What's a Mom to Do

[EmJay]

Last November when my then 7 yo was originally diagnosis'd with ADHD I was also going to push to have him tested for Auditory Processing issues. The school acted as though they had no idea what I was talking about and literally left it in my hands to deal with.
Since being on medications last November his behavior has improved (for the most part and as compared to the problem bx's we were having last year). I tried to find people in my area to have him tested with no luck. I inadvertently had his hearing tested; with the impression that I was going there for the AP testing. Once I felt like I had been spun in circles enough I quit looking. We also had a lot going on as a family at the time; so I felt like there were things that took over.
His original diagnosis came out of about a months worth of write-ups, phone calls with the principal, teacher, guidance counselor, and school board interventionist. I had even gotten to a point where I begged them to quit sending home write ups bc it didn't matter to him. He could care less about the consequences and a piece of paper meant more to ME than it did to him. Thank Goodness for such an awesome 1st grade teacher. I firmly believe had it been his K teacher; he would have been suspended 100 x's. (Kindergarten was an entirely different beast!)
We were following through with consequences at home; but how was I to discipline him at 330 in the afternoon for something that happened at 12p that day?! I felt like I was sinking there for a while. September-November of last year was pure hell.
And so we ended up at the LPC's office to discuss same family issues (a death, a loss of a job, and a pregnancy) and that's where she told me that unless I was able to get his ADHD under control there was no way she would be able to help him (because she does mostly talk therapy). SO I brought him to our pedi with all of the evaluation's from school and his LPC. We sat down, went over MY history, and then discussed our options.

So I'm here today asking about what I should do about the AP possibilities? Should I still pursue them? He was placed on Concerta and although it did wonders for the first month; he ended up pulling a knife on me one day and acted like he wanted to stab me with a pencil another day. He's on Adderall currently and has been up and down on that one. Right now we are comfy with 10 mg because anything less he is a basket case. Anything more he wants to claw his eyes out. We added the Intuniv about 2 months ago and it seems to have leveled his aggressive tendencies out.

He seems to be doing well in school this year. I volunteer and his teacher always tells me that "He's just himself" most days. on his rough days I do get notes home but with this teacher she has never written him up. (when they get to an F they are supposed to get a formal write-up... and believe me he has had his fair share of F's this year!) HIs report card always has A's and B's and he has received all A's in conduct on his report card this year so far.

I have inquired with the guidance counselor about what further help he would need and she basically tells me "let's leave well enough alone"... SO basically; if he's not causing a problem, let him be!

 

[buddy]

If you really suspect ap is an issue now would be the perfect time to casually investigate. Especially because, from my experience, you may hit a wall with medications at some point. To help address the underlying issues, you may not even need as much in the way of medications eventually. but if you are just investigating because you are checking out anything and everything (Not a bad idea for many, so dont get me wrong) I could see doing a wait and see if things are ok.

congrats on that by the way! Good for him pulling it together. I think the stims can be great, but I do believe they agitate and/or cause anxiety and for some aggression. My son is on them. I am switching back to the short acting ritalin to see if something about concerta was triggering him (partly). When I look back, when I switched was right before I started hearing more from the school staff and we re-did the fba and wrote the new IEP.... really wish I would have noticed that sooner. It may or may not make a difference but we will see.........

So matter what you decide it is ok. Very few things are forever. As mom's we want to make it better before it even goes bad, but we can only do so much sometimes.

 

[TeDo]

If he's got such good grades on his report cards, what makes you suspect now he might have AP issues? What are the signs you're seeing? Does he get any help at school to be getting such good grades? What kinds of things is he getting F's on....any particular "kind" of work?

Sorry for the questions but I'm just trying to get a clear picture of where things stand now. Our Occupational Therapist (OT) did some auditory processing testing. Our Speech Language Pathologist (SLP) is evaluating for any language processing issues. There is a special type of audiologist that does another kind of testing for auditory processing issues but we haven't gone that avenue (yet).

 

[EmJay]

If he's got such good grades on his report cards, what makes you suspect now he might have AP issues? What are the signs you're seeing? Does he get any help at school to be getting such good grades? What kinds of things is he getting F's on....any particular "kind" of work?

It hasn't been so much this year as last. This year is quite weird actually! K and 1 he was a handful. And now all of a sudden he is getting Student of the Month awards and coming home with A's in conduct. He IS a great kid; he can also be a handful! I'm not sure if the teacher just isn't making a great big deal about it or if she has so many other distractions in the classroom that he isn't a "major" one to be handled (there are several "hard to handle" kids in his class).

