[michsm]

hyperactivity. I am asking this question because everyone keeps telling me my fd is hyperactive. I just don't see it. I see all of her behaviors associated with RAD, but the ADHD I just don't see it.

I went and sat in on her class at school today and got a chance to talk to her teacher. One of her comments was, as you can see I have many hyperactive students in my classroom. What I saw was a bunch of kids all very eager to answer questions and learn what was being taught. They raised their hands, sometimes kneeling on their chairs, talked out of turn, sometimes shouting out answers. Alot of I know, I know.

We got to tx about 45 minutes early today and she sat in the car and read a book the for about 20 min. If she could act like she did while waiting in the car all the time I would be a very happy woman. Then when I discussed with her therepist about her behaviors at school (being disrespectful, insubordination etc.) and the fact that her meds were increased at her last Dr.'s appt. because she is so hyperactive, he basically told me that although I might not see her hyper at home that she may be in other places.

I hate to see her on medication she doesn't need. They have her on something now for ADHD and then I occasionally need to give her something in the evening to sleep because she is still wired at night. That got even worse when they just increased her meds because she is soooo hyperactive. So she is on nothing for now until they get her a new prescription.

So is there a new definition of hyperactive? This seems just like class as I remember it. There was no one jumping around, getting up repeatedly or running around the room. Also, since when can an ADHD child who has not been on her medication for 5 days sit and read a book for 20 minutes? Am I just misinformed by what hyperactive means?

[aspenhall]

I'm ADD and zero hyperactivity....I will also read for hours and days on end.

It sounds like this teacher just hasn't gotten control of her class. She's 9 so I would expect the kids that age to be able to practice a bit of self restraint....although the natural tendancy is to be boisterous.

The best way I think, to find clues/flags of ADD/ADHD is to watch/listen to them try to tell a story...so they bounce all over the place? Are they able to complete a thought?

[mrsred]

When You go to the doctor does he/she have you fill out a questionairre? I have a few adhd kids. Every three months I, and their teachers have to complete the the Conners' Global Index. It is a series of 10 questions that we answer from 0 (Not true at all, never, seldom) to 3 (Very Much True, Very often, Very frequent). If the child gets mostly o's and 1's with only a few 2's then they would not meet ADHD criteria. The questions are:
1. Temper outbursts; explosive, unpredictable behavior
2. Excitable, Impulsive
3. Restless or overactive
4. Cries often and easily
5. Inattentive, easily distracted
6. Fidgeting
7. Disturbs other children
8. Demands must be met immediately - easily frustrated
9. Fails to finish things he/she starts
10. Mood changes quickly and drastically

Of course, even if the answer to all of the above were to be a 3, it would not necessarily mean that the child has ADHD, because all of those things are also simptomatic of RAD. The real tell, to me is: When the child is on ADHD meds, do you see an improvement in the behaviors?
My oldest is classic ADHD. When he is on ADHD meds he would fall in th 0-1 range of every question except number 9. Even with meds he has a hard time finishing things.
Our older girl is on ADHD meds, and while they do help some of her behaviors, we do not see near as much improvement with her as we do J, even though she is on a higher dosage. However, we keep her on the meds as they do help with her impulse control problems, and without meds she can actually be a danger to herself and others.
Ds 8 was also on adhd meds for awhile because he is pretty much a 3 all the way down the line. However, we saw NO improvement what so ever with adhd meds, and in fact saw him become more aggressive and agitated. ADHD is clearly not his problem. We still don't know what is, but we know what it isn't.
Our 4 year old foster daughter is more than likely also ADHD, but I really resist medicating kids under the age of 6, as they are all pretty much adhd till they are at least 5.

If your daughter truly has ADHD you should see improvement with meds. Sometimes it is just a little improvement, which would then indicate that you should try a higher dosage. But if there are no improvements, and if a higher dosage does not help, then I would start looking at other caues for the behavioral problems.

[Adoption_Ally]

I'm with you - I would really wonder about the ADD/ADHD diagnosis. My son has ADD/ADHD, and to me the real diagnosis is for a child who CANNOT control their impulses or sit still, no matter how hard they try.

If increasing her meds is making her MORE hyper, then it's not ADHD. We could always tell with my son when his meds wore off - the change in behavior was pretty dramatic. He truly could not even stand still, no matter how much he wanted to.

Personally, I think way too many kids are labeled ADD/ADHD. Unfortunately, it's easier for a teacher to say that they have too many ADHD kids in their class than to accept responsibility for not being in control. And I have NEVER heard ANY professional say that a child can be selectively ADD/ADHD. They either are or they aren't -it's a chemical disorder. It's like saying a kid can be diabetic in one place and not another.

Another possibility might be that she is hypervigilant. If she's had a lot of loss and trauma in her life she might be so anxious that she can't focus, interrupts, etc. etc.

