Anonymous wrote:

Anonymous wrote:OP, you seem to be concerned about what others think or how your DD will be labeled if she is evaluated and diagnosed. Most people, frankly, don't care. When I tell people my DD has ADHD or is on meds, they reply "Oh really?" and never ask any follow up questions. DD is a popular girl, has plenty of friends, involved in competitive sports, works hard in school and is adjusting well. She has areas where she needs support and the teachers provide accomodations as they go along. You are doing your DD a disservice by not having her evaluated. As a PP said, you have many treatement options that inlucde therapy, meds, classroom interventions, social skills goups. The counselor at DDs school has a "Friendship Club". It is really a social skills group. The kids love it and think its cool. They share their thoughts and the counselor just lets them talk but gives them ground rules. It is a mixed bag of students with LDs, ADHD, traditional learners. So, I think you should be proactive in helping your DD and figuring it out.

Where on earth did you get that??

What I am trying to avoid is giving her an excuse to slack off or not put forth real effort. I have heard my nephew try to explain away bad behavior by saying "Well, I haven't had my ritalin today". I won't have that. I want her to learn to cope. That might mean medication down the road. But not now.

In any case, "should I have my child evaluated and medicated" was not my question. It was rather "what does ADHS look like in girls, and how are you managing it". My feelings about medication don't really need to come into it.

OP, your feelings about meds absolutely read loud and clear in your post. No matter what you think. the only reason a child on meds would give that response IMO is when they hear it from their parents. I'm saying this as a mother of an 8 yr od child with Asperger's and ADHD who is currently on meds to help control his impulses, as well as in OT, sports classes and starting a behavior modification program. He has NEVER given the response as you have stated above. I have never ever told him or anyone that the reason for his behavior is that he has not had his meds today. I think you are projecting from your experience with your nephew and you need to separate that from first getting your own child evaluated. Start with the evaluation to see what you are dealing with. Once you figure out what is going on, you talk with a professional about how to manage the issue(s) at hands.

Anonymous wrote:I would lose my shit if I ever heard her say "I can't do this because my brain works differently" (or whatever people tell kids to explain why they're taking pills every day)...

What I am trying to avoid is giving her an excuse to slack off or not put forth real effort. I have heard my nephew try to explain away bad behavior by saying "Well, I haven't had my ritalin today". I won't have that. I want her to learn to cope.

OP, regarding the above, see 13:19's post. I agree with 13:19 that awareness is step one, and coping is step two. (Your nephew is on step one.)

Of course your bolded phrase is ridiculous. What you obviously want to teach your DD is phrases like:

"It takes me longer than it takes some other kids to do this because my brain works differently. So I budget more time"
"I should do my homework at [insert time of day] because my brain focuses best at that time."
"When I'm playing with my friends, I need to work extra hard to listen before I talk, so that I won't interrupt. That way, we have more fun."
"When I do a school assignment, I need to make a chart and checklist to keep myself on track, because that's what it takes for me to get it done."
"I have extra energy that helps me come up with creative ideas sometimes. When I use that energy and work on staying focused, I do a great job."
"Sometimes I need to work for a few minutes, then take a break, then go back to the task."

An expert can diagnose and teach strategies (and make better phrases than I can). You can get advice on DCUM, but you need to decide when to call in the experts.

Tougher to get an ADHD diagnosis for a young girl, in our experience, even if you try.

1) Executive functions tests for that age group are simply less reliable.

2) Most teachers will stay out of the fray,or actively push back against even an ADHD investigation, unless there is real disruption to the classroom, or if the child is so far behind that her scores will start to impact the school.

They will not suggest evaluations, will invoke transition times, will pretty much do anything to avoid having the extra work of creating evaluation forms and following up with a special needs requirements (IEP or 509). (In our case, even though or child was completely uninvolved for most of her day in school, and had major meltdowns every morning just thinking about going to school, her teacher even blamed us ('what is hapening in YOUR home?') rather than cooperate with our investigations.

In addition, your girl is likely to behave much better at school than at home -- simply because she is a social child who likes to please, and is surrounded by peers. So in some cases, the teachers simply have not seen it, and have not evaluated the true potential of a child who meets the standards despite her distraction.

3)That leaves your word, alone. Doctors want to see multiple sources corroborating the reported behavior, in addition to the tests. For a young child who is not disruptive and does reasonably well in school, chances are you will not get a positive diagnosis at this age.

Now what would you do with a diagnosis? Mostly make sure your child meets her true potential. Medication or not, there are approaches to teaching that work really well with children with ADHD. Montessori education, for instance, is an excellent tool. You can choose to find a good Montessori school through 3rd grade, giving yourself a chance to better understand your child. With 3 successful years of great success and the experience of going deep into any one subject, you can petition for enrollment in an AAP center in public school. Much of the Montessori work builds executive function -- so you'd get a lot of the benefits of both school and therapy into one. But it has to be a really good school.

Along the way, you decide if and when medication is needed. My college-age niece calls it "eyeglasses for my brain".

