ADHD + Depression

[forkeeps251]

So, the most recent ARD meeting was today at my sons school. At the last one, I had requested (at their suggestion) that an evaluation be done on him for ADHD. I kind of knew what it was going to say, and so did they, but they said that it might be helpful just to have additional information when difficult child finally gets in to see a psychiatrist and psychologist. He has already attented play therapy and the therapist say "many indicators" of ADHD, so that is when we were referred to a psychiatrist. I had told them all that at the last ARD meeting, so the school psychologist suggested that I ask for a school evaluation for ADHD as well. Basically she gave questionaire's to myself and his teacher to fill out, and did her evaluation on that. Here are the highlights:

One of them, the first one (Connor's or something like that?) said that he tested as having a "clinically significant" problem with all of the categories, as rated by both myself and his teacher. From what I remember, this is just addressing ADHD.

The second evaluation was over some of the same ADHD stuff, but also addressed emotional problems. The psychologist said that she was "concerned" that both myself and his teacher rated him as having a lot of problems with depression.

The third evaluation said more or less the same as the first two (I with I had brought my paperwork up from the car, but I forgot it!), the only thing was it rated him as having "above average" indicators of autism. The school psychologist actually brought this up before I could even ask, and explained like this: he has indicators of autism, but she does NOT think that he is autistic. She said that she went back over everything and although a lot of indicators seem to be there, I guess they are the ones that overlap with his known problems (speech and ADHD), and that the "above average" indicators of autism did not apply to difficult child.

So, after we went over all that she said that the next step, if I requested it, would be to have him screened and have a full evaluation for special services... he is already receiving them for speech, but she said that his "emotional problems" might qualify him for additional services. She did say "emotionally disturbed", which I remember someone on here warned me about, lol.. but then she quickly added that she didn't like that term, and that she was only using it because it appeared that his emotional problems (depression?) were interfearing with his school work.

I told all this to my husband, who said "I think he is depressed because he is in trouble all the time at school due to his ADHD"... which kind of seems to make sense.

Side note: I actually got called from school last week to come and pick him up. First time that has ever happened... he threw a chair in the vice principal's office. Fortunantly they just wanted him home for the day, they agree that school is the best place for him.

So, I'm not really sure what other services he could get through the school... I asked if he would be in the same classroom and they said yes. At this point now we are still waiting for him to see a psychiatrist, and also the school psychologist will be doing an evaluation on him.

 

[buddy]

My gut agrees with your husband. Not that it matters, lol! I am obviously no one to difficult child, tee hee. But, I have filled out those forms and reviewed student's forms many times and much like what she said about the Autism Spectrum Disorders (ASD) stuff, the depression questions when you think of the answers you put can directly relate to the situations he is struggling with (example does he feel guilty? well, yes he feels guilty- when they act impulsively and then realize what they did, that tends to happen) I dont know your son but you get the idea. I would not go to depression until you have a full separate depression evaluation. If a doctor thinks then that it is true depression then you have something (and certainly even if it is situational it should be addressed, but how you address it???? If something that can be fixed is the main cause then it would certainly be better to go for that, right?)

Dont be too quick to shut down the autism question either...same as depression, it is best to check it out individually. The reason is as you have read here thousands of times, psychologists for some reason still don't want to go there and then after years (for some kids, of course not all and maybe not yours at all, but since there were some indicators and given the adhd and speech issues?? plus the anger/chair throwing thing.....) so, after years of receiving treatment for behavioral things and emotional problems, people find out they needed the specialized interventions that can come with the Autism Spectrum Disorders (ASD) diagnosis and by then there can be so many social complications and the child can be so hurt over frustration, etc. you rarely hear of it going the other way.... So for both things, maybe it would be worth just checking with someone who is an expert in depression (sounds like you are doing that) and another for autism (that requires a specialty clinic...docs will say they can but as you have heard here from countelss folks they will make a decision based on the one visit they see and many tend to want to reassure a parent that it is not that). Of course a neuropsychologist is an option.

In any event, sounds like folks are wanting to help and that is the main thing. You wont have to feel out there hanging on your own. It sounds like they really do care and that is the important place to start! Good for you getting this going for difficult child. He is so little still, lots of time to get it going for him! With a mom who is in there and fighting he will do well i am sure.

 

[InsaneCdn]

ADHD has probably been diagnosed the longest. So, people - schools, medical specialists, etc. - feel comfortable that they know what they are looking for. BUT... "not so fast". ADHD is a frequent first diagnosis... but not necessarily the last, and not necessarily correct in the first place.

Keep in mind that a whole range of dxes and disorders overlap quite significantly.

For example - executive functions issues often go with ADHD - but you can be ADHD and not have that problem, OR you can have executive functions issues and NOT be ADHD (e.g. - executive functions issues can be part of Autism Spectrum Disorders (ASD), as well).

APDs can look like ADHD - inattention, not following instructions, often getting into trouble (boredom), etc.

