How Do I Parent?

[mymulligan]

Our little boy is so special, so bright and social and all these great things but his ADHD has really reared it's ugly head now, in first grade.

He is officially diagnosis'd and in a collab. classroom with lots of teachers. He gets sensory breaks and special help to keep him focused. I thought I had dotted all the I's and crossed all the T's and this change has me surprised and stumped.

I had read about self esteem in kids with ADHD and conduct disorders but my boy was NOT oppositional nor defiant and I thought we were just lucky! But once first grade started he became a different kid.

No matter WHAT I say, do, suggest his answer is always the opposite. He argues with me about EVERYTHING and is probably testing me. He is having trouble with a little boy in his class who i'm sure DOES have conduct disorder and the two of them fight. He comes home upset every day, my little happy guy who LOVED kindergarten.

Now in first grade he is not as popular as before. He used to have play dates daily but now his friends are all doing Chess and Drama and Reading and doing things after school he cannot do. He is miserable being with me and always wants to see a friend after school. I know i'm all over the place but he doesn't seem to love or like me at all anymore! He is much more a Daddy's boy.

But I'm the one who is home and I can't imagine how bad this is going to get when he won't even wash his hands when I ask him to.

OH and he also said a few weird things to me (like he wants to set me on fire and then put it out really fast....he seems to almost hate me sometimes. I just have this sneaking suspicion that he is developing a conduct disorder. By the way his ADHD is moderate to severe.

Sometimes he seems to want help, he seems to know on some level what is going on is wrong. He is thank god extremely empathetic and sensitive but ugh he's got me worried.

He also must always wear a costume, it seems to make him feel safe. We went to a pediatric neurologist for therapy but she was a flake and it's soooo expensive around here.

What do you think? What do you suggest? I know this isn't as serious as many of you but watching him change....afraid it will get worse.

*Thank you for keeping up with my ADHD brain.

 

[BusynMember]

I suggest taking him to a neuropsychologist, which is not a neurologist at all. neuropsychologist's are psychologists with special training in the brain and they are the most elite diagnosticians for childhood disorders in the US. Conduct Disorder is a diagnosis actually rarely given and usually not until after age eighteen and usually due to untreated mental illness. The fact that he is adopted, like three of my kids are, complicates things and here's why.

Do you know anything at all about if his birthmother did any drugs or drank during her pregnancy, even if it was early on and she didn't know she was pregnant yet? This matters. Also, are you aware of any neurological differences or psychiatric illnesses on either side of your son's DNA tree? This matters too. Many of us with adopted kids are astonished at how much they are like their biological parents, in spite of our influence and a different enviroment, because they are made up of 50% bio. mom's DNA and 50% bio. dad's DNA. Many people I know whose grown adopted kids met their birthparents are shocked at how much they are like people they have never met, including both good and not-so-good traits. Like you, my youngest adopted child was born with my being there...I did not cut the cord, but I saw everything and knew the birthmother really well by the time she delivered and fortunately birthmother and I are a lot alike and got along really well. Thus, Daughter is a lot like her birthmother and we get along great. To correctly diagnose an adopted child, it is easier if you have a far and wide idea of his genetic family tree. This is not a parenting issue. It is a very real disorder or it could be, but is less likely to be, an indicator that he may develop some mental illness later on.

Now my adopted son had a much tougher start in life. He had cocaine in his system at birth and his birthmother danced out of the hospital as soon as she gave birth and had not had any prenatal care (also important). He has high functioning autism and was first diagnosed with ADHD/ODD. Now when he was in kindergarten he had tons of friends because he was so active and the other kids loved to run with him. As he grew older, and friendships grew more complicated and required more talking and pretend play, his friendships dropped off. He is twenty now and doing well, but he had early intensive interventions. You really do need to be sure of what you are dealing with, which is trickier when a child is not your biological child unless you know tons about the DNA history of your child.

I have no idea where the defiance is coming from, but I would forget about Conduct Disorder. He is likely aware that he is different and frustrated that he can't do what the other kids can do. Can he maybe play a sport? How does he get along with his same age peers? Can you please give us some background on his very early years? How was his infancy and toddlerhood and then at age four and five? Did he have any delays or speech problems? Did he hit all his milestones on time, including physical ones and pottying? How does he do academically? Does he react to certain food textures, materials, tags in back of his shirt, socks, or loud noise? Is he able to appropriately relate to his SAME AGE peers?

