What do I ask my pedi? (Updated pg 2)

[sdarwkcabemanmy]

Today, as part of Rodeo Week at DS's school, they had a stick horse parade for all the classes. I went down to help out and film the part DS was in and I ran into the school's diagnostician.

She's been doing testing on DS to see what kind of services he'll be eligible for next year, whether it is just speech/motor (which he's been recieving) or more. She mentioned to me that she noticed something which DS's teacher had talked to me about also. His attention seems to be all over the place, even when it's just him and the teacher/tester one on one.

I've noticed that too, but I put it down to DS being five and just having a short attention span. If he's REALLY interested in something, he'll concentrate and sit still FOREVER. But if he's only mildly interested...he'll try to concentrate but the moment a distraction comes up it's like, "OOh! SHINY!" and off he goes on a tangent.

We're seeing the dr on Monday for his annual check up/well-visit/whatever it's called. I know I need to mention this to the pedi, but I'm not sure what questions to ask regarding ADD/ADHD. I'm really afraid the dr is going to want to put him on meds, which I'm kind of hesitant to do at this point.

So what kind of questions do I need to ask? Where do I even start?

Help?

Thanks.

*edited to add--
Well DS had his well check or whatever it's called today. He's grown some (43 inches tall now) and his weight has stayed the same. Dr. suggested trying to get him to eat more meat which would help him gain a little weight. He also sent home some paperwork for us to fill out about DS's behavior, etc. They also had to do a blood draw for cholesterol and some other things. When did it become 'normal' to check 5 yr olds for high cholesterol? Fortunately, DS did pretty well and didn't cry until AFTER they took the needle out.

 

[KirstenB]

Our older dd who's 10 has ADD. Her teachers always commented on her lack of attention/focus, etc. Finally her 3rd grade teacher just wouldn't let go of it. So I started watching dd a little closer. My "a-ha moment" came when I told her to go upstairs and get dressed, cause we were going to Busch Gardens. Dd loves BG!! 20 minutes later, I walked upstairs to see what was taking so long. She was still in her jammies.

I told this scenario to her doctor, and the doctor said that was nearly a textbook example of ADD. A kid who cannot pull it together long enough to complete a task related to something she really wants to do. Anyway, it was a lengthy process to get dd dx'd. Teachers fill out a questionnaire, parents fill out same, and doctor observes/interacts with your kid.

We went straight to meds, but I believe there's things like biofeedback you can try too.

If i were you, I'd explain the teachers' concerns, and ask what treatments there are for ADD. Then see if you want to pursue the questionnaires, etc.

 

[bookwormde]

If he has the ability to concentrate for extended periods of time on areas of interest, and is not generally hyperactive then it is much more likely that what you are seeing is and executive function differential. Another indicator is if he is significantly visually based (as compared to verbal or other linear inputs). In the simplest description, the mind is more geared to taking in chunks of information (such as visual images) and does not have the same strengths in auditory linear recognition, focus, memory and often processing.

If his Ped is sharp he will have an auditory processing evaluation before he recommends anything. If this comes back as an issue he may well broaden the evaluations.

bookwormde

 

[sdarwkcabemanmy]

If he has the ability to concentrate for extended periods of time on areas of interest, and is not generally hyperactive..

This. Yes.
If it's something he's really into (which right now is cars of any kind, esp NASCAR and video games), he'll sit there and concentrate on it for hours. But he's not hyperactive. Active, yes. But not overly so.

If it does turn out that he has ADD/ADHD or a learning disorder, I won't be surprised. I myself have dyscalcula, my sister has dylsexia and while he's never been formally diagnosed my brother has had learning issues as well. I wondered if DS would have a learning disorder show up eventually.

 

[bookwormde]

Definitely time for an auditory processing evaluation.

From what you describe, it is likely more of a learning differential, not really a disorder, except that most schools do not have the curriculum modifications for his leaning “style”.

Dyslexia, as well as being ambidextrous (and being almost as comfortable to reading pages upside down) to a significant extent is quite common with visual/non linear individuals.


bookwormde

 

[sdarwkcabemanmy]

What exactly IS an auditory processing evaluation and would his pedi be able to do it, or would I need to have him recommend a specialist?

 

[RN4Babies]

My dd8 acts in a very similar manner as your ds. Her pediatrician suggested an evaluation by a child psychiatrist when she was four; she was diagnosed with Asperger's Syndrome four years ago.

