Help for ADHD?

[jdsf]

Not really sure what category to put this in as I don't think ADHD qualifies as special needs necessarily, but similar techniques for other disorders or conditions may be helpful here.

DD 11 is not diagnosed as I don't believe in medication for this condition in her case, but I'm pretty sure her memory issues are a symptom. What I need help with is that, specifically: she is very high functioning, so constant reminders only come off as nagging, but she only remembers to flush the toilet half the time (among other things) so I need some other techniques to get her to remember without coming off as condescending or "on her case" constantly.

She has check lists for things that are "check list-able", like getting ready in the morning and routines for after school, but I'm not really sure how to address the daily reminders to flush the toilet, put on her seat belt, etc. She is too old for clever songs or rhymes, so I need something that works on teens or adults. She also leaves things at school constantly and it is usually too late by the time she remembers, so I have her count what she goes in with but I can't remind her at the end of the day as she's coming out. Her school is split up in several small buildings and pick up happens at the main building, so by the time we leave the building will be locked by the time she goes back.

Has anyone tried any memory games or something that maybe inspire her to be more observant of things? I've tried everything I know, all the usual suspects, and nothing really works with her. She was evaluated by the professionals at her school since she was a late reader and they found no learning disabilities, so I'm thinking all the memory issues seem to be ADHD related. She also has no problem remembering things like her friends' parties or something she was told she would get, so it's definitely an inattention thing and not a general memory issue.

[blessedwithboys]

How about a note taped to the inside of the toilet seat lid that she will see when she lifts it up to sit down?  I had to do something similar to get my boys trained to put it back down before flushing!  haha  If one note isn't enough, tape another one on the wall opposite the toilet that she will see while she's sitting there.

I didn't medicate my ADHD-ish ds, who is almost grown now, but I kinda wish I had tried it.  He struggled a lot with attention and memory, still does.  We did other things like clean up his diet and even let him have a small coffee in the morning before school. 

Best wishes to ya!

[Jen Muise]

For things like this, we have had the kids make a small poster or note reminder and taped it somewhere that makes sense.  Sometime we need to replace it with something else if the kids get a little blind to it but the new behaviour hasn't fully taken root yet. 

[SpottedFoxx]

As someone with ADHD who was unmedicated as a child - notes don't really work - I was always too distracted to notice them.  There are very few tricks that will help with ADHD short of some sort of alarm that will go off and even then, you shut it off and as soon as you do that.... something shiny gets your attention.

How is she doing in school?   If it's not effecting her school work, then I'd say it's not a hill worth dying on.  However, if it is a problem at school, you may want to talk to several doctors (never just one) about medications and options.

I have a friend who's son was diagnosed with ADD this past fall.  His father was 100% against medication because it's "a crutch".  His mother wanted to try it.  I told her to ask her husband if his son broke his leg - would he not allow him a crutch then?  He finally gave in and agreed to try the medication.  After the first month, his mother she said "I don't think it's working - he hasn't changed - he's still the same kid".  I laughed and asked her how his attention was at school and she said "oh, it's wonderful!".  I explained that when the medication works correctly - that should be the only change.  

I bumped into her last night - she grabbed me and hugged me.  Her son's first and second reports cards were all d's and f's.  His report card yesterday.... all A's and B's!  He worked for it - hard.  However, that "crutch" gave him the ability to learn.  

So please please please, don't turn your nose up at medication.  I didn't have that "crutch".  Instead I was told I was stupid and lazy because I had such a hard time learning.  Nope, just a dyslexic with ADHD.

[melissa17s]

For ds, we did a couple of things to help which are unmedicated because some of ds's aed meds do not work with adhd meds. 1st, we started seeing a psychologist on a regular basis and she helped talk to ds about adhd and ways to work with it.  2nd we worked on using the psych's strategies. Routine and minimizing electronics are helpful.  3rd, took some advice from OT and got him an inflated seat cushion for school that helps concentration.  We also looked into toys, like fidgets and chewelry to help him focus some of the extra energy to concentrate.  In the end, we did change his aed, which help calm him down and besides disorganization, which is characterized by his teacher as normal for 5th grade, he is not having problems due to adhd behavior.   It is amazing how the brain is so effected by minor changes in the chemistry, so do not rule out meds as an option.  Consider working  with a child psychologist or psychiatrist to also develop skills to deal with impulse control and inattention, so that during the unmedicated times life goes on as usual.  

