I'm going to test my kid no matter what hubby says

[Kathrine]

Ok, I got husband to clarify, and he does think ADHD is a real illness, but just that our son does not have it. But he's being such an A-hole about it! He said "Let me work with difficult child for a little while and I'll determine if he has ADHT or not." Yes, he said ADHT. The man who doesn't even know what it's called is going to give me his expert opinion on the matter.

Anyway, I tell him I have been working with him for 2 years, and his teacher has been working with him for 2 years, and we've been patient, encouraging, motivating, and more patient with difficult child, and his attention span and focus has not gotten any better. difficult child says "Whenever I sit down and talk to him face to face and get his attention he listens just fine." I was like "Wow, you talk to him once a month and that means nothing is wrong." (I say that because I almost exclusively am the one who does his homework with him, who reads to him before bed, who bathes him, feeds him, and clothes him. Of course he's going to listen to dad the few times dad bothers to really sit down and do anything with him.)

Then husband pullled out the "I was just like him when I was his age" card. Well then I let the dirtly little secret out of the bag. For as long as we've been married (9 years), I've suspected husband of having ADHD. But I had never said so until today. I told him that if he thinks he's overcome his own ADHD by his own will power then he's mistaken. He doesn't listen, he interrupts people all the time when they're talking. He irritates my family members because he interrupts so much and even if he doesn't interrupt he'll just keep talking after they're done as though they've said nothing at all, and he's still in hiw own little conversation. He messy, he misses meetings because he's so disorganized, he can't find important papers in his office because it's so cluttered and disorganized, he doesn't keep records that are related to his job and his co-workers have to remind to write the things down that he's supposed to be keeping record of, he procrastinates and gets his work done just under the deadline, etc.

And you know what his answer to all that was? "Well, but when I make up my mind to do something then my focus is like a lasar beam." It's all a matter of willpower with him. Because he can occasionally focus on the things he wants to do then that means he does not have ADHD, and the same must be true with difficult child.
And for some reason he does not even want to go to a psychologist to get another opinion. He says ADHD cannot be empirically determined (like by a blood test or some other lab) and we know our son more than any psychologist and we should be perfectly capable of saying whether or not difficult child has ADHD. And I said maybe that's right and I, his teacher, and the family doctor have all agree that he has ADHD, and that I am the one who has been working with him on schoolwork for the last 2 years and I know better than he. And husband says "Well, let me work with him for a little while. I can make him want to do better." And I said "difficult child WANTS to do better, but he gets stubborn because he's frustrated. You have the cause and effect mixed up. I've looked into that boy's eyes and he's not NOT doing his work because he's stubborn, he's stubborn because he's frustrated with the work." In other words, difficult child can't accept failure and so doesn't want to do it at all.

husband also uses circular reasoning. He says ADHD exists and that some people have it. But he won't admit our son has it because it cannot be empirically proven and is just something extrapolated from childrens' behavior. Well how does he think the "real" cases of ADHD are determined? If behavior is the only way to diagnose it, then it should be acceptable to use that to diagnose difficult child too, otherwise there is no way to determine a real ADHD case.

Here are the results of my difficult child's Iowa Basic Skills test:
Vocab: 87th percentile
Word analysis: 95th percentile
Spelling: 95th percentile
LISTENING: 19th percentile (This means 81% of kids his age scored higher on this part of the test.)

Anyone see anything weird here? He's smart but doesn't listen. His social studies and science scores were low too because at the first grade level most of it is also listening skills. husband knows all this but thinks it can be corrected with making difficult child "practice" listening. I don't think it's fair that difficult child misses out on recess because he has to stay in and finish his work. And 2nd grade is going to be much harder, and he hasn't shown much improvement. I feel like this is the year he's going to flounder.

 

[Kathrine]

PS. I AM taking him to the psychologist on Sept. 11 regardless of husband's wishes. I'm the one who picks difficult child up from school (of course, and I take him there too), and I'll take him to the psychologist.

