My kid had very extensive, multi-hour testing done by a neuropsych. I think this is the norm for a true dx. Meds are an option and help many kids but strategies are equally important. Whether to use meds is a personal decision.
2 Likes
First off, your kid is seeing a counselor (who has a doctorate) – is this a one-time visit, or has your kid been seeing the counselor a number of times over a span of time? I’d tend to feel like a PsyD doesn’t hand out a diagnosis lightly. Also, you filled out the questionnaire, and that didn’t convince the PsyD that they had made the wrong call.
When your kid is little, like 5 to 7 yrs old, that’s pretty much the gold standard for diagnosis – multiple adults who observe and interact with the kid give their opinion of the child’s behavior (and for teachers, particularly as normed against the other kids in the room).
As the patient gets older and more reliable at self-reporting, they can say how they feel about things, as well.
There are some “computerized tests” that doctors can use to additionally discern if a patient has ADHD, although, in the grey area of the middle of the results, it’s still a professional judgement call.
There’s no absolute “blood test” or “brain scan” type of diagnosis. It’s a matter of degree – everyone gets occasionally distracted, or fidgety, but it’s not a disorder for everyone. Only for some.
Some of the ADHD meds (the ones that are harder to get, and schedule II) are actually short-acting, and if you take it and realize it has side effects you can’t abide, you just stop taking it. There’s no “ramp up” or “weaning off” period.
Other meds act differently, and aren’t “controlled substances”, and at least some of them have “weaning off” protocols.
2 Likes
That’s super helpful; thank you! Kid has been seeing counselor regularly for about a month, although the counselor started saying it after session one. Ironically, kid tested negative on the questionnaire we filled out, and only tested positive when kid and counselor went over it together and had follow up questions.
Counselor: “Do you forget things?”
Kid: “Not really. I use my planner.”
Counselor: “If you didn’t have your planner?”
Kid: “I’d be a total disaster.”
I really appreciate the thoughts about meds. I’m not sure why I’m so reticent for kid about this except that a dear friend feels like her fertility was affected by taking ADHD meds when she was a teenager. Anecdata at its finest, I know, but it made me start scouring literature. (In case you’re interested: Short term decrease in fertility in mice.) I think kid has just covered well for it up until now, but now that the stress levels are higher/more work to be done at a higher level, it’s coming out. Counselor is supposed to send more info, so we’ll go from there. Thanks again for giving thoughts!
1 Like
Fwiw, my kid – diagnosed in college – decided against drugs. He felt they were helpful but that he’d need them for more of the day than they were intended AND that strategies would be better for his health and would be sustainable over the long term. He wasn’t thrilled at the prospect of entering the workforce dependent on drugs. Having said that, everyone is different – there are people who can manage certain health issues with diet and exercise and others who absolutely need drugs to be well.
You’re right to do research, and to find the right solutions for you.
As for the testing, iirc, DS performed tasks over time and the results were measured. Yes, he answered questions but this testing may have been a check on whether his focus deteriorated “normally” or excessively.
1 Like
A kid who actually uses a planner is quite an achievement. Do you have to prompt the use (and check what’s in there) or is it self-initiated? Is that breaking down due to added workload/stress?
This is actually why I never would have said the kid had ADHD. (Granted, I didn’t know about inattentive ADHD at the time.) No, kid has the most beautiful planner I’ve ever seen, replete with highlighters. Kid uses it without prompting and I don’t check in. The biggest complaint? “Mom, I never got everything done in my planner for the week at the times indicated for the whole year!” (Me either, kid.) More seriously, kid switched to a charter school last year and suddenly had to manage DE classes, multiple online classes, and multiple platforms, and did fine once kid found a rhythm. Kid did have a signifiant bout of anxiety at the end of last year which I’d never seen–maybe this is a part of ADHD, or its neighbor? That’s what started the whole counseling process.
The one conversation that made me think that kid really might have ADHD is one that happened last week. Kid listens to rain or wind sounds “…because it fills up my brain so that I can focus. Otherwise I’m coming up with answers to conversations and I have to re-read the paragraph a bunch of times.”
This is all brand new to me. I appreciate all your thoughts.
2 Likes
D22 has ADD-I and has the most beautiful planner ever, and uses it. The problem is that she hyperfocuses and gets stuck in the creation of her beautiful planner. She is capable of initiating tasks (something difficult for those with ADHD), but does not focus her attention on the “correct” part of the task. Also, she needs additional processing time so tasks take a really long time.
3 Likes
@illneversaynever , I think there’s a challenge with all these conditions in that some level of this is normal. Most of us procrastinate, daydream, get distracted, and don’t finish tasks , and most of us work on some self management to address this. Why? Life involves a lot of necessary activities that are unpleasant or less pleasant than the alternatives. Finding a system that works is hard and takes discipline. Just look at the self-help section of any book store!
Likewise, most of us experience anxiety from time to time. Maybe it’s consistently about the same thing, like public speaking, or maybe it’s a response to being overloaded, or having things going on we cannot control. This too is normal.
If there’s a point at which these start making it impossible to perform daily functions, help is necessary. But even then, the fact that it requires, and is being helped by professional attention, may not mean it rises to the level of being a medical condition or one that requires medication. It’s challenging because distraction and anxiety (and sadness) are normal – and often healthy-- responses to things in our lives. Until they aren’t!
We also live in a society that is quick to label and medicalize much of this. Teen mental health has deservedly gotten much more attention over the years, and kids today face many different challenges than kids did a few decades ago.
In many ways, your son sounds like he is handling his life well. It also sounds like life is throwing a lot more at him. And it sounds like he trusts you, you take him seriously, and have found him resources for addressing his issues. He also seems pretty self-aware, which is a great attribute in working through this. If he can say why he doesn’t get to what’s in his planner, he might be able to break through. It could be that he needs to wear noise-blocking headphones to avoid distraction. He may need to put his phone in a different room and to block messaging apps on his computer while he works. He may benefit from studying in a different place. Or from changing his study habits, which may have been more effective for a different type of material, but are now inefficient and time-consuming. (Check out How to be a Straight A student by Cal Newport.) Maybe he has just taken on too much or doesn’t need to get all As!!
Not getting your work done DOES create anxiety. There’s a reason these things go hand in hand.
Your counselor is a knowledgeable professional AND I think you are right to be thinking through the accuracy of a seemingly quick diagnosis and its pharmaceutical solutions. The short version of this is that none of this is either/or – it’s all somewhere on the spectrum of life and it’s not all about making the person fit the environment – you have some control over the environment as well.
6 Likes
S23 had anxiety along with his ADHD, and took medications for both from middle school on. But the anxiety improved during high school and he dropped that medication. He also prefers not to take his ADHD medication during school vacations, because it leaves him quite tired at the end of the day, even though it helps a lot in terms of focus in the classroom. I don’t think he’ll take it forever and if he was functioning like he is now 5-6 years ago, then we might not have used medication. But at that point he was unable to sit still in a classroom.
It took a lot of work to get him to use a planner earlier in high school. He was always resistant and has decided over the last year that he can manage ok just using Canvas to plan his work. But his grades have never been amazing (especially compared to his intelligence) because he doesn’t want to do more than the minimum necessary, especially in subjects he doesn’t care for.
We’ll see how it goes in college, fortunately they only have 3 classes per quarter which should make it somewhat easier to keep on top of things. A year ago we weren’t sure that going to college made sense, but he has grown up a lot and become more responsible. And he’s found something he actually wants to do (astrophysics and astronomy).
4 Likes