[queenjane]

As a previous poster said, I would really look at your decision to not medicate. ADD and ADHD *are* a special need, as they can really interfere with a child's life. Right now, it might not be a huge deal to leave the toilet unflushed or to leave books at school. But what about college? What about when she has an apartment and needs to pay bills? Or when she is running her own home and is faced with chronic disorganization because she just can't get it together enough to fold laundry, put dishes away, clean etc...? Obviously at that point, the decision to medicate would be hers, but i strongly feel that had i had meds for ADD when i was younger, i would have at least finished college. I'm really thinking about getting diagnosed and meds now because i see the areas in my life that i have so much trouble with. Of course you may have really good reasons for not medicating, and the choice is yours at that point but i wanted to provide a different perspective.

My dd has ADHD and her meds have really helped both her inattention and esp her hyperactivity (which manifested itself as very poor impulse control, overemotional outbursts, sassiness, clumsiness, tantrums etc)...we went from phone calls and emails at least weekly from the teacher, to not one complaint this year. Last year her teacher said "i dont think i can do this all year...." this year it was "she is a joy to have in class..." At home i went from wondering if i made a horrible mistake in adopting this child, to being able to get through the day.

Also as another poster said, if the meds are working appropriately you shouldnt see major changes in behavior other than the thing that needed to change. My dd doesnt seem to have any negative side effects. Sometimes it takes trying several meds to find the "right" one.

In terms of nonmed interventions....maybe posting signs up everywhere "Turn out the lights" "flush the toilet" "rinse out the sink after brushing" etc? I'm not sure if that would help but worth a try. With bringing school papers and such home, its helpful that my dd's teacher has a structured system....she has a folder she brings home every day with notices etc, and a friday folder that she brings home every friday with all her completed papers. Many of those things need a return signature so the teacher can keep track if the parent got it. I have her bring her folder and planner (where they write their assignments each day) home every day even if its empty. She has a house key in case im not yet home when her bus arrives, and i drill into her that she puts it immediately back into her backpack every time she unlocks the door. Every single thing in her room has a "place", and i have to stay on top of her to make sure her room stays tidy or its a pit.

[enkmom]

First of all, please get a diagnosis so that you can be sure that ADHD is what you are dealing with.  Also, diagnosis does not mean you have to leap immediately to medication.  A diagnosis will help you get the help you need from school.

For school issues, I had success for some years giving my daughter a planner.  The teacher was on board, and she would make sure my daughter had written down any work to do and that she had all the necessary resources in her bookbag before she left school.  Have you talked to her teacher(s)?  What is her desk like?  Does she have trouble with the social cues and seem to be on the edge of the social scene?

For home, there were some battles I chose to fight and others I let go.  She could keep her room however she liked, as long as there were was no food in there and she put her laundry in the hamper when I asked for it.  Otherwise I just shut the door.  I never gave multi-step directions, and I always made sure she was looking at me when I spoke to her.  I would touch her on the arm and hold her gaze when she looked at me.  This helped a lot.  Of course the car didn't move until she put on her seatbelt, and I would call out "seatbelts everyone" when we got in.  Our main problem was shutting the silverware drawer, and I would make her go shut it every time she left it open. 

I do hope you will keep an open mind about medication.  If she does indeed have ADHD, it doesn't get easier as the child gets older.  In fact, lots of the time it gets harder and harder to cope, and the child is miserable.  My daughter was diagnosed in 3rd grade, but she was absolutely unable to keep up socially or in school when junior high came around and she had that many more things to keep track of.  She started medication at 13, and it was like someone flipped a switched.  She could manage her own life, and she was so much HAPPIER! It is not easy to feel different, and I know I was short with her lots of times over things she absolutely couldn't help.

[Jen Muise]

I agree with getting a diagnosis,  There are a bunch of things that look like ADHD but aren't, from sleep disorders to learning differences to sensory issues to boredom.  It can be hard for a trained clinician to tell the difference without testing.  It would be a shame to be treating your kid with ADHD solutions when what they need really is LD support or something. 

[jdsf]

Thanks for the replies and concern. DP is an Autism specialist and works with kids with multiple disabilities, and I also worked in Life Skills for a few of years, so we're pretty experienced in the SN area. She does GREAT at school. Amazing. Top of her class. She is a little on the anal retentive side, so it's not like she's disorganized or messy. She's just off in her own little world most of the time and not paying attention to the real one. The reason I'm not pushing for meds is because I don't want her to lose the things that make her so special, and I've seen a lot of kids medicated to the point where side effects are pretty equal to benefits. The way her brain works, I can tell she will be affected, but if it were holding her back, I would consider it. She is able to focus when she needs to. I am exactly the same way.

