OT: 4 year old with ADHD or something?

[1stluvispooh]

There are a whole host of disorders that could cause a child to be "difficult". These include ADHD, autism spectrum disorder, sensory processing disorders etc,etc. Even needing glasses could cause a child to be unfocused. I would err on the side of caution and take him into the pediatrician as soon as possible so that he doesn't end up being labeled the first week of school.

My suggestion is to take him to a developmental pediatritian. There will most likely be a significant waiting list but get him on it. I would era on the side of caution.

 

[MinnieVanMom]

I just have to disagree with most here. I am the parent of a child with autism. The one thing that everyone agrees on is that the best thing is early and intensive intervention.

How can you get early intervention if you don't identify the problem at an early age? Go to a specialist and see what they have to say. Not a general GP but an Psychologist or a Dr. that specializes in Autism, ADHA, NOS-PDD.

We have used ABA for the past 3 years and taught our child how to speak using ABA. It works for us and is a great way to modify behavior. It is hard work and takes dedication.

Good luck and

 

[Not so Dumbo]

My DS6 was just diagnosed with ADHD. Something was always off about him too, but until now the doctors wanted us to wait it out, because it could just be due to immaturity. I agree with the other pp's that said to delay kindergarten as long as possible. Here we have a developmental kindergarten for kids that aren't ready for K. The extra year really helps.
Once you establish what his pitfalls are, then you will know where he needs the most help, if it's with focusing then you can help him focus by working at a task in shorter timeframes with breaks inbetween. Or if he is too hyperactive, then give him time to wear off the energy before he has to sit and consentrate on something. Also, sometimes kids that age don't understand their feelings and helping them figure out what they are feeling and what the appropriate action for their feelings are helps them too.

 

[wildfan1473]

Another great book for Sensory Processing Disorder is Sensational Kids by Lucy Jane Miller.

When we adopted Jake and thought for sure this kid was ADHD, we found that he had severe sensory issues, and after a year and a half of OT (private, the school district will not provide "brain changing" OT), he is so much better. He still has some concentration and focusing issues, and he still is very much on or off (no middle ground, no idea how to relax), and it was suggested to us by my chiropractor that he could have an intolerance to milk (not lactose, but cow's milk completely). Turns out he hit the nail on the head with that suggestion. I watched Jake spend over an hour last week looking out various windows in the house, and drawing what he saw out each one. This is a child that, until recently, couldn't sit still long enough to eat a meal or watch TV, or color in a coloring book, let alone draw something.

 

[Disney_Angel]

My now six-year old was very spirited at that age and I worried. We occasionally got "the talk" at pre-school and at classes that we took. It is NOT fun to be "that" mom, right? I always felt like I was doing something wrong. Also, he was my first child and I didn't have any brothers, so normal boy behavior was a little bit of a surprise for me. I probably overreacted to a lot of it and worried way too much. We had twins when he was four and at first, he was fine, but he seemed to have a delayed reaction to the twins (say, 6 to 8 months out) as far as being jealous and a bit insecure goes and that definitely added some drama.

On the advice of the pediatrician, we waited it out. We found that positive reinforcement worked better than anything (although time-outs helped too) and that we had to be very careful not to escalate things when he was acting out (had to remain calm, never raised our voices) or things would get worse.

The other thing we did was not send him to school right away. He would have turned five a month after kindergarten began. We waited until the following year to send him, as it's very common to "red shirt" or wait out kindergarten for kids with summer and fall birthdays where we live. It was the smartest thing we could have done.

I'm happy to say that my son has outgrown all of this. He's very well-behaved in school, has lots of friends, and has adjusted to the twins. He still likes to be the center of attention and he talks all the time, but the transformation in the last two years has been amazing. I think what helped us was that our ped had a son just like ours (who is now getting a phd at an Ivy League school) so he didn't automatically label Eric and encouraged us to enjoy his personality (he's hilarious, like a very small, not hairy, Robin Williams). I'd be really careful of people throwing around the term ADHD, particularly those who aren't in the medical profession. If you're concerned, see a specialist.

Good luck. You might be surprised what the next couple of years bring.

OMGosh....you had an awesome doctor!!!

 

[Disney_Angel]

I I had one teacher call me becase dd made mention yellow was not the teachers color and she should not wear a particular shirt again. Yeah, she did have an issue with saying what she thought sometimes but really she was 9!

