Questions about ADHD evaluation

[MolieMuts]

DS1 is 6 and just finishing up his kindergarten year. His teacher has had problems with him staying in his seat, talking too much and occasionally pushing or hitting another child in a playful way. After meeting with her and discussing his behavior, we both decided that he should be evaluated for ADHD. It took months before the school-contracted diagnostician was able to evaluate him. We received a survey in the mail with lots of questions about his behavior and she said that before his evaluation she would contact us. Well, we never heard back from her, but N’s teacher told me that she came and evaluated him in class. Apparently, the evaluation took about 10 minutes and happened while the class was playing a game. The diagnostician then told the teacher that she didn’t notice anything unusual about his behavior and left it at that. We never did hear from her again or receive anything in writing. Of course N’s teacher is not satisfied with her evaluation and suggested that we have him evaluated elsewhere. We discussed this with his pediatrician and he said that ADHD kids usually have trouble w/ schoolwork and since N is doing well he thought that maybe he was just immature. He offered to evaluate him if we thought it was necessary but he didn’t seem too concerned about it.

I am not sure what to do at this point. I have always felt that there was something a little “off” with N’s behavior and now that DS2 is getting older I see a lot of differences in their development.

N was an early talker and late walker. He loves to be around other kids and tends to make friends pretty easily, but I feel he is a little awkward in his approach. He can sit with his legos for hours and build things, often very impressive and symmetrical. He easily sits through movies. About a year ago he became interested in chapter books and could sit and listen to me read for an hour or more, as long as I would do it. He is doing very well with his school work with writing being his weakest point. His memory is fantastic. He is coordinated w/ walking, running, catching, etc.

We have a struggle getting him to eat enough and sit in his chair long enough to do so, but he wants to snack constantly during the day. He has trouble following physical commands, when we take him to the photographer he will sit with his back to the camera or not pose according to instructions and has trouble with “behind” “in front”, etc. It seems he lacks common sense. He is sometimes afraid to be alone and won’t even go into a room by himself. He doesn’t like the dark. He talks constantly or just makes noise. He used to have a problem touching people’s hair, mostly mine, and had to touch my hair in order to fall asleep at night (for the most part he has outgrown that but still "plays" with my hair on occasion).

There are days when he does really well in class, so I know he can do it. I have read about different disorders on the web, such as ADHD, Asperger’s, anxiety, etc. and I am just more confused.

So, my question is…is his behavior typical of a 6 year old? Am I overanalyzing? Should we have him evaluated again? Do we have to go through his pediatrician again to do so? Does anyone have a similar experience? I want him to get help as early as possible if he needs it.

Sorry this is so long, but no one in my family thinks anything is wrong so they don't offer much advice.

[JBaxter]

I have a 6 1/2 yr old kindy boy and it does sound fairly typical. Now we are huge believers in the Feingold diet. Nathan will become very hyperactive with impulse control if he has ANY type of red yellow or blue food dyes. Check www.feingold.org

[MolieMuts]

I am ashamed to admit that I read about the Feingold program on this board and we planned on using it, but never purchased the program. We switched to foods with less artificial colors/flavors and some organic, but didn't do it wholeheartedly. We told his pediatrician about it and he said that it was proven to not work years ago, but it certainly couldn't hurt DS. We may need to look into that again. Thanks for your suggestion!

[egoldber]

What you have described sounds very typical to me. Children have a wide range of unique behaviors. Some are naturally very sedate, orderly and able to easily control their emotions. Some are not. ADHD has specific diagnostic criteria. All of my older DD's teachers have wondered if she has ADHD. The only problem is that no professional who has ever evaluated her agrees with them. So it is possible for a child to have ADHD-like behaviors, but not have ADHD.

If you have concerns and think he may have ADHD, then you could have him evaluated, but this is not cheap and often not covered by insurance. I would also personally wait until he is at least 7, because the diagnosis is much more accurate at that age.

But just because he is not diagnosed with ADHD does not mean that some strategies used for kids with ADHD may not help him out a great deal. And give the teacher some tools for the teacher when she is frustrated.

What is his teacher like? And the class itself? I have found over the years that a teacher's perception of my child is colored very much by the personality of the teacher, the make-up of the overall class behaviors and how experienced the teacher is.

