Neuro-psychologist and pre-school age children

[Malika]

Yes, quite agree, Step. ¨Personally I have never set any store by IQ, which again seems a narrow marker of what might be called true intelligence... (only happen to know mine because years ago I thought I would test for Mensa, by whose standards I am a reject and failure as they only accept people with IQs of 140 and above ) And, at school I was never that brilliant - always shone in English, and did well in other arts subjects, but nothing exceptional. The label "gifted" never came near me! On the other hand, I was not that fond of digesting facts or information or studying (even though I went to university, getting an English literature degree). I loved reading, learning, discussing subjects of interest, though... just not the way they got mangled and dried out in the school mill!

 

[DammitJanet]

I just wanted to chime in on the ADHD subject. It is very real. Nowadays it tends to be thought of as a neurobiological condition though, instead of straight psychiatric. My "simple" ADHD kid was diagnosed at age 4 and he was hyper as all get out and the extreme focus and attention issues really stood out as soon as he hit kindergarten. Before that it was his extreme hyperactivity and lack of being able to focus on much of anything at home. He was the one who would be in mid sentence when he would be saying something like "mommy, I just saw a...oh look at that butterfly!"

He was extremely physically active. He taught himself to ride a two wheeler bike without training wheels on his third birthday. He could hit a pitched ball by the time he was 3 and a half. He was goalie on a soccer team at 4. He never sat still. I dont think he ever watched a complete tv show until he was at least 10. The only times he played video games was when it was raining outside. He climbed trees and held onto the tops of them and parachuted out of them by holding on to the tip tops. He jumped of the roof of our house onto mattresses.

Thats when I got him a trampoline...lol.

Ritalin did do wonders for him. He took it from the age of 4 until he was 14. He stopped it so he could do HS without it so he could be four years off medication to enter the Marines. He ran 3 miles every morning and 3 miles every afternoon to help himself with his hyperactivity. He made it through the marines but he is still ADHD and he still has something in constant motion...his legs or his foot. He still has a bit of trouble concentrating on more than one thing at a time. He has taught himself some tricks to manage life. He does okay now. He talks all the time!

Without medications, he would have never made it though.

 

[Malika]

Thanks for this, Janet. Funnily enough, I was thinking of your son the other day as I was talking to a friend about adults with ADHD and she was saying that she didn't know any; I said I didn't either but there were people who SEEM hyperactive but have never had the diagnosis. Then later I thought of your son and wondered how his ADHD "manifests" as an adult, which you have answered a little.
It is interesting to hear anecdotal evidence. I can see my son in yours - physically. Mine also taught himself to ride without training wheels shortly after his third birthday, is constantly in movement and impulsive. Some problems with aggression (usually "playfulness" that goes too far - only person he hits in anger is me...) Etc. Thus far it all looks very like ADHD.
However... my son has no discernible problems with concentration. He concentrates normally for his age, I would say. Can play for a long time by himself, sits and does puzzles by himself, certainly watches DVD all the way through and so on. He sits with the other children in school and does the exercises they do; his teacher has said to me she doesn't see how he can be hyperactive because of this. Yet in other situations one would certainly say he is hyperactive... In my now fairly extensive reading on the subject I have learnt that sometimes children can be hyperactive as an emotional response to difficult circumstances, for example. I absolutely do not dispute the use of the stimulants in some cases, where it clearly allows a child to follow a school programme, etc. But for the moment it looks like my son will be able to go to school unmedicated.
Sometimes I think it would be very tempting to give medication to my son if it would make him more welcome in people's houses, for example - not rushing around wildly. Or if it would stop him having tantrums that also make people think he is not very nice to know... But, as Ross Greene says, medications themselves do not teach the skills that children lack that makes them do these things... And while I totally haven't shut the door on the idea that one day my son may take medications, I am naturally concerned, as most people are, about the side effects and so on. It just seems preferable to get through without medications IF ONE CAN and to use all the other available means...
I am glad your son is a "success story". Gives me hope

 

[4timmy]

My take is that ADHD seems to be the more popular diagnosis for any child who is hyper and can't seem to stay on task and pay attention... a lot of young children are like this so I tend to agree it's too early to know 100%. We were told difficult child was ADHD/ODD when he was 5 by our family doctor. At 3 our pediatrician told us he was just more immature and "strong willed" than other children and suggested we hold him back from starting school....... We didn't get the full picture of what was going on with him until he was 10 when I joined this forum and got him to a neuro-psychiatric. Obviously, all difficult child's are unique, so maybe it's more obvious in some than others.

