Diagnosing ADD in teens and adults, need help

[Tiggeroo]

After 3 years of fighting with my sons thru hs I believe we've finally found the problem. I suspect they have ADD. I work in the school and am surprised I missed it. However, neither of them are hyper-active, behave inappropriatly, or anything like that. Their teachers love them, but just don't know what to do. What happens is they just cannot get organized. They will get a's on their tests and fail a class because their homework is not handed in. I will stand over them while they do their homework, and it will get lost somewhere between home and school. My one son describes an almost out of body feeling he gets in certain classes. There is talking going on and he has no idea what's going on. He'll be thinking, we did this last week. He can read well, but has a difficult time reading for any long period of time.
Their father was recently diagnosed and placed on medication after a lifetime of issues stemming from this.
Their school psychiatrist feels very strongly that this is the case. However, he wants me to handle testing privately as it will take over 5 months to get everything done thru the school. How do I get this diagnosis and help for the boys. I call some places and they don't accept insurance and the testing will be over $1000. apiece. Others accept my insurance but have a long wait. Still others (like where my dh went) don't seem to do what seems like a true evaluation, and just want to write a script.
Is the first step a psychiatrist, psychologist, or neurologist? Once you have a diagnosis, who can help with learning to work with the problem. Dh and sons desperately need to learn organizational skills. The school psychiatrist said they should see educational or organizational counselors. And if they aren't licensed psychiatrists of psychologists my insurance won't cover that and it will be quite $$$. Anybody have any tips? Sorry for the long post.

 

[Christine]

Wow, where to begin???

Of course my children our younger, so we started with our pediatrician, who then referred us out to Children's Hospital. We were basically seen by a neurologist. I wasn't sure how my health insurance was going to handle it (health benefits or psychological benefits). Since it was a neurologist, we kind of lucked out and we fell under the 80/20 co-pay. If it had been deemed "mental health" we would have had a 50/50 copay and it would have cost a great deal more. So, you may want to try the neurologist route as that may get you more health care benefits.

Another thing to keep in mind is that there is no "real test" for ADD/ADHD. It is basically a diagnosis which excludes other disorders like depression/anxiety/bi-polar/learning disabilities and it also goes on the reported history of family members and teachers. You don't necessarily need a psychiatrist to do this. What I do really suggest is that you MAKE sure that there are no other learning disabilities going on. A psychiatrist cannot detect this. My cousin's son has been labeled ADD for since he was in 1st grade; however, the meds never really helped him. She finally (at age 16) started getting a more thorough evaluation and it turns out he has Executive Functioning Disorder which is treated in a very different manner without medication.

I probably haven't really helped you here, but this has been my experience. I also don't think that "empirical" medical trials are a bad idea. If you have ADD, in 80% of the cases the medication REALLY works. If you are not against medication, you may just want to try a 2-week trial of medication under the supervision of your child's doctor. It is not harmful and can tell you a lot of things in that short time. If it doesn't work, then you can pursue further testing.

 

[Tiggeroo]

Thanks. The hospital centers and university centers do not seem to take any insurance, yet they seem to do the most comprehensive evals. My dh has been on aderol for 2 weeks and feels a huge difference. But he doesn't know where to begin as to how to channel the energy/focus he has. Years of living with this have created a number of messes in his life and he needs help bringing order to the chaos.
Apparently diagnosing ADD is more difficult with teens, because some of the symptoms are similar to typical teen behavior. My dh's family history is full of people who sound like they have add. He's the only sibling out of 6 who graduated hs.

 

[buzzlady]

Originally posted by Tiggeroo
I call some places and they don't accept insurance and the testing will be over $1000. apiece. Others accept my insurance but have a long wait. Still others (like where my dh went) don't seem to do what seems like a true evaluation, and just want to write a script.
Is the first step a psychiatrist, psychologist, or neurologist? Once you have a diagnosis, who can help with learning to work with the problem. Dh and sons desperately need to learn organizational skills. The school psychiatrist said they should see educational or organizational counselors. And if they aren't licensed psychiatrists of psychologists my insurance won't cover that and it will be quite $$$. Anybody have any tips? Sorry for the long post.

