Who IS this child?

[forkeeps251]

Normally I've posted in the "early childhood zone" board, but not difficult child technically doesn't fit into that category.

A little bit of background: He's had behavior and speech problems all his life, and when he started Kindergarten this year, things got ugly. A lot of screaming, throwing chairs, hitting kids, and non compliance. We've been working with the school psychologist, as well as outside medical professionals. Not official Rx yet... but ADHD and perhaps some anxiety issues seems likely. I just had the first appointment with the child psychologist (outside of school) this past week, so official evaluations are in the near future.

Now that that has been said... On Christmas Eve my little difficult child turned six. He had one more week of Christmas break after that, and then he was back to school, so he has been back about two and a half weeks now. And oh.. my.. gosh.. he is like a TOTALLY different kid. If you ask him, he would say "I'm six now so I know how to act". Apparently being six means a LOT to him, and ever since then, he has gotten a "happy face" every single DAY while in school. For two and a half weeks straight! He has never even gotten close to this before! In fact it was rare to have a week where he didn't end up in the principal's office, and at a minimum, he would get his folder signed 3+ times a week.

I don't know if it is because he is finally getting used to the idea of school, or perhaps the school has finally started to make accomidations for him (but I think they have been doing this for a while), or if it is because he had a nice long break and missed his teachers and friends... whatever the case, things are SO much better now. I'm not sure if it will last, but I'm happy for the respite in any case. I think the issues are still there, after all this has been a long time struggle, but maybe things are looking up and won't be AS bad as they have been.

I think the most important thing is that turning six has given him a great deal of confidence. It's amazing how far that can go!
I did have one person, while I was sharing this good news with that asked why I was still seeking medical help for him (and possibily medication) if he was good for two weeks. I have to admit, that hurt to have it questioned. I feel I'm in for a long road of people questioning and judging me if/when he receives medication. Anyone have any good, quick responses to these "well meaning" people?

 

[buddy]

That is wonderful for him! It is probably a combination. Ihave had whole years of amazingly improved behaviors (not like yours, he can't pull it off, but no sending to principal or having to go home etc.) the biggest thing for mine has been just ONE person taking an interest and treating him really kindly. Being his rock.

It is really no one's business if he takes medications or not, so really you dont even have to tell anyone. If a teacher or nurse tells anyone who is not on the "need to know" list, and that includes no reason to tell an ed. aide... they can be in huge trouble. So, dont even discuss it. Not out of shame, but because you dont really need the added stress. on the other hand, if behavioral modifications, lowered stress etc. do this much to help him.... WOW, you may re-think your decision for now, doesn't mean you have to not do it ever. It all depends on what your evaluations show and what your gut tells you is in the best interest of your son.

Transition may be HUGE for him. maybe he has settled in much better... not all transitons, but maybe just really big transitions, think of all the new rules, people, tasks, etc... for a kid with adhd or any other even mild issue, they may need lots of time to figure it all out and settle in. the break may just have been the time he needed to process it all in a lower stress situation.

Take care. Sounds like a great idea to enjoy your time with your mature little six year old (K is still early childhood, really even through first in most academic circles, so post where you feel comfortable, in my humble opinion)

 

[Malika]

It indeed seems like a miraculous change and I can only marvel with you. I do hope it is a continued trend.
Buddy as always puts things very gently and inclusively. I fear I felt like one of the "well-meaning" people as I read your post because I don't understand why you want to medicate him if his behaviour is improved and doesn't pose problems. Forgive me if I have misunderstood and perhaps you will explain

 

[soapbox]

You could be dealing with a fatigue factor.
He actually likes school, but over time, his brain "wears out" until he cannot cope?

Some things that can cause this are...
- Developmental Coordination Disorder (DCD) - developmental coordination disorder
- Auditory Processing Disorders (APD) - either difficulty processing spoken language (Central Auditory Processing Disorder (CAPD)), or other auditory issues such as auditory figure ground, where the person has trouble picking out the "right" sounds, in a noisy environment (classrooms are terribly noisy!)

For now... start a journal.
How many weeks until things start going downhill?
It could take a couple of months... or it could be weeks or days (we've seen all of those...!)

 

[forkeeps251]

Well, here is my explanation. First, it would likely be months before he would have anything perscribed to him... I'm not going to stop the process, the first of which is getting a diagnosis, which I need whether we decide to go the route of medication or not. Two weeks, to me, is a very short period of time. If this behavior continues, down the road after he has had all the evaluations, seen a psychiatrist, been given a diagnosis, etc... only at that time would I really make a decision.

My reasoning for not stopping the process... well, I've been down this road before. Twice before I actually got him in to see the play therapist and he improved between the time I made the appointment and the actual appointment, and I ended up canceling to save myself the hassle, thinking "Things are OK now, I don't need to do this". This has proven a couple of times to not be the case. Now that I've gotten this far (pasts the play therapist, to the psychologist, next step would be a psychiatrist).

So, it will be a few months before I will really have to make some sort of decission. And like I said, two weeks isn't long and things can certainly change in the future.

