A third path for kids with ADD or ADHD (or suspected) would be a behavioral/developmental pediatrician. They are out there, but there are not enough of them. The good ones spend a fair amount of time with testing and counselling, both kids and parents. Sadly, their re-imbursement rates are low as a result, as it pays a lot more to see 4 to 6 kids an hour for acute physical illnesses and well child checks than it does to see one or two kids an hour for behavioral problems. But some of these practitioners are pure gold.
Look for one who is either board eligible or board certified in this subspecialty. It’s a new board exam, just introduced a few years ago. Many who are eligible to take the boards haven’t done so yet as it’s only given one place in the US, and infrequently at that.
IANAD, just an interested bystander to the field of psychology, but when Greathouse mentioned her divorce I thought bing-bing-bing - sounds like the problem right there. I’m surprised none of the rest of you have jumped on that.
Well, I should have mentioned that the divorce was 5 years ago. His mother and I are still very, very good friends. We just got married WAY to young and figured out that we make much better friends than we do husband and wife. We figured it would be better for him to see us get along and be friends than to see us fight constantly. He knows very well that he has 2 parents that love him more than anything and would do anything for him. Any related effects I pick up from him, I would guess started maybe a year after the divorce and have very, very slowly gotten worse. I may simply be frustration with his school work. Not really sure though. Hence, all the doctors.
That is a good point. I went through the same thing when I was younger. To muddy the waters further, she could consider a licensed social worker too. In my experience, they offer a type of counseling that is more feedback and practical based than most psychologists who usually have a speciifc theoretical leaning. A social worker usually talks with the patient dynamically and can talk as a person who has delt with people in similar positions before. The style tends to be quite different than that of psychologists. I have seen multiple people in each profession and I have a strong bias towards licensed social workers when it comes to just working out life issues rather than a medical problem or a clinical behavior problem that can be diagnosed.
I am not giving advice at all. I am just pointing out that their are other professions that offer mental health services and each has its place depending on the type of problem at hand.
In that case, you’ll likely have lots of options, including doctors teaching at universities that might be more up to date than some. Also, you’ll likely find a parents’ group (beware of the wackos these sometimes attrack) or some tutoring specialists.
In some states, any doctor can legally call themselves a psychiatrist without any further training. In others, a simple bachelors in psychology or less is all you need.
I second Qadgop’s recommendation of a developmental/behavioural paed. We see one and he is worth his weight in gold. My older kid’s diagnosed with ADHD and a few other labels as well and we got to that point via a neuropsych assessment. It cost a fair amount of money and we only did it after he was assessed by a psychologist. M’s a complicated kid and it’s taken a lot to tease out what is going on with him.
There’s no way I’d be impressed with being given a script by a psychiatrist in the absence of psychological testing. We use medication and it’s made a world of difference but you do need to know as much as possible what you are dealing with. With my younger son, it was apparent he had attentional issues but we took a long time to figure whether they were anxiety or ADHD issues. He’s on a microdose of prozac and bingo! it’s working!
I’ve not had a lot of luck with diet and ADHD. Fish oil supplements have made a difference for one kid but not the other. They’re worth investigating and trialling but I’m doubtful that if true ADHD is present that they will ‘cure’ it.
I’m not sure that fish oil (omega fatty acids) is shown to work on ADHD, but it has been shown to be effective on some other disorders like depression, I believe. Again, see the NIMH website.
Regarding your younger son, I think this is a great example of how several disorders can appear together or appear to be each other. Good going on your part.
I had an awesome reply last night, but the Board ate it or something. It never appeared. I’ll try to summarize…
First of all, in Texas, it is illegal for a teacher or other school employee to suggest our require that your child take any kind of medication. If the teacher has said “Get Ritalin”, alert the principal. I don’t mean to get the teacher in trouble, but he/she needs to be brought up to date on the legality of this issue. Sadly, some schools would tell parents to get their kids on Ritalin or whatever or take their kids out of school. The legislature felt the need to act.
That said, besides being a school teacher, I am a parent of an AD/HD girl. She has had behavioral issues her whole life. She would scream, be abusive, etc. At school, she would talk constantly. If the teacher moved her desk away from other students, she would find a way to talk to them.
Finally, when she was in third grade, we decided to act. We took her to a psychiatrist that we knew. After about an hour’s interview with all of us (two kids and two parents), the doctor prescribed Ritalin. The doctor wanted to ensure that we weren’t seeking to treat what were really parenting issues. She also wanted us to understand that it is perfectly normal for parents to be frustrated with their kids from time to time.
With Ritalin, peace came to our home. M’s (the daughter’s) behavior improved dramatically. She also seemed more comfortable with herself and she wasn’t so worried about “what am I going to get in trouble for today?”. She was nicer to her parents and younger brother. In school behavior was more stable and grades improved.
After about a year, we changed over to Concerta. Concerta is a time-release version of the same chemical as in Ritalin. It was an improvement. M was more stable for the entire day, rather than going up and down as her Ritalin level changed.