[pinkmomagain]

Hmmm. Well, I have a dd with adhd and anxiety. Your observations/thoughts sound like they can be within the realm of possibility....and yet, he is still a bit young. When my dd was in K (or 1st) the school psych did and adhd inventory, and while there were somethings on the checklist, it was not enough. She was eventually dx (I think) in about 3rd grade with adhd (the anxiety we knew about since she was 3 with signs even earlier)...when academics and staying on task became more of a problem. At that point, she was dx by an outside psychologist (or psychiatrist...uggh, my memory is getting terrible).

How is his self-esteem? Is he being reprimanded all.the.time.? Does he have friends at school? Overall, is he getting good grades? These are somethings I would consider at this specific point in time to determind how aggressively to pursue further evaluation/help.

[kransden]

It sounds like he has issues, but not super serious ones. Just remember it is in the best interest of the school district, i.e. money, that your child NOT receive services. Get a referral to someone that specialized in that sort of testing, don't have your ped do it.

I used to substitute a lot. There were three things that usually help children like this. Not that they are cures, but they makes a huge difference.
1. Structure - i.e. having a set schedule - especially a SET BEDTIME!
2. Sleep - Most do not get enough rest. Does he seem worse as the week goes on? They often get less and less sleep as the week goes on and they start acting out. Little sleep makes for a horrible classroom experience.
3. Healthy Food - Not that you have to go all the way and do a Fiengold diet, but a lot of kids get too much sugar and processed food. These kids are often sensitive to it, and changing thier diet makes a difference.

If you try these things for a month. I bet you'll see a difference. Just remember, especially with bedtime, they will fight you, but you're the parent.

Good Luck!

[MolieMuts]

I am pretty sure that his teacher is fairly new, she looks very young. She has also referenced what the other K teacher does for her students, so she may not have much experience in the classroom.

Not that I wanted him to have a diagnosis of ADHD, but I was really looking forward to him getting some help and one-on-one guidance from a specialist at school.

[SnuggleBuggles]

Ds1 was just evaluated. The teacher had concerns, just some quirks and still not remembering routines so she had the school counselor come and observe him. She observed him 3 times during various class activities/ lessons, about 20 minutes each. The counselor couldn't make a diagnosis but she wrote up her impressions and referred us to a psychologist. The psychologist observed him while asking me questions and by the middle of the appointment she felt pretty strongly that ADHD was a good diagnosis. We then went to a psychiatrist, again with ds and this time dh. We answered questions, filled out a questionnaire and ds1 was observed. They asked him some questions too and had him do a few things like read, do math and draw but even before they got to that the Dr. said ADHD too. It sounds like a more thorough screening of your ds wouldn't hurt, especially if you have health insurance to cover it. But, he sounds like a pretty typical 6yo! All kids have their "things" that make them unique. It sounds like this teacher isn't a great fit, perhaps. Maybe next year he can be paired with someone who gets him a bit more.

Beth

[MolieMuts]

1. I do feel like he is being reprimanded all the time and I feel awful about it. I hate to get on him at home for the things he gets in trouble for at school all day. He has friends at school, but not a "best" friend, I am not sure he would even know how to make a best friend. His academic grades are good, but his behavior grades are falling every time.

2. I feel like he eats pretty healthy in general, but sometimes he does get too much sugar and processed food.

3. Some days he does seem very tired and he was taking naps up until he started K, so I think he had trouble adjusting to the new schedule. Nighttime is tricky because DS2 is put down at 8, I then read to DS1, brush his teeth and he goes down around 8:30 or 9, depending on how long I read. He usually gets up around 6:45-7:00. DH has been getting home from work around 8:30, so that has really interrupted our bedtime routine also. It would be hard to put either of them to bed before 8 because it is still light outside. I may have to find a way though.

[JBaxter]

I am ashamed to admit that I read about the Feingold program on this board and we planned on using it, but never purchased the program. We switched to foods with less artificial colors/flavors and some organic, but didn't do it wholeheartedly. We told his pediatrician about it and he said that it was proven to not work years ago, but it certainly couldn't hurt DS. We may need to look into that again. Thanks for your suggestion!

Peds will tell you it doesnt work but I can say 100% it DOES work with Nathan. Doctors turn their noses up at most things natural they are trained to give meds.
One of the peds in my office said the same thing but Nathans preschool teacher ALL said it did/ does work and not to stop do to the drastic change for the good.

For the feingold to work you need to eliminate ALL the dyes you cant just do a little of it.

