So, we started with a new SLP yesterday and, for the third time, someone made the comment that Evie seems to have ADD. No one's ever mentioned this for Abigail. We see it too - Evie simply cannot follow through with very simple tasks due to distractibility. I can ask her to put away her shoes, and she'll get lost on her way to the closet and end up drawing a picture, dressing a stuffed animal and helping herself to a drink and finally wander back with her shoes still in her hands. I'm not sure that this is executive planning problems, because she's capable of age appropriate execution of tasks that she has interest in. It could be social in nature (i.e., why the heck should I follow through with what you ask of me?). Abigail does not seem to be affected with this ADD behavior.
Of course, Evie can focus for a long time when she's interested in something - she'll draw uninterrupted for up to an hour, she'll play dressup games with her sister, she stays very intently focused on stories, does well in circle time, loves art projects and the like, etc. - but if she's not interested, she has a very hard time staying on task.
I know ADS is almost a superset of ADD and that most of our kids have it in some degree. My question is, should we seek a more formal, professional evaluation for the girls (other than the school's ASD assessment) in order to get the break down of specific diagnosese and treatment recommendations?
I know that there are effective ADD medications (right?). DW, in typical form, mused that maybe Evie is just real severe ADD and not actually autistic and maybe if we get her on medication, she'll improve :)
I'm anti-medication in general, but I have heard stories of ADD kids who improved a LOT with medications. It's not a huge problem - just an annoyance, currently, but I do wonder if this distractibility is keeping her from learning as well as she could be - just wondering if I should seek a professional's opinion. I'd almost certainly not medicate her unless someone could say that yes, this would help her learning. The behaviors by someselves are not so severe that I'd want to medicate her for it.
Thoughts?
Hmmmm ... T's SLP addressed the ADHD in her therapy.
I have heard the meds can be very uncomfortable. I lean toward anti-meds, myself. But we all wish there was a magic pill ... and, sometimes it just plain gets better with age, too, Fred.
I have tried to find more info on behavioral therapy for ADHD so wil lbe interested in others' replies!
I didn;'t realize that ADD could be addressed behaviorally. I thought they just put the kids on stimulants and they got better :). BTW - no one has suggested we do this - just curious.Me, too :-)
SLP used to push her attn span a little at a time. It DID work. She focused for longer periods! No idea about how it works as they get older.
Mason's dr wanted to try him on meds when he was 4 and I refused...I thought that was way to young to be starting ADD meds!
Here is a list of things she told me to do with him to help attention and organization problems---
1. Obtain good eye contact prior to delivering directions. It may be helpful to place a hand on his shoulder or arm. Give 1 direction at a time to avoid attention from wandering. Use simple and numbered steps if needing to deliver more complex directions.
2. Organize materials to be learned, it will reduce the feeling of being overwhelmed by the material.
3. Minimize distractions to the greatest extent possible. (e.g. seating at the front of the classroom, increased 1 on 1 contact.)
4. Assign tasks, chores or classroom duties that can be successfully completed and use positive reinforcement. gradually increasing the hardness of tasks.
5. Begin to "train" attention. To do this, they should create a set time and place at a table without distracters like TV or visible toys. Use a timer. Each day he should be asked to work at the table on tasks of moderate difficutly (e.g. worksheets or coloring) for a set amount of time, until the timer goes off. Following a successful completion of time focusing on 1 activity, he should receive a reward. The beginning time should be achievable such as 2 minutes...each day increase the time by 30-60 second intervals, until he reaches a goal of 15 minutes.
Now I know your DD loves to color and draw but possibly if you could find something a little different to do the training tasks that could help a lot! It helped Mason a lot! Mason still has a lot of distraction problems, but they are definitely better...your DD is so young that maybe with a little training it could help...I would hate to see her have to medicated so young. I really think the making eye contact helps a lot too for those litte chores around the house...I used to be a caller...I would just call out to Mason "put your shoes away" etc...now I put my hand on his shoulder, make the eye contact and tell him 1 thing at a time and very rarely do we get side tracked anymore!
Good luck, it will be interesting to see what others do!!
It has been noted that my five yr old has deficits in the area of attention andHi Fred,
My son has been diagnosed with ADD as well as his PDD-NOS. His distractability was so bad that he was diagnosed with ADD on the first visit to a pediatrician at age 4.5. The psychologist who did his private assessment (May 2006) suggested medication also upon the initial meeting with my DS (This is the same Dr that dx's him with PDD-NOS and verified the ADD diagnoses as well). Over two (2004 & 2006)years I hummmed and hawwwed over whether or not to medicate him. However, I finally came to the decision to try meds when I realized that in grade two in the regular school environment, he could NOT LEARN period. He actually started stimulants in the last month of grade two after 2 years in school and almost no academic success. He has been on medication (I tried quite a few combinations) since May 2006. Grade three for Jordan was a pretty successful year! He has caught up in a regular class environment substantially. He is less anxious and feels so much better about himself. His quality of life has improved so much, and I am grateful for my decision to try the meds in addition to all the other therapies in place for him.