Just my $.02

[qs mom]

I resisted the dx of ADHD for my son and I resisted the meds. What I learned is that many symptoms cross over different diagnoses.

My son is definitely SID or SPD (whichever you prefer, same thing). Many of those behaviors look like ADHD. My son is PTSD, again many things look like ADHD. My son is Aspergers, some look like ADHD. These diagnoses often go hand and hand.

Ritalin didn't work. Adderall worked a little. So we tried to treat anxiety, that was bad news. So, onto the mood swings - Eureka that med was a God send. So that coupled with Adderall was a great help.

Do the ADHD meds make him calm? Nope. Do they help him control his impluses? To a degee.

Because he has all the other 'stuff' going on, the meds take the edge off for him. He is more able to control himself enough to use sensory techiques to work on the other things to calm down.

Fill out questionaires for a ton of things, see what shakes out. A good physciatrist will do that.

[michsm]

Originally Posted by Adoption_Ally

I'm with you - I would really wonder about the ADD/ADHD diagnosis. My son has ADD/ADHD, and to me the real diagnosis is for a child who CANNOT control their impulses or sit still, no matter how hard they try.

If increasing her meds is making her MORE hyper, then it's not ADHD. We could always tell with my son when his meds wore off - the change in behavior was pretty dramatic. He truly could not even stand still, no matter how much he wanted to.

Personally, I think way too many kids are labeled ADD/ADHD. Unfortunately, it's easier for a teacher to say that they have too many ADHD kids in their class than to accept responsibility for not being in control. And I have NEVER heard ANY professional say that a child can be selectively ADD/ADHD. They either are or they aren't -it's a chemical disorder. It's like saying a kid can be diabetic in one place and not another.

Another possibility might be that she is hypervigilant. If she's had a lot of loss and trauma in her life she might be so anxious that she can't focus, interrupts, etc. etc.

Just my $.02

These were some of my thoughts also.

When her meds were increased last week she got written up at school for the first time since she has been with me. I know it is hard to tell exactly what caused her extremely bad day, especially since she had just come out of her honeymoon period, but I am having a hard time seeing it at coincidental.

As for the hypervigilence. I have thought that a couple of times and her therepist finally mentioned today that he was also considering a PTSD diagnosis.

I truly cannot tell the difference between her being on meds and off meds. If she were more managable on them I would be all for them. I just wonder if any of her behaviors are being caused by them.

When I asked her psychiatrist about not giving the meds to her on the weekends. She told me if she needed it during the week then she needed it on the weekends and that she was very hyperactive.

Also, by all means am I trying to say that the teacher did not have control of the classroom. It wasn't that it was loud or out of control. It is just that what she saw as hyperactive behavior, I saw as kids being kids. Thats why I was wondering if maybe the definition of hyperactive had changed because to me a hyperactive child is like described above lack of impulse control, not being able to sit still, easily frustrated etc..

I was very frustrated by her psychologists response when he said she may be hyper one place but not another. If she is able to control her behavior when she wants to, which she is very good at changing her behavior when needed to suit her needs, then I have a hard time accepting the diagnosis. But I am not a Dr., just the fp who deals with her everyday.

[Adoption_Ally]

Originally Posted by michsm

I truly cannot tell the difference between her being on meds and off meds. If she were more managable on them I would be all for them. I just wonder if any of her behaviors are being caused by them.

Also, by all means am I trying to say that the teacher did not have control of the classroom.

But I am not a Dr., just the fp who deals with her everyday.

I understand that you did not say that the classroom was out of control - it was the teacher who was complaining. It just sounded like she had an issue with some of the kids' behavior, but wasn't doing a whole lot about it except claim they all had ADHD!

The drugs for ADHD/ADD are very powerful medications. If it were a child I were responsible for and I didn't see a real improvement in her behavior, I wouldn't give them to her. There are a lot of parents with kids for whom the drugs really work and the parents don't give the kids the meds on the weekend because they are concerned about the long-term effects. We didn't have that option with my son - he drove us beserk when he wasn't on them.

When, oh when, are the 'professionals' gonna learn to listen to those of us who actually LIVE with the kids?

[lucyjoy]

Can you switch doctors? This one isn't listening to you. If I said my child wasn't hyper and the doc insisted she was, I'd fire him.

If the hyperactivity is only when you are not there, hypervigilence is a better bet for what people are seeing.

If you see no change without the meds, I'd find a doc that wasn't pill happy.

