Diagnosing ADD

[klt]

How many parents here sought out professional diagnosis?  Did anyone decide not to?  I am afraid of labeling, and getting the schools involved. I am wondering if it is worth getting a diagnosis, or to continue to parent as I have been so far, and adjusting when we need to.

Do you contact your physician first if you want to diagnose it?  Do they care or is it more the schools who do?

This topic is so huge, I am just now considering it with my son. So. No idea where to start. thanks.

[OTMomma]

My child is not ADD, but we have our own issues.  You can choose to go through your own health care providers- which may mean you need a referral through your doctor, but it may be you can simply choose a child psychologist who does that type of tests from a list provided by your insurance carrier.  Some insurance will pay for it, many don't-  which results in a lot of people relying on the schools for such testing, because they can't afford to pay out of pocket for it.  However, I think going through this process privately gives you a lot more power- you can choose to share the information you learn from it with the schools, or not, if you feel the school will put too much emphasis on a label.  The professional you see should be able to give you a lot of information about how to help your child, what school choices would be best for him, and things you can do at home, after completing their testing.  If you go through the schools- you will need to have teachers who agree with you that they see a problem, and then they will start a process that may take months before your child is tested.   Some schools will even refuse to provide testing unless your child is working significantly behind their peers. 

Personally, I think if you can afford it, having a private professional opinion can give you a lot of good information.  Your child only gets "labeled" if you choose to share the results, and if there are findings you need to share with the school- you can choose to do that and skip the long drawn out school process. 

Good luck with your decision.  Parenting has no easy answers.

[Emmeline II]

If it is affecting how he functions in school he may already have labels--unflattering, unhelpful labels; though you don't have to share a diagnosis with the schools. I wouldn't bother with a ped or family doctor unless you need a referral. We first went to a psychiatrist then had a full evaluation done by the child development clinic at the children's hospital.

[karne]

We did.  I wish we had done it sooner.  My advice is to stop worrying about labels, or about what anyone else will think.  If your child is having difficulties, they, and you, deserve to know what's going on, and to be made aware of the range of help available.

[klt]

First off, thanks for talking ;-D
My son is in a private catholic school, so I am pretty sure they do not test for ANYTHING-not just ADD (we don't have school psychologist on board, or speech therapists etc like public schools, and not tutors.  Just one reading specialist, who my son works with.)

He is meeting standards and is doing fine in school; and is he is not disruptive, just under-performing in my eye (I have the mommy hunch he is underperforming.)

His taekwondo instructor worked with him this week, and in 5 minutes he told me "your son is dyslexic and has attention problems."  This didn't surprise me; he was a slow starter with reading, and we still tutor for reading. He is in Kindergarten.  The taekwondo Master said he has seen this before, and the kids work out of it in 1-3 years.  He is willing to work with him.. I feel grateful for that.

Since my school sounds like they have no support system for ADD, it sounds like I can go thru our physician. 

[melissa17s]

So, uh, is this taekwondo instructor also a dr?  Talk about labeling, and maybe incorrectly; I would likely disregard 5 minute consults with nonprofessionals.  I think you need to start with talking to your child's classroom teacher.  Does he/she feel your ds is underperforming?  If so, then I think you should go to a clinical psychologist or psychiatrist specializing in childern test for adhd-i and dyslexia.  6 years old is too young to dx dyslexia (going off the age on your tag), and it is also rare for adhd-i.  www.chadd.org and http://www.interdys.org/ are websites that can help with info and dx that my ds's psychologist recommended to us.   

[blessedwithboys]

Hmmm, I'm not liking the tawkwondo guy diagnosing your kiddo.  I would deff say go the private route if you can, but even though your child is in private school, the public school system may still be responsible for testing.