I feel that our children already must deal with so much on a minute by minute basis, that if we have the chance to change their life for the better, whatever that may be, we must try it. If you try only behaviour management tecniques when the child can't pay attention...how will this work without spending copious amounts of time trying to teach them?
My son is still pretty distractible by the problems caused by his SID and ASD, however the medication has allowed him to pay more attention to every minute of his life, better than without meds. So his potential has increased since his ability to pay attention and learn has increased. He had the same teacher's aid in grade two as he did in grade three (one year without meds and one year with meds). She says Jordan has been such a joy to teach this year compared to his grade 2 year, and he won an award for the amount of effort he has put into his year!
My son is presently on: Concerta, & strattera
He was recently put on Luvox for his anxiety. This has really helped him settle down at night time so he can fall asleep. He has until now been horribly sleep deprived for years, which only magnified his problems.
My decision was not based on my own opinions or my good parenting abilities. It really had nothing to do with my opinions on medications, and their side effects or long term effects. Our opinions sometimes can cloud our judgement, SO I decided to try medication as per his psychologit's suggestion. I felt if a professional thought that meds could improve his quality of life, then perhaps I should try them.
That is really good advice. I'll add my 2c. My favorite description of ADD is that it is an executive functioning disorder in which the person knows what to do, but does not know what to do with what they know. If you tell her to clean up the family room before bedtime, that instruction may get no results. She needs to be told the steps so you show her the executive algorithm that you think of automatically, but she can't. So instead of clean up the room, say please put those puzzle pieces in that box, and when that is done say please put those pillows back on the sofa, and so on. With the positive reinforcement mentioned above, this helps to train the behavior. It also helps to map out transitions so she will know what is going to happen in the future so she knows what to expect.
About the medicine. I believe it is real hit and miss. Some as you suggest do great on this and removes most of the issue. Others try and try different medications and amounts without a good result. Seems like luck has a lot to do with it. Mostly these meds are stimulants that have other possible negative consequences so I'd suggest getting a careful diagnosis first.
Yeah, I'm not sure if she has it, going by Horseless's description. She can do these things, but just tends to get distracted and quits the current activity in favor of the new one - it's more like impulse control. If I ask her to clean the playroom, she'll start, then start playing with a toy. If I check on her, I'll see her playing with the toy, and she'll act like she's forgotten that I had asked her to do anything. I'll remind her, and the same thing will happen. Rinse, repeat. Finally, I start getting angry, and I'll threaten punishment and set a timer and explain in a grouchy voice that she needs to have it done before the timer rings, and usually that gets her going and she'll see it through. So, she *can* do it if the consequences of NOT doing it are severe enough - so, maybe this is more a social defecit problem rather than actual executive dysfunction AKA ADD. When my oldest son was your daughter's age, there was some question as to whether or not he might be ADD. It was even noted in his evaluation at Children's Hospital and in his IEP. I spoke with his pediatrician about meds and he was totally opposed to it. He did not think it was severe enough and he was concerned about my son's young age (5 at the time). He felt that as he matured and acquired better planning skills, it wouldn't be much of an issue. In 1st grade things started turning around and by 2nd grade there was no mention of it. In my son's case, it seemed to be more of a maturity issue.I mentioned this in another post .Mikey just had ADHD added to his diagnosis by his pediatrician due to his distractibility and hyperactivity.Evie sounds very much like Mikey when it comes to the distractibility but he is way more hyper than she is from the videos I have seen of her.I guess that is the H in the ADHD. He can't make it to his room to get something when directed.He has to stop to play with his toys,play with the cat and is pretty much distracted by anything that is in the way.Eventually I will have to physically and verbally keep prompting and directing him to the room until he does what is required.
His BT came up with idea of a velcro bracelet to put around his wrist with a picture of the task he needs to do.So its there to remind and redirect him on what to do since he can't really avoid the picture that is on his wrist and it would be a constant reminder like a string on a finger. We tried that a few times.It worked for a little while and then he just started taking them off.We have tried the time timer but he fixates on it so much he keeps coming back to look at the timer instead of doing his task.
We are also absolutely against meds but now I am starting to think we can't really address his ADHD issue without a drug intervention and with just behaviourial/social skills therapy alone.
Anyone had any success with any behaviorial/social skils therapy to address ADD/ADHD issues without meds?
autumn - do you have a cite for that - or is this just anecdotal? It might be useful information for convincing their mother that their diet should be cleaned up (it's pretty good, but they still get a lot of refined sugar and corn syrup, etc.).
Aryan - yes, she is not hyper - just has the 'attention defecit' part.