I have been looking for someone for my DS11. His grades stink, he is very unorganized, and I could go on and on. I have called what was listed in my insurance plan as child and adolecent phychiatrists to be told that they aren't specialized in child/adol. I have called behavioral specialists to be told they have no openings. It was suggested that I call Catholic Charities. I haven't made that call yet but it seems my next step. Amazing all the $$ we pay for insurance and can't get help for our kids ~ can't even find a place to start. My peds. dr. was no help as far as where to take him. I see that you are also in NJ.

 

[DawnCt]

I would call a pediatric neurologist. ADHD is a neuro disorder not a psychiatric one. Your insurance should cover it.

 

[Tiggeroo]

It is amazing. And i'm so fed up with the school. They know there is a problem, but won't even take tiny steps to help until I get an official diagnosis. All I've asked for is that teachers email or call me if assignments are missing, or perhaps in some way make sure that I know of these assignments. I am running into the same problem. The names my dr. gave me were the same story. No appointment til Sept. or cash pay for the two boys over $2000. I am waiting for a call right now from a place that may be able to get my son in sooner. You are central NJ so you might have more choices, because you can go up north. Call all the colleges/univ. that specialize in teacher education. They seem to have the best services. Also, call children's hospitals. I'm waiting to hear from CHOP also who may be able to help.

 

[Tiggeroo]

Dawn, thanks alot. I'm sitting here with my insurance book looking up one now. But if this is the case, why do so many people want to send him into the psych. end of things. This includes his school psych. Some places will add a neuro eval after everything else has been done. I have a ppo so I don't need a referal, and would prefer to go directly to the best provider.

 

[sha_lyn]

If you are not against medication, you may just want to try a 2-week trial of medication under the supervision of your child's doctor. It is not harmful and can tell you a lot of things in that short time. If it doesn't work, then you can pursue further testing.

I would not try this especially with a teenager. If put on Meds as a teen it will limit their career choices as adults. I would hate to see this happen to anyone, especially if it turns out they do not have ADD.

Some of the career fields that come in mind that will not take someone who was on ADD meds as a teen are

Military

Any Federal law enforcement agency..ie... FBI, CIA, Secret Service

Some (if not most) state and local law enforcement agencies

Commercial Airlines... I also believe they can not get a private pilots license.




If the school system won't provide the testing in a timely manner they must, by federal law, pay for private testing. There are so many conditions that share symptoms with ADD. I would not take the chance of not having a through evaluation done.

Just recently I was having a conversation with a friend. His 2nd grade DS is really struggling with reading. He excels in classes that do not involve reading, so the parents didn't think it was ADD although the school suggested it. After talking with my friend a pattern came out that seems to point to either a visual processing problem, or his DS is weak in visual learning and does better with auditory stimulation. They have him scheduled for testing but I gave them suggestions to try for now. I can't wait to talk to him tomorrow and find out if it is helping.

The first thing I told him (which they have been doing for a couple of weeks) is to have the son use a plain index card and hold it under the line he is reading. It is already helping so is seems is was not doing well tracking the lines on his own. That could be caused by several different conditions including visual processing problems, just being weak in visual learning, or even ADD.

Then I told them to try having music in the background while he reads. If he is strong in auditory learning then that can help stimulate brain activity.


I learned all of this because of our fight with the school system. They insisted DS was ADD when the Ped felt strongly that he was not. Her initial test ruled out ADD but the school insisted they would not test DS for anything. They wanted us to try meds on a trial basis. The Ped suggested that DS was an auditory learner and we tried a few suggestions which really helped.


Luckily my aunt and uncle (who are both high school teachers) told me about the problems some of their former students faced because they had been on meds in school. One such student had been on meds in 10 grade for only 6 weeks "just to see if it was ADD without testing him". Well there went his career plans. I can't remember if he had hopes in the Military, law enforcement, or as an airline pilot. I know my aunt and uncle knew students who couldn't pursue careers in all 3 careers.