[everbodysmother]

I agree with you, and while it is good to listen to outside input YOU know your child best - it sounds like you have put in your due diligence visiting the class room talking to doctors and therapists - go with your gut. One thing I have found helpful in every child I have worked with, and for some reason the doctors, therapists and teachers all seem to ignore, is diet. Is the "hyperactivity" just before lunch? Low blood sugar could be the culprit. Just after lunch sugar allergy may need to be addressed. So many kids are sensitive to blood sugar fluctuations. My "cure" for a disentigrating child is a large tablespoonful of peanut butter washed down with a glass of apple juice. The apple juice instantly raises low blood sugar and the peanut butter provides stablizing protein. Of course this is not the answer for everything BUT if it is the hidden problem you will be amazed at the speed of the results (tears, anger, desperateness gone in 15 min. really). I actually have peanut butter and juice in the school office and the teacher has been coached to notice the signs in my daughter if she doesn't herself. Also I'm sure you know this one but caffine has a calming effect on many "hyperactive" kids. Most special ed teachers I know keep sugar free red bull handy again you will be shocked at the effects and the vitamin B in it helps them concentrate. My special ed daughter won't go to school without her vitamin B in the morning as she can tell the differnce in her ability to concentrate. Sorry if this is too long and please forgive the spelling

[kburch]

My younger son was 9 when placed with us and was dx'd ADHD and on Adderall XR when he moved in. For about a year we kept him on the medication, and we went to see his psychiatrist every 3 months.

Now, this child had impulse control issues and wanted to be up running around his classroom any time they'd let him, but he could also sit so calmly and quietly in the back of 3-hour graduate level math class that *we* almost forgot he was there.

Going to see the psychiatrist was both frustrating and amusing. This kid would sit calmly with us in the waiting room for his appointment, and as soon as he walked through her door, he turned into a totally different kid! He was fidgety, spacey, etc. And every time the psychiatrist would look at us and say, "See, he's ADHD. He can't control that behavior. He'll always be that way. Get used to it." She would not believe a word we said when we told her (in nicer terms), "Hey, moron! If you'd have seen him in the waiting room, you'd know you are just flat-out WRONG!" As we left, he shut the behavior right off again. Had we not been so naive at the time, we would have asked for a new psychiatrist; unfortunately, we didn't think we could.

Finally, we convinced the psych. to let us try him off the meds, just to see how he'd do. She agreed, and we weaned him off. He got into trouble two days in a row at school, but that's it. His behavior was no different on or off the meds.

So, anyway, while our son is still impulsive, talkative, etc., I would not label him hyperactive at all. He's just a boy who wants to have fun and is constantly testing the limits of what people will let him get away with. In his case, his ADHD label just let him get away with A LOT more.

[michsm]

She was taken to the psychiatrist today by a transporter. When I got her new presctiption the Dr. kept her on the higher dose of ADHD meds, increasing her from 30mg to 50 mg. The same dose she took last week when she threatened to rip someones head off, had her most out of control behavior and then was up until close to midnight because she couldn't sleep. Then she had the nerve to put her on 10mg of Prozac!(she's 9) Are you kidding me. Does this woman have a clue what she is doing. I called her cw and basically told her that I would not be able to get the prescription filled tonight and someone needs to talk to Dr.. Even the cw couldn't believe what she had been put on. I just tried to talk to this woman last week and she wouldn't listen to what I was saying. I am hoping she will listen to the cw, especially since the psychologist is all for drugging her up also.

By the way we are now on day six without any meds and today she had a very good day at school, she still had some minor issues but overall it was good, I communicate with the teacher by email everyday. She also managed to stay out of trouble in her afterschool program.

I just wish someone would listen. Sorry for the vent I am just so irritated tight now.

[lucyjoy]

Can't her caseworker find a better doctor?

My son was very aggressive on stimulant meds and he actually is ADHD but his other diagnosis require different meds.

I hope she gets some help

[mrsred]

She sounds a lot like my 8 yr ds. E presents as having adhd, but the meds make him so much more difficult as they agitate him even more. Atypical anti-phsychtic meds (risperdal, abilify, seroquel) help his behaviors, but he has had adverse reactions to all of them.
Last fall we started up with a new (wonderful) child psychiatrist. He ordered a blood draw where they checked his iron levels. Research is showing that many children that exhibit adhd symptoms, yet do not respond to adhd meds actually have low iron levels. Not low enough to show up as anemic in a standard blood test done during a routine physical, but lower than normal. sure enough, E had low iron levels. Psychiatrist started him on iron in November. In February we had his levels rechecked, and despite being on prescription iron for three months they had not gone up at all! At that time he added B1, as that will help the body process the iron. Last month when we went back I said I still hadn't seen any improvement in his behaviors. Now he takes 325 mg iron in the morning and 325 mg iron with 100 mg B1 at bedtime. And finally, we are seeing improvement. He is much more cooperative, much more able to complete his homework and schoolwork.
This is something I recommend all parents of children with adhd/stress issues check into. Don't just start giving iron, as it really needs to be monitored, but it can make a difference!