I want to offer you my "ADHD" BTDT.  My now-16yo ds1 was labeled ADHD around 3 or so, but very unofficially.  I had never seen such a hyperkinetic kid (learned later it was proprioception-seeking) and I asked his ped.  The ped agreed with me and offered a prescription for Ritalin on the spot.  I was horrified and declined, and then on and off through the years I had ds in counseling, behavior analysis, OT, etc.  I chose not to medicate bc I was able to see slight improvement with dietary changes and lots of outdoor time.  Ds has always been an A/B student, although his behavior in school could certainly have been better.

FF to this past year.  DS's physical hyperactivity is gone but mentally he's still floating up near Mars.  His life-long sleep problems intensified a hundred-fold, and we got agressive in pursuing the cause.  Turns out ds has lived for his entire life with narcolepsy. 

Point being:  many things masquerade as ADD/ADHD.  I highly recommend identifying "problems", but please know that many, many kiddos are wrongly diagnosed with ADD/ADHD.  For me personally, it's a diagnosis I would only accept and medicate for after all other avenues had been exhausted.

Sorry for the tangent here, I know it's not quite what you asked, I'm just on a PSA mission now.  Best wishes!!!

[klt]

Originally Posted by melissa17s 

So, uh, is this taekwondo instructor also a dr?  ..... Does he/she feel your ds is underperforming?  If so, then I think you should go to a clinical psychologist or psychiatrist specializing in childern test for adhd-i and dyslexia.  6 years old is too young to dx dyslexia (going off the age on your tag), and it is also rare for adhd-i.  www.chadd.org and http://www.interdys.org/ are websites that can help with info and dx that my ds's psychologist recommended to us.   

This made me laugh!  Know he is not!  However, it is obvious something is weird since the teacher will say "turn left" and my son "turns right." He does things opposite.  I am not sure if this would qualify for dyslexia either.  I am going to follow his school work and see if there are any signs there. So far, not really. Just a slow reader.

[klt]

Originally Posted by blessedwithboys 

  I would deff say go the private route if you can, but even though your child is in private school, the public school system may still be responsible for testing.

Really?

Thanks for all that your shared :-D  I am not a big fan of dx (even though I am a RN.)  AND I don't see it necessary right now.  My son's dad definitely has some kind of ADD going on.  I am grateful I started my research as I read one article that said early intervention, with a biological link, helped the symptoms. I have always parented to his needs, so I guess right now we are doing what we should be doing.   No, I am not rushing to the doctor for a medication.  Just behavioral "redirection", good parenting skills, lots of attention, and the natural route-diet, exercise and sleep.  Just gonna keep my eye on his school performance.

[Polliwog]

Kindergartners are still very young and many kids just aren't ready to read. My DS was diagnosed at 5 1/2 with ADD and I was diagnosed at 40. I wish that my mom would have known to get me tested. For ME, medication is what's needed to help me function. For my DS (now 6 1/2) it's not. Weekly visits with a psychologist (whom we LOVE,) and an OT are working for him (as well as working with the resource teacher at school.)

We did both private and school district evaluations. Even if you don't do the private ones, you'd need most of the SD ones anyway. They really do serve different functions. I'm not a fan of most labels but the ADD diagnosis gets him the services that HE needs.

[KCMichigan]

Originally Posted by Polliwog 

Kindergartners are still very young and many kids just aren't ready to read.

 Even if you don't do the private ones, you'd need most of the SD ones anyway. They really do serve different functions. I'm not a fan of most labels but the ADD diagnosis gets him the services that HE needs.

I agree.

6 is young for dyslexia dx. Developmental directional confusion (left/right) is age appropriate (until about the end of 1st grade!). As is still working on letter/sound relationships if he is in K (which I imagine is why he is seeing a reading tutor at school).  Not that it is saying he does not have a learning disability = BUT many kids from age 4 to 7/8ish have written letter reversals, directional confusion, trouble learning to read, disinterest in academics but wanting to play. Some kids still have not developed a hand dominance until the very end of K ( may also go with age and lefties often have a more delayed start to handwriting/reading).  Many of them go on to do fine--- a small percentage do end up needing remedial help and/or it is found that they have a learning disability and may benefit from alternative teaching methods (orten gilliangham, Touch Math, etc). It would be hard for him to get supplemental services in K or 1st grade for learning difficulties if he is at, around, or just below grade level  due to the wide developmental ranges that are normal for those ages.

