Anonymous wrote:We have this issue with our now 9YO DD. She was diagnosed at Children's with ADHD inattentive (not much of a factor at school as she does really well academically), with co-morbid anxiety. Since it's really difficult to tease apart cause and effect in these cases, we decided to work on the anxiety first, with a combination of CBT and a very low dose of anti anxiety medication (mostly because I have anxiety as well, and this worked well for me). Our pediatrician is coordinating care, and we see a therapist weekly, and a psychiatrist for medication management monthly. We have started treatment about 2 months ago, and there is some improvement, but we're nowhere near "done", there are still a lot of anger and anxiety issues to deal with, but we are hopeful. Good luck, OP!

+1 We had nearly identical experience to yours. Started around 8 and near crisis at 10. OP, look into Cognitive-behavioral therapy (CBT) and anxiety. Our pediatrician told us people (schools) are quick to connect ADHD and LD, and suggest stimulants. But for anxiety, that's kind of the last thing you want to do. Low dose anti-anxiety and bi-weekly CBT with psychiatrist has really helped. CBT is a practical way for your child to help themselves to be themselves.

Here are some FAQs.

https://www.understood.org/en/learning-attention-issues/treatments-approaches/therapies/faqs-about-cognitive-behavioral-therapy

Also, make sure the school explains their findings to you clearly. Ask as many questions as you need to. It's their job to make sure you understand. If they throw around a lot of jargon and acronyms, ask for specific examples and plain English definitions.

You're not alone and neither is your child. Approximately 1 in 5 people has a learning disability that is not related to intelligence deficits. There are lots of very smart people who can't spell.

Understood.org is a great place to start. It has simulations and tailored resources to help you and your child.

It reminds me of my child with ADHD/anxiety. And also my other child who just has ADHD. They are both strong students though clearly not working to their potential. And they both are eager to please and try really, really hard--which is exhausting. OP, I would do a neuropsych based on what you said. You can get a lot of information that the school wouldn't get based on observation. For what it's worth, the teacher questionnaires for both of my kids were absolutely worthless. Sometimes you can "pass" in elementary school if you try hard enough, or are bright enough, or your home environment is conducive to learning. But the struggle takes its toll/.

Anonymous wrote:

Anonymous wrote:We have this issue with our now 9YO DD. She was diagnosed at Children's with ADHD inattentive (not much of a factor at school as she does really well academically), with co-morbid anxiety. Since it's really difficult to tease apart cause and effect in these cases, we decided to work on the anxiety first, with a combination of CBT and a very low dose of anti anxiety medication (mostly because I have anxiety as well, and this worked well for me). Our pediatrician is coordinating care, and we see a therapist weekly, and a psychiatrist for medication management monthly. We have started treatment about 2 months ago, and there is some improvement, but we're nowhere near "done", there are still a lot of anger and anxiety issues to deal with, but we are hopeful. Good luck, OP!

PP, if it’s not a factor at school, then what led you to have her evaluated? How does it impact her life? I’m wondering if my DS has ADD - but he does very well in school so he’s never been flagged. His teachers tell me he’s a role model, he’s well behaved, etc. and gets straight As but he’s incredibly bored all the time and has a very difficult time focusing on on his homework, no matter how easy. He can definitely be spacey and in his own world.

And ADHD/ADD runs in our family too.

Anonymous wrote:We have this issue with our now 9YO DD. She was diagnosed at Children's with ADHD inattentive (not much of a factor at school as she does really well academically), with co-morbid anxiety. Since it's really difficult to tease apart cause and effect in these cases, we decided to work on the anxiety first, with a combination of CBT and a very low dose of anti anxiety medication (mostly because I have anxiety as well, and this worked well for me). Our pediatrician is coordinating care, and we see a therapist weekly, and a psychiatrist for medication management monthly. We have started treatment about 2 months ago, and there is some improvement, but we're nowhere near "done", there are still a lot of anger and anxiety issues to deal with, but we are hopeful. Good luck, OP!

PP, if it’s not a factor at school, then what led you to have her evaluated? How does it impact her life? I’m wondering if my DS has ADD - but he does very well in school so he’s never been flagged. His teachers tell me he’s a role model, he’s well behaved, etc. and gets straight As but he’s incredibly bored all the time and has a very difficult time focusing on on his homework, no matter how easy. He can definitely be spacey and in his own world.

We have this issue with our now 9YO DD. She was diagnosed at Children's with ADHD inattentive (not much of a factor at school as she does really well academically), with co-morbid anxiety. Since it's really difficult to tease apart cause and effect in these cases, we decided to work on the anxiety first, with a combination of CBT and a very low dose of anti anxiety medication (mostly because I have anxiety as well, and this worked well for me). Our pediatrician is coordinating care, and we see a therapist weekly, and a psychiatrist for medication management monthly. We have started treatment about 2 months ago, and there is some improvement, but we're nowhere near "done", there are still a lot of anger and anxiety issues to deal with, but we are hopeful. Good luck, OP!

Homework can be particularly stressful. Your child has held it together all day. Now he's home where he feels safe and can let his anxiety or whatever is troubling him flow freely. We use to take breaks during homework as soon as DS showed signs of stress or starting saying negative things. The break involved DS getting up and walking away. Maybe even a snack or a 10 min show. I also made sure to break down the directions into their smallest components. These techniques helped for a child who has ADHD and anxiety.

