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School admin pushing to get my DS evaluated...please advise - Page 2

post #21 of 30

Thanks for your detailed reply.

 

On a quick note, i do not believe that professionals, whether they be teachers,  doctors or psychologists, are out to get  my child so to speak. I just have a basic threshold of conviction  that needs to be crossed.  Contradictory evidence needs to be explained not ignored. (in your case, it looks like it was explained) . I dont trust professionals, unless they  make a proper case, which they often dont. I apply my skepticisim everywhere, to professionals, and to anyone, or anything, because truth is important to me. 

 

From your post i see that your son was different  than my son at home. I rarely see  behaviors that i consider adhd like, unless when applied too listening and comprehension skills. He has always been good with transitions for eg, and very quick at getting ready to leave. My skepticism only deepens the more i look into it. For eg, adhd is so multifaceted that anyone could qualify, even skepticism itself could be considered a symptom of adhd.(in a child it might be construed as oppositional)

(i just read this webpage which outlines different adhd types http://newideas.net/different-types-adhd)   Its hardly surprising that adhd patients respond differently to adhd medication.(This just  shows me that they are suffering from different conditions that are all labelled adhd)

 

If however,  my  ds2, not the subject of this post,  was labelled with adhd, i wouldnt for a moment doubt it. But he is not having problems at school, so his behaviors, are irrelevant. Of course, this again, increases my skepticism.

 

I think adhd is a convenient label, that is accurate for some, and not for others. Im still waiting to be convinced otherwise.

 

I am not trying to argue that adhd doesnt exist...just trying to understand my own son better, and hope this also helps the OP.

 

My son clearly does have problems in the classroom-i wonder if  the medication that worked for your son would work for mine.  I wonder if auditory perception is improved with medication  designed to increase focus  and attention in general....i would love that!


Edited by contactmaya - 2/17/14 at 1:46pm
post #22 of 30
Quote:
Originally Posted by contactmaya View Post
 

Its hardly surprising that different adhd patients respond differently to adhd medication.(This just  shows me that they are suffering from different conditions that are all labelled adhd)

 

While I agree with most of what you wrote, I don't think that the conclusion you've drawn above is necessarily valid. Variability in drug response is the norm in all areas of medicine, whether psychiatry, cancer chemotherapy or anything. I can take a hundred people with clearly documented hypertension, and treat them all with one of a broad class of drugs, and get perfect results with some, very little if any change in BP from some of them and a whole range of side effects from others. That doesn't necessarily mean that they are suffering from different conditions that are all being lumped under the misnomer, non-entity or mistaken label of hypertension: it simply means that hypertension is a complex multifactorial affliction and/or that there are differences in people's internal biochemistry and metabolism that are responsible for variability in response.

 

I do think that a fair number of kids diagnosed with ADHD likely have other issues that happen to look like ADHD. But I don't think that a variability in response to ADHD meds is sufficient to prove that. 

 

Miranda


Edited by moominmamma - 2/17/14 at 4:42pm
post #23 of 30
Quote:
Originally Posted by moominmamma View Post
 

 

While I agree with most of what you wrote, I don't think that the conclusion you've drawn above is necessarily valid. Variability in drug response is the norm in all areas of medicine, whether psychiatry, cancer chemotherapy or anything. I can take a hundred people with clearly documented hypertension, and treat them all with one of a broad class of drugs, and get perfect results with some, very little if any change in BP from some of them and a whole range of side effects from others. That doesn't necessarily mean that they are suffering from different conditions that are all being lumped under the misnomer, non-entity or mistaken label of hypertension: it simply means that hypertension is a complex multifactorial affliction and/or that there are differences in people's internal biochemistry and metabolism that are responsible for variability in response.

 

I do think that a fair number of kids diagnosed with ADHD likely have other issues that happen to look like ADHD. But I don't think that a variability in response to ADHD meds is sufficient to prove that. 

 

Miranda

Intersting point. I think the example you raise shows that treating symptoms rather than the cause,  is  often not the best way to treat the disease,  whether hypertension, or symptoms that look like adhd. At a guess,  I would say that a different response to the same medication is a result treating symptoms.  

post #24 of 30

While on the subject, i came across this article, which clarifies some issues for me.