[MolieMuts]

Ds1 was just evaluated. The teacher had concerns, just some quirks and still not remembering routines so she had the school counselor come and observe him. She observed him 3 times during various class activities/ lessons, about 20 minutes each. The counselor couldn't make a diagnosis but she wrote up her impressions and referred us to a psychologist. The psychologist observed him while asking me questions and by the middle of the appointment she felt pretty strongly that ADHD was a good diagnosis. We then went to a psychiatrist, again with ds and this time dh. We answered questions, filled out a questionnaire and ds1 was observed. They asked him some questions too and had him do a few things like read, do math and draw but even before they got to that the Dr. said ADHD too. It sounds like a more thorough screening of your ds wouldn't hurt, especially if you have health insurance to cover it. But, he sounds like a pretty typical 6yo! All kids have their "things" that make them unique. It sounds like this teacher isn't a great fit, perhaps. Maybe next year he can be paired with someone who gets him a bit more.

Beth


Wow, your son had a much more thorough evaluation. I'll check and see if our insurance will cover an evaluation by a specialist. If it does, I am pretty sure he would have to be referred by his pediatrician. Thanks for your info!

[MolieMuts]

Peds will tell you it doesnt work but I can say 100% it DOES work with Nathan. Doctors turn their noses up at most things natural they are trained to give meds.
One of the peds in my office said the same thing but Nathans preschool teacher ALL said it did/ does work and not to stop do to the drastic change for the good.

For the feingold to work you need to eliminate ALL the dyes you cant just do a little of it.


DH and I were not surprised that the pediatrician shot the program down. We are both big believers in the diet/behavior connection. I do think we will try the program and do it the correct way this time!

[egoldber]

If it were *me*, I would ask for a full neuropsych evaluation. It can be difficult to tease out ADHD vs anxiety vs giftedness (which can create ADHD like behaviors when a child is not properly challenged) vs various learning disabilities, or there may be a combination of issues. I would want a comprehensive evaluation, especially if you think that medication is something you want to explore.

[wolverine2]

Just a note about the evaluation. Did you sign a consent form? Was it an evaluation to determine eligibility for special ed? If so, you have a right to written documents and it is a legal process that has to conclude in a team meeting. It doesn't sound to me like this is what he had. I would ask the school evaluator for a write-up of the rating scales you completed. If you WANT to have him evaluated through the school, you can request it and they have to do it. If you decide to hold off (which I probably would in this situation- it's too early to really know), know that you always have that right in the future.

[kransden]

3. Some days he does seem very tired and he was taking naps up until he started K, so I think he had trouble adjusting to the new schedule. Nighttime is tricky because DS2 is put down at 8, I then read to DS1, brush his teeth and he goes down around 8:30 or 9, depending on how long I read. He usually gets up around 6:45-7:00. DH has been getting home from work around 8:30, so that has really interrupted our bedtime routine also. It would be hard to put either of them to bed before 8 because it is still light outside. I may have to find a way though.

I used blackout liners on the curtains in dd's room. I agree it's hard to sleep when it's light outside.

[daisymommy]

My 7 year old DS hs ADHD and is on Feingold as well as medication. Even with medication if he eats anything that is on the "NO" list on Feingold (dyes, preservatives, artificial flavoring, or high fructose corn syrup)--you do NOT want to be around him! It's awful for a full day, sometimes two days.

I would definitely get him evaluated--it can't hurt. Maybe you'll find out it's just his personality and that there are some behavior modifications that need to be made.

I hate to say this, but your DS sounds like my son on a very good day.

[jamesmom]

If it were *me*, I would ask for a full neuropsych evaluation. It can be difficult to tease out ADHD vs anxiety vs giftedness (which can create ADHD like behaviors when a child is not properly challenged) vs various learning disabilities, or there may be a combination of issues. I would want a comprehensive evaluation, especially if you think that medication is something you want to explore.

:yeahthat: DS was diagnosed with ADHD when he was almost 6 by a developmental pediatrician after a full neuropsych evaluation by his school. We also got a second opinion from a local developmental pediatrician who now oversees his care, as he also has auditory processing delays, sensory issues and gross and fine motor skills delays. We tried the Feingold diet (and still follow it), but it didn't make much of an impact in DS' case. DS now takes ADHD medication and is doing great on it.

[vludmilla]

If it were *me*, I would ask for a full neuropsych evaluation. It can be difficult to tease out ADHD vs anxiety vs giftedness (which can create ADHD like behaviors when a child is not properly challenged) vs various learning disabilities, or there may be a combination of issues. I would want a comprehensive evaluation, especially if you think that medication is something you want to explore.

I agree with this completely. I would not look to your pediatrician to diagnose or rule out ADHD.