Anonymous wrote:
OP, I hear you.

There is a child in my son's 3rd grade class who is the fidgety "class clown" and the teacher really has it in for him. It pains me to hear the teacher call him out on his behavior every 5 minutes, literally. There has got to be a better way! That poor child is bright and not malicious, and probably feels awful about it.

My son has ADD, inattentive, with an IEP, and daydreams without annoying the others, so does not draw the teacher's fire.

You need to revisit this with his doctors, maybe get an IEP or at least a 504 in place with the school so that subsequent teachers know there is a medical reason for his behavior.

There has to be a better way - I agree. If only there was some kind of medication that could help.

Wait . . .

What are you doing to help him develop appropriate coping strategies?

Do you do any of the following?

1) Have him do 30 minutes of real exercise before school every day and more after school? Does he have breakfast with a decent amount of protein?
2) Does your school have an individual trampoline in a special ed room where kids can go to jump for ten minutes if they need to let off some energy? This is what my ES school had and it was written into some children's IEP that it be available.
3) Does he have any fidgets?
4) Does he have an exercise ball for a chair? or can he stand at a desk instead of sit?
5) Have you tried relaxation yoga or meditation?
6) Does your school have a labyrinth to walk at recess?
7) Does he have a positive behavior chart on his desk? Written into his IEP?
8) Does he get frequent breaks?
9) Can he take tests in a smaller classroom with fewer children?
10) Does he see a psychologist or LCSW that is experienced with ADHD?
11) Has he every been to a social skills group?
12) Does he get positive reinforcement at home?

If school was different or I could get a full time one-on-one tutor in lieu of school (realistically) then we wouldn't do meds. But the system is not going to change enough to really help kids with moderate to severe ADHD and one-on-one tutoring full time is not realistic for just about everyone.

The fact is DD cannot complete class work or absorb anything going on without them. Even with them it's variable (we are still trying for the best med/dose). Some ADHD is worse than others. I agree it probably doesn't make sense for those who cope okay without them just aren't as stellar, but for those like my kid who are basically nonfunctional without them, I think the alternative is just worse. She also gets plenty of IEP support, OT, reward-based behavior therapy, and tutoring, but I think to function at all in a group setting for some time, she's going to need meds, and even then there are plenty of challenges.

Hats off to these courageous parents. I admire you.

OP, I think you need to look at meds as a piece of the treatment package rather than stand alone. My DS is medicated. However, he is also in OT, speech, social skills group and CBT. Meds are one part of his treatment. For my DS, adding meds was a decision we didn't want to make. However, after finding a med (and a dose) he is good with, it has made a world of difference in his ability to access the curriculum, make friends, generally be a part of things without feeling left out. However, it mostly helps him compartmentalize all the stimuli coming at him all day long (in his words, he is able to focus and can understand what is going on around him now). FWIW, he is 9. We went to meds when he came to us saying he just could not focus and no longer wanted to go to school. It's our hope/goal to not have him on meds forever, but for now they are a huge help while he learns strategies in the other therapies he is currently in.

Anonymous wrote:
Forgot to say that my son is not on meds either.
DH and I (doctor and scientist) have researched the issue, and know that efficacy diminishes after a couple of years (reasons are complex). Also, many meds suppress appetite, which would be bad for my undersized DS.

Reasons: experts disagree on which are more important, but they comprise
1. Failure by patients to follow exact protocols.
2. Hormonal changes and growth spurts affecting response to meds, hence a lot of switching around in the teen years, and dealing with unpleasant physical, mental and behavioral side effects.
3. Finally, and that is the big problem, loss of efficacy in the medication itself. Is the brain habituated? Million dollar question.

So we are saving the meds for when DS can simply not function anymore.

Unfortunately, the "not functioning" aspect happens at different times depending on the child. For us it was Kindergarten.