 

[smallworld]

How does the Iowa Basic Skills Test assess Listening (in other words, how is that score determined)? Depending upon how the score is arrived at, your difficult child could have an Auditory Processing Disorder, for example. Or he could be more of a visual learner rather than an auditory learner. Just because it looks like ADHD doesn't mean it is ADHD. I personally would not go to a psychologist who specializes in ADHD because he will be unlikely to look beyond ADHD to see if there are other causes behind his inattention and lack of focus. You want a professional who will look at the whole picture before deciding that it is ADHD.

 

[Kathrine]

Smallworld,
That fact had occurred to me as well (about the auditory learning problem), but you can put a page of easy math problems in front of him and he does no better. He can't work if there's any other noises in the room, he daydreams, fiddles around, and does one problem every 5 minutes. When he FINALLY gets them done, they're all correct. So I know it's not too hard for him. I honestly do not know who else to take him to besides the recommended psychologist. We don't have a large city nearby and there aren't a whole lot of choices.

 

[blb]

Katherine,

The guy you highlighted is a psychologist. He cannot prescribe medications, only a psychiatrist (MD) can. Also, just mho, but any psychologist that feels he can address adhd through behavior modification only isn't really all that versed in adhd. I'm giving you a link to an in-depth article from Dr. Russell Barkley on adhd

This is just my opinion, but you may want to reconsider and have a full evaluation at a Children's Hospital, which can include meetings with a psychiatrist, psychologist, and a neuropsychologist. Many on the board have gone that route and have been pleased with the results. A psychologist is ONLY going to be able to give you behavior modification techniques unless he refers you to a psychiatrist. And you would want a pediatric psychiatrist that is well versed in ADHD/attention issues.

Found this for Arkansas Arkansas Children's Hospital


From everything I've read, and lived through, most with severe adhd improve with a combination of medications and behavior mod. All the behavior mod in the world however, without the medications to allow them to increase their attention span, will not do much except on those days when focusing just clicks. This is the case with my oldest daughter (9yo)

The phrase I remember about adhd is that "kids with adhd are consistently inconsistent," in other words they can do well one day and then be held to that forever when often they are incapable of sustaining that level of attention on a daily basis. My difficult child was held to that standard and her self esteem plummeted from not being able to achieve that consistently.

Re your hubby, read "Driven to Distraction," by a Dr. Edward Hallowell. Your husband may very well have adhd, and when they focus on something they really are interested in, it's called hyperfocus. He may see quite a bit of himself in that book.

Also, there is a huge genetic component to adhd. Both my husband and I have it; I got by without medications, but could have really used them in college; my husband floundered in school and only at age 42 began medications with a huge improvement. Sounds like your husband is in a bit of denial re his own hx. This is not unusual. When my difficult child was initially diagnosed, we started shaking my husband's family tree to see his family's hx...oooweeboy let me tell you, I'm surprised I didn't run for the hills then

In any case, good on you for seeking help for your son!

 

[Marguerite]

Kathrine, I'm on your side. Thoroughly. But you're antagonising husband and thereby making it harder on yourself. Mind you, if I were in your shoes I might be wanting to choke him myself...

You wrote, "difficult child says 'Whenever I sit down and talk to him face to face and get his attention he listens just fine.'"
I'm presuming you meant husband, not difficult child? Very revealing... but it is a statement I would have thought you could agree with. because that IS what they're like - you CAN sit down and talk one on one with these kids, and they do SEEM to take things on board.

If it's not like that for you, then you're probably seeing more of the real problem and husband is still seeing a politer version, a kid who really wants to please his father and at least SEEM to be paying attention.

What would happen if you said to husband, "Wow, honey! You got him to LISTEN to you! He needs this sort of understanding, I'm just not able to fathom this sort of approach - how about YOU take over supervising his homework every night? It would mean so much to both of us and put my mind at rest about anything being wrong, if it could be so easily fixed." Try to not sound sarcastic. Tempting, I know.

Then if husband will follow through (and from your description, I doubt he can) then you get a break. If husband miraculously produces results, difficult child's marks greatly improve and his attitude in class becomes perfect, then your problem is solved.
I doubt this will happen. And when it doesn't happen, how will husband explain it?

Those test results worry me. He sounds like a very bright kid who isn't able to perform to his standard. This is so frustrating FOR THE KID, as well as for those trying to help him. And yes, a bright kid will get sullen, defiant and misbehave, especially if people around him expect this to happen and begin to consider him to be naughty and disruptive. They feel bad about themselves and resent themselves for not being able to come up with the goods.