Fred my dh, ds, & dd all struggle with ADHD. It affects them all in different ways. My husband grew up in a poor family situation, so no one was really paying attention to his issues with ADHD (they all had it too, it wasn't an issue to them), but the thing is he is a real smart guy who did only fair in school. He hates to read and has a lot of trouble with promotional exams. He forgets things around home all the time. He forgets to keep the kids on task with homework and him doing the homework was his idea.
You are right to begin thinking about your daughters ADHD now to find a plan that works for her. My dd is extremely hyper and impulsive, she's 8. We've tried different meds wih her off and on and she's doing well on Adderall. My son is HFA and ADHD. He needs meds for his ADHD and does not do well on them. I have been told by the neurologist that ASD kids frequently have paradoxical reactions to stimulants. ADHD is a brain chemistry thing. Behavior management helps out some for my children. My dd doesn't deliberately misbehave as much as she is driven by her impulses. My son can't remember his name or find the shoes in front of him on some days. It is not at all unusual to hear that your daughter can stay "focused" on something she favors. Getting off task on the usual routine things, as well as school work is pretty typical. Redirecting helps some, as well as classroom modifications. You could try a simple check list if your daughter is reading, or a picture list for tasks, they kind of like checking the things off and sort of stay on task that way. LOL..thanks !! Btw that pic took about 45 mins to take in the studio because he just wouldn't sit still . Finally hubby went into the store and got that pizza toy for him to distract him long enough to get that pic taken.
Autumn, We have cut sugar completely for a a month now. We have seen a little improvement as he is not bouncing off the walls as much but still has trouble sitting and focusing but there is no improvement in the distractibilty aspect.The only time nothing distracts him and he manages to complete activities is when he is on the computer or playing video games. Foxl, that's what got me to thinking that maybe I should switch his behaviorial aide to an OT to see if its really a sensory issue. Jordan's pediatrician (also a psycopharrmacologist) prescribed the combination of strattera and concerta. Conserta is the stimulant, and Strattera is not considered a stimulant but has similar results. DS is 8.5, 60lbs and takes 35mg of Strattera with 27mg of Concerta every morning. The only side effect he has is a reduced appetite, but he makes up for it in the evenings when that effect wears off. He still needs a LOT of help to organize his thoughts, and his work, and all his executive funcioning, social issues, speech planning, motor planning. The meds do not take this away in my son, but he can deal with these MUCH better when he has them because he is paying more attention to the help he is getting. He can see a bigger picture of the cause and effects of daily living. We are doing trials of Methylin (Ritalin's competitor), and in the chewables, there are very few side effects (if any) for Cole. The stuff is short acting, so although he doesn't have a giant lunch appetite (that's the side effect), by 1PM, the stuff is flushed out of his bloodstream. We tried the "patch" for methylphenidate (the active ingredient in Methylyin and Ritalin) and it had horrible side effects for Cole. Won't get into it, but it was bad. My friend's kid wears the longer acting time released patch with NO problems. Its trial and error with a knowledgeable doc to lead the way. In school, on low dose of Methylin, he will stay put during the least fun times instead of getting up to wander over to the window. He was able to complete his kindergarten testing for a solid hour without getting up!!! Cole pays attention when it is interesting, but daydreams big time when he is bored. By the way, if a kid's mind is "busy" thinking about movies, books, computer games, etc and it is not directed tot he task at hand, it is considered a form of ADHD. We never thought Cole had ADHD until a psychologist (whose own 9 year old is PDD NOS) spent time with him and then said to go get him meds pronto. It DOES improve his attention to task. BTW, Cole is 6 1/2, weighs about 46 pounds, is around 46" tall. We're giving him 10mg of this stuff first thing in the morning, and that's it. Good luck - we are big time medicine haters, but this doctor (and dad) made it seem right. And for us, it is. Oh, and both my kids are impervious to sugar. Has very little effect, except to make them slightly sleepy later. Dr. John Raiss is very good, and located in Santa Monica, across the street from St. John's Hospital. He was our first psychiatrist, and he is excellent. The only reason we stopped seeing him is because the drive was a pain in the a$$. We now go to Dr. Bruce Steinberg in Encino, which is much, much closer to us. No more 405 at the height of rush hour for a 15 minute appointment in Santa Monica
I don't know of anyone in Newport Beach, but my parents live there in the fall and winter, so they may know someone who knows someone...I'm down there visiting them a lot on Balboa IslandAnother hijacking from California:
