Possible case of ADHD (though I have my doubts)

[mamamoonbirth]

Hello everyone. I hope I chose the right place to post. My stepson's (he is 8 1/2) mother is convinced that he has ADHD. She says this based on her and her father having ADHD, both of them medicated themselves as needed. Stepson has a hard time sitting still in class, this is almost exclusively in the afternoon. He excels in his schoolwork, goes to a higher reading and math group than the others in his class. Has occasional issues with controlling anger. He spends one week with his mother then one week with us, each house has different rules. For instance, she allows him to play whatever video games he wants, even rated M, she and her boyfriend encourage the games by playing with him. He has a game console in his room at his mothers and is allowed to have however much screen time he wants and watch whatever he wants on tv. We do not allow games higher than E and limit screen time. There are no tvs in kids bedrooms at our house. If he has a good week at school she buys him a toy, if he sits still for his haircut she buys him a toy. We believe that these behaviors are to be expected and don't buy toys for something he should be able to handle at 8 years old. He is an amazing soccer player and great at martial arts, pays close attention to instruction.

So to the point: she took him to a specialist. After a one hour meeting with papers provided by the school and daycare the doc gave a diagnosis and prescription. We told her in no uncertain terms that we were taking him somewhere for a second opinion and NOT to fill the prescription as doing so would be against what the divorce papers say.

Opinions? Are we overreacting? Does this sound like ADHD? I am considering starting an ADHD diet with him but his mother would never go for it. I think part of the problem in the afternoon is having had a crap lunch at school and his body just can't deal with it. I also think that he just isn't interested in what they are teaching in the afternoons. They certainly don't get enough recess time.

Thanks everyone.

[termasan]

It sounds reasonable to get a second opinion. My son is only 6.5, so I can't say I can relate to an 8.5 yo, but getting another opinion is good. Hopefully with a good practitioner, you can get guidance on diet as well as if he needs neuro support.

[LynnS6]

This website might be a good place to start: Supporting the Emotional Needs of Gifted Children

There's a checklist/article there called "Before referring a gifted child for ADD/ADHD Evaluation" that would be interesting to have both your husband and his mother fill out. Bored gifted kids can mimic ADHD symptoms, or they can genuinely have ADHD.

I definitely think that getting a second opinion is worthwhile and would be a good thing before trying medication. The other thing I'd do is read up on ADD/ADHD and see how many of the traits fit your stepson. I would approach it as "well, can mom be seeing something we're not seeing" rather than "her parenting style is what's causing this" if you possibly can. It'll make you look better in the long run. It may be too late, but I'd also bring up to his mom that you want to make sure that his problems aren't being caused because his needs aren't being met by the school. That might get you to neutral ground where you can get some answers from his mom/her boyfriend as to how much of the ADHD type behaviors they see at home.

[serenbat]

regardless if correct or not

So to the point: she took him to a specialist. After a one hour meeting with papers provided by the school and daycare the doc gave a diagnosis and prescription. We told her in no uncertain terms that we were taking him somewhere for a second opinion and NOT to fill the prescription as doing so would be against what the divorce papers say.

WOW! So this would need to go before a judge? A medical prescription written and papers filed (I'm assuming) with the school?

I would work out the legal aspect prior to taking any action (another opinion).

I know it would be very hard in my state to go against a specialist and the school district and get that over turned.

DId you know that the school thought there was an issue?

Has an IEP been done?

[karne]

My first thought is that you should try very hard not to put your dss in the middle of an argument about a dx.  It won't help anything, especially if he needs help.

It sounds like your dh and his ex have very different views of their son at this point.  You could take him for a second opinion, but I'd like to suggest that ALL of the parents get together and pursue more information, and a second opinion, together, so that you are all presenting your concerns, you are all hearing the concerns of the school/daycare, and you all hear, together, the findings and options for treatment.  It's not helpful, nor in the best interest of the child to be split about this.  And, hearing about behaviors and experiences from the perspective of your home, his mom's home and the school (and other settings) will provide a fuller picture.  Getting a second opinion, with only your info would not be helpful.

FWIW, being good in school, gifted academically, good in sports, etc. doesn't mean you can't have ADHD.  Playing video games and eating junk food doesn't in and of itself cause ADHD, although it certainly doesn't help, and there is recent information about the negative/harmful effects of food dyes.  Having two parents with dx ADHD is a pretty strong indicator that attention should be payed to the possibility of offspring having ADHD. In your situation it sounds like there are different expectations and family beliefs within the two households, and certainly that's tough.  Hopefully the two families can find a way to work toward the needs of your dss, and not against each other.

There are a number of excellent recent threads here about ADHD, treatment, meds, etc. that might be helpful to you.   

[raksmama]

 Definitely get a second opinion!

What looks like ADHD can  often be  Sensory Processing Disorder or a Learning Disorder. Both can make kids seem  innattentive, but meds won't help.

Edited by raksmama - 5/11/11 at 2:28pm

[Emmeline II]

Originally Posted by karne 

My first thought is that you should try very hard not to put your dss in the middle of an argument about a dx.  It won't help anything, especially if he needs help.

It sounds like your dh and his ex have very different views of their son at this point.  You could take him for a second opinion, but I'd like to suggest that ALL of the parents get together and pursue more information, and a second opinion, together, so that you are all presenting your concerns, you are all hearing the concerns of the school/daycare, and you all hear, together, the findings and options for treatment.  It's not helpful, nor in the best interest of the child to be split about this.  And, hearing about behaviors and experiences from the perspective of your home, his mom's home and the school (and other settings) will provide a fuller picture.  Getting a second opinion, with only your info would not be helpful.