As for ADD/ADHD, if you say he is not having behavioral concerns. I would give it a bit more time and see. Again, some kids do go on to need further treatment/support for ADD/ADHD, but a large majority of kiddos that may have trouble focusing, keeping still, and/or day-dream in K/1 outgrow it and/or it is a poor match of teaching style for that kid and the methods used to teach (example: if K has a lot of desk work...not developmentally appropriate for that age, but a lot of places are moving that way and wondering why kids have a hard time) K is so much 'more' that it was in former years and some kids dont fit the 'sit and learn' mold at age 5/6/7 and/or are ready for the academic pressure. Keep an eye on it for sure and if it seems to severely impact his social skills, attitude toward school and/or academic success look into it ASAP, otherwise I would suggest waiting and seeing if some of it is developmental in nature.

You could talk to your Dr. They often have a simple screener checklist that could help you decide if you want to further pursue evaluation. You can also ask the local schools. A medical dx and a medical dx that is functional at the schools are two different things though.

Although if you do have a dx from a Dr- you can get a 504 put in place for any accommodations you think will help your DS. If he is at a private school, you likely will get nothing since they are not required to assist kids with any special needs. Public Schools often offer IEP/resource room support to kids that have ADD/ADHD and it is impacting their academic success. If no academic are impacted (and even if they are in K- they are unlikely to see a big enough difference to have a child qualify for an IEP for ADD related academic support) then, often a 504 is used to help make some changes to help your DS be more successful.

I would not take advice from the taekwondo instructor unless he is also an educational psychologist and has done an evaluation on your DS. 

As for labeling....my DDs both have had labels and they are 5.5. A label was a means to get therapy that they both needed (OT, PT, social skills). It has also made for dealing with some very supportive staff at the local preschool/ PreK and hopefully K (next fall) staff. It has never once been a negative in our experience- it has only been a positive in getting support in place for my DDs to be successful and gain skills they were otherwise struggling with.BUT, I am a Special Ed. teacher (before kids) and am very pro-support/services for kids that are struggling. It is frustrating to see some kids that could benefit from extra accommodations/support and unable to 'qualify' for it. In elementary school-- in my experience- it has been a plus to kids self-esteem and success to get help when they need it. I am sure there are different issues in higher grades, but really most of the kids I worked with were glad for the assistance and thrilled to find some academic and social success after having difficulties.

I would look into:

1. is the school teaching style a good fit? 

2.is your DS happy there and learning?

3. are his academics on par with his other skills (emotional development, physical, etc)

4. does he have concerns about attention outside of school?

5. does more sleep/diet/exercise alleviate some focus concerns?

FWIW- to help him learn L/R directions. You can put a smiley on his left hand (or a L), a bracelet, a watch--- or some other identifier to help him learn and practice left and right.

Edited by KCMichigan - 3/12/11 at 11:58am

[RiverTam]

By law, in the US, the school district in which a child attends private school is responsible for providing assessment and special education services to that child, free of cost, if those services are necessary.

I suspect that in most cases that the public school assessment will come back as "No services needed," but they're supposed to provide them. 

Originally Posted by klt 

Really?

Thanks for all that your shared :-D  I am not a big fan of dx (even though I am a RN.)  AND I don't see it necessary right now.  My son's dad definitely has some kind of ADD going on.  I am grateful I started my research as I read one article that said early intervention, with a biological link, helped the symptoms. I have always parented to his needs, so I guess right now we are doing what we should be doing.   No, I am not rushing to the doctor for a medication.  Just behavioral "redirection", good parenting skills, lots of attention, and the natural route-diet, exercise and sleep.  Just gonna keep my eye on his school performance.

