When is it ADHD and when is it just normal attention issues?

[Anonymous]

To 14:53 from 4/26: Thank you so very much for the description of the NIMH study! It sounds very interesting and helps a lot in deciding what to do. We have a developmental ped appt next month; I think if that doesn't give us a definitive answer with which I'm comfortable - and a good plan - this study may be the way to go. If not, though, I think I'll hold off. Both kids are having medical issues right now, and adding an MRI to the mix would not be fun. We have participated in other medical research and think it's pretty neat, though, so I'll keep this one in mind. Thank you so much.

[Anonymous]

Anonymous wrote:OP Childfind would have picked something up during the overall evaluation. I would trust them over your preschool teacher.

I wouldn't be so quick to accept whatever Child Find says. They take a much different approach than Infant Toddler Connection does. My personal experience as well as other anecdotal stories I've gotten from parents with direct experience leads me to believe that they are not as pro-active as ITC and that unless the issue is likely to have an imminent impact on the child's ability to access the curricula in school, they are unlikely to recommend intervention.

For those who don't know the difference, Child Find is for kids age 3 and up. Infant Toddler is for kids and babies under the age of 3.

[Anonymous]

Anonymous wrote:
I'm 11:59 and my experience will lead me to avoid evaluations or at least more carefully consider whether going for one is well founded or not. I don't think my experience was perfectly fine because I used my judgement not to go down the wrong path. I'll never have the attitude that getting an evaluation will not hurt anything so why not again.

Maybe I missed something but I don't understand how you or your child was "hurt". You had a bad experience with the first therapist and got freaked out by what they said. Are you expecting this area of medicine to be perfect? Do you not think some people are in this to make a buck? There's an element of drama to your posts and by your own admission you're a "nervous helicopter parent" who meshes well with a pediatrician whose modus operandi is to always refer to a specialist for a second opinion. We've had our share of dire evaluations that didn't mesh with our understanding of our kids but from what you post, the problem doesn't sound like it's with evaluations, it's with having a knee-jerk reaction and not having some common sense. I mean, if you knew your kid was fooling around while taking the eye exam, why did you acquiesce to seeing a specialist? And now you think evaluations can be harmful? I don't hink anyone will disagree with "more carefully consider whether going for one is well founded or not". But to outright avoid them. Not rational.

[Anonymous]

Anonymous wrote:To 14:53 from 4/26: Thank you so very much for the description of the NIMH study! It sounds very interesting and helps a lot in deciding what to do. We have a developmental ped appt next month; I think if that doesn't give us a definitive answer with which I'm comfortable - and a good plan - this study may be the way to go. If not, though, I think I'll hold off. Both kids are having medical issues right now, and adding an MRI to the mix would not be fun. We have participated in other medical research and think it's pretty neat, though, so I'll keep this one in mind. Thank you so much.

FWIW, the MRI was about 6 months after the initial evaluation. I totally understand not wanting to add something like that to the mix.

[Anonymous]

I find the positions by 11:26 and 11:59 so exhausting. I feel like I battle these attitudes all the time. What really gets to me sometimes is that I feel like they repeat conventional wisdom yet dismiss science based, peer reviewed research that contradicts what they think - and then accuse me of being ruled by emotion. My kids have ADHD and it runs throughout my and DH's families. We've seen the tragic toll it takes when left untreated. We recognize that medicine is a "practice". It is not perfect, so we educate ourselves by doing our own digging, considering the source and the motivation, and using our best judgment. It's hard not to be emotional about your kids but emotion doesn't get my kids where they need to be.

There is absolutely no evidence that today's educational demands have led to an increased diagnosis of ADHD. A PP provided links to some peer reviewed studies and I'll provide some more. Pretty much every mental disorder is underdiagnosed and undertreated.http://www.ncbi.nlm.nih.gov/pubmed/15939840" target="_new" rel="nofollow"> http://www.ncbi.nlm.nih.gov/pubmed/15939840 In adult populations (which parallel child populations), only a fraction of those with ADHD are being treated for it. http://ajp.psychiatryonline.org/cgi/content/abstract/163/4/716 The treatment rate for ADHD is much less than that for anxiety, substance use disorders, depression and bipolar disorders http://www.ncbi.nlm.nih.gov/pubmed/15939840 (Thanks to Gina Pera author of Is it You, Me or Adult ADD for pointing me to the studies).