If you look at the ADHD definitions, and then look at the Autism Spectrum Disorders (ASD) definitions - you'll find that pretty much everything under ADHD can also happen under Autism Spectrum Disorders (ASD) - except that with Autism Spectrum Disorders (ASD), there will be more. (Autism Spectrum Disorders (ASD) can also NOT look like ADHD... )

And then... you get the "also rans"...
- 50% of kids with ADHD also have Developmental Coordination Disorder (DCD)
- 70% of kids with ADHD and a Learning Disability (LD), also have Auditory Processing Disorders (APD)
- and so on...

Depression? at 5? Hmmm... Its not uncommon in complex kids to hit depression by 8 or 9, when their world implodes because they can't keep up at school, but at 5, it wouldn't seem so likely to be secondary depression (which is what your husband described...) What else would cause those symptoms?

I agree with the others... more digging needs to be done.

 

[TeDo]

I am so glad things are progressing for difficult child. I totally agree with Buddy and your husband. difficult child 1 got severely depressed because of the way the school was treating him because of his ADHD/Autism Spectrum Disorders (ASD) symptoms (behaviors & inability to put things into the right words). It was so bad that the psychiatrist ordered he be homebound for the last month of school. Please take whatever help the sd is willing to give you. I think too that you shouldn't rule out Autism Spectrum Disorders (ASD). Definitely find a Child Psychiatrist or neuropsychologist to do a thorough evaluation. In our sd, there is an Autism Consultant that I had to specifically request to evaluate difficult child 1. The school didn't tell me this person even existed. She found (after a PhD Psychologist & a psychiatrist diagnosed) that difficult child 1 was definitely on the spectrum and she sat in on many IEP (ARD) meetings to offer suggestions for interventions.

You might also want to check into a thorough Occupational Therapist (OT) evaluation. Most kids like ours have sensory issues that no one even knows exist (my difficult child has a hard time processing words in black letters on white paper & he couldn't STAND the smell of "coffee breath"). A good Occupational Therapist (OT) would pick up on things the sd might not even think about (ours said there were no Occupational Therapist (OT) issues).

Keep plugging away. You don't know how lucky you are to have a sd that is willing to bend over backwards for your little guy. Take everything they are willing to offer you.

 

[buddy]

TeDo.... Q HATES coffee breath.... when people would say they did nothing to provoke something...I would ask if they ahd a new perfume or drank coffee etc.

 

[TeDo]

difficult child 1 would get into trouble because he'd simply repeatedly say "stinky breath! stay away from me!" Everyone punished him for being rude and disrespectful.

 

[BusynMember]

A child can be depressed at two years old or even younger. I've fostered depressed babies who won't smile, won't eat, are just limp. Depression doesn't have to have a reason. It is an illness, like diabetes. Often the only cause, when a child is very young, is that he/she inherited it.

More than that, I personally was depressed way before five. Symptoms of early childhood depression include sadness, crying bouts, over sensitivity, phobias and sometimes just not getting much joy out of anything. I probably wouldn't believe it myself if I hadn't lived it. I was never a happy, contented child. Now the DEEP, DARK depression didn't hit me until age thriteen...that was my first bout of inability to function at all...but it had always been there. It just kind of fell off the cliff when I hit puberty and continued on into adulthood. I think you are a very good mother for addressing these issues early. Take advantage of the help that is offered. When I was that young, there was (cough) no such thing as childhood depression, Learning Disability (LD)'s, ADHD or any of the other things we now know exist and can treat.

Keep us posted. We care

 

[forkeeps251]

Thanks for all the feedback.
I was actually kind of wondering what questions I answered that flagged him as depressed. I would think that someone who suffers from depression would have it present more often then when they are just in trouble, but maybe I am missing some things... He is kind of a "loner", I wonder if that is a sign, for example? I mean, often times, he does act like a normal, happy, silly five year old. Probably more often that not, at least at home (home life is MUCH better for him than school life... not as many problems). I guess sometimes he does withdrawl, but usually that is short lived or when he is in trouble.

The only time I've seen him really upset was last week after I was called to pick him up from school after he threw a chair. He wasn't having a temper tantrum... in fact just the opposite. The school finally decided to call me after for five minutes they couldn't get him to speak or move or look at them or anything. He just completely shut down between the time he threw the chair and when I picked him up. The only movement he made was that the principal said he was going to leave the chair where it was so that "Mommy could see what he had done", and he got up and moved the chair and sat down in it (not defiantly, the principal had been asking that he pick it up before he said that). Other than that there was no communication, and when I picked him up, same thing for a little while. He went home and lied in bed. It was almost as if he had gone beyond a temper tantrum with tears and all to something else. He eventually worked his way out of it though.

He is on a waiting list to get an appointment I think at a neuropsychologist... and thank you all for reminding me, but I do still need to do an Occupational Therapist (OT) evaluation on him. I'm putting that on my list to do today.

 

[Confused]

Hi, its good you have support from your husband and the school. I am still trying to find out whats going on with my son,and have been told by one psychiatric evaluation different things and then he was fine! So, it sounds like your on the right path.Just keep how he is in a daily journal, video tape if you can. And that way, when your sons next evaluation comes, this may help. (Im sure you been keeping track as the school has )