What would you do if your highschooler told you he thinks he has ADD

Parents Forum
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<p>spectrum, I would get a second opinion. My LDs were not diagnosed until sophomore year of college. “Usually” is not a reason to not test or at least have a good discussion about the matter if that is something you are interested in and can afford. The really bright kids with LDs often manage to circumvent them well enough to cope until they are older and then things start to fall apart, it is not an uncommon story. I have no thoughts one way or the other about whether or not he has an LD, but if your doctor dismissed the possibility because of his age I would be talking to someone else. And as an ADHD patient myself, I would not settle for the teacher evaluations being the be all end all of this process, either.</p>

<p>You asked about our processes. I have been diagnosed with ADHD on several different occasions, as I have switched doctors a lot. The first time I was in 3rd grade, and my parents were interviewed, I was interviewed, I had a whole battery of intelligence and skills tests done, and there was a teacher report. I have read the paperwork from this testing recently and I get the impression the primary purpose of the teacher report was to determine accommodations moreso than having particular diagnostic significance, but this was the early 90’s, perhaps things have changed. This necessitated multiple visits and took a long while, I was diagnosed by a very well respected specialist. </p>

<p>The most recent time was a year or two ago as a college student. I was there for LD screening and he wanted to revisit the ADHD too for some reason, I was seeing an educational psychologist. So I had another full battery of intelligence and skills tests, an interview, a parent interview, and I also took a test called the TOVA (Test of Variables of Attention) which is designed to test factors related to ADHD like inattentiveness, impulsivity, etc. </p>

<p>I was also prescribed medication at some point by a psychiatrist and a neurologist, and they treated me based on a personal interview, parent interview, and the knowledge that I’d been diagnosed in the past.</p>

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<p>It could be very easy to miss a mild LD in a bright child. Each academic year provides different challenges and expectations. These new challenges can require skills and strategies that haven’t been needed in the past. A bright child will make his/her own accommodations for their learning needs, possibly with out even being aware of what they are doing. In high school the challenges and workload can become enormous and students, who have been able to get by on their smarts, can begin to struggle.</p>

<p>I would bring the questionnaires to the school. If the school counselor is available or the dean of students or both, sit down with them and express your concerns. Make sure you talk to a person, not just drop them off. Your son should be there too. The school should be able to refer you for educational/psychological testing through the school. My son was in a private school and our public school did his testing. Maybe testing through a private facility would be better, but not always. I don’t know what your town offers, but our experience testing with the public schools was wonderful. </p>

<p>If you’re not happy with your school’s choices, you can still get the testing done anyway; you don’t need your MD’s permission. You will most likely have to pay for it out of pocket because your insurance isn’t likely to cover it without a referral.</p>

<p>Your MD sounds very different than my son’s. His MD required that we find out as much as we could, and consider alternatives, before he would consider prescribing medication. </p>

<p>Good-luck.</p>

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<p>Spectrum: From my experience, do not rely on letting teachers diagnose learning disabilities/learning styles/accomodations/psych issues, etc. This is not their area of expertise. And I’d go beyond a family doctor to a child psychiatrist for a medication consultation.</p>

<p>I allowed the school system to “diagonois” my daughter for the last 9 years and now I have a 15 year old who has been “mis-treated” all that time. Back in 1st grade, she tested as both “gifted” and “resource.” Because she was never a behavior problem and because of her “gifted” status, her inability to learned to read was treated as “she needs remedial help.” She did not learn to read until 5th grade and by then her confidence was shot and her school anxiety was through the roof. And I think she learn to read by shear will, inate intelligence and stuborness rather than any actual instruction.</p>

<p>She has been now diagnosed with OCD – she has racing, obsessive thoughts. Give her a muliple choice test and she can spend 20 minutes analyzing all the possibilities of one question. And then she gives up because that kind of thinking is exhausting. Ask her what she knows about a subject and she will write you a wonderful essay. </p>

<p>The original question was “my highschooler thinks he has ADD.” He knows something is wrong. Trust him. My child has been telling me that for 9 years. I wish it hadn’t taken me so long to listen.</p>

<p>My challenge now is to find an appropriate educational setting for her for the next 3 years. Suggestions?</p>

