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[Malika]

My (adopted) son is four years old. Ever since he has been a small baby he has been physically hyperactive. He is certainly impulsive, has some problems with aggressiveness (though he contains these much better in public than he once did) and can be "oppositional" and continues to have tantrums when his will is thwarted worthy of a 2 year old... Since I have been reading and thinking about it since he was small, I naturally wonder whether he has this somewhat controversial condition called ADHD. More recently I wonder whether he has ODD as he certainly displays most of the signs of that (though is not mean, cruel or vindictive to animals, for example - rather the opposite). He certainly has almost all the symptoms, except for one... He has always gone to sleep very easily and quickly and does not move around restlessly in his sleep... He has been followed by two pyschologists until now, recommended by our paediatrician because of his physical hyperactivity... One of them told me that true ADHD is very rare and that she was almost certain my son did not have it. His two teachers so far seem to think it is unlikely, because he doesn't seem to have particular or extraordinary concentration problems though I think it is clear his brain does not conceptualise in the normal way... He is clearly bright, speaks two languages fluently, etc, but cannot recognise colours despite years of people trying to teach him, has some problems with recognising written numbers and does not seem to be learning the alphabet very easily. His relationship with the ordinary, material world also seems rather flimsy - much of what he says remains in the realm of fantasy or imagination and is very surreal... We are shortly to begin all the round of psychological testing, etc.
So where I am going with all this...? It looks like ADHD/ODD but... here in Europe, they rarely diagnose ADHD before the age of six or seven and do not medicate for it below the age of seven except in truly exceptional circumstances of a child being so aggressive that they cannot function in school or whatever. And I for myself do not want a diagnosis before then... Although it looks like ADHD, why set things in stone before it has become really obvious and problematic? There are other possible causes to his behaviour, I think, even if the balance of probabilities is that he does have it. And then, even if my son does get a diagnosis in a couple of years time, I am not at all sure that I want him on Ritalin or a similar drug. Again, that seems to me like a big decision, not to be taken lightly. What I would like is for him to receive any appropriate help with his learning difficulties, not to have a label put on his head. And certainly not for him to start taking very serious drugs as a matter of course...
What do other people feel about these issues?

 

[HaoZi]

Hi Malika, welcome. Has he been checked for allergies? Color-blindness? Sensory disorders? Non-verbal learning disorders? There are so many things that occur with each other or look like each other. Most of us here consider ODD to be more descriptive of behavior caused by an underlying untreated disorder. Get that under control, and the ODD usually turns into more age-appropriate expressions of frustration.

 

[DammitJanet]

I dont know why anyone would say that ADHD would be rare. It is quite common actually and it is not psychiatric, it is a neurobiological condition. Very young children can and do have ADHD and many of them are extremely smart. However, not knowing colors or letters at 4 wouldnt lead me to suspect ADHD off the bat. That could be a learning disability or simply being 4...lol. Is he extremely hyperactive and impulsive in two or more places? Say like pacing or running around the house and at school? Does he like to run all the time outside instead of sitting quietly on the benches?

My ADHD kid crawled very early, walked very early and was running before a year. He still hasnt slowed down! Some part of his body is in constant motion even if it is only his foot tapping. He was medicated at the age of 4.5 years of age and it was a lifesaver for him. We only gave it to him on school days for most of his school years unless he had some important event on the weekend such as a baseball game where he had to concentrate. Today he is a normal adult. Still ADHD but not on medication and fairly happy as far as normal late 20's go...lol.

 

[BusynMember]

ADHD is rare? Seems to me that it is overdiagnosed when often it is something else. Just saying........perhaps it is a cultural difference. ODD is sort of throwaway diagnosis...doesn't mean much other than defiance.

 

[AnnieO]

Malika - hi! I haven't seen any other posts, so WELCOME!

My stepson has been diagnosis'd with ADHD. His bio mom (BM) medicated him, kept upping the dosage... And when we got custody, we got rid of the stimulants and had him checked by a neuropsychologist team. They decided it was mild ADHD, learning disabilities and Fetal Alcohol Syndrome. Given that his sister and husband seem to have mild ADHD as well, that wouldn't surprise me, though I'm more concerned with the Aspergers-type symptoms he has (and not Fetal Alcohol Syndrome (FAS)).

