Anonymous wrote:OP,
One thing to consider is the longer-term impact of having that diagnosis on your child's record. I'm not anti-diagnosis when it's warranted, but in this case I would weigh the potential benefits (which sound minimal) with the effects that'll follow the child all the way to adulthood.
For one thing, some security clearances may be harder to get if there is a childhood diagnosis of ADD/ADHD - it depends on the agency and level of clearance, but it can come up and cause problems during a security investigation.
It will make it nearly impossible for the child to ever get an FAA medical certificate, if they desire someday to become a pilot (even a private pilot flying for recreation), air traffic controller, etc. The FAA considers any lifetime ADD/ADHD diagnosis - even early childhood - to be disqualifying. You may not even consider this a path your child will take, but do you want to make decisions now that'll limit their options 20 years or 40 years in the future?
I know this sounds really far off and theoretical, but I work in a world where it's a big issue. People come in with a diagnosis of ADHD from 2nd grade, they haven't received treatment or medication since middle school, but it's on their record and disqualifies them from a number of things. Again - if ADHD is truly an issue, I'm not opposed to the diagnosis and these rules are in place to prevent people with severe issues from ending up in a place where it can become a safety or security risk, so I'm not trying to circumvent the rules - but you should understand the long-term consequences of pushing for a diagnosis in borderline cases.
Anonymous wrote:Anonymous wrote:OP again, and a PP was correct. We took DD to be tested because she was struggling with writing and spelling, and we have an immediate family history of dyslexia. She was definitively diagnosed with dyslexia, as we suspected. The attention testing was done hand in hand with the full neuropsych test, especially because dyslexia and ADHD are often comorbid. We are in the process of trying to obtain an IEP for her for dyslexia, and the doctor said that because her attention testing results were borderline, we could also include an ADHD diagnosis based if we wanted. However, as noted above in the immediate post, after a lot of discussion with family, friends, trusted teachers, doctors, and therapists, we decided that we want to focus on the dyslexia diagnosis because it was certain. We will re-test for attention issues in the future, if we see her continue to struggle even with appropriate dyslexia interventions.
I do think it is extremely important and helpful for people to understand the cons of a diagnosis. We often look at these things in a vacuum, especially when we are so focused on advocating for our kids and fighting for the best services possible. I know several kids who are borderline ADHD and whose parents really pushed to get the formally diagnosed. I do think it is overdiagnosed. And maybe some of these parents are not aware of possible long term ramifications, especially if a child is borderline or the diagnosis is somewhat inconclusive. I did not know that it could be disqualifying for her to get a security clearance or other type of clearance in 20-30 years! That type of info needs to be shared more readily!
your approach kind of rubs me the wrong way. Your kid already has a learning disability; but it seems like you view ADHD as more stigmatizing. Focus on what your kid needs, not the incredibly distant possibility that she won't be able to be an FAA certified pilot some day. (I'd only imagine dyslexia could be a concern there too ...)
Anonymous wrote:OP,
One thing to consider is the longer-term impact of having that diagnosis on your child's record. I'm not anti-diagnosis when it's warranted, but in this case I would weigh the potential benefits (which sound minimal) with the effects that'll follow the child all the way to adulthood.
For one thing, some security clearances may be harder to get if there is a childhood diagnosis of ADD/ADHD - it depends on the agency and level of clearance, but it can come up and cause problems during a security investigation.
It will make it nearly impossible for the child to ever get an FAA medical certificate, if they desire someday to become a pilot (even a private pilot flying for recreation), air traffic controller, etc. The FAA considers any lifetime ADD/ADHD diagnosis - even early childhood - to be disqualifying. You may not even consider this a path your child will take, but do you want to make decisions now that'll limit their options 20 years or 40 years in the future?
I know this sounds really far off and theoretical, but I work in a world where it's a big issue. People come in with a diagnosis of ADHD from 2nd grade, they haven't received treatment or medication since middle school, but it's on their record and disqualifies them from a number of things. Again - if ADHD is truly an issue, I'm not opposed to the diagnosis and these rules are in place to prevent people with severe issues from ending up in a place where it can become a safety or security risk, so I'm not trying to circumvent the rules - but you should understand the long-term consequences of pushing for a diagnosis in borderline cases.
Anonymous wrote:NP here. We are in a very similar, although slightly more vexing, situation.
DS is six and we have received an IEP for him based on a psycho-educational evaluation that showed he is dyslexic (and maybe dysgraphic too). It is still early for a dyslexia diagnosis but it seems highly, highly likely so we are starting to give him the necessary tutoring to learn to read as a dyslexic kid.
There were also issues with attention and executive functioning in the psycho-educational evaluation. We have not gotten a diagnosis although we were encouraged to do further testing to rule out ADHD. I have reviewed the questionnaire (Vanderbilt scales) that are often used to diagnose ADHD and I know that my rating of DS would be borderline. And now that I know how the questionnaire works, I could just fill it to tip him in one direction or another (one way to try to get ADHD diagnosis, other way to avoid it). When the pediatrician sent me the Vanderbilt scales when I asked about getting an ADHD diagnosis, I almost laughed.....(of course, DS's teachers would also have to fill it out).