Kelly

I was that kid!!!
Now that I am an adult people love my sense of humor and ability to speak my mind. Why is it rejected for a child to speak their mind and praised for adults to speak their minds???

Great ideas were sprung from people who chose to look "outside the box" and stand up and say NO!

 

[Miss LD]

As a former pre-k teacher with degrees in behavioral science and psychology, please hold off on having someone diagnose your child with ADD/ADHD. It has been proven that diagnosing a child before age 6 is not a good idea and very difficult to pin point, and usually proves to be a detrement in the long run. It has become common for people to label children and medicate them instead of providing other alternatives like positive reinforcement techniques. So please look into private evaluation if possible and then discuss behavior therapy.

That's what we're trying to sort out. Like, at what point do you get help with medication vs. other options.

 

[keywestbride]

Sorry for the delayed response- no, the evals are not bad at all typically. Most therapists are really great with the kids, and remember that most of the kids they are dealing with have these same issues, so it's not like your son is going to shock them, no matter what he does!

So far, we've done a hearing eval (I thought it would be a nightmare, but it was a breeze, and only took maybe 20 mins tops), and speech eval. The speech one was a little more stressful, but mainly b/c we had a less than stellar SLP doing it. Typically, they have the kids look through picture books to name/point to things, etc.

In a couple of weeks, we'll have our OT eval, and I think that one will go well as it should be a more active experience.

I know a lot of people have cautioned you about labels- I was really worried about the same thing, but the thing is, a diagnosis (if there is one to be made) gets you the services your child may need, so you just have to ignore the label stuff. Yes, some people will look at it as a bad thing, but imho, it's worth it.

Nobody wants there child to be "not normal", but he is who he is-a label won't change that- and if there is some treatment that will help, you've got to go for it. Plus, it will most likely make your life a whole lot easier too.

 

[Alesia]

I work with kids and I can always tell when their moms are pregnant. I've actually known before the mom has a couple of times. I'm not kidding. From the day their mom gets pregnant, kids get more, well, I guess the word would be intense.

The thing that concerns me is that you say you've tried tons of different strategies. You need to pick something and stick with it -- for months, if necessary. I know its frustrating, but if you keep bouncing around, you are just creating more chaos.

 

[irene_dsc]

Not to add more fuel to the fire, but I notice more concern about behavior than attention in the OP's posts. A couple of books I found really helpful in that regard were Kids, Parents and Power Struggles by Kurcinka, and Greene's The Explosive Child. Both have a lot of good strategies, and you may (or may not) get an aha type of moment.

 

[Miss LD]

Not to add more fuel to the fire, but I notice more concern about behavior than attention in the OP's posts. A couple of books I found really helpful in that regard were Kids, Parents and Power Struggles by Kurcinka, and Greene's The Explosive Child. Both have a lot of good strategies, and you may (or may not) get an aha type of moment.

I don't know what that means really?
I will check out those books.
As far as attention goes, I can say that he requires a lot of it!

 

[Belle4mygrl]

I, too, think the "ADHD" label is used too much and I am glad that you are going for testing for various things. I just wanted to add to what others have posted that positive reinforcement and self esteem issues go hand in hand with this. My dd, now 21, was "that" kid. She was diagnosed ADD, then with Oppositional/Defiant, then Depression etc. Finally, we realized as parents, with help of a GREAT school counselor, that as hard as it was for us to the kid the teacher always calls about, her experience was way worse. The minute the teacher saw that she had been labeled it seemed she couldn't do anything. I had one teacher call me becase dd made mention yellow was not the teachers color and she should not wear a particular shirt again. Yeah, she did have an issue with saying what she thought sometimes but really she was 9!

Kelly

this gave me a good laugh. I know it probably wasn't funny for you but it reminds me of my DD3. She has yet to learn tact. She will tell someone their breath smells, their "big", or they shouldn't cut their hair. I am working on her but how does a 3 year old comprehend??

 

[DreadpiratK]

You've probably dealt with this already, but we had very similar concerns with our dd, she's 4 and would get just off the wall out of control at times. She would be defiant, destructive and very hyper. We found that the problem was actually an allergy to artificial colors. If she gets even a small drink of cool aid, or anything with red or yellow food colors, she goes NUTS! It's a very noticeable change in behavior, at least now that we know what to look for and are used to her NOT having any colors. Completely eliminating them from her diet changed things dramatically. She's still very high energy, but manageable, and she can focus on things and has decided that she wants to learn how to read, and is doing very well with it.