So far as the future goes, I think as long as she stays here for college, she will be fine. She is on top of half the things in her life, she just needs a little help with the rest. I think she is less emotionally mature than her peers but once she "grows up" a little, I have faith she will manage things. I would like her to go to the school her older sister goes to for HS, so that's the main impetus for trying to jog her memory. I know she will get into a good school, but I want her to get into the best one.
 

[Emmeline II]

Originally Posted by jdsf 

DD 11 is not diagnosed as I don't believe in medication for this condition in her case, but I'm pretty sure her memory issues are a symptom.

Diagnosis does not = medication. Memory issues can be symptoms of several different conditions; that is what evaluations help determine.

Quote:

Originally Posted by jdsf 

DP is an Autism specialist and works with kids with multiple disabilities, and I also worked in Life Skills for a few of years, so we're pretty experienced in the SN area. She does GREAT at school.

Great, then you won't have to spend time just trying to understand an evaluation, but I still think you should have an evaluation from outside your family. Aside from the bias we have towards our own family, if your DP works daily with Autism and kids with multiple disabilities then more subtle issues in her own child could be overlooked.

The reason I'm not pushing for meds is because I don't want her to lose the things that make her so special, and I've seen a lot of kids medicated to the point where side effects are pretty equal to benefits.

I'm on both sides of the ADHD fence. If an ADHD medication is causing personality changes in a child then it is the wrong medication. If the side effects are equal to the benefits, then don't continue. I don't see how other parents may handle ADHD medication has any bearing on whether you think it would benefit your child ; I've seen posts by parents that change a medication that they think is working well because the Dr. isn't satisfied, or want to change a medication/dose but are pressured not to/or the idea is simply dismissed by the doctor and they don't feel they have the right to protest--nothing to do with the medication, just the circumstances in which it is prescribed...and sometimes the side effects from a medication are still the better option to what happens with no medication --unlikely in this case but it happens. Medication is a cost/benefit issue, but just because you get the end result you want without medication (like good grades, no behavior issues) doesn't mean it isn't costing her. I had to work a lot harder than an unaffected person to get the same results before medication.

I've also learned that "that is how I was/am" is a poor diagnostic tool; it could very well mean that you have an undiagnosed issue.

Edited by Emmeline II - 4/19/12 at 9:25pm

[Linda on the move]

I just don't see how not flushing a toilet or being together enough to buckle her seat belt make her special. As far as holding her back, what impact do these things have on her peer relationships? Does she spend the night with other kids? Go to camp? Is she going up and becoming appropriately independent, or is she stuck being treated like a much younger child?

These sorts of things do hold children back. Life skills, social skills, and independence are as important as academics.

[enkmom]

Linda on the move is right.  I thought my daughter was just a "dreamer" or a cute little "space cadet", but when I really opened my eyes I saw that she was being left further and further behind socially.  Teen girls don't want to hang out with the girl who forgets to flush the toilet.  The academic part was a secondary  part to getting a diagnosis for us. 

I would love to discuss this with you, but I am concerned I will come off like I'm lecturing.

[jdsf]

In addition to doing great at school, she is also the most popular girl her age and has plenty of friends, half of which she finds annoying or babyish or otherwise not cool enough to hang out with outside of school, so I'm not worried about this issue holding her back socially, either. She does remember to flush the toilet at other people's houses, she is always a perfect angel at other people's houses as well because she cares what people think about her and would hate to tarnish her reputation.

I have talked to her about the memory issues and asked her if she felt like she needed help, if she needed to talk to someone about different things she could try, and she said "I can do it if I want to" and that she didn't want to take medication if there was a diagnosis. She admitted that she is off in her own world when she forgets things, it's not that she couldn't remember it if she was actively trying to. If the parents don't want it AND the child doesn't want it, I don't see the need to push for a diagnosis. However, if we really felt like it was holding her back, we would.

Anyway, she goes to a school with a lot of specialists and counselors who deal with LD and behavior issues, a couple of years ago I asked them to check her out for anything that might be causing the memory issues, and, of course, she passed with flying colors. The last time we went to the doctor, I told him about the issue and he tested for anything medical that might be affecting her short of a CAT scan (which he saw no reason for given this was an isolated issue) and everything was normal. I also talked to him about the possibility of ADHD and he recommended holistic treatments and dietary restrictions before we considered medication given that her symptoms are so mild. She is a very picky eater but we limit her sugar/carb intake and force her to eat as many veggies as we can, which is way more than any non-vegetarian child is probably eating in this country.

