Tell me about attention problems in young kids.

[SticksAndString]

@Kelby

Right on, and the diagnostic procedures vary greatly, as simple as behavior checklists completed by parent and teacher to as complex as a full neuropsychological assessment. An MD must also be involved, of course.

The end result is usually a “trial” of stimulant medication, which may have the desired effect of making the child more attentive at school, which it will have on most children. The question of course, is whether the treatment is addressing the symptoms or the actual cause of the problem. We shouldn’t be medicated a child for a family environmental problem, yet it happens a lot.

It’s useful to have longitudinal data of how the child has done in school…there should be evidence of attention problems to some degree all along. For a problem with attention/hyperactivity to crop up out of the blue suggests other things are happening in the child’s life.

This…exactly this. When Slim was 4, his preK teacher told us he was having problems sitting still and concentrating. I brushed it off as “He’s a boy and he’s 4. Of COURSE he has problems sitting still for long periods of time”

When his Kindy teacher brought it up at the end of the next school year, I said, “Ok. Maybe there is a problem. Let’s test him and see what comes back.” The school and an independant learning disorder specialist have tested him and he does in fact have ADHD. The school then suggested we put him on medication. The LD Specialist said we could try meds or not..it was up to us and it made no nevermind to her.

The LD Specialist suggested Ritalin or Adderall first, which I absolutely WILL NOT give to my child. WILL NOT. When those were shot down, she suggested Focalin, which we had him on for a year and it was absolutely the worst year of our lives. While I will not deny the fact that meds DO work for some kids, they do not work for ALL kids and this particular medicine didn’t work for Slim.

He didn’t like taking it, so it was a booger trying to get it into him. He was fine while he was AT school but after school he turned into a monster–little tiny things would cause meltdowns which turned into fits of rage where he was screaming, hitting, trying to bite, banging his head into the doors and walls. This would go on for up to an hour at a time, off and on for several hours until he was so exhausted he just COULD NOT keep it up. Then he would just bawl his eyes out and apologize and say he couldn’t help it. I know I told Stickman at one point that if this was going to continue for the next 11, 12 years until he went to college I would lose my mind. It wasn’t fair (IMO) to continue to put our family through this. The lack of appatite I could live with. I could even deal with the sleep disturbances. But the rages followed by the depressive spells were the deal breaker. Because of the way he reacted to this medication, we’re a little gunshy about trying anything else because we’ve been told the side effects are essentially the same.

Though we’ve been pressured by a couple members of the school staff to put him back on meds, we’re not giving in and his teacher has agreed to just try to work around it.

[lorene]

@Edward_The_Head

I don’t have a huge problem with testing, what I have a problem with is ‘Your daughter has gotten much better over the last year, though she doesn’t always do age appropriate work.’ to getting put into a doctors office and saying she needs to be tested and tested in two weeks without actually looking into other causes first. I’d like to slow down and take a look at things, yet my ex and the doctor are pushing full steam ahead. It’s also quite telling when a doctor who prescribed a drug for a child on the first visit and commits suicide at the age of 12, should not be saying on our first visit, ‘we don’t need to talk about drugs until she’s tested’ tells me he’s already got that idea in his head.

Is the doctor in that article the one your daughter has seen? If you don’t trust his judgment, can you find a different doctor, or at least get a second opinion?

Like Ms. Whatsit, I don’t see the harm in getting her tested. But of course I don’t—I had my kid tested and have derived some benefit from it. It seems to me that you don’t feel that this doctor is completely impartial and that’s why I suggest starting with someone new.

Can one parent overrule another in a case like this? I don’t know how medical decisions get made in the case of a divorce and/or when the parents disagree.

[SticksAndString]

I think (and don’t quote me on this) whoever has primary custody and/or the child on their health insurance gets to make the decision since they are the one living with the child and providing all other medical care.

If it’s joint custody, I have no idea.

[Edward_The_Head]

@lorene

Is the doctor in that article the one your daughter has seen? If you don’t trust his judgment, can you find a different doctor, or at least get a second opinion?

Yes, it is the same doctor. I’m not sure I can find another doctor since she has primary custody.

Thanks to MsWhatsit and other things I’m not as opposed to testing. I’d just like a chance, as in a couple of weeks, just to see what things go on during the testing and who the doctors are. My ex loves to jump into things too quickly, I should know I was one of them.

[Alice_The_Goon]

Just to balance out the horror stories about meds such as Ritalin, my 13 year-old son went from failing with D’s and F’s and having a horrible time at school to getting all A’s and B’s and being called one of the best students in a couple of his classes, after going on meds again after taking a break from them. The difference was amazing, like a miracle.

[living_in_hell]

Those leading questions were lame attempts at rephrasing the diagnostic criteria.

Psychologists don’t prescribe.

She’s probably irritable and squirming because like most humans she doesn’t like change, doctors, or pathologizing developmentally appropriate human behaviors.

There is no diagnosis called ADD, and no formal test for ADHD. Questionnaires, Observation, and most likely, a stimulant end result. Keep in mind, a six year old on a stimulant may create more concerns than playing on monkey bars.

What would you be getting a counselor for? To do what? How would it be measured? How would you know she is cured?

Best bet: work with a behavioral specialist. Concrete, clear, reinforceable interventions. Local school could probably recommend someone.

[Alice_The_Goon]

@living_in_hell

Those leading questions were lame attempts at rephrasing the diagnostic criteria.

Psychologists don’t prescribe.

She’s probably irritable and squirming because like most humans she doesn’t like change, doctors, or pathologizing developmentally appropriate human behaviors.