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<p>Spectrum: Your dr. is wrong; LDs are sometimes not caught until HS or college (even in adults) if the person has high verbal skills (you can get very far in math & science with high verbal skills; think about all the word problems, etc. Even the ACT science section is verbally based.) </p>

<p>While meds can be fine, they are not the end all, be all. Our pediatrician has been so supportive of our D during her process…how frustrating that your Dr. is blowing this off.</p>

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<p>RobD: I don’t know if this changes anything but actually S is much better with Math then verbal skills. When he was younger it was the word problems that tripped him up. Presently it has been reading that is giving him the greatest challenge. I was not expecting meds to be the beginning and end of it. When we visited we discussed organizational issues, and he indicated that basically S needs to work harder to organize himself. I don’t disagree with that I was just hoping for more insight into how ADD relates to disorganization. I have tried to help him improve in this area but while he does better than in grade school he has a ways to go.</p>

<p>Stillnadine: The teachers aren’t really diagnosing. As I understand they are scoring S on 18 indicators and the Dr. will use the total to decide if he should medicate or not. While I can see the questionaire can be used as a screening tool, it doesn’t seem that it should be the tool used to make the diagnoses. Good Luck with your dilemma.</p>

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<p>Spectrum2 -have you read through those questionaires. I found them pretty useless in the diagnosis of my D. She was a quiet, polite, well behaved student. Her forms indicated no concern for ADD.
My Son on the otherhand was obviously ADD. He gets A’s with meds. Grades all over the map without. Absentminded, disorganized, you name it. He is going to be a college jr. He refuses to take meds even though they help him. Not all college students are seeking the study help that ADD meds might give.
Can you see a neurologist without a referral? My son was diagnosed by a psychiatrist and a neuropsychologist but my D was diagnosed by a neurologist. The neurologist could give you a referral to a psychologist who does testing. My son had hours of testing along with observations by parents and teachers.</p>

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<p>When classroom teachers fill out the observation forms, they are looking at behaviors they see in a classroom. Like Mom60, my d was well-behaved and polite. She would volunteer to straighten the bookshelves. They saw her as helpful. She didn’t say to a teacher, “I’m organizing these books because crazy thoughts are going through my head and the only way I can calm them is to refocus on making order.” I’m just saying that a doctor who makes medication decisions based on classroom observations by teachers may be missing huge chunks of information.</p>

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<p>How frustrating spectrum2.</p>

<p>Meanwhile on the Time blog… </p>

<p>[Study:</a> ADHD Checklist Too Easy to Fake - TIME NewsFeed](<a href=“http://newsfeed.time.com/2010/06/15/study-faking-adhd-is-easy-so-is-getting-adhd-drugs/]Study:”>Study: ADHD Checklist Too Easy to Fake | TIME.com)</p>

<p>To me, the checklists are the screening tool for more testing, not the diagnosis tool itself.</p>

<p>Your comments about his ease with math reminded me of visual spatial thinkers/learners - another reading assignment if you are interested: [Visual-Spatial</a> Learners](<a href=“http://www.gifteddevelopment.com/Visual_Spatial_Learner/vsl.htm]Visual-Spatial”>http://www.gifteddevelopment.com/Visual_Spatial_Learner/vsl.htm)</p>

<p>If your insurance allows it - I’d move beyond the primary care physician and go directly to a developmental pediatrician, neurologist or adolescent psychologist that specializes in ADHD and learning disabilities, if not, time for a new primary for a second opinion and referral.</p>

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<p>Very interesting about the Visual-Spactial Learners! While this doesn’t fit S to a T it does describe many of his tendancies. Now this is the type of info I hoped to get from an assessment. I expect to visit this site several times. Thanks for the link.</p>

<p>I emailed 3 teachers and all three wrote back to tell me they would do the assessment within 2 days of me sending it out. Pretty awesome for teachers on summer break isn’t it? I expect I will go forward with this and one way or another pursue further testing either by further discussion with current MD or a second opinion. </p>

<p>Stillnadine and mom60: I can see that this form would be useless for some students especially older ones. Surprisingly when S and I looked at the form we saw him to varying degrees in many of the items. I really don’t know if teachers see these things in him. S usually rides the line of staying just within the boundaries of acceptable most of the time. He mixes well with athletes and intellects and can win over a situation just because he can make you laugh. So he may get away with more, with some things overlooked. I don’t know if the correlations to the items on the list to S are based on ADD or as another poster suggested, typical boy behavior.</p>