 

http://vitalitymagazine.com/article/homeopathy-for-add-adhd/

 

 

 
 
<<...Dr. Richard Bromfiled, Ph.D. of Harvard Medical School explains: “ADHD exists as a disorder primarily because a committee of psychiatrists voted it so. In a valiant effort, they squeezed a laundry list of disparate symptoms into a neat package that can be handled and treated.” 

......Having a hyperactive or disruptive child who has difficulty learning is certainly a legitimate cause for concern. The problems arise from the arbitrary diagnosis and suppressive treatments used to address the condition. The clinical diagnosis of ADHD, based on the DSM IV, is an intricate task. It involves a careful examination of the child’s medical and developmental history, observations of their behaviour over a sufficient time period (at least six months) and the administration of different neuropsychological tests. “There is a great deal of evidence for co-morbid conditions and the so called mimic syndromes (i.e. conditions that look like ADD/ADHD but are clinically different in their etiology, treatment, and prognosis). Consequently, the clinician must consider several sources of information besides the developmental history from parents to piece together the puzzle to sort out which characteristics are primary, and which ones may be secondary and tertiary problems. Such a multi-level analysis will frequently lead to a multi-component treatment program that addresses each significant component."
- See more at: http://vitalitymagazine.com/article/homeopathy-for-add-adhd/#sthash.kXsDt2Uv.dpuf....>>
post #25 of 30
Quote:
Originally Posted by Geofizz View Post
 

To be clear, you, me, and the OP aren't in the classroom seeing what's happening.  Nor is the pediatrician.  The teacher is very clearly frustrated and is documenting his behavior.  "The teacher clearly doesn't want to deal with a typical 7 year old," is not something I'd yet assert at this point.  The pediatrician does not have sufficient data at this point to assert that he's a "bored typical 7 year old boy."  I see three hypotheses here:  (1) bored typical 7 year old boy, (2) a boy with ADHD, or (3) ADHD + bored.

 

Only a specialist with experience distinguishing the three can really make the distinction.  Pediatricians typically don't have the background to make this distinction.  Once the specialist has made a distinction between these hypotheses, then the discussion should shift to how to address it: different educational environment (e.g. differentiation/acceleration), behavior modification, medication, or a combination.

 

Yes, this!  There is really no way of knowing if the teacher's making something out of nothing without having an expert do an evaluation.  It could be boredom or ADHD or both.  I would get a referral to a pediatric neurologist or psychiatrist and see what they have to say about it.  

 

Also, I wouldn't dismiss the teacher just because he doesn't do the same things at home.  School is a different environment, for one thing, and for another, even if we don't realize it, we as parents are really quite used to our children and have a much harder time seeing some of their quirks the way others do.

 

I also would not discount the teacher's reports just because she is a first year teacher. For one thing, she had to spend at least 3 months and up to a year as a student teacher, so it's not like she just walked in off the street. For another, even if she was a brand new teacher off the street, she'd certainly have a very good idea at this point in the year what behavior is unusual. She just may not have a good sense of the cause of the behavior, or the experience to adjust that behavior effectively.

 

In a nutshell, I'd get the eval, but not with the school's person.  Get your own.  And don't rely on your pediatrician for the eval. S/he is not an expert in ADHD, and you want someone who is.

post #26 of 30
Quote:
Originally Posted by Aufilia View Post

 

Also, I wouldn't dismiss the teacher just because he doesn't do the same things at home.  School is a different environment, for one thing, and for another, even if we don't realize it, we as parents are really quite used to our children and have a much harder time seeing some of their quirks the way others do.

I agree with most of your post except this. Sometimes the 'quirks' seen at school simply  dont exist at home.  This is the case with my son.  Parnts understand their kids better than teachers. But school may bring out different aspects to the child. Sometimes that means school which is after all an artificial environment, just isnt the right place for that child.

post #27 of 30

We went through this last year (DS was in 1st grade).  A typical eval consists of a teacher with her view on behavior, your view on the child's behavior and then the dr or psychologist on their view.  We used the school psychologist for testing (remember a psychologist has a phd and can not prescribe medication, a psychiatrist is a medical doctor and is more likely to do so).  If you are not comfy with that, find a psychologist with a specialty in educational testing.  Part of an eval for ADHD is an IQ test.  There are 3 forms of ADHD - Hyperactivity, Inattentiveness, and Impulsivity - most kids exhibit 2 of the 3 (DS is inattentive and impulsive).  He also has a high IQ.  We have worked with the school and have an IEP in place to help him at school.  He is not medicated.  The private LCSW we took him to to help with some behavior mods and help with transitions told us she would not recommend medicating unless his behavior was a threat to himself or others or his ADD was a significant barrier to learning.

