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Parents of ADHD Children

Still not convinced it's ADHD...

My 6 year old started to have huge behavior problems at school last fall—big, angry outbursts primarily with some refusal to do work when he felt incompetent doing it or it was really boring.  He was also placed a a multi-age level class where he did a lot of independent, quiet seatwork.  I think that was really not working for him.  There was no history of major difficulties in Kindergarten.  Also, he is a gifted learner and receives enrichment programming at school.  When I finally convinced school to move him to a regular, first grade only class for the last two months of school, things went much, much better so I know much of it was environmental.  The problem is, it’s moved out of just the school setting to home as well now.

I had a psychologist evaluate him in November, as I have another son on the autism spectrum and wanted to rule that out right away.  She diagnosed as ADHD impulsive type.  We tried Quillivant XR with him at two different dosages.  He showed no improvement in behavior—if anything he was even more irritable plus he wasn’t eating and sleeping well at all.  We switched to Intuniv and he has shown some improvement, but his psychologist feels it is not working well enough.  In the meantime, he’s also developed depression.

I’m having a hard time seeing the ADHD in all of this, though.  He isn’t what I would consider “hyperactive” in fact, since this all started he hasn’t really wanted to do much of anything but watch TV and play video games.  He’s stubborn and has difficulty with transitions.  Mostly he’s just really irritable and the slightest little thing sets him off.  He has huge reactions to most everything—I guess that’s the only place I really see impulsivity.  He can only handle so much of a boring or unwanted activity and then he’s “done” and he’s emotionally immature. 

I worry that the fact that the stimulant medication didn’t help means that this isn’t ADHD at all, but something else.  I really don’t know what.  Am I crazy here?  I’d love to hear other people’s experiences…

Jennifer

Replies

The diagnosis of ADHD is complicated given the often numerous co-occurring conditions. Very rarely does ADHD exist on its own. There are also various symptoms that fall under the categories of “Inattentive” and “Hyperactive” that cross over to encompass the entire diagnosis.

In many ways your son sounds very much like mine in regards to certain Inattentive ADHD characteristics: high emotional reactions, is in the gifted program, difficulty changing activities, getting bored easily, in addition to the fact that when I changed my son’s school from one to another he seemed to be doing better for a while. It didn’t last however. He was also diagnosed with autistic tendencies. It can feel like there is one label that always follows another, but that just goes to show how complicated the condition is.

Stimulants, and nonstimulants, can have such negative side effects that finding the right medication, at the right dose, given at the right time, that will works best for your child can take time. It’ is so important for their well-being that you figure out what is the most helpful. I’m grateful that we were able to since the positive results of the medication have been life-changing for my son.

After all of the difficulty that can accompany diagnostic labels I’m a big one in favor of ultimately focusing on treating the symptoms which is what we all want for our children.

Posted by Havebeenthere on Aug 04, 2014 at 9:01am

Hmmm. Autism and ADHD are very similar. Have you thought about taking him to a developmental pediatrician? They might have some insights,which could make your fuzzy picture clearer. We took my son to see a develop mental pediatrician at the Melmed Center in Scottsdale, Arizona after he was evaluated by a psychologist. The doc helped us a lot. It was 250 miles one way, but worth it. I don’t know where you live, but if there isn’t a developmental pediatrician in your area, you could probably contact the Melmed Center for a referral. I think they do that. You can reach their website through google. You could also try your insurance company’s provider directory or just google developmental pediatricians in your area.

I hope this information is helpful to you.
Sue H in PC, Ohio

Posted by SueH on Aug 04, 2014 at 1:51pm

Thanks to you both for your helpful replies. 

We do have an appointment with a neuropsychologist in late September (scheduled for him in April—yikes!) because his pediatrician was concerned about the autism history in our family.  He certainly has both similarities to and differences from my son who has autism.  I’m really not convinced either way.  Some days, it’s hard not to worry about it, though.  Especially since I don’t know any other ADHD kids who look like my son.

We’re seeing a new psychiatrist in a couple of weeks and I hope that she will find a medication option that will help him more.  It’s nice to have some parents to “talk” to, even if we’re not face to face!

Jennifer

Posted by jlemke-p on Aug 04, 2014 at 2:20pm

There are two classes of stimulants for ADHD: methylphenidate and amphetamine (http://www.additudemag.com/adhd/article/9875.html). Your son tried a methylphenidate. The psychiatrist should know to now try an amphetamine and see if he reacts better. Many people do better with one class or the other, a few benefit from both.

An individual can certainly have ADHD without any hyperactivity (http://www.additudemag.com/adhd/article/8144.html). I could relate to each symptom you described - seeing them in my son’s ADHD as well. Each individual’s ADHD presents in a unique way, so he can have ADHD but not be exactly like others you know with ADHD.