What I mean to say here is - ADHD isn't exactly rare. In the USA, though, I think it's over-diagnosis'd - if I had been a child in the last 15 years, I would definitely have been diagnosis'd ADHD, but in my case it was - being a kid.

In your case, of course, I can't say exactly, but I would suggest having him tested - allergies, neuropsychologist, etc. I can say this - we pretty much got rid of certain food colorings and added sugars (due to a friend's sensitivities), and it helped - but not a lot.

As for ODD - I wouldn't be at all surprised if, when the other issues are treated and worked with (because they can't all be treated... Some, you have to work with), the ODD subsides. It's rather a catchall diagnosis - and to be honest? All kids are oppositional, and defiant, at some time or other.

Again, welcome - and HUGS!

 

[Malika]

Thanks a lot for your views and thoughts. This psychologist (actually a child psychologist called a "psychomotricienne" which is a profession I have never encountered outside of France - works physically with small children who have manifested various "problems") actually meant, I think - certainly this is how I understood it at the time - that the actual proportion of children who TRULY have ADHD, ie a neurobiiological condition, is small compared to the proportion who are JUDGED to have it... She was speaking from her experience, that is what she said.
In terms of my son, I find his behaviour confusing. That is to say, with me he is constantly hyperactive, jumping around, cascading off sofas, spinning, turning, etc; taking him to shops is not pleasant because he will never stay with me but is running everywhere touching everything, climbing where he shouldn't be, etc. However, at school the teaching tells me that he is "restless" but sits for up to an hour alongside the other children, doing the little exercises they do, apparently without too much distress on his part. When I leave him with childminders, they tell me he is "good", more active than most but nothing like he is at home... he doesn't jump on other people's sofas, for example, except when I am present!! It is all very mysterious... At the same time he has a compulsion to touch things all the time as in classic ADHD, has to "physically interact" with all he encounters - children, adult, animal, inanimate, etc, etc...
Is it "normal" for hyperactive children to be more or less hyperactive in different situations? To be honest, I feel my head spinning with all this sometimes - is he, isn't he?? Physically he is clearly much more active and restless than the "norm" but doesn't seem to have particular problems concentrating...
And I imagine these questions and doubts are shared by many parents now that ADHD has become so widely known and talked about... This is what my psychologist meant, as I say - lots of people are medicating their children needlessly. Which is not to say that the quality of SOME children's lives is not greatly improved by taking medication... IBut I don't want my son, in my own view, taking something with potentially very serious side effects unless it is absolutely indispensable.
A shame ADHD cannot be simply diagnosed via a brain scan...

 

[HaoZi]

Spinning and touching everything, fluent speech... hmmm.... how well does he interact with his peers and kids of age groups vastly different from his own?

 

[Malika]

Yes... that's the confusing thing... he has lots of the symptoms of hyperactivity, no doubt about it... but - he doesn't seem to have real problems in a school environment and that is the whole reasoning and rationale behind giving kids these drugs... I cannot drug him to make him an "easier" child! But he definitely needs special help to develop his under-developed capacity to tolerate frustration, for example. And he needs help in socialising. He is at the moment often "too much" for other children - too energetic, too physical, too loud, too apt to jump in without waiting to watch and listen to the group... He has his little "best friend" at the school and seems to be held in affection by the little school community as a whole but that does not mean there are not things that need real attention. But I just want him to develop socially and educationally much more than I want him to be labelled ADHD/ODD or anything else...
Today I received "The Explosive Child" and it seems very good.... really very good... And confirms my own growing instinct (unfortunately not generally understood by my entourage) that some children need different handling beyond rewards and punishment...

 

[HaoZi]

Thing is, there's a lot of kids with higher functioning autism, learning disorders, and food allergies that ALSO act like your kid (and I'm sure others can add to that list). So first, rule in or out the physical - food allergies, food dye or additives sensitives, etc. Gluten is the main allergy you find causing things like that when there's an allergy, but it's not the only one. Autism and learning disorders (of which there are many kinds) are treated with training and therapy, not generally with medications. So he definitely needs a more thorough assessment.