This may not be as serious as some of us are facing, but we want to help you keep it that way A good, intensive neuropsychologist evaluation would help you. It is usually 6-10 hours of testing (I'd question the neuropsysch if it were any less). He will test in all areas of function and then point you in the right direction for the proper treatment and help.

It's always fun to talk to other adoptive parents, especially one who had the great experience of watching her child's birth, just like I did. Can you believe my husband wouldn't watch the birth? He felt embarassed to do so and waited in the hallway! LOL

Welcome to the board. Others will also come along with suggestions. These are mine.

 

[TiredSoul]

So he only became oppositional and defiant since starting first grade? Was he in all day Kindergarten? If not, maybe the longer day is too much for him.

Has anything else happened or changed in his life? Any deaths in the family? Extra stress?

Welcome to the board - others will be along soon.

 

[soapbox]

Our little boy is so special, so bright and social and all these great things but ...

Read more: http://www.conductdisorders.com/forum/f6/how-do-i-parent-55491/#ixzz2hrZF471d

Welcome... sorry you had to find us, but glad you did.

Grade one is a major proving ground for problems. Including really showing up social skills issues. We tend to evaluate our kids' social skills on how they interact with adults, but the defining relationship is same-age-peers. (I didn't know that until my kids were in HS) By about age 5 or so, most kids' social skills take a major leap forward, but some of our challenged kids don't make those milestones, and the social gap gets bigger fast. Plus... kids are mean. As soon as you are just a bit different and they start to notice, bullying tends to rear it's ugly head, even if it's subtle our kids notice.

Beyond that? Not sure who gave you the diagnosis, and not saying it's outright wrong but... in my experience, it's probably at least incomplete.

Has he ever had an Occupational Therapist (OT) evaluation for sensory and motor skills issues? either of those could be clobbering him in a classroom setting. Occupational Therapist (OT) report is useful for other evaluators. Occupational Therapist (OT) has therapies and interventions and accommodations that work. And at least here (I'm not in US), Occupational Therapist (OT) report has some traction at school in getting help.

He's too young yet for a full Auditory Processing Disorders (APD) evaluation, but that should be on your radar also. Not just the classical form of Auditory Processing Disorders (APD) - if he had that, you'd probably already know because that affects processing of verbal language. But there are other forms of Auditory Processing Disorders (APD), such as auditory discrimination and auditory figure ground, that have a huge impact on school. They usually don't test for this until at least age 7, due to the complexity of the testing and the need for accurate response and focus over a fairly intense period (a couple of hours). But start watching for it. Does he tend to miss your instructions if it's noisy and do better if it's quiet? That's likely related to auditory figure ground - where the person hears everything but can't filter out the background noise, so can't make sense of what is important. Does he get the generalities of speech and the meanings of words, but sometimes has an inappropriate response because he heard a word wrong? The ability to distinguish similar sounds is auditory discrimination.

If he has a problem with any of these, he will be putting in a huge effort, with little results. This makes him "stupid" in the eyes of his peers... really fast. If he's having trouble getting started on reading, they should be pulling him for one-on-one instruction, partly because it takes out any risk of Auditory Processing Disorders (APD) being a factor, and partly because success at reading is the single most important skill for school and for life.

Motor skills issues, even subtle ones, mean he will be left behind on the playground. By the time he gets out there, other kids will already have their play underway and there won't be room for him. Because his skills may be behind theirs, they have no patience with clumsiness or slowness. Kids can be really mean especially on the playground where there is limited supervision.

Any of the above would just be in addition to an ADHD diagnosis... and not uncommon to have these go together.
But... he could also be a more complex kid. It may be too early to get a full diagnosis especially if he's fairly high functioning. But in the long run, keep an open mind. He could be something like Asperger's.

 

[DaisyFace]

OH and he also said a few weird things to me (like he wants to set me on fire and then put it out really fast....he seems to almost hate me sometimes.

OK - this is NOT ADHD (at least not ADHD all by itself!) Fantasizing about setting you on fire is really scary.