The only downside has been appetite. M simply would not eat. She lost weight and some of my friends were quite worried she might have an eating disorder. That was never the problem – she just never felt hungry. We would take her off Concerta for a few days at a time and let her eat.
She’s fourteen now, and we’ve decided to take her off Concerta long-term. Unfortunately, some of the behavior problems have returned, with the added bonus of the usual hormonal teenage stuff. Her grades have also slipped. Right now, we’re modifiying her academic load and working on some parenting things, tyring to reign her in again. Concerta may be in the future if things don’t improve.
Your first resource should be your school. Ask for an ARD meeting (Admission - Retention - Dismissal). Your son may qualify for services under Section 504 or Title I. This doesn’t mean your child is “special” (any more than all children are special). It may help him get the help he needs.
Next, check with your local university. Denton has a big one (Go MeanGreen!). It has a reputable education school. Check it out. I’m an SWTSU man myself, but San Marcos is a bit of a drive from Denton.
The school and teachers never recommended any Dr. visits or medication. But when I told his teacher that I wanted to have him tested for ADD she said that it was a good idea.
Drum God, did you notice any drastic personality changes with your daughter when she was taking the medication? I have had family members take Ritalin before and they just weren’t the same while taking it. I want my son to do better in school, but I don’t want to sacrafice the personality of the kid I love so much. If that is the case, then we’ll probably have to find some other way to deal with this. What sort of non-school related effects (personality, mood) did the meds have on your daughter?
-Daniel
I’m goad your school has dealt with your son’s problems ethically and legally. They can be your best ally.
A personality change was one of my biggest fears. I made it clear to the doctor that I wanted M to be M, even if God fated her to be a difficult person. I did not want to alter the essence of who she is. She was on a relatively light dose of Concerta (36mg, once per day). My wife works with a psychiatrist and she says that 36mg is very small compared to what some kids take.
We really did not see any change in personality. She still liked the same things she always liked. She disliked the same things. She found the same things funny as before. If anything, I would say that Concerta helped her be herself. It allowed her to control her behavior better so that she could get along with her family and her teachers. (Like your son, she has always been well-like among her peers. She makes friends easily and can fit into a group.) With Concerta, she was able to focus on the things that made her happy without worrying about getting into trouble all the time (and it was ALL the time).
M decided to stop taking the drug. I think she just felt like she didn’t like depending on something to control her. Her friends don’t take Concerta, so why should she? She also didn’t like the weight loss and people constantly encouraging her to eat. She eats like a horse now, and has physically matured. She’s probably thirty pounds heavier since May, and that’s a good thing. She’s filled out into a young lady, and not a fence post.
Of course, your child’s results may vary. Concerta and Ritalin do not stay in the system for long. If your child takes it and you or he decide that you don’t like it, you can stop and go back to the way things were before. It doesn’t stay with you and there are no withdrawal effects that I’ve ever heard of. If your doctor suggests yet, I would suggest trying the least effective dose. If you don’t like it, simply stop taking it and try doing something else.
IANA Psychiatrist, or a psychologist, I have been in the system since the third grade. So I’ve picked up a few things.
As other posters have said, if you want testing you go to a psychologist. For medication, you go to a psychiatrist.
For those 55 minute hours of talking, you usually go to a psychologist. Psychiatrists generally don’t do therapy sessions. You can also go to a therapist who has proper certification but has no PhD. Generally these folks have degrees qualifying them as social workers. In many cases, they charge less for therapy and are very good at it.
Re Ritalin/Methylphenidate/Dexedrine/Concerta
I’ve been on one brand or another since the third grade. My personality hasn’t changed as a result. I can concentrate, think without feeling like I’m surrounded by a croud of people shouting, and sit still. Side effects vary. Whether your son experiences any can’t really be predicted. Changes in diet might help. They might not. There’s even the chance that they’ll make things worse.
If your son is diagnosed with ADD, I recommend Concerta. It really does smooth out the effects. On methylphenidate (generic Ritalin), I could actually feel the morning pill wearing off around lunch. There was also the problem of missing a does. While I was in public school, I was also required to leave my pills at the nurse’s office. It can be embarrassing to have to leave class every day and walk down the halls and know that your schoolmates all know that you are going to get your brain medicine.
The only personality changes here have been positive ones. M was off meds for a couple of months earlier this year while we tried to figure some stuff out and he was so relieved when the dex was put back in.
I second the SR forms of the meds. Much easier to manage and much smoother.
Drhess fish oil and efalex is very fashionable as a remedy for ADHD currently.
This is only anecdotal so take it for what it’s worth. When my son started first grade, he drove the teachers nuts. He talked a lot, was very social, and fidgeted all the time. In fact the teacher called him Gabby Hayes.We had one teacher that always sat him off by himself so he wouldn’t distract anyone else. She even suggested Riltalin and said she thought he was hyperactive.
I was not going to give him drugs. I have only seen one truly hyperactive child in my life, and he was slightly mentally handicapped. My son was not hyperactive like this boy. He was just being a very social little boy.
He was the same way at home. It was hard to punish him because he could take a piece of string and imagine an airplane or whatever. Take away the TV and he would play with a piece of fuzz and be just as interested in that.
