[kdk545]

Ive really benefitted from reading all these recent posts regarding ADHD issues and medications.

We are probably going to be in this same boat with my son, who I feel will be diagnosed with this as soon as all the evaluations are completed. He just started kindergarten in late August, so naturally this is when we are seeing a lot of the manifestations of the ADHD symptoms.

I did notice his (possible) symptoms before he started kindergarten this year and even had him evaluated by a behavioral pediatrician last summer because of my suspicions. And even when this pediatrician told me he doubted my son had ADHD, I knew in my gut his diagnosis was wrong and done under the wrong conditions (basically a 20 minute evaluation done in a quiet room, one-on-one with my son. No distractions, no other people in the room, no outside noises etc etc. This is NOT the way to evaluate for ADHD symptoms.)

So I do have a few questions for those of you experienced and in the know.....

On the DSM-IV criteria, my son has 8 of the 9 symptoms under the "Inattention" criteria checklist. Under the "Hyperactivity" and "Impulsivity" checklist, he has 6-7 of the symptoms.

In the classroom the teacher (and I as well because I volunteer in the class once a week) have noticed these behaviors:

--easily distracted by any little thing going on in the class

--inability to focus on work so only about half his work gets done compared to the other kids who can finish all their work. He needs CONSTANT reminders to keep on task and finish his work and needs either a parent volunteer or the teacher sitting with or near him keeping him on task

--VERY fidgety and wiggly. He doesnt get up out of his chair and move around the room or anything like that, but just constantly wiggly in his seat like he has ants in his pants or is uncomfortable.

--chews on everything. hes always been VERY oral!

--fine motor skills (writing/printing) not the best and below the level of even other boys (not girls)

Basically, the classic ADHD symptoms.....

These are the things we are doing now to help him, until we get everything else completed and he is officially diagnosed.

--teacher has him sit in a quiet part of the room facing away from the action when he is doing seat work. and this does help him quite a bit.

--my physical therapist friend gave me something called the "disco sit", basically a squishy padded cushion he puts on his chair that diminishes his "wiggly worminess"

--a squooshy ball for him to squeeze during work time

--I make sure he gets LOTS of physical exercise every day with climbing, hiking and/or riding his bike.

So my questions are these:

--if/when we decide we have to medicate him, will the medications help him both with his focus/inattention AND with his wiggly wormy/fidgety nature?

--would occupational therapy help him with any of the above symptoms?

--what are the downside to medicating him? I know there are side effects to the medications and that we may have to try a few different ones til we get the right fit, but Ive also read things like giving kids adhd meds will increase their chances of becoming drug addicted later on, or something like that....

Anyway, I guess Im just wanting to chime in and start a new dialogue on the whole ADHD thing....

Thanks!

[Mykidsmom]

Could it possibly sensory integration disorder? Some of the actions you discribed sound so much like my son in pre-K and K. He never tested in the adhd spectrum. We worked on sensory which it sounds like you are doing with the squishy ball and the disco sit. The lights with the buzzing and the heat or a/c coming on would distract. He had a difficult time with drawing or coloring because he would not hold his writing instrument tight enough in his fingers.
He is now in 2nd grade and is bringing home A's and B's on his report card. He is in a very small class size but fast paced regular classroom.

[angelkisses0102]

So my questions are these:

--if/when we decide we have to medicate him, will the medications help him both with his focus/inattention AND with his wiggly wormy/fidgety nature?

Yes if it is due to ADHD. DD is doing so great already and as you know from the other thread...we are still very newly into medication.

--would occupational therapy help him with any of the above symptoms?

Yes, if it is sensory related. DS who has SPD and unDX'ed ADHD (unmedicated and will remain that way for at least another year or two)...OT helps....we will now be doing DS's OT at home as he is doing so well. DS has fidgit toys and the squishy seat at school...they both help (as does the fact that there are only 4 other kids in his SN class.) DD has some minor sensory issues along with the ADHD and we just keep her physically active and it helps. Gymnastics is great for her...we took a break from it and we see a definite difference.

--what are the downside to medicating him? I know there are side effects to the medications and that we may have to try a few different ones til we get the right fit, but Ive also read things like giving kids adhd meds will increase their chances of becoming drug addicted later on, or something like that....

The medications available today are so, so different than years ago...DD gets no 'high' from the Vyvanse...but most ADHD meds, if ABUSED, could become addictive. I have also read that some non-medicated ADHD teens and adults self-medicate with caffiene and other legal and/or street drugs as well as sometimes alcohol...so it is a catch 22. We are so lucky that DD is responding so well to the Vyvanse...and we decided in our case...the risk of the drugs were totally outweighed by the potential (now real) benefits.