No. one thing that struck a chord with me is that I will look him in the eye and give him a piece of a direction and he will ask me "what?" right after or turn around and immediately forget it. I wanted to make sure this was either his ADHD or an AP problem.

To give you some background about myself:

I have a Bachelor's Degree in Psychology. When I graduated from college I worked with children ages 5-11 with severe Emotional and Behavioral problems. I was a Mental Health Specialist at an Outpatient Mental Health Program. I would go into the schools and help with observing and deescalating situations with my clients. ALL were boys. ALL had ADHD and were co-morbid with some type of ED. and Almost every single one of them had some type of Mood D/O, Learning Disability (LD), and/or Autism Spectrum Disorders (ASD). I worked with the Principals, Guid Couns, Sp Ed teachers, and so forth to assist with their IEP's and Bx plans. I coordinated with the Licensed Clinical Social Worker (LCSW) at our agency and the psychiatric to assist with developing plans for their education and at home. But the problem we had was with the parents following through. Most were non-existant much less active participants in their childrens education/program. So I became very frustrated and burned out and left that job. I went on to work with Mentally Ill adults and then with the Geriatric population.
After 10 years of working I am now a stay at home mom. And now I am dealing with some of this with my own child. I sorta kinda know how to work the system; but I have no doubt things have changed since 2001.

So back to your original questions: He does not receive any help; that I know of, at school. That's the thing. He's a Straight A student with Bx issues (at times). I'm thinking this is why he is overlooked by the teacher and the principal and the like. Because it isn't affecting his "grades" they aren't worried until it starts affecting the teacher/classroom. (that's just my opinion)
And again..... Kindegarten and 1st grade were VERY different from 2nd grade! It's almost awkward. I THINK the teacher is just letting a lot go! Especially since I'm up there so much!

 

[EmJay]

I also wanted to point out that one of the reasons I am considering having him tested for AP issues is that I orginally thought this in the beginning and was lead in circles. After going through all of that it was basically brushed under the rug.
I posted on Tuesday some things that made alot of people on here question maybe it was AP instead of ADHD....

So this is why I am inquiring about what/where I need to go/do with this!

 

[TeDo]

Thanks for all the background. I hope I didn't offend you with the questions. It was just reading your post left some in my head so I had to ask them. As I said in my post "Our Occupational Therapist (OT) did some auditory processing testing. Our Speech Language Pathologist (SLP) is evaluating for any language processing issues. There is a special type of audiologist that does another kind of testing for auditory processing issues." Have you tried the Occupational Therapist (OT) approach yet? That is probably where I'd start. Ours is awesome. I had no idea they did some AP testing so I was surprised when she mentioned it.

If all else fails, you chould check with an audiologist. There is special testing where they can do differential stuff like noise (different kinds of distracting & sometimes annoying noises) in one headphone and directions in another to see if they can follow the directions through the noise, etc. Hope this helps.

 

[EmJay]

Thanks for all the background. I hope I didn't offend you with the questions. It was just reading your post left some in my head so I had to ask them.

No indeed.... You did not offend me at all!


If all else fails, you chould check with an audiologist. There is special testing where they can do differential stuff like noise (different kinds of distracting & sometimes annoying noises) in one headphone and directions in another to see if they can follow the directions through the noise, etc. Hope this helps.



I did inquire with the audiologist during his apparent HEARING test and she was clueless. That's why I felt like we were lead in circles. I like the Occupational Therapist (OT) idea.... Is this something I have to seek out on my own or can they provide this through school.

Also, since you mentioned the noise; he is sensitive to certain types of noises. And he also gets very caught up in repetetive noises. FOr ex: his brothers toys. He will aggravated the heck out of me by pushing the same button over and over and over and over and over (you get the picture) again with no regards to who is in the room or where we are. Certain things make him annoyed (if my voice gets too loud; which I'm known for doing) and his brothers crying drives him nuts. He has told me at times that he just wants to pull his ears off!

 

[TeDo]

Personally, I go outside of the school if I want something reliable. Our Occupational Therapist (OT) at school did an "evaluation" for difficult child 1's IEP. She "found no issues that would impact his learning". Within the first 4 visits, our outside Occupational Therapist (OT) discovered (and gave us a method to deal with) that difficult child 1 has a very difficult time reading black letters on white paper. Hmmmm. Now why wouldn't the school Occupational Therapist (OT) be able to figure that out. And if she did, how would that not impact his learning. That is just one example of the ineptness of SOME school personnel. If you want, you could do both and cover the bases.