So here's another direction to take, with husband - in this test you have empirical results. You can point to the scores and give a number. There is clearly a disparity - those numbers should be much more similar. With most of these tests, there should be similar results across the board, unless there is an underlying problem.
A kid can't get a false high result, but he CAN get a false low. The test is designed so this is unlikely to happen by accident. The kids generally enjoy these tests, they're like games. They are highly motivated to do as well as possible. But difficult child couldn't do better than this? It's not his vocabulary that let him down - he understands the questions. He's bright, he has the language skills and communication skills. So what went wrong? Can husband explain this? Does he have any ideas? Because if there is something wrong with difficult child, he needs it discovered NOW so he won't fall too far behind. With support and finding out what this problem is so he can get around it, difficult child can pick up the pace and become anything he wants to be - a doctor, a lawyer, an airline pilot. But if he can't resolve whatever is interfering with his ability to listen (and it could be as simple as a subtle hearing problem, or frequency discrimination problem) then difficult child is going to head in a very different direction.

At this point, don't say anything to husband about what you think his (husband's) problems are. This is attacking, and husband will HAVE to defend himself, probably by increasingly denying that the problem exists; or that it's a problem at all. That is not what you want. Right now, your focus has to be difficult child. Don't try to fix husband at the same time. Maybe later, if he ever accepts the connection... (hey, at least he knows he's difficult child's real father!)

husband is right when he says that when he concentrates on something, REALLY puts his mind to it, he can narrow his focus down. This is a typical adaptation coping skill in someone who is bright but has ADHD. You're born with this condition, it's just one of those things, but you adapt as you get older. If you get support, you adapt with tuition. If you're floundering (as husband would have been) you work things out for yourself. You end up managing, coping. Would he have done better in life with support? Almost certainly. But it's almost too late to intervene, with an adult. They become too set in their ways and their own personal management strategies.

I was born with poor eyesight. I never realised how bad my eyesight was and because I found ways to cope, it took a school eye test to identify the problem. When I got my first pair of glasses I realised how much I had been struggling, but I also began to REALLY do well. Before then I had been using colour to see my way, which meant I couldn't get around in the gloom and dark. I had also been clumsy. So I could have been accidentally diagnosed with Vitamin A deficiency and poor gross motor skills. Instead, I was merely short-sighted.

Similarly, don't hammer on about ADHD to husband. He's not an expert (although he's probably more of an expert than he realises!) and neither are you. Let an expert assess. What is concerning you is what you see - he has a listening problem which is seriously hampering his ability to reach his potential at school.

In the meantime, to help difficult child cope - when you talk to him, make sure you have eye contact. Reduce distractions when you need him to pay attention - this means turn the TV down or off, turn background volume down or off, unless it is masking other sounds such as traffic noise outside. Keep the lighting comfortably bright, not too dim and certainly not glaring. Make sure his clothing is comfortable - I had to remove manufacturing labels from difficult child 1's clothing because it itched the back of his neck. I've known some kids who wear their clothes inside out because that way the seams aren't rubbing. make sure he isn't hungry, thirsty or needing to go to the toilet.

And treat husband the same way.

Focus on their qualities and abilities. Boost their self-esteem, constantly but appropriately. Like, don't say, "You're the most handsome person I've ever seen" because we live in a world with Pierce Brosnan and Brad Pitt. But boost the things they are good at - "husband, I do like you you can really focus on something important you're working on, and get to the source of the problem." or "difficult child, you have a lovely smile and I love your hugs." (or swap, depending on the situation). I love you needs to be said often. But only if you can mean it at the time you say it.

You need answers. difficult child has a clearly identified problem. It needs further assessment to identify the underlying cause, which could be physical. Don't talk to husband about any other possibilities.

And hopefully you'll be able to help difficult child enough to make some changes for him. One day, if husband is looking proudly at his son achieving well and says, "He's a chip off the old block," you can smile and say, "More than you know, husband."