 

[SRL]

One other thing you might look into is Sensory Processing Disorder. Sometimes kids who are hyperactive are not doing so because they can't sit still, they're doing so in order to try and regulate their sensory systems.

Another book you might look into is: What Your Explosive Child Is Trying to Tell You: Discovering the Pathway from Symptoms to Solutions by Dr. Douglas Riley


I s he getting any help at school for the social interactions?


Are his interests typical for his age?

 

[Malika]

Thank you again for your thoughts. It's difficult to explain, perhaps but really there is a different culture here towards diagnosing "problems". Sensory processing disorder, for example - I've no idea what it is and I have never heard anyone talking about it here! As for high-functioning autism - I really wouldn't have thought so, though again I obviously don't know much about it in detail. He does not have any compulsions or requirements for things to be a certain, regulated way or any apparent difficulty in meeting with or engaging with people. Adults who see him by himself generally think he is "charming" - not that that is anything to go by, most small children are charming... When other children are present, however, he becomes loud, rumbunctious and over-stimulated... I would think his interests are typical for a four year old boy - Spiderman, firemen, playing with his cars and pretending to kill people in games of "cops and robbers" As for allergies, again have no idea of how one tests for that... Also he craves and wants sugary things and it would be difficult to eliminate these entirely - I just limit them. School doesn't help with socialising but school is itself a forum for him to learn to socialise! He is much "better behaved" at school than at home; I get the sense he is awed by the group, like a dog being awed by the pack... He loves his teacher, who seems very fond of him and very devoted to all the children... So I don't know.
Maybe I'm just feeling each child is unique and interesting, with much potential beyond "labels".... I really focus on seeing the qualities and the positive points of my son - his intelligence, playfulness, loving, affectionate spirit and empathy - as well as all the things that make me feel like I want to tear my (and his) hair out!!

 

[HaoZi]

His regular doctor could do allergy tests or refer him out for them. The only adults that have asked if I've had my kiddo tested for autism are those who have or work with Autism Spectrum Disorders (ASD) kids. So I'll grant it may be bias, and for years I looked at my kid and said "No way," but at this point even I have to admit that she and I both have some strong Aspie traits if nothing else. Many gifted kids do share a lot in common with Aspies, though I couldn't tell you if it's intertwined or parallel.

All that aside, "The Explosive Child" - and changing my approach, can make a lot of difference in her tantrums. Catch my kid when she's having a great day, and she's the kind of kid that makes me proud to be a parent, which is saying a lot considering my life plans did not include any kids. Catch her on her down days.... *shudder*.

 

[SRL]

Thank you again for your thoughts. It's difficult to explain, perhaps but really there is a different culture here towards diagnosing "problems". Sensory processing disorder, for example - I've no idea what it is and I have never heard anyone talking about it here! As for high-functioning autism - I really wouldn't have thought so, though again I obviously don't know much about it in detail. He does not have any compulsions or requirements for things to be a certain, regulated way or any apparent difficulty in meeting with or engaging with people. Adults who see him by himself generally think he is "charming" - not that that is anything to go by, most small children are charming... When other children are present, however, he becomes loud, rumbunctious and over-stimulated... I would think his interests are typical for a four year old boy - Spiderman, firemen, playing with his cars and pretending to kill people in games of "cops and robbers" As for allergies, again have no idea of how one tests for that... Also he craves and wants sugary things and it would be difficult to eliminate these entirely - I just limit them. School doesn't help with socialising but school is itself a forum for him to learn to socialise! He is much "better behaved" at school than at home; I get the sense he is awed by the group, like a dog being awed by the pack... He loves his teacher, who seems very fond of him and very devoted to all the children... So I don't know.
Maybe I'm just feeling each child is unique and interesting, with much potential beyond "labels".... I really focus on seeing the qualities and the positive points of my son - his intelligence, playfulness, loving, affectionate spirit and empathy - as well as all the things that make me feel like I want to tear my (and his) hair out!!

Sensory Processing Disorder is when an individual has a sensory system that has problems with sensory stimuli to the degree where it causes life issues. For instance, I'm fairly tactile sensitive and would never, ever wear itchy clothing or tags, but a child with sensory processing disorder (SPD) may feel an all out assault that they can't cope with when putting on a garment that another child wouldn't even notice. Sounds, lights, pain, touch, food tastes and textures, odors, temperature, etc.--being overreactive or underreactive to can make life excruciating. Most parents first notice problems to be extreme pickiness with foods and clothing, but that does vary.