It is good to follow your gut and look into it further with specialists—they can either confirm your suspicions and start a new path, or they will confirm ADHD and you’ll be able to let go of questioning the diagnosis and focus on treatment.

Penny
ADDconnect Moderator, Author & Mom to Tween Boy with ADHD and LDs

Posted by adhdmomma on Aug 04, 2014 at 2:46pm

When my son was in kindergarden he would roll on floor during carpet time. When he was in 1st grade he had trouble completing his work so I got him tested and they determined he had ADHD the combined type. My son can get into a hyperfocus state where he can focus for a long time on something he likes.

Posted by Chelley on Aug 04, 2014 at 2:49pm

I’ve been following this thread. I don’t rly have any advice, I just wanted to say I’m going through a similar thing. My daughter is also 6. She will be in first grade and was dx at age 4. However at age 3 she was dx with PDD NOS, which was then proved wrong and was decided it was ADHD instead. Sometimes I’m still unsure about whether she does not also have PDD NOS or something similar, as well. It’s so confusing had mentally exhausting. My son is 5 and I have similar concerns.

Posted by Les_Etoiles on Aug 04, 2014 at 3:28pm

Keep digging.  You know something is going on.  Explore every avenue you can, don’t discount anything at this point.  Every kid is different with ADHD symptoms.

I had both my sons have full psychological and academic evals, to really get a clear picture.  Also, work with the school for support for him.  Talk to his teacher and the principal about his behaviors ahead of time.  They can do evals too, but don’t depend on them for a diagnosis.  The teacher can implement some accommodations in the meantime to help you and your son work through this.
Good luck!

Posted by Pdxlaura on Aug 05, 2014 at 2:52pm

Unfortunately, school has been completely unhelpful.  They seem to feel this is all behavior and don’t understand the underlying neurological component.  There has been little help given because they think he’s choosing to act this way.  We have been refused both an IEP and a 504 plan.  I’m hoping this fall, with a different teacher, we may get some of the support we need.  It’s been a long and ugly year for us. 

I agree with you that further evaluation will be helpful.  Just wish there wasn’t a 6 month wait!

Posted by jlemke-p on Aug 05, 2014 at 3:44pm

My son was diagnosed with the combined type of ADHD, which includes the hyperactivity side of it.  My son’s hyperactivity shows in the form of fidgeting, talking nonstop, or chewing.  He’s been a chewer since he got teeth!  Before his diagnosis, I never thought of any of those things as “hyperactive”...I always thought of a hyperactive child as one who “bounces off the walls”.  If I allowed him, my son would do nothing but watch TV and play video games because it’s the one thing he can absolutely focus on for hours without difficulty.  But I agree with previous posters who say keep digging until you find the answers. 

On a side note - My BF’s son was diagnosed with and treated for ADHD for years before it was realized he actually had Asberger’s.  He just turned 21 this years.  Both conditions share similar symptoms. 

Take care!

Posted by KWalling on Aug 06, 2014 at 3:12am

I haven’t read your post in full nor any of the comments yet (I will go back and do so) but I thought I’d post this in case it’s helpful: it’s a list of 20 conditions that mimic ADHD.

http://wakeup-world.com/2014/05/29/20-health-conditions-that-mimic-adhd/

Posted by OopsForgotAgain on Aug 06, 2014 at 4:41am

Ok so now I’ve actually read the thread (lol) and want to post this:

http://www.amazon.com/The-ADHD-Autism-Connection-Diagnoses-Effective/dp/1578564980

SUCH a good book. It made so much sense to me when I read it. My son’s school thought he had Autism, which was ruled out by actual diagnostic professionals (I have a pet peeve against our school staff trying to be doctors when they’re not, but that’s another issue, lol). Anyway, since the beginning of our journey with the school my son has now grown and developed to the point where it’s abundantly clear that he’s never been on the spectrum. So how did the school get it so wrong? I read “The ADHD Autism Connection” and the light bulbs started going off. Ah, that makes sense.

Anyway, this comment of mine is basically in response to and in support of SueH’s comment about Autism and ADHD being very similar. It’s so true. The difference lies in the diagnostic criteria… however the behaviors and characteristics can be so similar that there are kids who are misdiagnosed either way.

Posted by OopsForgotAgain on Aug 06, 2014 at 4:49am

Have you had him checked out by an eye dr? My dtr has apd and we’ve learned she has visual processing problems as well. BUT with all my reading about visual therapy ...I’ve leaned that kids can be misdiagnosed as ADHD when they have a vision problem. Going to have my oldest son tested for vision therapy ( officially diagnosed ax ADHD).

Posted by Starla571 on Aug 08, 2014 at 4:25am

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