I don't know how common this is in kids that are diagnosed with ADHD or other disorders, but we have two other friends who had similar experiences (that's why we picked up on it.)

 

[pweyl36]

My ds20 was dx at the age of 5 w/adhd,thanks to his k-teacher,who's daugther was also dx with it. I did take my son to a ped neurologist who dx him and dx his tourrettes also. The symtoms my son had was the he could not sit still,play with something to long.at school he would get up and roam around the class and he had this thing with touching his class mates heads . He did take meds one for adhd and one for his tourettes,with out the medicine he would not have been able to graduate with As and Bs. He was also disiplined when he was bad. I never used the excuse " well he has adhd".Now he works and is a very well mannered young man.I always have people telling me he is such great kid. Iam very proud of him .

 

[poohguys]

We had a similar situation. We always suspected that DS was ADHD since he was very little. Mentioned it to DR when he was 5 and they said they would not even consider evaluating for ADHD until he was 7. He got through Kindergarten fine, but started having a lot of problems in 1st grade, falling out of chair, swinging arms around and bumping into other kids, not being able to focus long enough to do school work etc. Well 2 weeks after his 7th birthday we took him to ped. neurologist and he was put on meds.

Prior to this we had tried Feingold and other behavior mod with out much success. My advice is to read and try everything you can. Some stuff works and some does not. Like PP said try to keep things consistant/structured as best as possible. Good Luck

 

[kellyg403]

this gave me a good laugh. I know it probably wasn't funny for you but it reminds me of my DD3. She has yet to learn tact. She will tell someone their breath smells, their "big", or they shouldn't cut their hair. I am working on her but how does a 3 year old comprehend??

Yes...my dd was/is the same. Since she was little the minute she thought it she would say it. Really, most of the time I was thinking it too just knew not to say it! Honesty was her best policy.

OP..I agree with others when mentioning that consistency, consistency is the best advice while you are waiting. As another mentioned it could take months for something to work, or it could take a week. We too took all sugars and food dyes out of our family diet and felt we noticed alot changes in the ability for dd to focus and not be so high strung. Having a child who is a little more prone to needing alot attention can be a daunting task. It will definitely make you wonder if you are a terrible parent. The truth be told in some instances I was being a lax parent. My dd would just know how far to go and could be so strong willed I would give up way before she would just to stop the problem. I was told by the psychiatrist she was seeing at age 5 that I was my dd's major problem. She just had more drive to get her way than I did. Once I took his advice and implemented some of the tools he gave us, we were able to see more behavior changes. Back then, the big help book was the "Strong Willed child". I believe by Dr. Spock. I didn't agree with all of it, but most of it was right on target for us.

Good Luck! and keep trying to find out what is best for your child whether it be medication, diet or behavioral changes.

Kelly

 

[irene_dsc]

I don't know what that means really?
I will check out those books.
As far as attention goes, I can say that he requires a lot of it!

Well, you started your OP by saying that he is difficult. ADHD stands for Attention Deficit Hyperactivity Disorder (just to be a tiny bit pedantic for a moment). Difficult can mean a lot of different things - but you haven't really explained in what ways he is difficult. The attention deficit portion of ADHD usually means lack of focus. The hyperactivity portion has to do with movement. As I read into ADHD more, I found that impulsivity is also lumped into ADHD.

Fwiw, my 7 y/o ds was diagnosed as having some signs of ADHD last year, but not necessarily in a "classic" way, whatever that means. He also was diagnosed with Oppositional Defiant Disorder (which is explained in The Explosive Child) and mood disorder, although I think he is maturing out of a lot of this, tbh.

Alas, none of this stuff is really cut and dried, so it really pays to educate yourself about different possibilities, imho.

 

[mjkacmom]

If you think there is something not quite right, trust your mommy instincts. You might not know what is up, so ask for an evaluation. He could have sensory issues, he could have ADHD, he could have a food allergy. Once you discover the problem, and figure out a path to correct it, you will feel relieved.