Another reason I'm not ruling it out is that there is a pretty big grey area between what is expected of a child his age, and how he was acting (thorwing chairs, shutting down completely, hiding from kids, biting, hitting... the list goes on). Now that the most serious behaviors at school have lessened, like throwing stuff and screaming, it doesn't mean that there isn't still work that needs to be done... and that is just where behavior is concerned. I'm THRILLED that those really terrible things have lessened, because it makes the possibility of expulsion or something like that a lot less, but it doesn't mean he doesn't still have some issues. I received his "report card" yesterday, and read on it that he still requires teacher directions multiple times before he can comply, and that on his behavior plan everything is still listed as a 'work in progress'.

And finally, there is more to the problem than just behavior. I really need to know, and I think that the psychologist will help me with this, whether the stress, anxiety, and depression that he is feeling is related specifically to ADHD or something else. Even if he isn't in the principals office every day, if he is very unhappy because of his inability to control himself, that in itself is an issue. Plus, there is the issue for learning... I'm completely aware that everyone has different abilities, and I would absolutly condsider other techniques before medication when it comes to school work and learning, but there is an issue there, too. He is behind academically... well, as much as you can get behind in kindergarten.. from the other students. Basically, he isn't progressing. He knew all his letters before he started, and that is still about all he knows. He is not learning to read at all... each six weeks they are given sight words to learn, and he hasn't learned any of them. Also on the report card it shows how many students have "mastered" the subject matter... and usually all but one or two have, and one of them is always difficult child (based on his "failing" score).

I know this is only kindergarten so I'm not THAT worried. It is getting very likely that he will be held back. But I do see the potential for it to become a bigger issue down the road, so I want to be prepared for that.

In any case, I'm going to give serious consideration to what the multiple doctors and psychologists advise me. Medicating him, when and if the time comes, isn't something I would take lightly.

I think the best advice comes from Buddy... I should just keep my mouth shut about it all! The person who said that to me in particular is a friend that I have shared a lot of the problems I've been having with. I'm rethinking what I should be telling people about it though.

Anyway, that is a LOT to have to explain to people, so that's why I was wondering if anyone else had come accross that and what they said

 

[soapbox]

Yes, he's young.
We saw the problems start at that age, too.
Not "over the top" until he got to grade 1... and not the same behaviors (more extreme anxiety).
But... you are absolutely correct to continue to pursue.

Some stats...
- half of the kids with ADHD, also have Developmental Coordination Disorder (DCD)
- LDs are frequently co-morbid with ADHD
- if you have ADHD plus a Learning Disability (LD), then you have a 70% chance of having an Auditory Processing Disorders (APD)

In other words... chances of him having more than ADHD is high... and it could be something other than ADHD, too.
So... count me among the ones who supports continuing with evaluations...!

 

[Malika]

Okay, thanks for taking a deep breath and explaining all that. Certainly helps me, for one, understand.... The question then, I guess - and personally I don't feel equipped to answer it - is whether the medications would help him acquire these skills. My own feeling, without wanting to alarm you, obviously, is that even if it is "only kindergarten", any difficulties in learning are important in the sense that they need to be considered and perhaps evaluated, without in any way meaning necessarily that there is some "problem". Luckily it sounds like you have a lot of professional support, will have more, so will presumably have signposts of where you can get help. More in-depth testing really seems on the cards? It may or may not be significant that he is not learning to read at this point. Very best of luck.

 

[buddy]

OH I get it, I have had even professionals tell me he is on too many medications etc... I mean a kid who obviously has serious medical issues and then again, others say well you better get on those medications and stay on top of it.. .... like medications are the magic answer! It can just be exhausting.

I like the idea of being proactive and planning for IF you decide he needs it. I dont know about bipolar in kids....if this is a pattern one would see and like you say, certainly the adhd and how circumstances come and go can make a difference, and learning issues, processing etc. Is he going to a neuropsychologist then since you are also concerned about academics and have had this problem for a while? I hope you can get answers from whom ever it is you are seeing and that they are doing a comprehensive evaluation for you so you can get some answers. Yes, he is young...but the younger we can help our kids the better so you are doing great.

Enjoy the break. (by the way, I didn't mean nto to say anything here! We do get it, just asking questions to understand, but not judging you at all.... I can't speak for others, but that is MHO)

 

[confuzzled]

listen to that voice that just plainly articulated all your reasons right here.....sounds like she knows what she's talking about ;-).

and you dont have to justify it to anyone...it IS a long process, and an inexact one too, so it makes sense to continue along. you outline a whole host of things that may or may not be causing issues, it will help both of you to ferret out those issues and move forward. it doesnt always result in medications-he might need accomodations, a different teaching style (i hate sight words, lol!) or something else.

it sounds like you have a very reasonable plan...i might add, if he is making no progress, i'd want the school to evaluation him too to see if he needs an iep--what does the teacher say about this lack of progress?

 

[InsaneCdn]

Sounds like you need to start a parent report - if you haven't already.
(its not called exactly that - but its over on site resources)