Oh, and stimulants NEVER worked after about a week of taking them. He's taking Intuniv for is inability to focus now, but I couldn't tell you if it's really that effective.

 

[agee]

And then there is a pretty universal assumption, which one hears and reads over and over again, that a reliable diagnosis cannot be made before the age of six or so because of how rapidly and uncertainly young children develop and because many of the symptoms of ADHD are too close to "normal" behaviour in young children. Having said that, I have always been aware of the difference in my son's constant movement and high energy levels and the "normal" spectrum... I think the difference is clear and observable.

This was our experience. I knew something was not quite right at age 3, but waited until 4 to call doctors and I finally found a practice that was willing to consider it. First we saw a child psychologist who was to refer us to a psychiatrist if our interview warranted further action. I imagine she was to ask me about discipline and expectations and boundaries at home - but within 7 minutes of watching my son fling himself at me, climb the couch, jump off, fly in the air with no regard for landing...she said she'd refer us.
For my boy it's a combination of things - ADHD, sensory processing disorder (SPD), probably fetal alcohol effects - all bundled into one. Stimulants help the neurons in his brain fire faster. They can communicate better. He is less impulsive. He does less self-stimulating activities that he did to keep his brain humming (noise making, wiggling, jumping, jerking, etc.). Off the medications all bets are off.
Now that he's older he's less a bundle of energy, more a bundle of impulsivity. Not sure what that means for the future!
A

 

[Malika]

Your son sounds as though he has had to deal (and you with him, of course) with so many difficulties... and is coming through. Who knows - maybe one day my son will be on medication and I will be grateful for what it does for him... At the moment, it's just not at that point of urgent necessity. Though, like I have said, the idea of a medication that will make him quiet and "unobtrusive" is tempting sometimes
What puzzles me about the hyperactivity (in all cases? Or just my son's?) is that it varies, depends on the situation. For example, yesterday we went to the opthalmologist. In the waiting room, it was my version of mini-purgatory.... Various other children who look around J's age are sitting quietly (for the most part) on the chairs. J is rolling around on the floor, running in and out, singing loudly and then - which gets me stress and dishevelled - starts playing with light switches and does not stop until I get really cross with him. Then he is lying on the floor crying loudly. It was late in the afternoon, after school, and he was very tired, which of course always makes things worse. Anyway, after 20 minutes of this calvary (why aren't medical appointments like formal dinner invitations - 5.30 for 6.00?!), we go into the doctor's office where for the next 20 minutes J sits stock still on the chair, doing all the things the doctor asks like a perfectly compliant, wonderfully behaved child... IF there is something in his brain that is making him move all the time, surely it would be in operation in all circumstances?

 

[4timmy]

we go into the doctor's office where for the next 20 minutes J sits stock still on the chair, doing all the things the doctor asks like a perfectly compliant, wonderfully behaved child... IF there is something in his brain that is making him move all the time, surely it would be in operation in all circumstances?

Did he sit still while the doctor was talking to you and examining him?

Your stories reminded me of the time I took difficult child to Pee Wee Soccer. All of the other little kids gathered anxiously around the coach when she called them in to teach them how to hold or kick the ball. They were all so intensely focused and interested in what she was showing them. My difficult child???? He had wandered off to the corner of the field to put one of those big orange cones on his head......God love 'em. I knew then sports really wasn't gonna be in his future.

Taking difficult child to the doctor or anywhere for that matter was a nightmare. My difficult child would usually have every single drawer in the examination room emptied and all the paper torn off the examination bench while we sat for another 15 to 20 minutes waiting on the doctor to come in. It always seemed like we were in that room for hours! lol

I just tend to believe there are just some situations and environments that capture difficult child's interest more than others. This adds to question the whole Video Game question I hear all the time...."how can he sit for hours and play a video game" but can't sit for 5 minutes to do his homework? The answer is (supposedly) that he's engaged in a stimulating, structured game where the rules and goals and what is expected is well known to him. My difficult child is most calm when he doesn't feel pressure or fear of the unknown....... and no to your last question, my guess is no from what I've observed in my difficult child. On top of that, each child will react differently depending upon his sensitivity to things. Also, if medications are diagnosed correctly and at the right levels, you won't witness "quiet" and "unobtrusive"....maybe a little the first week, but that's it.