[kbins]

I'm going to respectfully disagree. At least in Texas, if a parent puts a child in private school (including homeschool) the public school does NOT have to provide services. They do have to evaluate, only. Our experience (and that of some we knew at Catholic school) is that the district can/do provide services for SN kids in preschool, but at elementary + age, the kid must be in public school. And I have to say, I believe our school district is wonderful in their detailed evaluations and services. I expected a fight and instead have had proactive support and services every step of the way.

From TX Education Agency: "Procedural Safeguards":

Voluntary Private School Placements by Parents
You have specific rights when you voluntarily place your child in a private school. IDEA does not require a public school to pay for the cost of education, including special education and related services, for your child with a disability at a private school or facility if the public school made a FAPE available to your child and you choose to place the child in a private school or facility. However, the public school where the private school is located must include your child in the population whose needs are addressed under the IDEA provisions regarding children who have been placed by their parents in a private school.

Children Ages 5-21 —

If you choose to place your child with a disability in a private school, your child does not have a right to receive any of the special education or related services he or she would receive if enrolled in the public school.
If your child is determined to be eligible for special education services, the public school district in which your child resides will hold an ARD committee meeting to determine whether it can provide a FAPE to your child. However, the FAPE will be available to you only if you choose to enroll your child in the public school full time. If you make it clear from the beginning that you will not place your child in the public school, the school does not need to develop an IEP.
Some special education services may be available to your child while enrolled in the private school, but the type and amount will be limited by how the public school where your child’s private school is located decides to serve private school students. The school’s decision is made after consulting with representatives of private schools and parents of private school children with disabilities. The school determines how to use the limited federal funds that are designated for private school services. If a public school elects to provide any type of service to your child, then a services plan must be developed by a services plan committee. The services plan includes goals and those elements of a traditional IEP that are
appropriate for your child and the services to be provided.

[QueenOfTheMeadow]

Originally Posted by RiverTam 

By law, in the US, the school district in which a child attends private school is responsible for providing assessment and special education services to that child, free of cost, if those services are necessary.

I suspect that in most cases that the public school assessment will come back as "No services needed," but they're supposed to provide them. 

Unfortunately, school services take place during the school day. If you have a child in private school, you still have to get them to the public school during the day to get them the services. It makes things pretty difficult1

[Linda on the move]

My child isn't ADD, but from what I've seen, most of the support for ADD kids comes from accommodations during their school day -- how their day is structured or how much homework they get. It would be irrelevant to a child who didn't attend school there.

I personally feel that getting experts involved and finding out what is going on with one's child is a really good idea. Otherwise, one is really just attempting to dx their own kid based on what they read on the internet. My DD is on the autism spectrum and knowing that (for sure) and being clear with people who spend a lot of time with her (like her teachers) helps everything flow more smoothly for her. She has a better life because of it.

[Heavenly]

My son has ADHD:I (along with many, many other problems) and he was diagnosed by a psychologist after extensive testing.  Our kids attend a private Christian school and although we could have gotten the testing covered by the public school it was a 3-5 year waiting list so we paid for it privately.  It wasn't cheapt but our benefits covered 90% of it.  I believe that many children are diagnosed with ADHD that don't actually have it but for the ones that actually do it is a godsend to have the diagnosis so they can get the help the need.

[RiverTam]

Made me look. :)  You're right.

The IDEA requires public school districts to:

• Evaluate a private school student for special education if a referral has been made.
  

• Determine if the student is eligible for special education.
  

• Develop an appropriate Instructional School Plan (ISP) for the child's school.
  

• Consult with parents and the student’s teachers when developing an Instructional School Plan.

They're not required to give services, but may do so. My location does give services. As another poster stated, they also don't provide transportation to school for services.