 

[Miss LD]

Well, you started your OP by saying that he is difficult. ADHD stands for Attention Deficit Hyperactivity Disorder (just to be a tiny bit pedantic for a moment). Difficult can mean a lot of different things - but you haven't really explained in what ways he is difficult. The attention deficit portion of ADHD usually means lack of focus. The hyperactivity portion has to do with movement. As I read into ADHD more, I found that impulsivity is also lumped into ADHD.

Fwiw, my 7 y/o ds was diagnosed as having some signs of ADHD last year, but not necessarily in a "classic" way, whatever that means. He also was diagnosed with Oppositional Defiant Disorder (which is explained in The Explosive Child) and mood disorder, although I think he is maturing out of a lot of this, tbh.

Alas, none of this stuff is really cut and dried, so it really pays to educate yourself about different possibilities, imho.

That's exactly where I'm confused in general.
I think ADHD is thrown around a lot by people who don't have any experience with it really.
In my case I am just beginning to educate myself. But, the Attention Deficit part seems not totally relevant in our case. For DS one of the big things we struggle with is that he likes things a specific way. A meltdown happens, for instance, when he has a line of cars and someone moves one. He can literally spend an hour building a complex lego structure. But if he makes a mistake on it then the world falls apart.
Or, for instance when we did gymnastics he would want to go on the different apparatus in one order. (this was 2 years ago). If they changed the order or, god forbid, didn't do one at all, he would melt down.
This sounds like just stubborness, but it's not. My niece, for instance, will want things her way and have a temper tantrum sometimes. But, she can get it back together.
And, I think this need to have things a certain way tends to cause problems in a group setting. Like, lining up can be a huge issue. Why? I don't know. In daycare he did well because he knew when he had to line up. It was all routine. And so he managed. But there was tons of one on one at daycare and that helped him.
The hyperactivity part may hold true. He does have crazy energy. But, I'm not sure how much of that is just being a 4 year old boy.
I find more it's also a lot of just wanting to move. Sitting still in an assembly is really hard. He needs to move.
And the other thing is that things will agitate him. We were in a vacation bible school today and there was a poster on the wall. It had a rip in it. He was in tears because they didn't have tape to fix it. To the point I had to take him out because he was so upset. So, again in this case, it wasn't that he had to have his way because he's spoiled - it was just that until he was completely distracted he could only focus on the ripped poster.

Anyway, thanks for clarifying what you said. It's helpful.

 

[perkinsrose]

That's exactly where I'm confused in general.
I think ADHD is thrown around a lot by people who don't have any experience with it really.
In my case I am just beginning to educate myself. But, the Attention Deficit part seems not totally relevant in our case. For DS one of the big things we struggle with is that he likes things a specific way. A meltdown happens, for instance, when he has a line of cars and someone moves one. He can literally spend an hour building a complex lego structure. But if he makes a mistake on it then the world falls apart.Or, for instance when we did gymnastics he would want to go on the different apparatus in one order. (this was 2 years ago). If they changed the order or, god forbid, didn't do one at all, he would melt down.
This sounds like just stubborness, but it's not. My niece, for instance, will want things her way and have a temper tantrum sometimes. But, she can get it back together.
And, I think this need to have things a certain way tends to cause problems in a group setting. Like, lining up can be a huge issue. Why? I don't know. In daycare he did well because he knew when he had to line up. It was all routine. And so he managed. But there was tons of one on one at daycare and that helped him.
The hyperactivity part may hold true. He does have crazy energy. But, I'm not sure how much of that is just being a 4 year old boy.
I find more it's also a lot of just wanting to move. Sitting still in an assembly is really hard. He needs to move.
And the other thing is that things will agitate him. We were in a vacation bible school today and there was a poster on the wall. It had a rip in it. He was in tears because they didn't have tape to fix it. To the point I had to take him out because he was so upset. So, again in this case, it wasn't that he had to have his way because he's spoiled - it was just that until he was completely distracted he could only focus on the ripped poster.

Anyway, thanks for clarifying what you said. It's helpful.

I'm no expert but the items highlighted were behaviors/issues present in students I've had that had autistic tendencies and/or obsessive compulsive disorder to some degree.

I'm wishing the best for you and your child. I think that one of the hardest things as a parent is the feeling of not always being able to make it immediately all better--however big or small the issue may be.