My difficult child used to say these types of scary things at a very young age. She has since been diagnosis with a personality disorder. Today? That diagnosis is probably correct. When she was little, however, I strongly suspected Aspergers. The docs all dismissed me. My personal theory is that the PD developed as difficult child used dysfunctional coping mechanisms to get through her day.

My advice would be two-fold:

Firstly, if you can get a professional test for ASDs and processing disorders - that would be best. If you cannot get this, see if you can identify areas in which your child is struggling. Is he having trouble with transitions, language, remembering lists, facial cues, social interactions, etc? Read all you can about helping kids cope with these issues and see whether you can help him rehearse or practice solutions at home.

Secondly, be on guard for the fact that YOU may not be able to help your son with any of these. He may have decided that you are the bad guy and there may be nothing you can do to change that (at least not right now). Try to be firm, calm, and unemotional about it. The less reaction he gets, the better.

(((Hugs)))

 

[mymulligan]

Dear Midwest Mom, for some reason I read your post first so I would like to answer it first as it is fresh in my head. We are in an open adoption and I know his bio parents VERY well. I also know their sibs, HIS sibs and here is what I know: Major addiction issues in both birth mother and bio father. diagnosis'd ADHD and dyslexia in bio father (and a couple of his brothers/my kids uncles). Possible learning disability in birth mother but she is very bright and good natured. Just continually has issues with her own siblings mostly based in her addiction issues.

She used crack at least once in first trimester (before she knew she was pregnant) and possibly more but doubtful it was much more because she was on parole and getting tested weekly. And get this, she brought me with her to meet her parole officer so she could tell me she only had ONE "dirty drop" as they call it. She did smoke cigarettes though she really tried to cut way back and she drank in the third trimester at a party, she said it was one drink. The smoking and drinking who really knows but I feel ok about the crack exposure given that he had nothing in his system at birth. He did have one small kidney and apparently the genital/urinary tract is the first thing to develop in a fetus so I always thought the early exposure caused that too.

Milestones: Sat up, crawled and walked on time. Well never walked....but ran on time , speech a little delayed and conversational/pragmatic language never very strong but after years of speech they said he doesn't need it anymore and that his speech issues are directly related to his brain just being all jumbled sometimes. #1 trained very quickly and easily at 3 (I waited because i felt it would be a nightmare to push him) but number #2 was very very late. like age 5. Teeth came in late. Was in CPSE and early intervention for sensory seeking (Occupational Therapist (OT) and Speech) for years and had a SEIT in 3's and 4's (including camp) because of his impulsivity. We live in a very progressive area with a great school district.
VERY VERY VERY PICKY EATER. Only eats like five things, all highly processed and easy to chew. I noticed in his 4's he was a sensory avoider in certain areas and that became worse as his seeking became better. He NEVER cried when he got hurt but now he does thank god. He has friends his own age and a year younger but older kids think he's a great kid. He's always been super comfortable in his own skin and decidedly un neurotic LOL unlike me. He's gorgeous (seriously all eyelashes and blue eyes and blonde hair) so I think that helps him a lot with the big kids, the girls, the moms LOL Hey looks arent' everything but they can help! Thank god for small favors right?

I 100% agree in the genetic thing. I was always a nature v nurture thing and now i just think the best we can do is nurture the nature.

The only other things I would mention that seemed off are 1. He was not an affectionate baby. 2. He was a GREAT self soother (bottle) and GREAT sleeper. Both which are kind of good but kind of weird? 3. He had a kind of flat affect very early on but ALWAYS made amazing eye contact. And that changed at about 6 months and then he was very expressive. OH OH OH and this was always odd. He definitely was most comfortable hyper extending his neck. It was almost crazy whatit looked like sometimes! He also slept like that. Now he's not as pronounced with that but he does still sleep with his head a little back. I always thought that was weird.

He's a brilliant swimmer and LOVES being underwater. Like a much older kid with water. Dives etc... Thank god for this I hope he will join a swim team.

OH and i forgot one thing. I had to put him in pullups at 11 months because I had to change him standing up anyway he would NEVER lay down to be changed. I think they said it was propiosensory or whatever.

OH MY AND THE MOST CRAZY THING OF ALL: He has ALWAYS ALWAYS needed his head bounced or squeezed to get to sleep.