Increased educational demands also don't cause ADHD. Even if the demands were reduced, they would still have ADHD, it's probably just being noticed more at an early age because we know "normal" kids are capable of a lot more than what educators thought they were 20 years ago - that's a good thing on both accounts when it leads to increased recognition of problems. My kids have absolutely no problem sitting still. They don't get fidgety or inattentive because of lack of recess, they get fidgety because of mental challenges that their peers don't have a problem with. It is an age appropriate education, they just can't do it without accomodation and modified instruction. They could have recess three times a day, wouldn't make any difference. It's not stress that inhibits the functioning of elementary/middle/high school kids, it poor brain functioning.

It's so exhausting.

[Anonymous]

I'm confused, 11:59. Two different clinicians told you your child didn't have extensive issues and one told you he did. So you are letting the one, the minority report, guide how you deal with any possibilities of developmental issues in the future? Does that make sense? Cause to me it sounds like you've found two trustworthy clinicians that you could go back to if there are any issues or questions down the road.

In my experience, kids who have ADHD or other developmental issues will have more trouble at school because of the demands of the classroom, but its not like they are entirely different children at home. The same kid who can't sit still in the classroom also can't sit still at the dinner table. The child who has trouble attending to work at school will also have trouble attending to homework. I don't understand how this myth of teachers concocting diagnoses comes about. teachers can flag issues, that is their responsibility, but in my experience these red flags correspond to issues the kids are having at home. Its just that at home every compensates to make things easier (sure its OK if Jr. gobbles down his food and leaves the table in 5 minutes) so it might not be as obvious.

[Anonymous]

OP I've been reading this thread since interest since my DD can be hyper at times. Right now, it seems situational only, she acts like a normal kid and her teachers have no concerns but who knows. I understand your concerns about locking into the track. The zealous ADHD posters are not convincing and pretty much highlight the whole obsessive everyone must be ADHD trend. I can't imagine thinking its cool to put a kid through a MRI.

[Anonymous]

Anonymous wrote:OP I've been reading this thread since interest since my DD can be hyper at times. Right now, it seems situational only, she acts like a normal kid and her teachers have no concerns but who knows. I understand your concerns about locking into the track. The zealous ADHD posters are not convincing and pretty much highlight the whole obsessive everyone must be ADHD trend. I can't imagine thinking its cool to put a kid through a MRI.

Who said everyone must be ADHD? I missed that post. All I saw were people trying to combat the "conventional wisdom" about ADHD. Anyone advocating that everyone with ADHD is just repeating a myth. Only an estimated 5-10 percent of the population has it. I thought people were just saying that it was underdiagnosed and under-medicated. If your DD is only hyperactive in certain situations and that's her only symptom, there's no reason to suspect ADHD which makes me wonder why you even bothered to look at this thread? In fact, why do you even bother to lurk in the Special Needs Forum?

BTW - I'm the the mother of the kid who did the MRI - you should just go back to trolling on the General Parenting Forum. Not only do you not get Special Needs, you don't know anything about MRIs, ADHD or the value of research. You might think about how you and your DD have benefited from the people willing to participate in research rather than get all judgmental. Don't think you haven't benefitted.

Wow - I'm sounding like some of the harpies on General Parenting. I don't know why I let the trolls get to me. Maybe I'm tired - it is late. I'm not going to feed them anymore.

[Anonymous]

I have two children with special needs. I like this section of DC Urban Moms because we're all so supportive of each other. Now it seems parents of kids who don't have special needs have come here to attack us. Please, if all you are going to do is insult us, go back to the other forums.

And BTW, my son who has an ASD was asked to be part of a study that involved an MRI. After determining that no needles were involved I strongly considered it. We are so desperately in need of a better understanding of these disorders and that will only happen if we allow our kids to participate in studies. Since you don't have a child with special needs, you wouldn't understand that. In the end, it was just too much of a logistical burden to schlep back and forth to Baltimore for the study so we didn't do it. But if we lived closer, we absolutely would have participated.