FWIW, being good in school, gifted academically, good in sports, etc. doesn't mean you can't have ADHD.  Playing video games and eating junk food doesn't in and of itself cause ADHD, although it certainly doesn't help, and there is recent information about the negative/harmful effects of food dyes.  Having two parents with dx ADHD is a pretty strong indicator that attention should be payed to the possibility of offspring having ADHD. In your situation it sounds like there are different expectations and family beliefs within the two households, and certainly that's tough.  Hopefully the two families can find a way to work toward the needs of your dss, and not against each other.

There are a number of excellent recent threads here about ADHD, treatment, meds, etc. that might be helpful to you.   

Also, I would try to find out if and what he is eating for lunch. My son is 2x diagnosed with ADHD (psychiatrist and hospital) and medicated, but had increased problems in the afternoon if he hadn't eaten lunch.

We took ds to a developmental-behavioral pediatrician/clinic at a children's hospital; it was a 3hr evaluation in addition to the preappointment surveys, his OT report, and teacher reports.

[SleeplessMommy]

If he DOES have ADHD, one of the first steps for non-meds management would be to reduce screen time, including video games. :-(

For the diagnosis there should be a questioneer for the parents and teachers to fill out - diagnosis requires symptoms at both home and school. For ongoing management, there should be an experienced child therapist working with the child and parents, to help with management strategies (such as reduced tv/games.)  Since the mom has adhd, I can see how she might find meds easier than the more challenging process of behavior management strategies and divorced parents working together.

[SpottedFoxx]

Originally Posted by jalilah 

 Definitely get a second opinion!

What looks like ADHD can  often be  Sensory Processing Disorder or a Learning Disorder. Both can make kids seem  innattentive, but meds won't help.

Actually, central auditory processing delay can, quite often, be mistaken for ADHD (more so than SPD).  Many of the symptoms of ADHD and CAPD are identical - the differences are very slight but the treatment is very very different.  If you want to rule out CAPD, you would just need to have him screened by an audiologist who specializes in CAPD.

[beenmum]

Junk food and video games and having TV's in ones bedroom does not cause ADHD.

Her rules may be different from yours, but that doesnt make them wrong. Nor do you have the right to put him on any type of diet that would upset his mother.

On the other hand, if his father disagrees with his dx, then he could pay for a second opinion. Then both parents should work out a plan of action together.

But if it is to work, then the comepetition between the two households needs to stop. It seems a lot of blame is being put on this mother for doing things differently then you approve of.

Nothing you listed screams that this child is being ill cared for.

[VocalMinority]

A second opinion sounds like a good idea.  Esp. if Mom has ADHD, he might have it.  ADHD does not preclude a kid being very intelligent, or being able to stay focused on activities that hold his interest.  So nothing you've said ensures that he doesn't have it.  

However, I (and plenty of studies) agree with you that kids who spend too much time watching TV and playing video and computer games are more likely to exhibit "ADHD-type" symptoms than kids who spend plenty of time in nature, who get ample exercise and who are regularly expected to entertain themselves without video stimulation.  

You also seem to suggest that Mom expects ADHD behavior from him (perhaps because she expects it from herself), so she rewards him for not exhibiting it (perhaps because she needs such incentives).  And if he's really not ADHD, this might actually be an incentive for him to act like he is, so he can get rewards for perfectly normal, everyday behavior.

I can't remember if you said anything about diet, but the idea that it factors into kids' behavior seems like a no-brainer, to me.  I also think traditional school schedules - especially now that school days tend to be longer, to accommodate working parents - are not ideal for some boys and the fact that a boy (especially a smarter-than-average one) gets bored or fidgety by the end of the day does not necessarily mean he has ADHD.  PLUS he has to deal with trading weeks between two homes and constantly adjusting to a different set of rules - which some kids do effortlessly, but it's hard on others!  And he's only 8.  He may also be pretty upset about his parents not being together, even if he doesn't say so.

The problem for you guys is you're not capable of changing the conditions and parenting-style at Mom's house, if that's the root of the problem.  Even if you take DSS for a 2nd opinion, there are a lot of doctors out there quick to prescribe meds for kids.  I took my mildly-Autistic twins for professional educational testing, for their IEP and the guy "diagnosed" them as ADHD and wanted to prescribe meds!  Not only was that not why I was there, but their teachers were outraged and insisted these are NOT ADHD kids - they consistently get awards for good behavior and hard work, in school!  Keep in mind, he who prescribes meds is guaranteed repeat visits, to monitor how things are going...  

But if your DSS's teachers support a diagnosis and medication, fighting his Mom about giving him the meds will be a tough battle.  It's not like there's a blood test that can prove whether he should be on them, or not.  If you and your DH are convinced you're right, you should stand your ground.  Mom will stand hers.  You will end up in court or mediation.  And a third party will wind up making the decision.  You need to prepare yourself to accept it, if the decision is not what you want.  In fighting to keep him off meds, I'd also fight for some type of counseling that includes both parents, with the goal of testing environmental factors to see how they affect his behavior.  That way, a professional may suggest limiting video games, spending more time outside, changing his diet, etc... and she will be recommending it for both parents, in a scientific-seeming way, rather than your DH criticizing his ex and her defensively sticking to her guns about how she does things in her own home.

[2xy]

Peop;e can also appear to have ADHD when they're suffering from sleep disorders.