<p>I agree the questionalre should be a screening tool not a diagnostic one.</p>

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<p>Here is the update to what we have done so far about getting S evaluated. We got 2 teacher assessments sent to MD (a 3rd is MIA, I’ve asked teacher to send it again.) and we have an appt next week with a psychologist. S has been away until this week and we just had the MD appt to review the teacher evals. Bottom line results were consistent for both teachers. S scored 0-1 on the attention questions and had fewer than 6 indicators in the 2-3 range of the hyperactivity section. Based on this information, and S’s good grades MD determined he isn’t a candidate for meds. As he explains it, the risks of the meds outweigh the benefits. He did say that psych intervention for evaluation and strategies to deal with issues could be our next step. Based on everything I know about my S the inattention issues are far more prevailent than the hyperactivity issues but looking at the questions, several of them categorized as hyperactivity I would call inattention. Although MD didn’t look at this I asked S to score himself and he scored himself a 2 in three inattention categories and a 2-3 in eight of the hyperactivity categories. His responses are very close to the way I would score him. I know that the psychologist will provide non medical intervention but I am hoping the evaluation will shed some light on the severity of the deficits and if it would be valuable to see another PCP or psyciatrist about the possibility of meds. It is frustrating because so many of the questions relate to things that I don’t think the teachers know enough about S to really score accurately. I asked our PCP if there was a descrepancy between psychologists findings and teachers findings if he would reconsider the decision about meds. He seemed doubtful about that. I think that for him the grades just don’t stand out as enough of a problem. For me, I am worried that they could become a problem if we don’t make some changes. I expect that if it is indicated based on psych findings I will revisit this with him or go for a second opinion from a new PCP or psychiatrist. It is interesting that S’s scores and mine are so consistent with each other and teacher’s scores are also consistent with each other. I believe everyone is being honest, I just don’t think the teachers see what is going on behind the 50 min per day that they see S. I somehow feel that I may be coming accross as wanting drugs for my S, but really I want the decisions to be based on relaiable data. I understand that people can answer questions just to skew results but I know that we aren’t doing that and it is frustrating that the answers from the people who know son best aren’t really being considered.</p>

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<p>Spectrum2, I’m very interested to hear how your meeting with the psychologist went.</p>

<p>I’m new here but my son is diagnosed with ADHD (and somebody up there has it right: there is no more ADD in the nomenclature; just ADHD, primarily hyperactive-impulsive type or primarily distractible type or a “mixed” type) and I’m also a psychological professional.</p>

<p>What strikes me is the idea of somebody saying “I think I have _____ (because I’ve heard of it or read about it or know people who have it)” and then screening for that – as opposed to – “I have such-and-such symptoms” and going to a qualified professional to see what the symptoms are about.</p>

<p>Does this make sense? it’s the difference between saying “I have a rash, I’m going to the doctor to find out if it is or isn’t chickenpox,” as opposed to "I have a rash. I’m going to the doctor because I know there are about 1,000 causes for a rash, and since I’m not a doctor I only know of maybe 10 of those causes, whereas my doctor knows how to rule out the most common causes and " well you get what I mean; sorry for bad English, I’m tired.</p>

<p>Anyway, yes. I agree with all the people who say get your child tested. And this is because, even if he “has” ADHD, ADHD is often a kind of “front” for a lot of other things. In other words, it’s a constellation of symptoms (manifestations) that are what you see in response to other, more underlying causes. Some examples are anxiety and depression. And learning disabilities. </p>

<p>Also in my experience pediatricians are generally NOT good at diagnosing psychiatric disorders in children. (and ADHD is, of course, a psychiatric disorder). </p>

<p>I also agree that LD can be diagnosed at any time. So can ADHD. </p>

<p>And I am also appalled at the posters whose first response was that your kid wants medication so that he can sell it! </p>

<p>My son, by the way, did well for a few years on some of the stimulants, then not so much. Then he was on Strattera for awhile. Not so great.</p>

<p>Now he’s off meds, and a senior in h.s., and, well we’ll see (he did very well last year in a special ed. setting). Good luck. I hope you report back again!</p>