WAIT! If your child has dyslexia (or "a dyslexic type LD") then you need to get him specific help for dyslexia, and that might mean you need to get help outside of school, like an Orton-gillingham tutor so he can actually learn to read through/around/with his dyslexia. If he can't read and he's concfront with all that homework, UGH - of course he's blowing up.

So I'd also call around and get someone who works with dyslexic kids who can look at the results of the test and figure out how to help him actually learn to read. Dylslexia isn't only reversing letters - there is a lot more to it than that.

He's holding himself together all day, and just can't take anymore in the afternoon. That could be ADHD.

Sometimes my child does this. He has severe ADHD and is medicated for it, but we're reaching a growth spurt or something and might have to switch to a higher dosage, because the meds are not helping as they used to in the afternoon, and if he has a lot of homework, he starts to despair. Then I need to reassure him, scribe for him, proofread, etc (he's in 7th grade, so not something I would typically do for a teen!).

...it may be that he is good at holding it together and then just simply collapses when he gets home...

All kids are different, but for what it's worth, wanted to share our experience: His teachers reported that our (non-SN) 1st grader was an ideal student: cooperative, focused, hard-working, friendly, etc.

At home, he had frequent all-out tantrums: screaming, fighting, biting, destroying, threatening to kill us and kill himself, which would last for up to a half an hour. Sometime I'd have to literally restrain him until he calmed or fell asleep. This was clearly not normal for a 7-year old.

Over the summer, he calmed down. We worried it would start up again this year, but it didn't. He talked to the psychologist in our ped's office a few times, but I think basically he just grew out of it.

I don't say that to deter you from looking for help, just to note that in some cases children do grow out these kinds of problems. Good luck.

Anonymous wrote:What did the school evaluation find as the root cause?

What you are describing could be ADHD, anxiety, a learning disability (alone or combined with either of the above, or even depression.)

You need a referral to a good child psychologist from your pediatrician, and probably for the family, not just your child.

Good luck. It's hard.

The school diagnosed Learning Disability. The specifically said not ADHD but that he did have some of the characteristics but not enough and not consistently. I have to read back through all of the paperwork but I remember them saying that the LD was in the Dyslexia family. He reverses some letters and numbers but not full words. Spelling is a nightmare and writing is extremely poor. Reading comprehension is at grade level but only for small passages. If he is given a full page of text he shuts down.

He does get disciplined at school and the teaches said he handles it well. We did discover a correlation to stressors at school and trips to the nurses office for "stomach aches". So it may be that he is good at holding it together and then just simply collapses when he gets home.

We have an appointment at the ped office specifically for this.

Thank you to everyone that answered. I know this is going to be a long road and that this time of year is a challenge for all kids. I was just feeling overwhelmed.

Anonymous wrote:Have the doctor give the school checklists for the emotional part too.When they say he is fine do they mean as compared to other special ed children or as compared to all peers. If he struggles so much when getting in trouble, they may just not discipline him much so as not set that off. Also, sometimes parents don't react well when they hear the kid struggles emotionally at school so it's easier to say nada.

On the other hand, home is a safe place to express emotions so he really may just feel more comfortable letting it out after holding it together all day. That certainly happens too.

Re:doctors. I would ask for a rec for a developmental pediatrician.

Dev peds don't do much for 9 yo's, at least not ones they haven't seen from a much younger age.

Have the doctor give the school checklists for the emotional part too.When they say he is fine do they mean as compared to other special ed children or as compared to all peers. If he struggles so much when getting in trouble, they may just not discipline him much so as not set that off. Also, sometimes parents don't react well when they hear the kid struggles emotionally at school so it's easier to say nada.

On the other hand, home is a safe place to express emotions so he really may just feel more comfortable letting it out after holding it together all day. That certainly happens too.

Re:doctors. I would ask for a rec for a developmental pediatrician.

What did the school evaluation find as the root cause?

What you are describing could be ADHD, anxiety, a learning disability (alone or combined with either of the above, or even depression.)

You need a referral to a good child psychologist from your pediatrician, and probably for the family, not just your child.

Good luck. It's hard.

Our DS 9 just finished testing at school and we now have an IEP in place for support at school. He is receiving support in both reading and math. He is definitely below grade level and had identifiable problems but nothing extreme.

We completely agree with everything listed and we feel like he is now in the right place with the correct academic support. Our challenge now is that at school he appears to be doing fine emotionally. The staff notes he does better with adults and in small groups but otherwise he is good.

At home he is completely different. He gets overwhelmed with homework and breaks down into tears. The tears quickly turn into angry sad outbursts about how the whole world hates him. He often says that no one at school like him, he has no friends and everyone makes fun of him. Half of the time at home he is a very sweet and loving boy that shows incredible empathy towards others. But if he gets in trouble he spirals out of control and finds a place to hide. He will stay in his hiding place (under a table, bed or in the closet) for hours. Once we coax him out and calm him down he will quickly put the episode behind him and act as if it never happened.

We are now starting the process of getting treatment from a doctor (starting with the pediatrician). Any advice or suggestions on the path we should be following?