[Anonymous]

Anyone who thinks everyone has been diagnosed with ADHD should read Judith Warner's "We've Got Issues." She thoroughly debunks this myth.

[Anonymous]

First, I do have a special needs child but I do not agree with the positions that the few posters here who claim to be the ultimate authority over all others keep pressing. Can you believe it? I don't agree with you and frankly, I think you are the one dismissing science. You can not comprehend anything beyond your own opinion on all this.

Second, parents of children who do not have special needs do come here to ask questions about concerns. Its fine to have strong opinions but there is more than a small tendency for at least a few posters to push any parent describing anything toward thinking their child must have XYZ or they must run not walk to a high end developmental pediatrician when this could be an over-reaction. You may have an attitude that any test is fine, any number of consults is fine, or its fine to try out expensive therapies even if they don't work but not everyone agrees with this.

The OP asked for opinions and 'go immediately for an evaluation because so many people have ADHD or Childfind must have missed it so find someone else to do another evaluation' is not the only valid opinion or in IMO not a good one. It is valid to take a wait and see approach, or talk with your pediatrician.

Try watching Frontline's the medicated child. It offers a balanced view of both sides. It doesn't dismiss people who have true need but it also rightly questions the trends in current diagnoses and medications.

http://www.pbs.org/wgbh/pages/frontline/medicatedchild/

Or look up the 60 minutes piece on the pharmaceutical industries marketing campaign directly to consumers for adult ADD medication. Big pharma is hoping for 8 million subscribers.Does this mean that no adult has ADD or would not benefit from these drugs? Absolutely not. It does show that there is a significant financial interest and a tactic from big pharma to pressure consumers to pressure their doctors for prescriptions.

[Anonymous]

I suppose childfind must have changed in the past 2 years because they told me they would not diagnose ADHD or SPD because they do no provide treatment for these conditions- even though they said that it was quite likely and apparent that he had both. Then again he might have been on the 3 year old side of things, so maybe it was an age issue?

and I must admit my confusion about MRIs being a problem. You lay down and it makes a noise- why are people loading references to it like we are torturing our children when they require a non-invasive test?

[Anonymous]

PPs raised my question somewhat - when was OP's child looked at by Child Find? If not recently, then it is worth having the child tested again. That is what happened to us. One test told us DC had SPD. Eventually, other red flags led us to speech testing later on. Other red flags led to a ADD diagnosis. We did not get a full picture of all of DC's learning disabilities until age 9. This is also because some were quite subtle and needed school to really come into focus.

People do come to these boards for info. I am in the camp that says try to send your child for an evaluation if you have concerns. I think many of us wish we had had a dx sooner rather than later. I know I did.

I am not an expert, but if you have joined this board and you describe red flag behavior - familiar to me and those of us with kids were the same - then yes, I am going to suggest that you have your child examined professionally. And there is nothing wrong with waiting a while or starting with your pediatrician, but my experience with 3 good peds in this area is that they really could not help me. Their experience with special needs children was either children with physical handicaps or who needed psychiatric help. No fault of their's, but not everyone gets exposed to LDs in medical school. And contacting Children's Hospital was pure frustration when we did not know what was wrong.

In the end, to me, what makes a child "special needs" is when that child is having problems and it is not transient. Something is going on with your child that is preventing him/her from learning, listening, playing with others, normal physical functions, etc.

May I say that I have a very serious version of a fairly common disease for which there are few treatments and no cure? I have been in 5 clinical trials - some ranging from a single test to extended study of more than a year with drug infusions. Research is critical to understanding diseases and how to cope with them and how to treat them. You may not want your child be the "guinea pig" which is fully understandable. But without research into diseases, we will have less solutions for improving our daily life.

[Anonymous]

Am I wrong or is SPD not yet an accepted diagnosis? My son also has sensory issues (tactile and auditory sensitivity) but was told since SPD is not yet an accepted diagnosis, they have to code it something else (I can't ever remember what they wrote down).

[Anonymous]

SPD is not a medical diagnosis. Its real, but its more of a symptom than a disorder. OTs will diagnose SPD, but I always advise parents who have this diagnosis to seek a fuller evaluation.