Good luck...it's a very difficult decision to make...but I now regret now looking into medication sooner.

[kdk545]

So what determines the difference between sensory processing and adhd? Is there some kind of evaluation that would determine that? And what about that he scores so high on the DSM-IV, with the "6 or more following criteria"?

[lovestruck]

If your child truly has ADHD there are no downsides to meds, once you find the right medication and it may take a few.

My son's ADHD did not truly start to manifest until fourth grade, however his impulsive behavior has been there from age two, impulse control being one of the biggest, but one of the least talked about symptoms of ADHD.

Don't get discouraged if the first meds you try don't help in fact may have side effects, there are a lot of new good ones out there, just commit yourself to finding the right one!

[angelkisses0102]

Originally Posted by kdk545

So what determines the difference between sensory processing and adhd? Is there some kind of evaluation that would determine that? And what about that he scores so high on the DSM-IV, with the "6 or more following criteria"?

Last question first...DD was on the high end for everything as well. On one recap of the Conner survey I think...the scoring had ranges starting at about (I think) 35-normal range going up to 70+ extreme high something or other. DD got a 90+ for impulsiveness and an 85 for inattention (or the other way around...my file is at home) so she was off the charts high as well.

As for sensory processing and ADHD...MY totally unprofessional opinion is that in some of kids (like my DS) it will be impossible to seperate the two. DD is having a great reaction to her meds...but her sensory issues are still there...but hers are minor, although maddening at times. She has sock, underwear, and clothes issues which make us both nuts...plus some minor sensory seeking behaviors...but again no where near DS's. For DS...it's going to be a longer and harder battle because of his sensory issues as well as his feeding/swallowing issues. Luckily our school district and home elementary school (and his angel teacher) will work with us and all of his issues.

Has your DS been evaluated by an OT who is familiar with and had success with treating SPD? OT with help with sensory issues...but won't help ADHD...I don't think.

...however his impulsive behavior has been there from age two, impulse control being one of the biggest, but one of the least talked about symptoms of ADHD.

Oh the impulse control...that is the behavior that drove us over the edge and to medication this year. DD's has probably been around since age two as well..although it is easier to write off as 'normal' when they are so young. DS is also impulsive but his is a combo of everything. Lots of fun at our house. Oh the stories I could tell!

[momraine]

My son was finally diagnosed with Aspergers, which also has some things that mimic ADD.

[mdaisyq]

I hope you don't me popping in from the China/Korea board. No one on these boards talks about ADHD - yet I know there are other parents who have adopted from these countries who are dealing with ADHD

I, too, was so scared about just putting my kid on medications - I had visions of a lobotomized zombie. And then there was the guilty part of me that felt that if I was only a better parent, they wouldn't be acting like this.

Our daughter is very high end ADHD for both hyperactivity and inattentiveness ( don't even get me started on the compulsiveness.)

ADHD is a neurological disorder and there are a number of medications for treating this. Some medications work great for some kids and are terrible for other kids - it can take a while, and a good medical professional can help you find the right medicine at the right dosage level for your child. Our 6 year old became very aggressive on Adderal, after it wore off, so we just switched her to Concerta. She may need to have her dosage level changed, but we and her psychiatrist are working on it.

Personally, I have found that since our kids come from institutional backgrounds with sometimes less than good care, it can be hard to tease out what is ADHD and what are their other possible issues.

[KiraLin]

As others have already said it is very difficult to separate one "disorder" from another. They overlap to begin with and with our kiddo's background it is really just not worth driving yourself crazy over. In addition to meds there are some other things (besides the above mentioned school strategies) that we are doing to help dd with her symptoms. She has been doing theraputic horseback riding (hippotherapy) for the last two years. She has gained tons of confidence from this and it has helped her in many other ways as well. She just began taking a yoga class taught by a special ed teacher who is working with her and 2 other children with ADHD. A huge focus here is to teach them to be able to change "speeds" more easily (from silly/hyper/upset to calm/quiet/relaxed). Once their instructor gets to know the kids and the kids know each other she plans to add another aspect of teaching the kids to "read" a social situation before "entering" it. She has a term for that but it is failing me at the moment. At her first class yesterday dd did great and loved it....until she spent 25 minutes flipping out because she refused to put her socks on...oh well one step forward two steps back.
Despite this dd has made tremendous progress with many of her ADHD symptoms (without meds as the ones we have tried have not helped enough to outweigh the side effects...although she will likely try more when she is a bit older). Her ADHD is still pretty apparent relative to others but compared to herself in the past it is vastly improved.