Marg

 

[Liahona]

We talked to our pediatrician first. He had us fill out a questionair and the teacher fill one out. Then he diagnosis ADHD and gave us medications to try. difficult child 1 has been to see many therapists since age 3, and they weren't able to diagnosis. Even the one he is with now (and I think is the best one so far) won't diagnosis. He'll send us to a psychiatrist (MD) to get the diagnosis. Therapists are necessary in my opinion to help the kids and family through everything that is going on, but they aren't great at diagnosis. At least the ones we saw.

Maybe a pediatrician could help get the multidisiplainary evaluation started? I didn't go that route, so don't know how to get it started.

 

[Kathrine]

I guess here in Arkansas they don't go through all the same routines as elsewhere. My family doctor was ready to prescribe Strattera based on what I told him about difficult child's behavior, test scores, and teacher comments. He didn't even give him a physical exam.

I had another idea too. When I was 29 I lost almost all the hearing in my right ear for no apparent reason. I had the same kind of permanent nerve damage that elderly people get from strokes or seizures--except I hadn't had a stroke or seizure. So this morning I decided to get difficult child an appointment for a hearing test. The doctor, who is a specialist in "head" stuff will examine him first and then the audiologist will give him a thorough hearing exam. I know that 2 years ago at his school's free hearing exam difficult child scored a little low, but we chalked that up to a head cold he had at that time. This could explain his listening skills because I tune out when I don't have my hearing aid in. It's too hard to ask people to repeat themselves all the time. It doesn't necessarily explain why he won't finish written work, but I do need to get him tested to rule out the possibility of hearing loss. I don't know why I didn't think of it before.

If we do end up going to a city it would probably be St. Louis. My mom lives there and so we'd have a free place to stay.

Oh, Marguerite, last night I did get husband to take over more activities with difficult child. I told him it wasn't fair for him to swoop in and work with difficult child for 15 minutes and then tell me nothing's wrong with him, because extra attention from dad is new and exciting and of course difficult child's attention will be better. husband agreed and now is in charge of a lot of difficult child's day. This will accomplish one of 2 things: husband will realize that difficult child has ADHD after having to deal with him a lot more, or all the extra attention from husband will help difficult child settle down and do a little better. Either way, it will be an improvement from what we have going on now.

 

[OpenWindow]

I just moved to Vilonia last year, about 30 miles from Little Rock, so I know about the lack of places in Arkansas to get my difficult child tested. I'm lucky we started the ball rolling in St. Louis and were able to see experts in psychiatry, psychology, neurology, autism. However, the experts weren't able to pin anything down.

We recently had him re-evaluated by a pscyhological examiner at UCA in Conway. We were very happy with her, although she said the same thing as the big city experts - couldn't pin anything down in regards to a specific diagnosis. She did add major depressive disorder and severe mood disregulation to the ADHD and ODD.

I just emailed her and asked if she knew your psychologist. I'll PM you and let you know once she responds.

I work in Little Rock and have talked to people about where to go for more testing - both Children's and UAMS were recommended. I haven't pursued it because I was waiting for this evaluation to be done. But really, they would probably be fine for your initial evaluation instead of going to St. Louis if your insurance would be a problem.

It's possible your family doctor will prescribe something if the psychologist recommends it after testing, so you wouldn't need a psychiatrist. I'd recommend finding a pscyhiatrist.

As far as your husband, I think he may be an identical twin to my husband! I had to make all the decisions about getting evaluations, medicating or not, getting an IEP at school, etc. etc. because my husband is mostly in denial about himself and difficult child. The thing that convinced my husband to OK the medications was that Ritalin is quick in and quick out. You can tell the day he takes it whether it's going to work or not. If he is diagnosed with ADHD, ask your husband if (or ask the dr. to ask husband) to let difficult child trial it for 2 weeks. If it works, your husband will notice the difference right away. My husband was still reluctant to agree to continue it, but he did because he saw what a difference it made.

He still goes in and out of denial and makes it hard for us to progress with the decisions, but usually he just says he'll do whatever I decide, but that I should know that he disagrees! Fine, whatever.

By the way, if you decide to go to St. Louis for testing, I can recommend a doctor's office that does a great job of evaluating. Once my difficult child was diagnosed and seemed more stable, we had to go back every 3 - 6 months for follow-ups and to keep his medicine prescriptions.