Anonymous wrote:

Anonymous wrote:OP, you are not the only one. DS is also ADHD and no, he is not on meds. His grades are not suffering so far. He has learned a lot of tactics to manage his ADHD to his advantage and to channel his extra energy into other activities. In other words, we got ourselves a huge drama geek and a voracious reader. Oh, and he's a class clown. So far, no major complaints from ES, MS and now HS.

FWIW, diagnosed at 10 with ADHD.

OP here, thanks for the reply. DS is the class clown and the teachers hate that. I was sad to hear many of the other moms chatting about what drugs their child is on. Then the doses and that special dose just to get homework done....
My son can not write anything down. He has no patience and does math in his head rather than write. I have sat and watched the other kids (mostly girls) carefully writing out tons of work. Paragraphs long.
DS is 9 and labeled by teachers as trouble. He is smart and they mention that in a patronizing way.
His self esteem is taking a dive, and I suspect that meds would make him feel less like a standout.
One day he told me that he does not understand why all the other kids in the neighborhood do not want to play as much as he does. That was a cute statement, but it saddened me.

Is there a reason you are not medicating? We did not medicate for grades. We medicated because it impacted his decision making and his self-esteem.

Anonymous wrote:Sometimes meds are necessary, but I don't think every unmedicated kid suffers without them. It's an overstatement to blame substance abuse problems at 50 on being unmedicated at 10. ADHD sufferers are frequent substance abusers, regardless of whether or not they use meds as kids. Some studies have found that med use increases the risk of substance abuse, not decreases it.

Brock and Fernette Eide are Harvard educated doctors who specialize in working with SN kids. They are tremendous diagnosticians and have written extensively about ADHD. They are cautious on drug use for kids with ADHD. They acknowledge that it is necessary for some kids, but believe that kids who can do without meds should not be given meds. You might want to check out their book "The Mislabeled Child."

Way too much of a generalization pp. Every situation is different and it is up to parent/doctor team how to effectively treat.

And the substance abuse problems don't wait until age 50. They begin early, as a way to self-medicate.
Impulsive decision making, poor school performance, and difficulty making healthy friendships all contribute here.

GP OP!

Anonymous wrote:

I just don't like the way the teachers seem impatient with this one hold out child. As if we need to get with the program.

OP, I don't know your child or the type of school he goes to, I am the pp above who said I was struck by a frustrated teacher at the age of 8 before my ADHD diagnosis. I feel bad that the women lost her job because I was acting up in a way that deep down I knew I shouldn't have been behaving(not that it was okay to hit, but I remember feeling guilty as a kid because I knew I wasn't behaving how I should in class.) I will also say a lot of my acting out came from trying to be social and connect with kids, if I got them to laugh then I was in and that became paramount to learning. That is why I really recommend finding something outside of school he likes (therefore can concentrate on without as much hard work) and can feel good about and connect to peers in an appropriate way.

That said, if you child is disrupting the class and the teachers have already made every accommodation they can it is fair that they feel frustrated, not directly AT your child but more the situation. Perhaps he isn't in the right academic setting for him, he might need more one on one time then his teachers can give. Like I said I do not know if your child's teachers are being reasonable or not but if your child requires extra accommodation that they do not have the ability to make, that is frustrating for everyone, especially your child. And if they are just not patient with him, well I hope you child gets better teachers next year cause that sucks and they should find another profession.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, you are not the only one. DS is also ADHD and no, he is not on meds. His grades are not suffering so far. He has learned a lot of tactics to manage his ADHD to his advantage and to channel his extra energy into other activities. In other words, we got ourselves a huge drama geek and a voracious reader. Oh, and he's a class clown. So far, no major complaints from ES, MS and now HS.

FWIW, diagnosed at 10 with ADHD.

