeling. So his frustrations and difficulties come out as behaviors. I don't think that's being lax. I think it's that you're not a mindreader, kwim? 

 

Your ds is at the age my dd was when we started getting evals, and for me part of it was I finally came to the point where I was POSITIVE she was trying and that it really just was not working, that something was wrong. Like she had handwriting trouble, persistent handwriting problems, and it's so easy to blame yourself, blame the kid for that! She turned 11 and I was like REALLY?? No, at this age I know she's trying and that something is wrong.

 

It's really a misnomer to assume kids with ADHD are going to be ill-behaved in public. I laughed a LOT when my ds was young, because these people would come to classes with their very rambunctious, uncontrolled children and then make excuses about how they were just SURE their kid had ADHD. Meanwhile, my ds was there, doing the gig for the class, pretty much rolling along with it, and he did get that diagnosis a few months later. 

 

ADHD does not mean BAD BEHAVIOR. It's not considered a behavioral disorder anymore, and your kid does not have to be acting BADLY somewhere to get the label. That's how I know you're not a lax parent btw, because your verbally gifted ds (who does latin, etc.) is telling you how he feels and having enough self-regulation to have expected behaviors in most places. He sounds like a really good kid! And you can be a really GOOD KID and have really, really, really significant ADHD. 

 

What it tells you, when there's that gap, is that he's working really hard to control himself. And that's really fatiguing. Does he sleep an unusual amount? How does he wake up? 

 

Heathermomster made the posts on metronome protocol at home. It's good stuff. 

 

I'm glad your ped is giving you a referral to get some help! Should be good! Keep us posted and fire away with more questions. There's tons of ADHD experience around here on the boards. :)

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Headaches etc. sound like something is going on physically as well as perhaps ADD.  When he says he cannot focus does he mean concentration or visual?  And have you asked for more details about what is happening from his pov?

 

beside general Ped check up, and including asking the Pediatrician for possible follow up on ADHD evaluation, what about:

 

Allergies? Vision? Environmental toxins?

 

 

 

 

I'd stay away from sodas and diet drinks.

 

 

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https://www.google.com/search?client=safari&rls=en&q=mary+poppins+days+ohelizabeth+site:welltrainedmind.com&ie=UTF-8&oe=UTF-8

 

Ok, just for fun I did a search for you. Do you know how to google site search? Go to your google bar and type the terms plus site:welltrainedmind.com  So I searched "mary poppins days ohelizabeth site:welltrainedmind.com" It's my favorite way to search the boards. You can even hit "cached" for links and read when the boards are down. :D

 

Anyways, have fun and see how many times over the years I had posts about Mary Poppins days. Then ponder that those were only the ones where I MENTIONED it. 

 

:scared: 

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Headaches etc. sound like something is going on physically as well as perhaps ADD.  When he says he cannot focus does he mean concentration or visual?  And have you asked for more details about what is happening from his pov?

 

beside general Ped check up, and including asking the Pediatrician for possible follow up on ADHD evaluation, what about:

 

Allergies? Vision? Environmental toxins?

 

 

 

 

I'd stay away from sodas and diet drinks.

 

Interesting. I do think allergies are coming into play lately but I need to take him back to the allergist.  He has seasonal allergies and a bit of asthma that is not consistent (might use inhaler once every two weeks). I am a tad concerned the allergy medicine might be causing some issues--it's Zyrtec, and Zyrtec gives me brain fog big time. 

 

When he says he can't focus he means concentration. Sort of like a dog in a room of squirrels being asked to read a book. 

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Interesting. I do think allergies are coming into play lately but I need to take him back to the allergist.  He has seasonal allergies and a bit of asthma that is not consistent (might use inhaler once every two weeks). I am a tad concerned the allergy medicine might be causing some issues--it's Zyrtec, and Zyrtec gives me brain fog big time. 

 

When he says he can't focus he means concentration. Sort of like a dog in a room of squirrels being asked to read a book. 

 

 

Bold: That would be a terrific way to describe the way ADHD may frequently seem.  Was this his description or yours?

 

 

Meds causing brain fog is a possibility.  Or things could also directly cause brain fog as well as breathing issues.  

 

Seasonal allergies usually suggests plant related.  But not always or exclusively. And sometimes when someone is subject to one allergy they may have more than one like to pollen and also foods or smog or other things.   

 

How about electrical pollution?  Wireless, etc.

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Bold: That would be a terrific way to describe the way ADHD may frequently seem.  Was this his description or yours?

 

 

 

No, it's my description.  It just seems like that sometimes. Not every day, but some days are bad.  Every little sound or movement in the room is a fresh distraction.  =)

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No, it's my description.  It just seems like that sometimes. Not every day, but some days are bad.  Every little sound or movement in the room is a fresh distraction.  =)

 

 

What are the triggers for bad days?  Or what seems to make some days better?

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Too busy! Thanks all.

 

I was just reading about some of the symptoms of non-celiac gluten sensitivity (my oldest has Celiac)--brain fog, ADHD like symptoms, headaches. . .  Hmm . . . I wonder if I should try taking him off gluten also?? He has tested negative for Celiac a couple of times but we have had some weird bowel issues this past year, plus the other things I mentioned above.

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