I will add one last thing and that is I see somewhat of a trend here on this post it seems with the intial diagnosis of ADHD/ODD. My difficult child received the same diagnosis at 5 and then when he was ten, he displayed characteristics of Autism, Bi-Polar, Obsessive Compulsive Disorder (OCD), and Asbergers. I'm really close to being convinced 100% that the ADHD/ODD diagnosis is the default for young children that doctors use because of the impossibility of asking a young child any in-depth questions to get detailed answers. Since any scientific method of diagnosing it would be way too expensive to "waste" on a developing mind, Doctors just give this diagnosis as a catch-all and tell you that he might grow out of it and that "we'll keep and eye on it'

 

[BusynMember]

Since I can't know what is going on with your difficult child. First, there are no neuropsychs in the US who only look for ADHD...they test for everything.

This is a TOVA test which is pretty reliable for ADHD...it is a computerized test where the child has to pay attention to blinking lights for a LONG time and press a button when he sees them. I took the test once, my autistic spectrum son did and my daughter did. Son and I were able to stay on task and did fine. ADD daughter totally messed it up. She could not follow it. She is fourteen now and has complained to me about her inability to pay attention AND to remember what she is taught. We put her on medications, but she didn't like how she felt on them, so we took her off. Still, shes struggles in school and needs extra supports. She gets C's with her help.

It seems that perhaps you worry too much about school in my opinion. I'd just let him be happy, but I was definitely try to figure out what is wrong. Something is or you wouldn't be so questioning. The earlier he gets help, the better the prognosis,

ADHD and ADD are real. So is Aperger's syndrome and kids can also be depressed and have mood disorders, whether or not doctors will diagnose them. I was a very depressed child who thought of suicide often, and back then they did not diagnose that in children. So I had a miserable childhood in which I felt I could not do anything right and I did not do well in school nor know how to make friends. I desperately wanted help, but there wasn't any. I'm thinking that perhaps France is where the US was back when I was a child, when you were supposed to cope, even if you had a disability. It was a lonely place to be. I barely graduated high school and grew more suicidal until not taking medications was life or death for me.

Good luck!

 

[Malika]

Thanks MWM. Little confused as to why you say I am worried about school as to my memory I have only said my son has no problems at school! Also, I am really not interested in "academic performance" - I have friends who are teaching their small children letters, numbers, etc. I feel for myself this is foolish and unnecessary. The most important thing children can be doing at pre-school age, in my view, is play... So I have no problems with just letting my son be happy.
I am very interested to hear about this TOVA test. Is that an acronym? Do you know what it stands for, if so? That would help me find out if there is a French equivalent. by the way, I am a little concerned about this impression I seem to have given that France is somehow "backwards" medically speaking... France is consistently at or near the top of the WHO list of the best healthcare systems in the world and in terms of clinical excellence and sophistication it really is one of the best. Mental illness, emotional problems - they are all talked about, diagnosed, treated... It is just that, like all societies, France is complex. On the one hand there is a lot of knowledge and supposed acceptance, on the other, in certain areas - particularly in the rural south - it is conservative and old-fashioned. Much the same kind of paradox as would exist in the States, I think...
I am questioning a lot. I feel like I'm evolving towards, if not answers, at least greater clarity... For me I am very happy to wait for the moment, not to have any diagnosis (since there is no question of my son taking stimulants before 6 or 7, there is no need yet) but to be aware of the skills he lacks and to try to work on those. Because really I don't know how things will go with my son. Eighty per cent of the time he is a joy to be with. Perhaps more, I haven't calculated it! When things are bad they do seem bad - but I am learning how to deal with it better. I do feel there is some possibility that he will calm down and improve with age, and never receive an ADHD diagnosis. On the other hand, I am not counting on it! Just opening to how things are and learning more and more to accept him for who he is, for good and bad.

 

[ThreeShadows]

http://www.tovatest.com/

 

[agee]

My son took that test when we first transferred to our new neuropsychologist - he took it unmedicated as they'd asked for us to take him off the medications for the first visit.
After about 5 seconds he started slamming his hands on the keyboard - whole hand, random fingers, etc. They'd told me only to read him directions and do nothing else.
The results were whatever the lowest possible score is.
I'd be kind of interested to see how he does when properly medicated, but at the time I felt completely hopeless - but also that they were seeing his true, unmedicated self.
A

 

[Malika]

How old was your son when he took this test?