Most parents arrive here being adverse to labelling their children. Most of us want to give our kids a wide leeway for being unique individuals. We seriously get that, because we've been there. Where a parent goes from there depends on their individual situations. Can they help the child on their own with a little research, meaning finding formal names of issues is enough to search out help? Do they need a label for healthy insurance purposes so doctor's appointments and/or therapy is covered or to get school services (both very common here in the US). A label can be very helpful to communicate issue to others (such as teachers).

Personally I view labels as a helpful road sign, designed to succinctly communicate the issues, and get the child help in whatever form that may take. Labels should be taken with a grain of salt--I always suggest that parents consider any diagnosis for a young child as a "working diagnosis". Try it on and see if it fits and if the applicable treatments work. Labels are also fluid in that a label that's appropriate at one point in a child's development may not fit a few years later, for reasons such as maturing developmentally, learning to compensate, or responding to treatment.

A label should not become a weight to be hung around a child's neck, nor does it take away from the unique individual that every child is. It is simply a tool that we seek out when we need it (and most parents know when they reach this point) and use in order to help the child.

 

[Malika]

Thank you for that explanation. From what you say, I don't think my son has a sensory processing disorder.
I do feel ambivalent about labels as I guess many people do... On the one hand, they are indeed useful in getting others to understand that it is not just a child being "naughty" or a parent being "incompetent". And in getting help where that's needed. On the other hand, labels stick - and also often become self-fulfilling prophecies. What we are told to see, we see... It shouldn't be so but putting a label on a child does stigmatise them to some degree. And no-one, children included, wants to be seen as some handicap rather than just an individual...
What feels important to me is to talk about the behaviour and to try to address that rather than worrying overmuch about what to call the behaviour... Personally I would rather think of my son as having difficulties dealing with frustration and stress rather than "having ODD"...! I don't know why - the former helps me find solutions, perhaps, whereas the latter just makes me feel rather helpless and overwhelmed by some strange monster I don't like, understand or relate to Well, I'm stating the case too graphically.
As a child I was myself (amid difficult home circumstances) very passionate and hard to deal with at times... particularly as an adolescent... In another era and place, I would probably have been labelled something or other. And that label may perhaps have stuck to me for life, limiting my view of myself and my options??
But these are just thoughts... I am open to persuasion!

 

[SRL]

Thank you for that explanation. From what you say, I don't think my son has a sensory processing disorder.
I do feel ambivalent about labels as I guess many people do... On the one hand, they are indeed useful in getting others to understand that it is not just a child being "naughty" or a parent being "incompetent". And in getting help where that's needed. On the other hand, labels stick - and also often become self-fulfilling prophecies. What we are told to see, we see... It shouldn't be so but putting a label on a child does stigmatise them to some degree. And no-one, children included, wants to be seen as some handicap rather than just an individual...
What feels important to me is to talk about the behaviour and to try to address that rather than worrying overmuch about what to call the behaviour... Personally I would rather think of my son as having difficulties dealing with frustration and stress rather than "having ODD"...! I don't know why - the former helps me find solutions, perhaps, whereas the latter just makes me feel rather helpless and overwhelmed by some strange monster I don't like, understand or relate to Well, I'm stating the case too graphically.
As a child I was myself (amid difficult home circumstances) very passionate and hard to deal with at times... particularly as an adolescent... In another era and place, I would probably have been labelled something or other. And that label may perhaps have stuck to me for life, limiting my view of myself and my options??
But these are just thoughts... I am open to persuasion!

I don't have any need or desire to persuade you. Parents arrive here at different places: different philosophies, different kids, different countries with different school and healthcare systems, different places in their journies with their kids. A parent who is ambivalent or even dead set against a label may one day find themselves pressing for one in order to get their kiddo what he or she needs. Parents also have different philosophies to labels, from telling the kids right up front all the way to not ever mentioning it and treating the issue just like any other issue. Also, labels don't necessarily stick here in the US--school systems and insurance companies are often happy to drop them when applicable because it costs them less.