WOW, now that i've written it all down it does give a weird picture doesn't it!?

Can't wait to hear your thoughts. Hoping we can talk about the adoption stuff too. My husband was in hallway too!!!!!

 

[mymulligan]

Daisy thank you. I will say that I think I was talking about fire when he said that. I am HOPING he just put his anger together with the imagery there but I will look out for that. One other scary thing he did (well out of character) is he sat in his bed one morning waiting for me to come in his room to wake him up and shot me with a water gun in the face. That was kind of shocking.

The worst thing I find is the constant laughing, falling and weird noises. They are driving me to drink. I cannot handle it and I have to learn. Thanks for all that. He def. has some kind of sensory processing disorder but he tested out of Occupational Therapist (OT) and Speech and now the only help he gets is he gets to wash the desks at school, run in hall, he gets his head squeezed (which I KNOW is related) and sits with weighted beanbag dog at floor time.

In a word. He. Is. Exhausting. But he is still socially appropriate in most situations. Still polite to others. He can write pretty well, is excellent in Math but is CONSTANTLY saying he's bored and he doesn't want to do things because they are BORING. I could have a three ring circus in the livingroom but if it was something other than the ONE thing he wanted to do he would complain it was boring.

Thanks so much for responding. Can't wait to hear more of your thoughts.

 

[InsaneCdn]

He def. has some kind of sensory processing disorder but he tested out of Occupational Therapist (OT) and Speech

School-based resources? or private?
School-based Occupational Therapist (OT) will never give you the complete picture, nor will they provide the therapy, interventions and/or accommodations necessary for the big picture. Occupational Therapist (OT) in school, for the most part, is related to school work only.

Has he had a private Occupational Therapist (OT) evaluation?

 

[mymulligan]

Hi Jules. Yes since first grade. We had a problem with them not implementing his sensory breaks the first few weeks but that is fixed and they are helping him. He was in all day kindergarten but there was so much more free play and he was pulled out for services all the time. now they are saying he doesn't need services (he tested very high on expressive language etc. but he still can't form a normal sentence when he speaks....much of the time at least) So the day is an hour longer, he is expected to sit a lot more and he is never out of there. They have "specials" every day and do move around a bit but it's clearly too little for him. He complains a LOT that it's too long.
Nothing else has happened. No deaths, nothing different. I've gone to work but I'm still around a lot.

Oh and he never wants to be with me. Only his friends. I could say we are going to his favorite place on earth and he'd rather be at a play date with another kid.

 

[mymulligan]

Thanks Soapbox. He's had sooooo much testing. He's also a very keen listener. He does get distracted easily but I feel like it's as much sight and touch as hearing. Never say never though and I will keep an open mind. He was THE most social kid in his group. The most polite, the sweetest, every mom's favorite. But I will definitely agree about the motor stuff. He's def behind in sports and gets down on himself.

Also something I'm JUST thinking about is even with his SEIT and the collab class last year I think this year he is much more aware of being one of the Special Education kids and he talks so much about this one kid who is also Special Education and a lot more aggressive than him. He must realize they are alike in some way that they both need special attention and maybe he finds this confusing. Maybe this is getting him down, this being different. More like that boy than the rest of the class even though he's somewhere in the middle. Hmmmm (he's also more aware of everything: adoption, ADHD diagnosis etc....

 

[mymulligan]

Not only has he not had an Occupational Therapist (OT) evaluation but in Occupational Therapist (OT) last year they focused primarily on fine motor/handwriting which maybe he needed but most certainly wasn't the main thing he needed which was all about knowing where his body is in space. I know I don't have the right language but he's very expansive. Takes up space, falls, moves a lot, laughs a lot. What he needs is a way to feel GRAVITY and reign himself in.

If i could design the perfect Occupational Therapist (OT) for him it would be lots of deep pressure, heavy work stuff like that. I think you are so right.... his only Occupational Therapist (OT) has been early intervention, CPSE or school based.

 

[TheBoyHasArrived]

He sounds very similar to my first grader (adopted at 5 yrs). Mine has a lot going on in addition to what you are seeing, but we are pretty sure a lot of it could be explained by prenatal exposure. The only thing that I see that sounds different is that these "weird" things are out of character for your son...it's not unusual at all for mine to threaten to "break mommy's arm," so it's not a surprise. For him to be showing strange things all of the sudden is interesting.