Talk to your pediatrician about a referral to a child psychiatrist for an evaluation. (Speaking from personal experience, if you're not happy with the evaluation process at the first psychiatrist, go to someone knowledgeable or who specializes in ADD/high functioning autism/asperger's syndrome). In my daughter's case, the psychiatrist observed her in his office on several occasions, and also had me and her teachers complete a lengthy questionnaire regarding her actions, reactions, behavior, etc.

I don't like puttling labels on kids, but once you have a diagnosis, it opens many doors for information gathering, educating yourself and treatment options. We call dd's issues "learning differences" instead of "learning disabilities."

 

[jodifla]

Today, as part of Rodeo Week at DS's school, they had a stick horse parade for all the classes. I went down to help out and film the part DS was in and I ran into the school's diagnostician.

She's been doing testing on DS to see what kind of services he'll be eligible for next year, whether it is just speech/motor (which he's been recieving) or more. She mentioned to me that she noticed something which DS's teacher had talked to me about also. His attention seems to be all over the place, even when it's just him and the teacher/tester one on one.

I've noticed that too, but I put it down to DS being five and just having a short attention span. If he's REALLY interested in something, he'll concentrate and sit still FOREVER. But if he's only mildly interested...he'll try to concentrate but the moment a distraction comes up it's like, "OOh! SHINY!" and off he goes on a tangent.

We're seeing the dr on Monday for his annual check up/well-visit/whatever it's called. I know I need to mention this to the pedi, but I'm not sure what questions to ask regarding ADD/ADHD. I'm really afraid the dr is going to want to put him on meds, which I'm kind of hesitant to do at this point.

So what kind of questions do I need to ask? Where do I even start?

Help?

Thanks.

Any child will stop paying attention and disengage if they are confused or not really able to follow what's going on. So you get a lot of children who have issues like a visual processing disorder or an auditory processing disorder or difficulties, and schools quickly want to slap them with an ADD label. Many teachers like their kids to "sit down and shut up" so if that means sedating them, then they push for that. s m

If your child can attend to things he wants to do, I'd think many, many times before putting him on meds or letting anyone slap an ADD/ADHD label on him.

At the university research hospital we went to, the lead clinician said, "Oh, I can see how this is going to go. They're going to want to call him ADHD, or autistic, or learning disabled. He's none of those things." What my DS does have is a language and communication disorder.

So the most important piece of advice is: be VERY, VERY CAREFUL who you go to. There are LOTS AND LOTS of bad clinicians out there.

 

[LMC]

This is my experience:
DS14 is ADD (& other issues) but this is how I see his ADD manifested. "Johnny" put on your shirt, get your shirt on, go over there and put on your shirt. Now don't forget your deodorant. Did you put on deodorant? Then make sure you put it on. Lets go take your medicine. (I'm waiting, as all this transpires over a 20 min period or so). Come on, you need your medicine. "Johnny", get in here for your medication. (give it to him) Did you remember to put on deodorant, No, well go do it. Now lets go fix your hair (I wait in the bathroom for 5 mins and have to go get him again), etc, etc. He does not have a hyperactive bone or hair on his body.
DS8 is EXTREMELY adhd according to the phsyc. He wakes up and the screaming and noises start. It is like this for an hour until we get medicated and leave for school (and we are chasing him down to get him dressed). Screaming and noises continue in the car and I hope he can calm down for school until the meds kick in. He gets a second does of meds at 1:30 so he is good all day at school and by the time I get him home at 4 and we start homework at 4:30, guess what, the meds are wearing off so the commotion starts again. he can't sit still, falls out of his chair, can't stay in front of his fav tv shows more that 10 seconds at a time (constantly running in and out of the room to get or do something while watching tv). He is so exhausting. I don't know how I did not go insane the first 8 yrs of his life dealing with special needs DS14 and DS8 who is out of control. No wonder my DD10 is so stressed out she now sees a massage therapist!
Just watch for these type behaviors. I am sure if you stop and watch, you may see something that you have just always overlooked because you have become accustomed to. That is how I was until I saw DS8 medicated, now I can't stand to be around him when he is not medicated. But, his actions NEVER bothered me before I saw him in another light.

 

[sdarwkcabemanmy]

If your child can attend to things he wants to do, I'd think many, many times before putting him on meds or letting anyone slap an ADD/ADHD label on him.