I am so glad I just let him be himself. He is now in high school, he’s very bright, get’s decent grades, and while I can’t say I haven’t wanted to beat the HELL right outta the boy, I wouldn’t want it any other way. Well, maybe he could do homework more often and listen a LITTLE better but hey…
The thing is my wife is/was exactly the same way in grade school. Her report card for one grade said she was very social and left it at that. I am at the other end of the spectrum so it is a little annoying at times because it’s hard for me to understand sometimes. I let my wife deal with the boy and I deal with the girl whose personality is closer to mine.
While I’m not sure about your situation, but it really bothered me that he was just acting like a 7-year old boy with a VERY active imagination and I had a teacher telling me to drug him.
This is only my observation on the subject YMMV, considerably.
I bet my physician - a family doctor - didn’t take longer than that to prescribe Ritalin for me when I asked for it, but I was 19 at the time and I had done my homework. I’d like to point out, though, that while there are tests that can be done for ADD, none of them have been proven terribly effective. The problem is that testing is inherently difficult for those with ADD, because tests are inherently focused in a way that helps eliminate distractions. It can be quite difficult for someone with ADD to focus in a complex, stimulating environment, and a test in a doctor’s office won’t pick that up because it’s precisely the opposite. And a test involves a novel stimulus, which is naturally more interesting to an ADD person, so most doctors don’t really believe in empirical testing. However, an accurate assessment based on personal history, input from family members, and so forth ought to take considerably longer than 15 minutes, I should think. Don’t expect a test, though, to give you accurate answers. A physician - of whatever variety - who is willing to take the time to evaluate your son properly is what you need.
I highly recommend this book - it’s by Edward M. Hallowell and John J. Ratey and it has a prominent place on my bookshelf. It has a lot of insight into the internal workings of the mind of someone with ADD.
My therapist is a social worker, and I have to agree that this type of therapy, for me at least, is the most effective sort by far. Social workers offer a far more practical variety of therapy than psychologists, in my experience, and it’s practical issues that are central to handling something like this. But if a kid has developed depression or low self-esteem secondary to having ADD, which is incredibly common, a psychologist could probably help.
I’ve been on Ritalin for a couple years now, and in my case at least, it has not changed my personality at all. I think the notion that ADD treatment somehow turns children into little automatons is completely without merit. I don’t think anyone who had seen the effects of the drug could possibly believe it was an accurate one. In my case, it simply gives me a chance not to act on impulses. Before I was on the drug, I would find myself acting before I had even consciously decided to. I would realize I was thirsty when I was already up from my seat to go to the water fountain. I would say something before I had consciously realized I was talking.
At the same time, it allows me to pay attention in class, by controlling the impulses to think about something else, doodle in my notebooks, look out the window, and so forth. It hasn’t made me any less lively when I want to be, or less creative (on the contrary, in fact: it’s hard to be creative when you can’t focus long enough to accomplish a task) or less anything - it’s just given me the ability to sit through a class and actually listen to the lecture.
There’s a great danger, in my opinion, in the ideological opposition to treatment for ADD. I think it’s valid to suggest that schools need to be able to accomodate different learning styles and personalities rather than drugging kids, but to imply that the schools are just trying to shut the kid up is ignoring something important. ADD has internal effects - and no matter how accomodating the school or home is, as a kid, you can tell when you aren’t able to sit in your seat or be quiet.
It’s incredibly frustrating to feel like no matter how hard you try, you can’t get anything done. I couldn’t sit and do homework, I couldn’t read books (which had once been one of my great pleasures), I couldn’t pay attention to lectures in my classes - and it sucked. I felt like I was trying so hard and still failing, and I felt that way through a lot of my primary school years too. A kid’s ADD isn’t just a problem to the teacher; it can affect their ability to socialize normally, to get along with their family, and to accomplish the things the kid herself wants to do. And it’s so incredibly frustrating to try, and try, and try, and find yourself unable to do things that you know you have the capacity for.
Depression and low self-esteem are quite common, as I mentioned above, in people with ADD because it’s just plain depressing to realize that you can’t get anything done. It can be incredibly miserable, and even when I was able to make myself sit down and shut up in class, the effort was so unpleasant and so taxing that I didn’t have anything left to actually pay attention to the instructor.
Don’t put your child on drugs if you don’t believe he’s got ADD, but remember: Ritalin is not a life-sentence; if you try it and it has negative effects, you can discontinue and try something else. Don’t let the people who are opposed to medication because of personal ideologies make up your mind for you.
Is there any research on it? There maybe and I’d like to see it. Otherwise, I doubt it. Of course, it cann’t hurt, but good fish oil pills (Omegabrite) aren’t cheap and the cheap ones can have nasty effects on bowels and acid reflex.
Dr Jacqueline Stordy has a book out on it and apparently has done some research – not gonna vouch for the quality of the research though. The LCP Solution.
If you google it, there’s a lot of links out there. I read the LCP Solution and it was enough to encourage me to buy good quality oil and do a trial.