I was thinking we should go ahead and get the ADHD diagnosis, primarily to see if there are more school supports with it. But here's the catch: since he was 3 years old, DS has always wanted to be a pilot. He is obsessed with everything to do with airplanes and at this point, has a pretty good understanding of aerodynamics and how airplanes function. Now that I know that he might be excluded from this passion with an ADHD diagnosis, what do I do???
DS is also a very young first grader and I know that those kids tend to get over-diagnosed (boys and young for the grade).
Anonymous wrote:NP here. We are in a very similar, although slightly more vexing, situation.
DS is six and we have received an IEP for him based on a psycho-educational evaluation that showed he is dyslexic (and maybe dysgraphic too). It is still early for a dyslexia diagnosis but it seems highly, highly likely so we are starting to give him the necessary tutoring to learn to read as a dyslexic kid.
There were also issues with attention and executive functioning in the psycho-educational evaluation. We have not gotten a diagnosis although we were encouraged to do further testing to rule out ADHD. I have reviewed the questionnaire (Vanderbilt scales) that are often used to diagnose ADHD and I know that my rating of DS would be borderline. And now that I know how the questionnaire works, I could just fill it to tip him in one direction or another (one way to try to get ADHD diagnosis, other way to avoid it). When the pediatrician sent me the Vanderbilt scales when I asked about getting an ADHD diagnosis, I almost laughed.....(of course, DS's teachers would also have to fill it out).
I was thinking we should go ahead and get the ADHD diagnosis, primarily to see if there are more school supports with it. But here's the catch: since he was 3 years old, DS has always wanted to be a pilot. He is obsessed with everything to do with airplanes and at this point, has a pretty good understanding of aerodynamics and how airplanes function. Now that I know that he might be excluded from this passion with an ADHD diagnosis, what do I do???
DS is also a very young first grader and I know that those kids tend to get over-diagnosed (boys and young for the grade).
Anonymous wrote:OP again, and a PP was correct. We took DD to be tested because she was struggling with writing and spelling, and we have an immediate family history of dyslexia. She was definitively diagnosed with dyslexia, as we suspected. The attention testing was done hand in hand with the full neuropsych test, especially because dyslexia and ADHD are often comorbid. We are in the process of trying to obtain an IEP for her for dyslexia, and the doctor said that because her attention testing results were borderline, we could also include an ADHD diagnosis based if we wanted. However, as noted above in the immediate post, after a lot of discussion with family, friends, trusted teachers, doctors, and therapists, we decided that we want to focus on the dyslexia diagnosis because it was certain. We will re-test for attention issues in the future, if we see her continue to struggle even with appropriate dyslexia interventions.
I do think it is extremely important and helpful for people to understand the cons of a diagnosis. We often look at these things in a vacuum, especially when we are so focused on advocating for our kids and fighting for the best services possible. I know several kids who are borderline ADHD and whose parents really pushed to get the formally diagnosed. I do think it is overdiagnosed. And maybe some of these parents are not aware of possible long term ramifications, especially if a child is borderline or the diagnosis is somewhat inconclusive. I did not know that it could be disqualifying for her to get a security clearance or other type of clearance in 20-30 years! That type of info needs to be shared more readily!
Anonymous wrote:If the ADHD assessment is "borderline," I would say hold off on the diagnosis and you can re-assess in a couple of months or years if you feel your child's behavior has deteriorated.
Anonymous wrote:Anonymous wrote:Is ADHD formally considered a mental illness?
No. It is a neurological disorder.
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:I don't understand this. ADHD is only supposed to be diagnosed if attention issues are causing significant impact at school. If the child simply scores below the norm, that is not ADHD. I would get a 2nd opinion.
You are incredibly incorrect. ADHD is diagnosed when symptoms are present across multiple environments, not just school and not just significantly. There are also multiple assessments used to diagnose ADHD, some are norm-referenced, some are not.
You're right that it has to be multiple environments. But it absolutely has to interfere with functioning. Otherwise why are you even seeking a psychiatric diagnosis?
They always test for a bunch of things, including things you might not have been looking for yourself. In OPs case, it sounds like her kid was struggling in school and they found dyslexia with possible ADHD as a secondary factor. Mild ADHD doesn't necessarily interfere with functioning if the kid is still able concentrate when necessary. But if she wants an IEP for ADHD symptoms, then there has to be an impact at school. That's more of a legal issue than a medical one.
No, ADHD has to actually interfere with functioning. That's the DSM definition.
What DSM V means by functioning and what a parent or school means by functioning are two different things. My DW has ADHD but she always had good grades in school, did all her work, went to college and held 9 to 5 jobs. But she is super high energy, talks a mile minute, is often late, and loses her keys a lot. So yeah, there is measurable interference with functioning, but she lived most of her life just fine.
ok so sounds like she has no psychiatric disorder if all she does is talk fast and lose her keys. What is your point?
My point is she got diagnosed with ADHD by psychiatrist, not that she only does two things. But she functioned well enough for many years before that without much problem.
So what was the problem? Presumably some area of functioning was impacted signidificantly.