I have DREADED the day a teacher would come to me and say, "I think your son might be ADD/ADHD/whatever." because it seems to be a very popular way to diagnose kids who don't fit the mold right now. *sigh*

I remember my own struggles growing up with dyscalcula, how I was told I couldn't POSSIBLY have a learning disorder because of this,t hat and the other. I remember my sister being misdiagnosed as ADD and being put on ritalin which wasn't the right thing for her (and may have led, later on, to drug addiction, but that's another thread entirely). I don't want to have to go through this with DS but I will if I have to, to get him the right diagnosis.

 

[BeckyScott]

We had a hard time w/ the meds. Oldest DS is currently on them, but about the lowest dose you can get. He probably "needs" higher, but no. Because what happens with him is, even the extended release, at some point wears off. And he became, gosh I don't know how to even describe it, angry agressive hateful, and on top of that it would still interfere with his sleep. So we took the dose down, and I told the school we weren't going to increase it, period, maybe it helped at school (which it did but he still showed signs) but the side effects and home life were too much for me to handle. He is now IEP'ed for OHI.

I could see signs of ADHD when he was 3 or 4, probably, but of course everyone just tells you that he's a boy and a toddler and blah blah blah.

Oh look, a squirrel.

I have looked into and somewhat adopted the Feingold diet for him. It's very tricky for me personally, to have one kid gf/cf/other allergies and one kid Feingold and trying to cook around that, even though we try to eat organic as much as possible and probably both kids should be gf/cf anyway, well right now I'm still trying to figure out how to do all of that. But that might be an option to try out- is he already gfcf? You're probably most of the way to Feingold already.

Isn't your DS on the spectrum? Or is that a different DS? In that case, I don't think it's that unusual for a secondary ADHD diagnosis. Youngest DS has both, but I don't really think too much about the ADHD one, bigger fish to fry I guess.

 

[packetminnie]

We had a hard time w/ the meds. Oldest DS is currently on them, but about the lowest dose you can get. He probably "needs" higher, but no. Because what happens with him is, even the extended release, at some point wears off. And he became, gosh I don't know how to even describe it, angry agressive hateful, and on top of that it would still interfere with his sleep.

That is how my DS7 acted on the Daytrana patch. We switched to Vyvanse and the only side effect is mildly decreased appetite. My DS11 is still on the patch and doing very well. We had to change DS11's medication four times before the patch.

 

[bookwormde]

Auditory processing evaluation generally is done by a group of specialists at a children’s hospital, although occasionally in a large specialty practice.

The process generally includes a parental and/or other setting questionnaire and test to check comprehension, memory and processing of linear auditory groupings (including verbal language). Be aware that for individuals with significant auditory processing deficits is can be quite frustrating.

Beware almost no psychiatrists are properly trained in this area, so unless you suspect a primary psychiatric disorder (not a syndrome or disability) then they are the wrong direction.

Beware of any clinicians who want to put a “label” on from just one of even a couple of evaluation in specific areas. Our children are complex and ever-changing so competent clinicians will get the “whole” picture before even thinking about a formal diagnosis.

bookwormde

 

[jodifla]

What exactly IS an auditory processing evaluation and would his pedi be able to do it, or would I need to have him recommend a specialist?

If you look on yahoo groups area, you'll find a board that deals with auditory processing issues in children.

There's also a late talkers boards over there as well that's very active and has a lot of great info.

 

[sdarwkcabemanmy]

Isn't your DS on the spectrum?

Not as far as we know and we only have one. We've never had the serious desire to have another and I just had an IUD put in a couple of weeks ago to make sure I don't get pregnant accidentally. I think with DS and his issues we kind of have our hands full.

That is how my DS7 acted on the Daytrana patch. We switched to Vyvanse and the only side effect is mildly decreased appetite

I've heard of decreased appetite occuring with several different types of meds, which is one of the reasons I am hesitant to put him on meds. He's already slender for a boy his age and I don't want him to not eat because he's on some med that decreases his appetite.

bookwormde--thank you. I will keep that in mind when we go to the pedi's on Monday morning.

 

[BeckyScott]

My bad. I'll blame the lack of coffee.

 

[sdarwkcabemanmy]

S'ok. It happens. I've often said that if it were scientifically possible and monetarily feasible, I'd have the drs make 100% SURE I would have another DS because I only want boys. But it's not. So we're going to be happy with the one we have.