There's also a mental health initiative going through the schools in Arkansas right now. When I have a few minutes I'll try to find the link. Maybe your son's teacher could initiate an evaluation at school for an IEP? (You could too, but not sure you'd want to until your husband is more on board if someone else would do it for you.)

Linda

 

[Kathrine]

Thanks for the info Linda! I tell you what, I am not impressed with health care in Arkansas. When I take my kids for check-ups I have to tell them (the nurses) what innoculations my children should get at this appointment. It's frightening. And they don't do nearly as thorough a job examining children as they did when we lived in St. Louis. I really have to be on my toes and insist on things to be done right. Arkansas Childrens' Hospital does have a good reputation though. Hopefully it's better since they specialize in children. I also was unhappy with the OB/GYN's that I went to here. I tried 2 different ones and was unhappy. Last month I drove all the way back to St. Louis to my old OB/GYN and found out more answers to my questions from his nurse than I did from the doctors down here. It was worth the drive. Well. That was a tangent. But I think the lessons I've learned could apply to mental health care around here as well.

 

[Marguerite]

Kathrine, you said, "This will accomplish one of 2 things: husband will realize that difficult child has ADHD after having to deal with him a lot more, or all the extra attention from husband will help difficult child settle down and do a little better. Either way, it will be an improvement from what we have going on now."

Good onya, girl, you got the idea!

I think getting difficult children hearing checked is a very sensible thing to do - it needs to be assessed because if you find something at THIS level it could answer a lot of problems in a much easier way. And if he tests as normal - then you know to keep looking.

A hearing test was our first port of call with difficult child 1, because he was not responding even to his own name, when he was 2. But there is a simply, subtle hearing test you can do on your own - it's sneaky - crinkle a chocolate wrapper on the other side of the room when he's not expecting it.
Basically, think - does he respond to sounds of something he likes? What about an ice cream truck going along the road? A favourite ad on TV? The theme of his favourite show? A favourite song on the radio? His best friend calling his name?

A proper hearing test is far more sophisticated than this. It's also delivered in a distraction-free environment in a one-to-one situation. He will be really trying hard to get it right. This means the results of his hearing test are likely to be as close to his actual ability as possible.
So if his hearing checks out OK, but his listening score already has not, you then have to think - what else is needed, for attention?

For now, treat him as if he has a hearing problem. As a rule they don't ignore to be annoying, they really haven't heard; or there can be a delay before your words 'sink in' - "oh yeah, I think Mum just called me for dinner, maybe a few minutes ago - I'll go check." It's like when someone says something to you that you don't quite catch and even as you're asking them to repeat it, your brain has continued to sift trough and sort possibilities and you finally realise what was said, without having to hear it again after all. Imagine that happening on a much bigger scale, much more frequently - your brain is constantly playing catch up.

I like entering game shows on TV. For most of them, the audition process is a trivia quiz where questions are asked one after the other. There is a time limit for each question and at the end of the TOTAL time, you hand your paper in to be marked. Something I've done - I might not be sure of an answer, or it might be on the tip of my tongue and I want to think about it a bit more, but already they're asking the next question. I'll make a small pencil mark giving a fragment of the question, so if I answer a later question faster I can use the extra seconds to give the earlier question some extra thought. But to do this, you have to also keep listening to each question and not be so distracted that you lose your place.
Someone with an attention problem (for whatever reason) is constantly playing catch-up like this. They CAN lose their place or get totally confused. Teachers hate it when a kid keeps asking them to repeat something, especially if they think the kid missed it through laziness or inattention. As a result, these kids learn to not ask for it to be repeated.

It really sounds like you're making good progress in your own ideas and handling. I hope you get some useful answers soon. Good on husband for taking on the extra responsibility - there's hope for him yet! Maybe take him a cuppa while he's sitting with difficult child? My difficult child 3 drinks coffee too (decaf only) so I'll sometimes take him a fresh cup of coffee when I can see he's working well and I don't want him to stop to get a drink for himself. If husband is working with him - they both get a cuppa, if it's taking time. It's the reward for working well together.

As for your health care system - sometimes you have to do whatever works for you. What we do Down Under is not what most people on this site advise - but it's how things work here, I can't change it. Wish I could sometimes, but there it is. At least to get started, you go with the flow sometimes.

Marg