So you'll find no need for persuasion from me as long as you're adequately able to get whatever help (if any) your son needs at the time. If you could better address his needs by going further, that's when I'm more apt to give a nudge. At all times, it's important to listen to your child's words and behaviors, educate yourself, and be open to being flexible because you may find yourself in a different place with all of this someday.

Hope this helps.
SRL

 

[ThreeShadows]

Welcome, Malika! I grew up in France (during the 1950's and 60's, lol). I had never heard of ADHD there. What do they call it in French? I couldn't find an English word for "psychomotricienne", that, in itself, is an interesting fact. I suspect that you will have to struggle to get him diagnosed the way the US moms would. My French half sister had something called "spasmophilie", a condition that I still can't figure out!

I struggled to keep my twins (adopted) from being labeled, I was afraid it would follow them for the rest of their lives. I admired their energy and their creativity. The school did not. What will follow them for the rest of their lives is my failure to get them the appropriate services available to them, as it were, in small town Maine. They will struggle financially and socially for the rest of their lives. I was an older, uninformed mother, and foreign-raised to boot!

Do you know anything about your son's biological family? Was his mom a drinker? Is there a history of psychological "differences"?

I'm sorry you had to find us, but glad that you are here. I always enjoy hearing how other cultures deal with kids like ours.

 

[SRL]

I struggled to keep my twins (adopted) from being labeled, I was afraid it would follow them for the rest of their lives. I admired their energy and their creativity. The school did not. What will follow them for the rest of their lives is my failure to get them the appropriate services available to them, as it were, in small town Maine. They will struggle financially and socially for the rest of their lives. I was an older, uninformed mother, and foreign-raised to boot!

This is why it's so important to stay in tune, educate yourself and be flexible. I know of one young man who had had some struggles along the way--nothing too serious or unmanageable but that suddenly escalated into a mental health crisis during the teen years. They decided to trial some ADHD medications and it has changed his life in remarkable ways.

 

[Malika]

Sorry, the imperfect medium of communication that is the internet - in saying I am open to persuasion I didn't at all have in my mind that you might want to persuade me, SRL Simply that, as you say, these are early days yet and there may come a time where, despite my reluctance, I would welcome a diagnosis of ADHD.
I guess things have moved on a little in France. ADHD (TDAH) as it is known here is now widely known among psychologists, doctors, etc although less so among the general population. There is no difficulty in getting a diagnosis if that is what one wants Indeed, I have a psychologist ready and willing, by the sounds of it, to make a diagnosis of ADHD based on some questionnaire she wants to do next time (Connors?) But we are also going to be seen by the area school psychologist and the local medico-pyschological centre so I would think that between all that some light will be shed!
ADHD does seem to be over-diagnosed... perhaps one is wise to be cautious. There is time to see and evaluate...

 

[ThreeShadows]

How do the French treat TDAH?

 

[Malika]

Hi ThreeShadows! In France, Ritalin is the only drug licensed to be prescribed for ADHD, from the age of seven. I get the impression that it is recommended by conventional doctors IF there is trouble at school - this seems to be the touchstone for all here, school being so important If there is no trouble at school, I guess one has the leeway to work with whatever means one wants. I think behavioural therapies are also offered. Thanks for your questions about my adopted son's background. Unfortunately I have absolutely no information about his birth mother and never will have. He was tiny and underweight at birth (after being abandoned in a hospital after his mother gave birth to him, the typical scenario in Morocco), implying that she had not taken care of herself. There is of course a possibility that she drank/took drugs during the pregnancy. When he was smaller I had to stop myself thinking about "who my son would have been" if it had not been for this probable damage. On the other hand, he could have inherited ADHD or its traits genetically... Strangely, my ex-husband (Moroccan), with whom I adopted him, has a hyperactive kind of personality and hyperactive-type children are more common in Morocco than any other country I've experienced. Could be something (or a lot) to do with the fact that Moroccan children are often not disciplined as they are in the west - although they are punished, often brutally - and grow up largely unsupervised. This is particularly true of boys... So that's another unknown variable to add into the mix! I am sorry to hear about your boys... I hope they will find their path in life.