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<p>The Psychologist’s test indicated exactly what we suspected. Mild ADHD. Testing was negative for LD’s. Discussion also confirmed that son was already using many of the compensatory strategies that they were likely to suggest. We took test results back to MD and we discussed meds. We decided to just start with 10 mg of Adderol/day. We also discussed extended realease but I thought that since this wasn’t a real emergency it would be better to experiment with a medication that was in and out of his system more quickly. His first dose was yesterday. I wanted him to be home for that but he was doing homework with a group of friends at the time and he noticed a difference, at least one of his friends also noticed a difference. He didn’t complain of any ill effects so we will see. We will monitor this for about 3 weeks and then go back to the doctor and discuss and assess. We have not yet discussed this with anyone at school. I’m not yet sure if this would be a good or bad idea. The downside to this medication trial is that since the medication lasts for less time than the school day it will be wearing off at the end of the day since he needs to take it before going to school. Interestingly enough with testing, which was all done in one sitting, performance declines as the testing progressed. This makes me wonder if in a perfect world it would be better to take meds that don’t last all day a few hours into the day. For now we’ll just go with the simplest route and try to observe the effects.</p>

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<p>Spectrum: my D is on an extended release med for 4 years now and it’s worked really well for her. Feel free to PM me if you have any questions.</p>

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<p>I haven’t read the entire thread but I’m hoping the people who’ve responded actually have experience with ADD/ADHD since you specifically asked for those people to respond. People with a no personal experience and their .02 are worth about that much in relevance to this topic.</p>

<p>Trust your instincts here. In addition, find a doctor(s) who will insist on testing and getting input from teachers of previous grades in addition to the current one. They will want to send those teachers questionnaires about your son’s learning abilities in addition to his grades.</p>

<p>When you have a child who has had a history of getting things done quite easily and suddenly becomes overwhelmed in HS it’s quite natural to wonder if there is something else going on. However, these people insisting your child wants meds to sale are being quite irresponsible. They do not know your child and it’s offensive for them to assume your child aspires to be a drug dealer vs. seeking ways to improve their educational experience.</p>

<p>In this situation, you have two choices, ignore this and if he’s truly ADD then at SOME POINT HE WILL SELF MEDICATE. Or he will begin to doubt his ability and start to lose confidence. His self esteem will suffer and he could end up depressed. I have experience with this scenario.</p>

<p>Or you could have him tested and hope that you find a physician who will start with very low dose meds that are not the ones often associated with abuse. If you insist that medication is a last resort then they are more likely to help you find those medications. In addition, DO NOT take meds from a doctor who does not offer to test, medicate AND cognitive therapy. The therapy could actually take place first. A qualified therapist can help your son pinpoint troublesome habits that may have worked for him in the past and coping with their new dynamic.</p>

<p>I resisted the ADD diagnosis about 4 years longer than I should have. I live with the regret that I did not get it sooner as to help my son not feel incompetent or inferior because of his struggling at school. My husband refused to medicate so we waited and waited to see if things would get better. They never did. In the end my son responded to the first med the Doc recommended, Concerta, and at the lowest dose. He has since upped it one time and it’s working for the most part. He’s been able to go about a year on a dose before it seems to lose it’s effectiveness. He takes it only during the school week and school year. He does not take it on weekends, holidays, or during the summer. I always thought, mistakenly, your kid would have to be drugged to the hilt. Some do, many don’t. FWIW, my son went from a “D” student to almost a solid “B” since he began taking the medication.</p>

<p>If your son truly has ADD it likely won’t get better by itself. There are many effective ways of addressing ADD. Ignoring it isn’t one of them.</p>

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<p>Spectrum–Since I first posted, my son has had a few months of extended release Concerta. The change is remarkable! He is waking up in time for a crack of dawn class. He planned study schedules and his budget for the year on his own without prompting. He has been getting up for breakfast to take the medication and to be sure that he will have cycled through it in time to fall asleep at night. No negatives so far. I wish we had figured this out years ago.</p>

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<p>sewnsew: Is there a reason that your S started with Concerta. My MD didn’t discuss various meds and since S had tried none of them it just seemed like a good idea to start somewhere. He suggested adderol extended realease and then I suggested not beginning with the extended realease and he was in agreement with that.</p>