[QUOTE=MamaKat]Another hijacking from California: I don't know if he sees adults, but if he doesn't, I'm sure he can recommend someone for you. Give him a call at (310) 829-4787. I have also heard that ADD symptoms in students can be reduced by addressing sensory issues. One of our therapists told me about a class that had the children sit on an exercise ball instead of a chair. The teacher reported that the students paid better attention. Also, fluorescant lights will either eliminated or shaded. Autumn - you make an excellent point about diet. I just searched pub med for various combinations of ADD + dietery, ADD + sugar, etc. and found nothing. Seems like a common sense thing to try - I'm sure someone's studied it... let me know if anyone has any research papers re: dietery interventions for attention problems. Fred I would talk to her dr next time. I have been told when questioning about my own two that unless it is severe they won't diagnose or treat before the age of 6. I have heard of diet and excercise for ADHD, not sure of ADD. I would talk to the dr about that too. ETA: Don't you have them on fish oil? I've been reading about it for the boys and I read the DHA/fish oil is suppose to help with the ADD. That might be a natural way to approach it for now. I don't know much about ADD, other than what I have seen in my middle school students, but I do Know some of my son's teachers commented on attentional issues. DS is PDD-NOS, and his "distractibilty" comes around when he has no idea what to do. If he's not sure of his role in a task, he removes himself from it--by rolling around, running, being silly, or simply spacing out. For my DS, he would not put his shoes away because sometimes I gave him too many steps in a set of directions. Anyway, the Dr. we see at KKI is an ADD/ADHD guru, and he said, sure, we could medicate--medicines work for EVERYONE (look at Desperate Housewives making fun of that issue--a Ritilan-junkie mom), but if we were to medicate DS we would miss out on the reasons he's spacing out or rolling around. His actions tell us so much about what he does and does not understand, and that makes us more aware of how to approach things. I haven't read all of the posts... ADD can be addressed with behavioral techniques. As part of my Master's thesis I ran a cognitive academic and social skills training group for ADD/ADHD 1st graders. We used a cognitive behavioral approach and all kiddos experienced a significant decrease in symptoms by the end of the study as reported by their teachers and parents on ADHD/ADD checklists. Another thing, we always addressed when diagnosing was allergies. Sometimes, allergies produced ADD symptoms. I always think it is wise to try teaching the child new ways of learning and thinking before medication, but that is JMO. (especially when they are young.) [QUOTE=flip] ADD can be addressed with behavioral techniques. As part of my Master's thesis I ran a cognitive academic and social skills training group for ADD/ADHD 1st graders. We used a cognitive behavioral approach and all kiddos experienced a significant decrease in symptoms by the end of the study as reported by their teachers and parents on ADHD/ADD checklists. Another thing, we always addressed when diagnosing was allergies. Sometimes, allergies produced ADD symptoms. [/QUOTE] Wow !! I didn't know that. Mikey has a list of allergies.Wheat,most Nuts,Egg Whites,Soya were the ones were found out through a blood allergy test.We also found out certain sunscreens have given him a rash.We are waiting for another intensive allergy testing to check enviromental allergies and other foods.We just started on the GFCF diet too. Fred, did Evie ever get tested for allergies?
is extremely helpful. Any recommendations as to a good one in Southern
California? For me Newport Beach is closer to me than LA. But LA will work.
I think that there are a lot demands that are placed upon our kids. I do want
my sons school experience to be positive.
IBGECKO: Does Dr. Raiss see adults? I'm the one that needs ADHD meds
around here, I am quite certain. I also have the "innatentive type"-meaning
no hyperactivity.
IBGECKO: Does Dr. Raiss see adults? I'm the one that needs ADHD meds
around here, I am quite certain. I also have the "innatentive type"-meaning
no hyperactivity.
[/QUOTE]
http://cogmed.com/cogmed/sections/en/6.aspxAryan, Mikey is GORGEOUS, BTW!
Newport Beach is 20 minutes from us and Santa Monica will be 1hr(Traffic)
Newport is very pretty, we spend a lot of time there as my husband works
there. My daughter sails her sabot in Newport Harbour quite often. Lucky
you that you have such a nice getaway.
My son starts Kindergarten in the fall and has quite a few behavioral
supports/interventions in place. I think there will be a need for meds at
some point. I have seen what demands are placed of my middle school and
high school children. I want to be able to help him in any way that I can. Your a sailor? So am I! I grew up sailing sabots in Marina del Rey. I used to race my sabot all the time. I was a sailing instructor at our Yacht Club (Del Rey Yacht Club), and at a camp in the High Sierras, and even did a short stint at Club Med Martinique. My parents live on their boat in British Columbia in the spring and summer, and rent an apartment on Balboa Island in the fall and winter. Nice to meet another sailor on this board!No unfortunately I am not. A lot of my freinds and neighbors are sailors. I
do think once my youngest gets a little older and starts sailing, I will have
to learn to be one. We live near Alamitos Bay so my two oldest have been
sailing sabots. My oldest gravitated more towards golf / swimming/polo.
My middle one is 13 and barely 85 lbs. She loves sailing. We encourage her
as much as possible. I love watching the regatta's , it is a beautiful sight.
Now if I have any sailing questions, I ll know who to ask.
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