 

[EmJay]

Ok, so I am familiar with Occupational Therapist (OT)'s. I actually know a few. Do they have to specialize in this? Is it a referral process from the PCP?

and about your school Occupational Therapist (OT)... UM, YEA!!!! that WOULD indeed affect his learning!!! geez!
We had sorta the same experience with the SBLC person last year. SHe observed him for an hour in class and did a little bit of testing and said nothing should impact his learning. So we didn't get anything... Oh yeah, and because ADHD by itself gets them NO accommodations in this state!

 

[TeDo]

They do not need to specialize in it but you might need to ask if they do that. I guess as with other professionals, some maybe don't have enough knowledge to. As for a referral, it depends on your insurance. It's not going to hurt getting one but in our case, our insurance doesn't require one.

Just an FYI, ADHD is a diagnosis under Other Health Impairments under FEDERAL Idividuals with Disabilities Education Act if it interferes at all with his learning and/or that of others. If that is the case, I would remind the school that it is FEDERAL LAW.

 

[EmJay]

I'm seeing now that I need to brush up on my facts. I knew that!

ADHD is a diagnosis under Other Health Impairments under FEDERAL Idividuals with Disabilities Education Act if it interferes at all with his learning and/or that of others. If that is the case, I would remind the school that it is FEDERAL LAW.

I had asked about accommodating him and she said that he didn't qualify for accommodations... I'm forgetting though whether or not it was because he isn't officially "labeled" as anything. ie 504 They are a wait and see type of school. If it isn't an issue now; don't stir the pot! I'm already worried about next year though! Third grade could be completely different and here I'll be stuck waiting on them to get their -ish together while he suffers.
I'd rather have the accommodations in place now, not use them, and access them later when and if he'd need them.

Looks like I need to make a visit to the SBLC Coordinator and the Guidance Counselor next week!

 

[TeDo]

You could leave it alone for now and get all your ducks in a row in the meantime. Once you have all your own diagnostics and evaluations done, you can request he be evaluated for services. Unless you put the request in writing, they don't HAVE to do anything and probably won't. If that's how they work, do everything on your own and go in "armed" (if you Know what I mean?). The diagnosis of ADHD alone doesn't qualify him for services but if there is any related behavior because of it that is impacting his learning or interfering with others' learning, then it does.

Do the legwork behind there backs while things are calm and then go in with everything you've got. Good luck.

 

[soapbox]

Lets see...

You don't seem to have access to Speech Language Pathologist (SLP) or audiologist resources who are clued into this stuff.
However, it seems like you have a fairly good Occupational Therapist (OT).

Perhaps you could start with the other set of issues...
Has the Occupational Therapist (OT) done an evaluation for sensory issues? that would include sensitivity to sounds etc.
Some of what you are describing, sounds more like sensory issues than Auditory Processing Disorders (APD).

Auditory Processing Disorders (APD), specifically auditory figure ground...
It sounds like he is doing well in school - therefore, understanding teacher instructions, participating in class discussions, etc.
In which case... auditory figure ground is not so likely to be a problem.

For the record... 70% of kids with ADHD and a learning disability... also have Auditory Processing Disorders (APD).
As LDs are fairly commonly co-morbid with ADHD... the Auditory Processing Disorders (APD) will not be uncommon either.
But unless they are specifically testing for it... they won't find it.
(Auditory Processing Disorders (APD) is not always co-morbid with ADHD, either... its just easier to make the links with ADHD kids because they are a fairly well-known population)

 

[EmJay]

Lets see...

You don't seem to have access to Speech Language Pathologist (SLP) or audiologist resources who are clued into this stuff.
However, it seems like you have a fairly good Occupational Therapist (OT).

Perhaps you could start with the other set of issues...
Has the Occupational Therapist (OT) done an evaluation for sensory issues? that would include sensitivity to sounds etc.
Some of what you are describing, sounds more like sensory issues than Auditory Processing Disorders (APD).

Auditory Processing Disorders (APD), specifically auditory figure ground...
It sounds like he is doing well in school - therefore, understanding teacher instructions, participating in class discussions, etc.
In which case... auditory figure ground is not so likely to be a problem.