First grade has really complicated things for my kiddo, because first grade work is so much more complicated than kindergarten. Kindergarten is so concrete and relies a lot on memorization but first grade incorporates a lot of comprehension. Another MAJOR factor for us is The Boy's poor auditory processing. Typically, poor auditory processing isn't diagnosed until around 7...up until then, it might just be something "off" you can't quite put your finger on yet. It can look like low cognitive skills, ADHD, autism, etc--if you aren't "getting the whole message," you tend to tune out, be fidgety, have poor auditory memory, miss social cues, etc.

 

[TerryJ2]

Welcome, mymulligan. You've gotten some great feedback here.
Definitely, it's not conduct disorder. He's got some neurological issues.
Lots of deep pressure sounds like autism to me. As well as "constant laughing, falling and weird noises."
I'm so sorry that the last "pro" was a flake. It's amazing how many flaky doctors are out there.

Our therapist is a behaviorist, so he's into things like ... "Today you're going to fall down 150 X in a row. I'll time you. Get set-GO!" Then your son has to try falling down that many times. When he stops, you tell him he's not finished yet. I did that when my son was into kicking the seat while I was trying to drive and I would pull over and stand outside the car while he kicked. It only took a few times, maybe three (incl one time in the driveway at home) until he got over it.
When he falls down the next day, you immediately say, "Oh, time to fall down again. GO!" or "No, it's not falling down time until 5:00. You'll have to wait."
When kids have to do something at a certain time, it loses its appeal.
You have to set aside time to do these exercises and it's maddening, but not as maddening as having him fall down unexpectedly and spontaneously.

It's worth a try.

 

[mymulligan]

Really? Even with amazing eye contact as a young child and above average social skills (even now) He's mostly angry at me and his defiance is so sudden. I honestly don't think it's that. He was diagnosed by soooo many people including a behavioral neurologist (the flake who scheduled an observation at our house and never showed up) but she was smart and she was impressed with him. AND Dr. Martin Kutscher who is a top Pediatric Neurologist? I really want to keep an open mind but i find it much more likely that it's sensory processing disorder. But would like to hear more about why you think this might be autism!

 

[mymulligan]

How are you moms so strong with all this! I really need to toughen up!

 

[DaisyFace]

How are you moms so strong with all this! I really need to toughen up!

We are not stronger or tougher than you....most of us are just a little farther down the road.

Read the signatures. Most of us have kids who have been diagnosed with "Alphabet Soup". Multiple issues are common.

Processing disorders do tend to go hand-in-hand with ADHD.

 

[mymulligan]

Thanks. What is attachment disorder?

 

[InsaneCdn]

I doubt your son has attachment disorder... it's the result of on-going abuse and/or neglect during the first three years of life. The child doesn't learn to establish normal trusting relationships with caregivers... never forms "attachments".

Prenatal drug/alcohol exposure?

 

[mymulligan]

Yes prenatal exposure to Crack (not much she was on parole and constantly tested, I was involved) though I am not so naive to think it was ONLY once. That and cigarettes and a little bit of alcohol. She didn't eat well that's for sure. Drank a lot of milk and he only eats cheese! I wonder if there is a connection!

 

[mymulligan]

By the way I just read this and it hits unbelievably close to home!

Another response to being overwhelmed is to flee. If a child dashes out across the playground or parking lot, oblivious to the danger, Peske says that's a big red flag that he may be heading away from something upsetting, which may not be apparent to the rest of us, or toward an environment or sensation that will calm his system. This "fight-or-flight response is why someone with sensory processing disorder (SPD) will shut down, escape the situation quickly, or become aggressive when in sensory overload," she says. "They're actually having a neurological 'panic' response to everyday sensations the rest of us take for granted."

My son has actually fallen asleep at basketball games with bright lights and music and crazy noise

Along with touch, hearing, taste, smell and sight, Dr. Ayres added the "internal" senses of body awareness (proprioceptive) and movement (vestibular). When the brain can't synthesize all this information coming in simultaneously, "It's like a traffic jam in your head," Peske says, "with conflicting signals quickly coming from all directions, so that you don't know how to make sense of it all."

Feels soooo like him.
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