In public schools, you can set up some accommodations. It can be as simple as preferential seating in front of the class, or having her work at an independent table for some assignments. Discreet reminders from the teacher can keep her on task, immediate feedback on her work can enhance the learning. The school counselor can keep an eye out next few years, as ADHD kids tend to polish off their big-girl social skills a bit later, exposing them to bullying and feeling left out. Having a school counsellor on the look out, maybe even participating in a 'friendship circle" will be a valuable tool.

The point is: it will be tough to find positive diagnosis for a younger inattentive girl. But it may be worth while, as too often, the first few years of school guide where the child is headed. And for a bright, well educated young child slogging it through rehashing of the alphabet and counting in K and even 1st grade, life at school can be incredibly boring, building her adhd up.

My advice in moving things forward is to talk often with your child's teacher and counselor, express your concerns, build their awareness of the large untouched potential your daughter may have, despite meeting the grade. Don;t take "she's doing great, by the state standards" for an answer.

Our child, who was doing 2nd grade math before K and was easily reading with fluency and intonation by the start of the 1st grade, always had straight 4 in all the core subjects, and her teacher kept pushing back on the suggestion that she may know more than she shows (K and 1st grade), or that she has attention challenges (2nd grade). Despite functioning well above grade, no advanced services were offered, and her teacher evaluation, heading into the AAP pool was very poor. That evaluation provided us with the best glimpse on what was really happening in school, not the report card. Because it showed the deep discomfort surrounding DD in school, her lack of confidence and the failure of the teacher to really get her out of her shell.

I still don't have all the answer, but I do know the caveats of the early years with ADHD...

> language immersion is great, but not if your child has ADHD/language issues.

This is true for our daughter as well. We just did not understand then why it was not working for her but it started making sense after her diagnosis.

She is a bright child but struggles with writing and reading comprehension. Doing a reading response is always so hard for her. She just tunes out whenever she has a in-class group discussion. Novel study is just a pain when she has to write down her own responses as well as her classmates answers. She couldn't do it.

A diagnosis with ADHD and 504/IEP will help. But, it's important that the kid's teacher actually carries out the plan. Medication helps too but we honestly don't know how much it helps. Definitely it is not a day and night difference.

She is a preteen now but still wets her bed almost nightly. Apparently there is a connection between ADHD and bed wetting.

Sometimes I just want to cry when she is a pain to deal with. But I really should try to put myself in her shoes too.

Sorry to rant here. OP, if you are still reading, please educate yourself and be prepared.

I have a daughter who just turned 7 who was has always been very emotional, but bright and funny. She started having considerable problems in school in first grade with attention, and I ended up having neuro-psych testing performed at Stixrud at the urging of the school guidance counselor - she thought it would give me great snapshot of how my daughter learns, and it did. My daughter was diagnosed with ADHD (inattentive/impulsive), and they were able to provide a number of recommendations including therapy. I also took my daughter to a child psychiatrist when I wasn't able to find a therapist (I called 6 and none were taking patients, and I really wanted a second opinion), but it turned out to be lucky for me, because the psychiatrist also suspected auditory processing issues. Several more months of testing later, I had yet another diagnosis. It was absolutely heartbreaking for me - not the stigma, but finally understanding the enormous challenges my child faced daily with her conditions, how hard she had to work to keep it all together (I was not present for the Stixrud tests, but I sat in on the speech pathology tests and it took all my effort not to cry as I heard my daughter struggling to remember instructions, having to have her attention refocused by the tester time and time again). We started medication - it has helped tremendously with attention (how do I know it works? The school psychologist was kind enough to do observations - with and without medications and he thought there was a 20% improvement in her ability to focus in class with medication). This summer my daughter went to Lab School, and I foolishly let her have a break from medication, and I cringed when I read the reports from the school which detailed my child's inability to focus during tutoring and her pouting, tears, and frustration - much of that could have been mitigated with medication.

I am not trying to advocate for medication - it is not a magic pill at all, but has helped with an area where I know my child has a real weakness. In our case, extensive speech therapy has also helped my daughter as well as changing schools (language immersion is great, but not if your child has ADHD/language issues). But I do think a parent owes it to a child to get as much information as we can to help the child navigate life's challenges. Testing is a long process - we waited 6 weeks for an appointment at Stixrud, and a couple of months for the psychologist's reports. Speech and language testing also took several months. ADHD is often co-morbid with many other conditions - anxiety, sensory issues, and language issues. If your child had a physical illness, you would take her to a doctor and get a diagnosis and treatment asap - even if your child doesn't have ADHD, she may have sensory issues, and her behavior negatively impacts her at school (not to mention how difficult it must be for the other kids to concentrate while she is being disciplined again and again or how frustrating for the teacher). Just this poster's humble opinion, but as the person who knows your daughter best, if you suspect something may be wrong, you owe it to her to find out what it might be.

OP, if your child, at age 3, had the insight into herself to say, "I was acting up because I was tired and hungry," you shuld be impressed, not angry. Many adults never achieve that level of self-awareness. It's not an excuse -- but understanding why is the first step towards controlling bad behavior.

OP you are not in a place yet where you are ready to receive all the good advice you are getting from those of id who are battle scarred veterans. See you back here when your daughter hits third grade or if she is super bright and adept at compenssting, maybe not til middle school, when you are at Defcon 10.

She's six, for god sakes. Her behavior sounds fine to me.