 

[Tiggeroo]

Shalyn - any idea what would be considered a timely manner. I would really prefer that this was done by a thorough assessment center. And several times I have brought up the question, what if there are other learning issues here? Will these tests detect that? I either get no answer or am told, maybe. Are you certain about the med. career problem. My one son is considering commercial piloting or military. Can I refuse meds and insist on trying other solutions first. All I hear is, they should be on meds.

 

[sha_lyn]

I din't pursue the matter further since we had already decided to home school, and the Peds suggestion worked. I know I've read about other parents fighting their school system when they couldn't test. I believe it was on the Motheringdotcom boards.

I am 100% certain about the career situation. Last time this came up on the DIS someone provided a link to the miltary's position. I'm tryign to find it and I'm looking at the FAA site about pilots.

 

[sha_lyn]

I'm trying to remember exactly what I've read about commercial pilots license. I think it has to do with the diagnosis of ADD and it being a neurological disorder. Also I know they can not be on any meds when they are flying. Remember the pilot that grounded because of Viagra.

 

[KarenC]

Originally posted by sha_lyn
I would not try this especially with a teenager. If put on Meds as a teen it will limit their career choices as adults. I would hate to see this happen to anyone, especially if it turns out they do not have ADD.

Some of the career fields that come in mind that will not take someone who was on ADD meds as a teen are

Military

Any Federal law enforcement agency..ie... FBI, CIA, Secret Service

Some (if not most) state and local law enforcement agencies

Commercial Airlines... I also believe they can not get a private pilots license.

I have never heard this before. Do you have a source for this information? I know that people in the military can't be taking ADHD medication while they are serving, but I never heard that drug prescriptions now would affect their future career choices. I would be interested to learn more about this.

 

[buzzlady]

Originally posted by Tiggeroo
Shalyn - any idea what would be considered a timely manner.

When I had DS7 tested for learning problems, the school had 90 days in which to start testing.

 

[FINFAN]

I have no proof of this, but My cousins friend was given a "special issuance" from the FAA to obtain his private pilots license. As I understood it, he cannot be on meds for 30 days B4 or during flying (I think). He also needed his physician to verify his mental health and condition.
This was a few years back, so it may have changed, but he rec'd his license. He would have been crushed if his ADD neds wuld have kepy him from his dream. He would've never graduated HS had he not been on them, but the only other thing getting him through was to then be able to take privatr lessons.
Maybe call the FAA and ask them directly? I do remember him saying something about the military tho, because that was one way he could've gone about getting his flying time and good job refferral...from the Air Force.

 

[Christine]

Hmmm, interesting. I know someone in the Marine Corp who is taking Ritalin. I wonder how that happened. I don't really know the military's rule on that.

If there is a strong family history of ADHD in the family then most likely your children probably have it. It really sounds like it and is definitely genetically based. While I do not really believe in jumping on the medication bandwagon, I also do not think that NOT treating this is the answer. If you cannot afford to have the testing done and it is going to take approximately a year to get it done, then these kids are suffering. And let me tell you, untreated ADD/ADHD is also going to lead to not being able to do a lot of things (such as fly a plane, peform certain military tasks, etc). I think you see, based on your DH and his siblings what untreated ADD leads to. I'm not trying to sound like you don't know this--it is very obvious that you do. I guess I am just angry that our current medical system makes it so hard to quickly get a diagnosis/treatment on this, while your kids are suffering for it. Then to want to maybe just try the prescription, but have to worry about your future. It is just such BS. Untreated, you won't HAVE a future.

I am very good friends with a man who has probably the WORST case of ADHD I've ever seen. He is now 53 and was not diagnosed until he 45. The man is nothing short of a genius, in my opinion; however, his life in school was hell, he couldn't complete college and he abused drugs and alchohol in an attempt to self-medicate. He is now fully treated and so much better, but his patterns of disorganization are so entrenched, I don't think he'll ever become what he could have if he had been treated as a child. It's really a shame. My point is, not treating him at all, kept him out of doing a lot of things.

Also, I don't understand how taking a drug for 2 weeks would bar you from anything. You explain that you were "trying" the medication for suspected ADHD and that it was proven you did not have it and the medication was stopped. If they are penalizing people for this, that is just wrong. Additionally, I would much rather have an medicated ADHD person flying my plane that one who did not take the meds in order to sneak through.