There is no diagnosis called ADD, and no formal test for ADHD. Questionnaires, Observation, and most likely, a stimulant end result. Keep in mind, a six year old on a stimulant may create more concerns than playing on monkey bars.

What would you be getting a counselor for? To do what? How would it be measured? How would you know she is cured?

Best bet: work with a behavioral specialist. Concrete, clear, reinforceable interventions. Local school could probably recommend someone.

Not being snarky, but genuinely curious- what is your area of expertise in this? Are you a doctor, counselor, or parent of a child with ADD/ADHD?

[SticksAndString]

I’d like to hear Living In Hell’s answer on that too. Because I’m curious…incredibly curious.

[InsomniaMama]

@SticksAndString

The LD Specialist suggested Ritalin or Adderall first, which I absolutely WILL NOT give to my child. WILL NOT.

Why?

[Enola_Gay]

@Edward_The_Head

I I would say that I know more what my daughter likes and I would say I understand her much better since she’s a lot like me.

I’m really looking for people who’ve been through it

Been there (my daughter is 8; “problem” identified when she started school at 5; got her tested at 6) and here is my 2 cents:

My girl tested in the ADHD range at age 6 by a psychologist (female). The testing was long and I was left in the waiting room, so I’m not exactly sure what it entailed. When I asked my daughter, I got the usual “can’t remember”. They also gave questionnaires to me, my husband, and her teachers. Ultimately, they gave us the test results which put her in the middle of the ADHD spectrum.

The psychologist recommended weekly visits with her, which we did for about 6 months @ $150/hr, not covered by insurance), but it didn’t seem to help much and my daughter didn’t like it.

She was also seen by the school counselor (public school) who recommended an IEP, consult w a psychiatrist, and weekly visits with the psychologist. My daughter also did not like doctors (I think because it made her feel stigmatized…like something was wrong with her–when in fact, she was/is a normal kid).

We did consult with a psychiatrist who recommended medication (Adderall).

After about a year of all this, my husband and I decided that nothing was wrong with her. She is a normal kid who would rather play outside than do multiplication tables. Incidentally, both of us were asked if WE had ADHD as children and we couldn’t answer because when we were in 1st, 2nd, 3rd grade, there was no homework, not state testing and no such thing as ADHD. We were allowed to be rambunctious kids and when we grew up, we settled down and eventually learned to love balancing our checkbooks and learned to hate playing on the monkey bars. Today our gal is happy, healthy 3rd grader who is excelling in school. They all take their own time.

My advice: YOU know your daughter better than any specialist who sees her for an hour or two a week. If you think she is ok, she most likely is. Let her be a kid while she has the chance. She has the rest of her life to focus on boring stuff. In a rush, but later on I will give you some tips that helped us keep her focused.

ETA: I think there are some kids who do need medication (e.g. those who are so hyperactive that they are horribly disruptive and cannot learn). However, I think that most kids diagnosed with ADHD are just normal kids with a lot of energy. If they lived on a farm100 years ago, that energy would have been considered an asset. The issue today is that active kids are expected to sit quietly in a classroom for 6 hrs per day and listen, then go home and do homework.

[Alice_The_Goon]

@InsomniaMama

Why?

I think the generic name for those drugs scare people- it’s amphetamine! But I have to say that Adderall is what caused such a drastic improvement in my son- possibly literally saving his life, considering the misery that his ADD was causing him. And he’s had really no side effects from it. He has not lost any teeth, moved into any trailer parks, or starting manufacturing it out of our bathtub!

[Rachellelogram]

@kushiel

Sorry, I just find in that stuff like this, it’s luckily never the worst case scenario, but as humans we’re driven to drama and thinking of the extreme.

Huh? How can it never be the worst-case scenario? You don’t think kids ever get abused by their stepdads? I’m a victim of childhood sexual abuse. I know my own bias in that area, which is why I peppered the proposition with disclaimers. But I still thought it was worth bringing up the possibility.

[kushiel]

@rachelellogram

Huh? How can it never be the worst-case scenario? You don’t think kids ever get abused by their stepdads? I’m a victim of childhood sexual abuse. I know my own bias in that area, which is why I peppered the proposition with disclaimers. But I still thought it was worth bringing up the possibility.

Sorry, I was trying to say it’s much more likely that she’s bored by the doctors or by her schoolwork than being abused. Abuse is the worst-case scenario, but it’s more rare. You were asking if you were being too quick to jump to that conclusion, and I believe you were. I don’t mean to marginalize your experience, I was just saying it was less likely than the alternatives.

[living_in_hell]

@Enola

The psychologist recommended weekly visits with her, which we did for about 6 months @ $150/hr, not covered by insurance), but it didn’t seem to help much and my daughter didn’t like it.

There’s a shock. I’m sorry EG–you are another victim of a shitty mental health system. As I have said before, very few people warrant long term therapy. And if there was no progress, it’s probably because 1. She didn’t need therapy 2. There was no treatment plan and 3. There was no discharge criteria. I would love to see how that clinician justified care. There’s a reason insurance companies pay for a limited amount of treatment–what would 6 months do for someone who probably does not want to be there in the first place?! Ugh. Stupid exploitive system.

[China_Guy]

I would give a lot of weight to what the teachers say. Teachers have experience and daily benchmarking. If a child in the class/school is an outlier, the kid will stick out like a sore thumb. Closer to the norm maybe not, but if the child is out there a ways the teachers will know.

I say this as a parent of an autistic child.