Next steps for 4 year old with ADHD

[Anonymous]

What do you mean by his speech is not great? If he has any delays they sometimes look like this. Delays cause weird stuff. He may be overwhelmed frustrated etc. I would meet with a dev ped and get a speech evaluation.

[Anonymous]

OP here. As mentioned in my first post, we saw a dev ped who did not flag any speech issues. We got a speech evaluation a year ago and he was "borderline" on articulation issues, but excellent on expressive and receptive. He had fluid in his ears for at least two years (long story about why it wasn't removed immediately), which by the end was causing a 50% reduction in hearing. Had the tubes in March and have been doing speech therapy since then. The therapist doesn't think his speech is that bad, but he definitely has a global weakness/lisp that we're working on. She thinks he'll need about a year of therapy to resolve it. Some of that may be related to the ADHD, but in general I feel like we've run the speech thing into the ground and no one thinks there is anything more going on there to worry about.

[Anonymous]

I just know that sometimes speech delays, even minor ones, can cause weird social stuff b/c its harder to interact socially, so they revert to physicality. It sounds like you are totally on top of it and doing all you can do. Our dev ped also said just minor speech issues, and like you, I suspect they are connected to ADHD, but I do think they affect him socially. I would not underestimate it. It is really just another way to understand him and what is going on, not to suggest you need to do any more therapy. It sounds like you have it covered. My son's OT place does a co-treat which I like because it is a way for them to do speech while doing OT and to figure out what helps him calm down to learn.

[Anonymous]

Anonymous wrote:I just know that sometimes speech delays, even minor ones, can cause weird social stuff b/c its harder to interact socially, so they revert to physicality. It sounds like you are totally on top of it and doing all you can do. Our dev ped also said just minor speech issues, and like you, I suspect they are connected to ADHD, but I do think they affect him socially. I would not underestimate it. It is really just another way to understand him and what is going on, not to suggest you need to do any more therapy. It sounds like you have it covered. My son's OT place does a co-treat which I like because it is a way for them to do speech while doing OT and to figure out what helps him calm down to learn.

Agree that the speech issues certainly don't help. I wonder if he would have been having a much easier go of all this if he hadn't had such bad hearing for the first 3 years of his life. It definitely affected his socializing with people around him back then, so I wonder how much of those issues carried forward even now with his hearing better.

[Anonymous]

Anonymous wrote:OP here. It's only been two weeks! So we've had literally no progress. Having talked to a few psychologists who specialize in kids with ADHD (one of whom even has a son with the exact same profile as mine, only older) the psychologists all indicated that therapy isn't likely to help much - because at this age he will lack the maturity to transfer the skills over to a classroom setting. A couple of them (and some people on this site) recommended social skills groups as something that might help - so we've been trying to track down a group that is offering a group for preschoolers - and that works on our schedule/geography (we're in the district and I work - so outside the beltway during rushhour just isn't viable). No luck yet.

He started his new year of preschool yesterday, and this morning I got the "we're working with him on his hitting and pushing" from his teachers.... argh.

OP, progress takes a while and sometimes it's one step forward, two steps back.

Not sure why the psychologists wouldn't say therapy wouldn't help much. Were you talking to behavioral psychologists? Behavioral therapy is different cognitive therapy. A social skills group is a good idea. Ivymount offers them as well as other groups like SLPs and OTs.

Also, ADHD can interfere with social skills and pragmatics. So as he learns to regulate himself, that will help.

[Anonymous]

Therapy can't fix the overactivity

[Anonymous]

Anonymous wrote:Therapy can't fix the overactivity

No one is trying to "fix" their kids. We are trying to teach them skills to help them learn and grow to the best of their abilities.

Depending on the type of therapy, kids learn impulse control and how to regulate themselves.

Physical activity, good sleep habits, healthy diet help and some kids need meds.

[Anonymous]

I have a child with similar profile and challenges with keeping his hands to himself and elopement from activities to another area of the room.

We have worked with ABA therapist to have shadow at preschool reinforce positively those times when he is keeping his hands to himself and stayin in activities. It is very Kazdin-like programmatically.
And it seems to be helping, but slowly.

We found play therapy for a year to be unhelpful. We may try it again later if the nature of the issues changes.

[Anonymous]

Can the teachers (or shadow) take him on sensory breaks? Your OT can outline helpful movement breaks.

[Anonymous]

behavioral therapy, movement breaks and accommodations, and a protein-heavy breakfast is what I would recommend based on our experience. A neurologist told me he would get worse without meds, that that was the only thing that would help, but the doctor was wrong. The kid has greatly improved.

[Anonymous]

I have a similar child (4.5) but he does display defiant behavior at times. I'm out of state, so I'm not sure if they have this in your area, but we have our son in a therapeutic preschool. The class size is small *6 kids) and there are 2 full time special ed teachers there. He is doing great so far. He also gets OT and friendship group 1 time per week. The OT is to help him get regulated. We are still trying to figure out the best strategy to do this.

I'll be honest, the last time we saw our dev ped (about 3 months ago) he told us that we might need to consider meds if things don't improve. In other words, if we want him to be able to succeed in a regular K class next year, we might need to try this route.

I am hoping that a full year of this preschool along with other therapy and activities that regulate him (karate) - will help him enough. But neither my husband or I have ruled out meds.

We have not noticed any changes by removing dairy, wheat or sugar from his diet as well.

Do I want my kid to be taking meds at 5 years old? hell no, but we will consider it if we have no other choice. I don't want my kid ostracized from day 1 because he is unable to handle a regular classroom. I want his experience in school to be positive, and I'm afraid it won't be if he can't get his body under control.

[Anonymous]

Anonymous wrote:I have a similar child (4.5) but he does display defiant behavior at times. I'm out of state, so I'm not sure if they have this in your area, but we have our son in a therapeutic preschool. The class size is small *6 kids) and there are 2 full time special ed teachers there. He is doing great so far. He also gets OT and friendship group 1 time per week. The OT is to help him get regulated. We are still trying to figure out the best strategy to do this.

I'll be honest, the last time we saw our dev ped (about 3 months ago) he told us that we might need to consider meds if things don't improve. In other words, if we want him to be able to succeed in a regular K class next year, we might need to try this route.

I am hoping that a full year of this preschool along with other therapy and activities that regulate him (karate) - will help him enough. But neither my husband or I have ruled out meds.

We have not noticed any changes by removing dairy, wheat or sugar from his diet as well.

Do I want my kid to be taking meds at 5 years old? hell no, but we will consider it if we have no other choice. I don't want my kid ostracized from day 1 because he is unable to handle a regular classroom. I want his experience in school to be positive, and I'm afraid it won't be if he can't get his body under control.

We are in a similar position. I have also been told by my dev ped that when older ADHD children are not medicated they often medicate themselves and many end up smoking marijuana because it calms them.