 

Our experience is that he tends to exhibit impulsive and distracted behaviors more when he is bored and during transitions, so we do our best to help him stay engaged.  Things like allowing him more leeway in the topics of his writing assignments, using a stop watch to see how fast he can do a math worksheet.  Allowing privileges (like reading aloud to the class or helping the 1st graders, extra trips to the library, etc) when he stays on task and completes his assignments.  Some days are better than others.  

 

We did not see anything "different" about our son, but both DH and I are GT.  Also the change in environment will bring out stressors that did not exist before.  We also found that a lot of the structure and parental guidance tips for ADHD kids were things we already did at home, so we were already helping him in the home environment without even realizing it.

post #28 of 30
Quote:
Originally Posted by anj_rn View Post
 

We went through this last year (DS was in 1st grade).  A typical eval consists of a teacher with her view on behavior, your view on the child's behavior and then the dr or psychologist on their view.  We used the school psychologist for testing (remember a psychologist has a phd and can not prescribe medication, a psychiatrist is a medical doctor and is more likely to do so).  If you are not comfy with that, find a psychologist with a specialty in educational testing.  Part of an eval for ADHD is an IQ test.  There are 3 forms of ADHD - Hyperactivity, Inattentiveness, and Impulsivity - most kids exhibit 2 of the 3 (DS is inattentive and impulsive).  He also has a high IQ.  We have worked with the school and have an IEP in place to help him at school.  He is not medicated.  The private LCSW we took him to to help with some behavior mods and help with transitions told us she would not recommend medicating unless his behavior was a threat to himself or others or his ADD was a significant barrier to learning.

 

Our experience is that he tends to exhibit impulsive and distracted behaviors more when he is bored and during transitions, so we do our best to help him stay engaged.  Things like allowing him more leeway in the topics of his writing assignments, using a stop watch to see how fast he can do a math worksheet.  Allowing privileges (like reading aloud to the class or helping the 1st graders, extra trips to the library, etc) when he stays on task and completes his assignments.  Some days are better than others.  

 

We did not see anything "different" about our son, but both DH and I are GT.  Also the change in environment will bring out stressors that did not exist before.  We also found that a lot of the structure and parental guidance tips for ADHD kids were things we already did at home, so we were already helping him in the home environment without even realizing it.

Thanks for your helpful post.

post #29 of 30
Let them pay to have him evaluated - have them do a whole psychoeducational assessment including IQ etc. Its not cheap to do it on your own, so might as well have them pay if they are pushing for it. The school was trying to push the ADHD thing on my son too and i called a ppt and had them do IQ and behavior testing. As much as they were hell bent on him having ADHD or ODD, the test results (from their own testers) showed no clinical evidence, in fact their tests supported our theory to them that he was acting out out of boredom.

Unfortunately even with the data about his IQ available they have been unwilling to accelerate him in any way and we continue to have the behavioral issues. Get as much data as you can as you will need it down the line of you are looking to have any type of differentiation or acceleration for your son.
post #30 of 30
Quote:
Originally Posted by natlav View Post

Let them pay to have him evaluated - have them do a whole psychoeducational assessment including IQ etc. Its not cheap to do it on your own, so might as well have them pay if they are pushing for it. The school was trying to push the ADHD thing on my son too and i called a ppt and had them do IQ and behavior testing. As much as they were hell bent on him having ADHD or ODD, the test results (from their own testers) showed no clinical evidence, in fact their tests supported our theory to them that he was acting out out of boredom.

Unfortunately even with the data about his IQ available they have been unwilling to accelerate him in any way and we continue to have the behavioral issues. Get as much data as you can as you will need it down the line of you are looking to have any type of differentiation or acceleration for your son.

 

This is a good point, if the school tells you that he must have an eval, then they may on the hook to do it or pay for it. That said, I would do it privately if it's financially feasible and then send them the bill and cross my fingers. The IQ test the school psych did last fall on DD was literally the most worthless and unreliable test DD's ever had done. They came up with a 48-point difference between verbal and non-verbal IQ and didn't care because they only needed it to check off a checky box on her IEP. I have considerably greater confidence in the reliability and quality of the non-school-associated professionals I've selected myself (and I also don't have to worry about them having an agenda).

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