I was also evaluated for ADHD but the actual issue is my inability to test well, which I think she has a little of but not to the extent that I do. Last I checked, test anxiety isn't something they medicate for. I think we are both just incredibly left brained to the point where it looks like ADD but it's not.

[Jen Muise]

wait a minute, I thought that ADHD/ADD meant that they can't focus even if they want to?  If she can remember some places but not at home, doesn't that selectiveness mean she *is* in control?

[melissa17s]

Originally Posted by jdsf 

I was also evaluated for ADHD but the actual issue is my inability to test well, which I think she has a little of but not to the extent that I do. Last I checked, test anxiety isn't something they medicate for. I think we are both just incredibly left brained to the point where it looks like ADD but it's not.

If it is true ADHD, then food will not change it.  

If she has an issue with test taking, and her performance is compromised, then ask the school to evaluate her.  They can not dx or give her drugs, but what they can do is help her in the classroom.  

[Azik's mom]

Originally Posted by Jen Muise 

wait a minute, I thought that ADHD/ADD meant that they can't focus even if they want to?  If she can remember some places but not at home, doesn't that selectiveness mean she *is* in control?

If she is only not remembering when at home then this is something to look into.  I have a LO who seems to have memory issues too but he is much younger.  Our OT suggested that we try positive reinforcements; she said it has to be something that really counts.  So we have been doing that and it seems to be working (its still to early to tell.)  Perhaps you can also journal her memory/ forgetfulness and see if there is a pattern.  Since there are times when she does remember is that something going on or not going on that causes her to be not so forgetful?

I recently read a book called Simplicity Parenting.  Its not about ADHD but about things we can do at home to simplify things and some of these have proven helpful with children who have some ADHD traits.  It might be worth a try.

[Emmeline II]

Originally Posted by jdsf She was evaluated by the professionals at her school since she was a late reader and they found no learning disabilities, so I'm thinking all the memory issues seem to be ADHD related....Anyway, she goes to a school with a lot of specialists and counselors who deal with LD and behavior issues, a couple of years ago I asked them to check her out for anything that might be causing the memory issues, and, of course, she passed with flying colors....

I would not rely on the school's evaluation. I recommend doing a private neuroeducational evaluation.

If the parents don't want it AND the child doesn't want it, I don't see the need to push for a diagnosis. However, if we really felt like it was holding her back, we would.

Well, you posted because this is causing problems for her at school and at home; I think it would be better to have more information (via an evaluation) and seek outside help (such as a behavior therapist or "coach") with that information in hand. Obviously the school doesn't think she has a problem so you may need an outside opinion to get more formal school support in place.

[melissa17s]

Originally Posted by Emmeline II 

I would not rely on the school's evaluation. I recommend doing a private neuroeducational evaluation.

Well, you posted because this is causing problems for her at school and at home; I think it would be better to have more information (via an evaluation) and seek outside help (such as a behavior therapist or "coach") with that information in hand. Obviously the school doesn't think she has a problem so you may need an outside opinion to get more formal school support in place.

I don't know.   I think evaluation outside of school will be expensive and yield little results especially since jdsf stated they are not interested in testing.  I am not really seeing the ADHD except some with the memory, but is not enough to impair her, if it is adhd.  Maybe enroll her in a martial arts program or an exercise program.  Both are good form of natural treatment for ADHD and are great for kids with out ADHD, too. 

[blessedwithboys]

Originally Posted by Jen Muise 

wait a minute, I thought that ADHD/ADD meant that they can't focus even if they want to?  If she can remember some places but not at home, doesn't that selectiveness mean she *is* in control?

No, it doesn't mean the child can't focus at times.  Something that is especially engaging, like a favorite TV show or video game, can keep a child with attention deficit entertained for hours.  This varies from one individual to the next, of course.  It doesn't indicate "control".

[SpottedFoxx]

Also - some people with ADHD can become hyper-focused as seen with television and video games and even books.  You could set off a bomb next to my husband during a video game and he wouldn't flinch but other activities he'd be so scattered.

My ADHD makes me an amazing multi-tasker which means I can focus incredibly in short bursts but anything that requires longer attention, I really struggle.  I can do it but it's not easy.  Medication has only changed my ability to focus.  I can still multi-task like nobody's business but when I need to focus longer, I can.