 

[mackay_j]

hopefuly you be lucky and your doctor will be able to help you. For the most part they do know what to look for. All I would say is be careful not to get him diagnosed with something to young, lots of young kids find focusing on any subject for more than 5 mins to be difficult. When my eldest was 6 she really stuggled with maths, we had to restart from scratch after 2 years of schooling (and I mean back to counting and number bond to 10). At that point, as she came across as bright was a great reader for her age, so the teachers suggested we got her assesed for discalcula, we agreed that we would but (after discussing it with them) but that we would try a few other maths techniques first. Now many many years later my daughter is about to go to do maths and civil eng at uni (finger crossed she starts her final exams soon) her fav subjects being maths and Physics. But at aged 11 this avid reader/writer was diagnosed with dislexia.... (I kind of new she had it as you can probably tell I have it so could identify certain things lke table setting /right and left problems co-ordinations problems that go along with the spelling difficulties . But had ignored it as it never stopped me from doing what I wanted to do - I'm a pharmacist involved medical reaserch -and didn't seem to be stopping her she flew through school in top sets for everything until she had to learn to write in French- then we had a problem!!). However, my wait and see approach before jummping in, is for a child who in all other aspects acted and behaved within concieved normal boundaries (and who was not loosing any confidence due to their dificulties), I think if a child is outwith these then the sooner help and asistance is given the higher the chance for that child to maintain its education the usual school system or get the appropraite special needs schooling.

Good luck with your appiontment and if you are not happy with the outcome def seek a second opinion, you will know and understand the behaviours of your child better than any doctor will and will be able to tell if the meeting he has with the doc is typical of his behaviour.

 

[sdarwkcabemanmy]

Well I understand more now about what the teacher and diagnosticians meant about him having a lack of focus/easy distractability.

On Friday, they had "Rodeo Day" at his school where the classes went outside and did rodeo themed activities (cow roping, pony rides, western stories, etc) for an hour. Since his class was scheduled for the first hour in the afternoon, I decided I would just take him home after it was all over with. I ran into the OT on the way out and he asked me if it was ok if DS stayed for another 20 min to do an OT session with him. I said sure, why not? I'm not in any hurry.

So the OT took DS and another boy from his class to do a session. As soon as the OT took his attention off of DS, DS was looking around, playing with his crayons and not doing what he was told to do (draw a horse).

We were also given a sheet to give to his pedi which states where DS is according to some test they gave him that shows where his skills are in relation to 'normal' kids his age. It's not good on some of it..it shows that he is below age level on several things--namely paying attention/focusing, self help skills (can't button/snap/zip w/o help) and writing (still tends to hold pencil/crayon pronated).

 

[jodifla]

Well I understand more now about what the teacher and diagnosticians meant about him having a lack of focus/easy distractability.

On Friday, they had "Rodeo Day" at his school where the classes went outside and did rodeo themed activities (cow roping, pony rides, western stories, etc) for an hour. Since his class was scheduled for the first hour in the afternoon, I decided I would just take him home after it was all over with. I ran into the OT on the way out and he asked me if it was ok if DS stayed for another 20 min to do an OT session with him. I said sure, why not? I'm not in any hurry.

So the OT took DS and another boy from his class to do a session. As soon as the OT took his attention off of DS, DS was looking around, playing with his crayons and not doing what he was told to do (draw a horse).

We were also given a sheet to give to his pedi which states where DS is according to some test they gave him that shows where his skills are in relation to 'normal' kids his age. It's not good on some of it..it shows that he is below age level on several things--namely paying attention/focusing, self help skills (can't button/snap/zip w/o help) and writing (still tends to hold pencil/crayon pronated).

What's your child's language level, though?

My 7 year old acts 7 with some things, then with other things, he acts the age of his language level, which is quite a bit behind (last year, for example, at age 6, it was receptive age of 4 and expressive age of 3). That language lag creates a lot of frustration for him, so he often acts much younger than his chronological age. In addition, he's just taking in a lot of the auditory world at at 3/4 year old level, although now I'm thinking it's more like a 4/5 year old level.

Also, late talkers OFTEN have fine motor problems. At 5, he couldn't do buttons, snaps, zippers, hold a pencil correctly. At 7, he can do most of those things (with once a week OT help from the school. still doesn't hold pencil correctly most of the time.)