Originally Posted by kbins 

I'm going to respectfully disagree. At least in Texas, if a parent puts a child in private school (including homeschool) the public school does NOT have to provide services. They do have to evaluate, only. Our experience (and that of some we knew at Catholic school) is that the district can/do provide services for SN kids in preschool, but at elementary + age, the kid must be in public school. And I have to say, I believe our school district is wonderful in their detailed evaluations and services. I expected a fight and instead have had proactive support and services every step of the way.

From TX Education Agency: "Procedural Safeguards":

Voluntary Private School Placements by Parents
You have specific rights when you voluntarily place your child in a private school. IDEA does not require a public school to pay for the cost of education, including special education and related services, for your child with a disability at a private school or facility if the public school made a FAPE available to your child and you choose to place the child in a private school or facility. However, the public school where the private school is located must include your child in the population whose needs are addressed under the IDEA provisions regarding children who have been placed by their parents in a private school.

Children Ages 5-21 —

If you choose to place your child with a disability in a private school, your child does not have a right to receive any of the special education or related services he or she would receive if enrolled in the public school.
If your child is determined to be eligible for special education services, the public school district in which your child resides will hold an ARD committee meeting to determine whether it can provide a FAPE to your child. However, the FAPE will be available to you only if you choose to enroll your child in the public school full time. If you make it clear from the beginning that you will not place your child in the public school, the school does not need to develop an IEP.
Some special education services may be available to your child while enrolled in the private school, but the type and amount will be limited by how the public school where your child’s private school is located decides to serve private school students. The school’s decision is made after consulting with representatives of private schools and parents of private school children with disabilities. The school determines how to use the limited federal funds that are designated for private school services. If a public school elects to provide any type of service to your child, then a services plan must be developed by a services plan committee. The services plan includes goals and those elements of a traditional IEP that are
appropriate for your child and the services to be provided.

[Polliwog]

I actually had a conversation with both my ADHD doctor and my son's psychologist. They both said that ADD/ADHD are both over and UNDER diagnosed.
 

Originally Posted by Heavenly 

My son has ADHD:I (along with many, many other problems) and he was diagnosed by a psychologist after extensive testing.  Our kids attend a private Christian school and although we could have gotten the testing covered by the public school it was a 3-5 year waiting list so we paid for it privately.  It wasn't cheapt but our benefits covered 90% of it.  I believe that many children are diagnosed with ADHD that don't actually have it but for the ones that actually do it is a godsend to have the diagnosis so they can get the help the need.

[hergrace]

Originally Posted by Polliwog 

I actually had a conversation with both my ADHD doctor and my son's psychologist. They both said that ADD/ADHD are both over and UNDER diagnosed.
 

Our developmental pediatrician agrees.  Her assessment is that many kids are diagnosed without ruling out other causes of attention issues and many kids aren't diagnosed because parents and physicians are skeptical about diagnosis because so many kids are incorrectly diagnosed.

DS1 has been diagnosed with ADHD, but the developmental ped. thinks it is not correct.  Because of the diagnosis, we are doing a blind trial of stimulant meds to see if there is any benefit.  At the same time, we are continuing to assess the other issues that are known to contribute to attention issues: SPD, sleep, vision, etc.

If a child really does have ADHD and needs accommodations and/or medication, not having a diagnosis can be a problem.

[bec]

I am just starting down the path of pursuing a diagnosis for my 10 year old dd.  The school suggested attention issues towards the end of last year, but her grades were high, and she was not struggling.  This year, she is very much struggling, is starting to spiral and her life is not in her control.  I liked how someone put it that their head is still in Mars.  That's my child.  I'm pursuing a diagnosis because I want her life to not be a constant struggle to maintain a thought, a homework assignment, a test, a conversation, etc.  I have tried other things first.  I've been very careful about her diet, her structure and support at home.  Her school is fabulous at creating an environment where she can be successful.  But, she still has to put out a tremendous effort for pretty minimal results.  She has pretty good grades, still, but I think this is a reflection of fantastic coping skills, rather than anything else.  And the grades are starting to slip.  As is her self esteem.