OP here, thanks for the reply. DS is the class clown and the teachers hate that. I was sad to hear many of the other moms chatting about what drugs their child is on. Then the doses and that special dose just to get homework done....
My son can not write anything down. He has no patience and does math in his head rather than write. I have sat and watched the other kids (mostly girls) carefully writing out tons of work. Paragraphs long.
DS is 9 and labeled by teachers as trouble. He is smart and they mention that in a patronizing way.
His self esteem is taking a dive, and I suspect that meds would make him feel less like a standout.
One day he told me that he does not understand why all the other kids in the neighborhood do not want to play as much as he does. That was a cute statement, but it saddened me.

It sounds like you really need to talk to your developmental pediatrician. My son was the same way and the"drugs" turned his life around. After a while, your child's self-esteem will begin to plummet and he will become ostracized by his peer group and labeled a trouble maker by his teachers. Just imagine being 10 years old and experiencing this?

NP. This was our child at K. He was on meds...but not the right one/dosage at the time. And yes, we were doing all the therapies, and major exercise, social groups etc.
It did get worse. Kids teasing and ostracizing. And teachers patronizing is a great way to put it OP. All of the above. Different meds have helped him get through the day and feel "normal" -- not zombie-like as feared by some or pushed.

Sometimes meds are necessary, but I don't think every unmedicated kid suffers without them. It's an overstatement to blame substance abuse problems at 50 on being unmedicated at 10. ADHD sufferers are frequent substance abusers, regardless of whether or not they use meds as kids. Some studies have found that med use increases the risk of substance abuse, not decreases it.

Brock and Fernette Eide are Harvard educated doctors who specialize in working with SN kids. They are tremendous diagnosticians and have written extensively about ADHD. They are cautious on drug use for kids with ADHD. They acknowledge that it is necessary for some kids, but believe that kids who can do without meds should not be given meds. You might want to check out their book "The Mislabeled Child."

Anonymous wrote:

Anonymous wrote:
Forgot to say that my son is not on meds either.
DH and I (doctor and scientist) have researched the issue, and know that efficacy diminishes after a couple of years (reasons are complex). Also, many meds suppress appetite, which would be bad for my undersized DS.

Reasons: experts disagree on which are more important, but they comprise
1. Failure by patients to follow exact protocols.
2. Hormonal changes and growth spurts affecting response to meds, hence a lot of switching around in the teen years, and dealing with unpleasant physical, mental and behavioral side effects.
3. Finally, and that is the big problem, loss of efficacy in the medication itself. Is the brain habituated? Million dollar question.

So we are saving the meds for when DS can simply not function anymore.

Wow. OP here, I am also a doctor. I feel the same way you do. I have looked at long term outcomes WRT ADD and feel even more that we need to take a more holistic approach to some of these "illnesses". After reading lots of research articles, I am not sure that medication is the way to go. I am also concerned about the habituated neurons, and would like to hold off on meds for as long as possible.
I just don't like the way the teachers seem impatient with this one hold out child. As if we need to get with the program.

Maybe because they see his self-esteem plummeting and how much he is struggling to focus academically?

Anonymous wrote:
Forgot to say that my son is not on meds either.
DH and I (doctor and scientist) have researched the issue, and know that efficacy diminishes after a couple of years (reasons are complex). Also, many meds suppress appetite, which would be bad for my undersized DS.

Reasons: experts disagree on which are more important, but they comprise
1. Failure by patients to follow exact protocols.
2. Hormonal changes and growth spurts affecting response to meds, hence a lot of switching around in the teen years, and dealing with unpleasant physical, mental and behavioral side effects.
3. Finally, and that is the big problem, loss of efficacy in the medication itself. Is the brain habituated? Million dollar question.

So we are saving the meds for when DS can simply not function anymore.

Wow. OP here, I am also a doctor. I feel the same way you do. I have looked at long term outcomes WRT ADD and feel even more that we need to take a more holistic approach to some of these "illnesses". After reading lots of research articles, I am not sure that medication is the way to go. I am also concerned about the habituated neurons, and would like to hold off on meds for as long as possible.
I just don't like the way the teachers seem impatient with this one hold out child. As if we need to get with the program.