 

[Tiggeroo]

Christine, I agree. From what I can see on the military sites, taking it in school is not going to affect military service. But you cannot take it while serving. You need to be off of it anytime between 2mos. and a year depending on the branch and who is giving the answer. My dh sounds alot like your friend. Diagnosed and starting meds. now at 45. When he was younger he tried self-medicating w/drugs and alcohol. He has built his life since marriage in ways to minimize on his own his symptoms. One way was by being self-employed. But everything has been more difficult for him then alot of people. Originally I thought my sons were absorbing his bad behavior patterns rather then the fact that all of them had an actual problem.
The military is not the only institution trying to deal with ritalin use. My one son is a competitive runner. When athletes hit college they need to drug test. They may not have ritalin in their system when they test. So the NCAA is stuggling to come up with guidelines for their athletes who need this medication. It is thought to be a performance enhancer giving these students an advantage.

 

[robsmom]

Originally posted by Tiggeroo
My one son describes an almost out of body feeling he gets in certain classes. There is talking going on and he has no idea what's going on.

You mentioned that your one son was considering the military or being a pilot. I understand the point about limiting career choices and am generally in the camp that we are too quick to medicate our kids today. That being said, you may want to help your son to look at his career options and consider if they play into his skills. If we is sort of "zoning out at times" without medication, would being a pilot really be a good idea for him anyway. I think you don't jump to the meds too quickly, but in the end if there is no other way to control his condition, the career paths mentioned are really out of the question anyway.

 

[Tiggeroo]

You mentioned that your one son was considering the military or being a pilot. I understand the point about limiting career choices and am generally in the camp that we are too quick to medicate our kids today. That being said, you may want to help your son to look at his career options and consider if they play into his skills. If we is sort of "zoning out at times" without medication, would being a pilot really be a good idea for him anyway. I think you don't jump to the meds too quickly, but in the end if there is no other way to control his condition, the career paths mentioned are really out of the question anyway.

Sorry. I have twin sons. The one who is having the severe problems is not at all the military type. The other son's problems are limited to disorganization in certain areas. The main effect is in school work. He may or may not decide on the military or piloting. Either way they are both going to get a thorough screening. If in the end they needed medication it wouldn't matter what career they had in mind. They would be on the meds. But since this son has an interest in this direction, and his problems are less severe, I would be inclined to have the dr. try other options such as behavior modifaction therapy if he felt there was a chance it would work. I seriously doubt my other son is going to get off so lightly. I'm not a dr. but I suspect he will need meds.

 

[sharbear]

It's really sad that your HS is not cooperative. We had some of these problems with our DS, we had him tested through our ped. and our insurance paid for it. Our DS does not have ADD or any learning disorder, which was almost worse than finding something. I reached out to the school and they were so great. We had a conference with all of my DS's teacher's. None of them saw that he was inattentive until all of them were together and then they noticed somethings. The team of teacher's made a few changes which really helped us.

My DS is very quiet and they would put him with the chatty kids because he wouldn't cause any trouble. I asked to move him and put him in the front of the room. It really helped. He's a soph. and he had a great freshman year. He bumped up to a few Honors classes and they seem to be the one in which he excells in. I think mostly because it's less distracting.

Another thing that I do is go over all of his classes as soon as he comes home from school. We go over the class one by one and talk about the assignments in each class. If he hasn't done so yet (usually the case) he will list his classes in his assignment book and what he needs to do in each one. If he has a long term assignment, he will put reminder's in his book later in the week.

We still have some problems but these approaches have helped. Writing is a esp. hard thing for him to do. I try to go over his papers and make only a couple of suggestions at a time and then go over it and make a few more suggestions.

This is a lot of hard work and it's not easy. My DS has gone from the lowest level of math in elementary school to the Honors track. He's doing better than many of the kids who started out in the Honors track and were in the gifted program.

 

[MICKEY88]

Originally posted by Christine
Additionally, I would much rather have an medicated ADHD person flying my plane that one who did not take the meds in order to sneak through.

but what if they forgot to take their meds...