ADHD Behavior therapy for 3.5 year old

[Anonymous]

I was the poster asking about ADHD and my 3.5 year old in another posting. I wanted to start a new posting on the question of therapy....

The dev ped recommended intensive therapy for a few months, with the likelihood of meds in a year or so. I'm skeptical about therapy for the following reasons:

- he's 3.5. A lot of people on here have expressed skepticism for therapy at this age.
- His ADHD is hyper/impulsive, and not inattentive or any defiance. He's an exceptionally well-behaved kid -- just one who moves around ALOT and when his hyperactivity level escalates, he loses physical self regulation. He is pretty perfectly behaved at home (save for some bouncing and jumping) but loses his sh*t at school. He knows that some of the stuff he does is wrong, but when he loses control and escalates, he can't control himself. It's hard enough for me as an adult to self-regulate in situations where you feel out of control. So I struggle to see how a 3.5 year old is going to benefit from learning coping skills to control their behavior when said behavior only happens when he is out of control.
- As parents, we've been pretty attuned to his "differences" since he was an infant, and we've already implemented a lot of things that were common sense to us that have minimized his issues. I've read a lot about hyper kids, sensory issues, etc and have implemented a lot of the guidance that is available online. His teachers are also pretty well versed in the area and implemented a lot of great ideas. As said in the previous bullet, he's actually a really well-intentioned good kid when he's not hyper, and I think that's in part because we've been working so hard for so long already on techniques to adapt and adjust to his behavior. Obviously, a therapist is going to be an expert well above and beyond what we're doing, but my point is that there aren't any fundamental issues that a therapist is going to magically turn around.

I think what would be really helpful is 2 or 3 sessions with a therapist and both parents and my son to talk about high level techniques we can implement at home. And also another session with teachers to talk about strategies at school (they are very accommodating and would be happy to get more advice). But I'm skeptical that twice a week for 4 months as recommended by the dev ped is going to do anything. I would be open to therapy when he's a bit older and has settled down a bit (which according to a bunch of you on here and the dev ped, will probably happen a bit in K or thereafter).

And I know people are going to say "it doesn't hurt to try", but I'm of the mindset that it does hurt -- because it costs a fortune and is super stressful to pull my son out of school twice a week and for me to essentially take two half days off work every week.

I am interested to hear anyone's opinions on this.

[Anonymous]

Try two types of therapy:

1. with an OT on how does your engine run type of program so he can start to learn to recognize when he's getting amped up

2. behavioral therapy like they do at the KKI Center in Columbia, MD

Read the Kazdin Method as well.

[Anonymous]

Anonymous wrote:Try two types of therapy:

1. with an OT on how does your engine run type of program so he can start to learn to recognize when he's getting amped up

2. behavioral therapy like they do at the KKI Center in Columbia, MD

Read the Kazdin Method as well.

Isn't the kazdin method for kids with defiance issues? Sorry for the ignorant question, but every time I read descriptions of it, it doesn't really seem relevant because he's well generally behaved but just too physical.

[Anonymous]

No, it's about behavior shaping in general. If you prefer you can read his newer book, the Every Day Parenting Toolkit

[Anonymous]

I posted in response to your previous thread, and suggested the exercise routines and yoga. I think I would be skeptical too. I would push the developmental pediatrician on exactly what they're going to do in therapy and what the goals are.
My son did the OT "how does your engine run" therapy...I'm not sure it helped. I personally think whoever came up with the engine running metaphor was a little crazy -- my son's response was always something along the lines of "My engine is super fast! I am a super fast race car!" and then he'd go running off. I tried to use a different metaphor, like train running off the tracks, or ball of yarn unraveling or something. The engine thing was counter-productive for us.
I sit in on my child's therapy, so I'm pretty aware of what goes on in his therapy, at least. I would say that, even at 6, it is a real struggle for him to recognize his triggers and be self-aware enough to assess them and then implement calming strategies when he's amped up. We've made some progress, but it's slow going.
Some kids are more self-aware than others...3.5 is very young for a child to be self-aware of when he's getting amped up, I think. It's more helpful for the adults around him to recognize the early warning signs and figure out how to get him back on track.
I have heard some people say that intensive OT -- like 2-3 times a week for a short period can be very helpful. We did it once a week for a year+, and it was hard to tell if it was making any difference. Maybe we would have been better off with like daily OT for a month.

[Anonymous]

best therapy might be time and avoidance of triggers (in my son's case, lots of other kids, noise, activity). he is also a deep touch seeker (I still get 'attack hugs,' he was a biter, swings, crashes, jumps, etc).
could not slow down at that age. still gets amped up, but we have strategies in place to help him regulate, and he is now aware that he needs to. Sometimes he is too amped up to put those into place, but other times he can. But at 3.5? No way. That's when we were at the dev peds, and yes, there were and still are times I think "If I give hm a pill, will all this go away?" but it is rarely so simple.

Give him time, a good atmosphere, and lots of activity in which it is okay to be energetic. I have found swimming calms him and soon we will try rock climbing.

[Anonymous]

Anonymous wrote:best therapy might be time and avoidance of triggers (in my son's case, lots of other kids, noise, activity). he is also a deep touch seeker (I still get 'attack hugs,' he was a biter, swings, crashes, jumps, etc).
could not slow down at that age. still gets amped up, but we have strategies in place to help him regulate, and he is now aware that he needs to. Sometimes he is too amped up to put those into place, but other times he can. But at 3.5? No way. That's when we were at the dev peds, and yes, there were and still are times I think "If I give hm a pill, will all this go away?" but it is rarely so simple.

Give him time, a good atmosphere, and lots of activity in which it is okay to be energetic. I have found swimming calms him and soon we will try rock climbing.

What specific strategies in place do you have when your son gets amped up? I ask because my son is this way (4.5 years old). Just curious what works for you. I have a whole list of sensory diet suggestions, but nothing seems to consistently work with him.

[Anonymous]

I wouldn't put my child in therapy at that age, I would go to a parenting consultant who works with the parents of kids with ADHD.