Another poster who agrees that you are looking at the good old days through rose colored glasses. Three of my brothers suffer from ADHD. All three are high school drop outs and two of the three have not yet gotten beyond their substance abuse problems even though they are well into their 50s. I can guess which kids in my class also had ADHD and all had substance abuse problems. I know of only one who managed to get and hold a good job and that was military active duty. Even still, his personal relationships suffered.

I'm glad that those that you know didn't suffer. But, I don't think that is the norm.

My ADHD child is medicated. With everything else that's on his plate in terms of functioning, I am glad we were able to eliminate some/most of the self esteem issues and to improve his functioning with the use of medication. Due to medical reasons, medication was not even a consideration for the first few years after the diagnosis, so we experienced trying to manage without the medication and we saw his self esteem, ability to function and ability to learn both with and without medication. I cannot imagine how teenage years would have been otherwise.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, you are not the only one. DS is also ADHD and no, he is not on meds. His grades are not suffering so far. He has learned a lot of tactics to manage his ADHD to his advantage and to channel his extra energy into other activities. In other words, we got ourselves a huge drama geek and a voracious reader. Oh, and he's a class clown. So far, no major complaints from ES, MS and now HS.

FWIW, diagnosed at 10 with ADHD.

OP here, thanks for the reply. DS is the class clown and the teachers hate that. I was sad to hear many of the other moms chatting about what drugs their child is on. Then the doses and that special dose just to get homework done....
My son can not write anything down. He has no patience and does math in his head rather than write. I have sat and watched the other kids (mostly girls) carefully writing out tons of work. Paragraphs long.
DS is 9 and labeled by teachers as trouble. He is smart and they mention that in a patronizing way.
His self esteem is taking a dive, and I suspect that meds would make him feel less like a standout.
One day he told me that he does not understand why all the other kids in the neighborhood do not want to play as much as he does. That was a cute statement, but it saddened me.

It sounds like you really need to talk to your developmental pediatrician. My son was the same way and the"drugs" turned his life around. After a while, your child's self-esteem will begin to plummet and he will become ostracized by his peer group and labeled a trouble maker by his teachers. Just imagine being 10 years old and experiencing this?

The self esteem issues come from the teachers (and some parents don't want him around).
You know, 40 years ago, there were tons of kids like him in class. I remember my 5th grade class with five boys who were clowns. They fooled around in many ways. Some straightened out by HS and some went on to jobs that they could handle with their personalities (one is a big landscaper in the DC area). I "selfishly" wish that DD just had more friends like himself. Where has that gang of quirky boys gone?
FWIW, at our HS reunion, the gang of mischievous boys had great things to say about their days in ES. One did say that when it came time to hit the books, it was very hard to catch up, but he did.

like the pp before me, I agree that your recollection is through rose colored glasses. My Father had un-diagnosed ADHA, he self-medicated, dropped out of school was seen as the bad kid and his self-esteem suffered greatly. To this day he struggles with his sense of self-worth. Both my brother and I were diagnosed (me at age 8, and my younger brother at 4.) I was medicated from 8-13 when I decided to stop taking the meds for myself. My brother to this day uses meds to keep a job and focus on his tasks at work. Meds come with side-effects and it can be frustrating/scary to keep trying till you find the right one, but if you son is already having issues with self-esteem then you are already in trouble.

If he were different and oblivious, it would be one thing. I am not saying you should strongly reconsider medication. Just saying something about how very important the self-esteem thing is, it is not the teachers fault- unless he has a mean or abusive teacher (I was hit by a student teacher the year I was diagnosed, because I was a class clown...she lost her job.)

I recommend that you find an activity that he loves, he can find something that he is good at and makes all the fast paced craziness going on in his head slow down for a few moments everyday- you will have a different child and you will give him something to be proud of so you can do a little esteem building there.