For the record... 70% of kids with ADHD and a learning disability... also have Auditory Processing Disorders (APD).
As LDs are fairly commonly co-morbid with ADHD... the Auditory Processing Disorders (APD) will not be uncommon either.
But unless they are specifically testing for it... they won't find it.
(Auditory Processing Disorders (APD) is not always co-morbid with ADHD, either... its just easier to make the links with ADHD kids because they are a fairly well-known population)

I can speak with the pedi.... i think her sister is an Occupational Therapist (OT) who deals specifically with some of what ya'll have been discussing. I AM beginning to think that we are dealing with some sensory issues here. I sorta always have. Just didn't know how to go about figuring it all out!

 

[EmJay]

So I've done some diggin on the internet....

Who does the checklist/evaluation?

Do they ask us or just take an hour and observe him?

Because from my 8 years of experience with my little spit fire.... He meets a lot of these!

Sensory Processing Disorder Checklist

 

[TeDo]

Then it sounds like you have a plan. One rule we have here (not officially but practically) is to trust your mommy gut. Nine times out of ten, your gut will be right. For the other one out of ten, you are usually close but didn't have ALL the info to be right.

Go for it!!!

 

[EmJay]

congrats on that by the way! Good for him pulling it together. I think the stims can be great, but I do believe they agitate and/or cause anxiety and for some aggression.

So matter what you decide it is ok. Very few things are forever. As mom's we want to make it better before it even goes bad, but we can only do so much sometimes.

I think part of what has been making a difference with him this year is the fact that I'm a stay at home mom and I volunteer at his school. We live all of 2 miles from his school and he knows that if I get a call I will be up there in all of 2 minutes; as with last year I either sent his daddy or couldn't show up right away bc I was at work.

 

[buddy]

Since kids with autism often have sensory issues, you can use an autism program's Occupational Therapist (OT)'s and they do understand all sensory kids, not just those with autism. But any childhood therapy place will do evaluations for sensory integration disorder, just ask to make sure. You will likely need a referral for that, but again, just ask for it...sometimes the therapy center will get it for you. I usually do both, let them call and I also call my doctor and say I need a referral for an Occupational Therapist (OT) evaluation (or whatever evaluation I want) I dont ask the doctor what they think.... I figure they should want the information too. IF they didn't then I wouldn't keep them.

All insurances are different though, I realize that so just as long as you make it clear you WANT it you are not asking them IF you can have it.

sensory issues can make a child look adhd, autistic, odd, Obsessive Compulsive Disorder (OCD), anxiety disordered, etc. If that is the core issue it is so important to treat. It can also be a co-morbid issue, still very important to treat of course, but important to keep open to any other issues that may be going on.

by the way, ask for a full Occupational Therapist (OT) evaluation because many of the motor things can be subtle and as was discussed in other people's posts they will be able to check that. I posted recently the results of an evaluation that Q had a couple of years ago.... the things discussed are very interesting and impact any child's life greatly, but are so invisible... really good to get that information. So, not just a sensory integration evaluation, ask for a full Occupational Therapist (OT) evaluation. IF you can get a full neuropsychologist evaluation that would be good too. But one thing at a time, since this hits your mommy gut, that means it is really important to check out.

 

[buddy]

I think part of what has been making a difference with him this year is the fact that I'm a stay at home mom and I volunteer at his school. We live all of 2 miles from his school and he knows that if I get a call I will be up there in all of 2 minutes; as with last year I either sent his daddy or couldn't show up right away bc I was at work.

I did the same thing, I am stay at home mom now and the morning restraints are eliminated. I volunteer at school and he knows we are all on the same page. He will say to the teacher, hey...that's what my mom says...and he says the same to me about mrs C. lol. He never doubted I would come, but to know I can be there in minutes, yup, huge deal. Mostly it has helped because my overall stress is lower, my patience is higher.... I am on Q time. So when his stress and anxiety lowers, then everything is better.

 

[EmJay]

I did the same thing, I am stay at home mom now and the morning restraints are eliminated. I volunteer at school and he knows we are all on the same page. He will say to the teacher, hey...that's what my mom says...and he says the same to me about mrs C. lol. He never doubted I would come, but to know I can be there in minutes, yup, huge deal. Mostly it has helped because my overall stress is lower, my patience is higher.... I am on Q time. So when his stress and anxiety lowers, then everything is better.

Yes, I agree! M knowing that we are all on the same page is definitely playing a big part. And I like the term Q-Time... As with us it is considered M-Time! I'm here when he gets off the bus, I'm the one waking him up in the morning, I come to school to help out, I show up in his classroom unannounced (and the teacher is happy to see me), all the kids know who I am, etc etc etc. There is no "hiding" at school. He KNOWS that I'm a part of his education now and he KNOWS that I'm going to follow through with what I say.