A NeuroPsych is a psycologist with additional training in the brain, who knows howt to do perforamance testing and observation and come to about the most accurate diagnosis you can get. They usually spend a lot of time with the kids--ours spent twelve hours with our son, as opposed to one hour and a snap diagnosis with NO testing. The meds for bipolar, which is a mood disorder, are mood stabilizers. They may or may not have side effects, depending on the child, but, if the child has bipolar, they should work far better than stimulants, which can make a mood disorder considerably worse.
You can find a NeuroPsych at university hospitals and children's hospitals. They are well worth searching out. Child Psychiatrists (with the MD) would be my second choice. I'd personally skip the regular Psycologist--they are only trained in behavioral therapy, which won't work with any child who has a mood disorder. I wasted a lot of time spending money on a "behavioralist." I like to go to the people with the highest credentials rather than the low men/women. I hope wish you a lot of luck. It's not easy to get the whole picture and, unfortunately, the first diangosis is very rarely the last one. Kids evolve and, as they grow, things become more clear.
MomWI38900.5749421296Questions: Does she have any speech or sensory issues? Does she have trouble making transitions? Is she friendless because she is annoying or because she is socially clueless (this is important) OR because she doesn't care that much about being with people. Did she let you cuddle her? Make good eye contact? Ok, now, do you have any mood problems or substance abuse in the family tree? Does she sleep well or have trouble sleeping? Can she be the angel/devil girl (one minute sweet and the next just horrible?)
I personally would not trust a pediatrician to diagnose her. They are great for sore throats, not good for childhood disorders, and usually call every difficulty ADHD. Adderrall causes trouble with a lot of kids, but you are saying your daughter has trouble on/off the meds. She may not just have ADHD. It could be a mimicker. I would take her to a NeuroPsych. They do intensive observation/performance testing to try to nail it down as accurately as possible and can diagnose ADHD and beyond. My son is on the autism spectrum. He was first diagnosed with ADHD. I have no idea if your daughter is on the high functioning end of the Spectrum, but PDD/autism has a site just like this you can check. STick with the posts about the high functioning children--the kids who can't even talk are NOT your daughter. These kids tend to be socially CLUELESS. It's way beyond the ADHD poor social skills or immaturity. They have no clue. There is also early onset bipolar, another disorder commonly diagnosed first as ADHD. Kids with bipolar have tons of ODD, probably more than with any disorder. Rage is the name of the game with that disorder, but some Spectrum kids rage too. Bipolar kids should not be on stimulants. Here's the PDD site, in case you want to visit. The parents are really nice, just like they are here. One last note: ODD is usually a symptom of another disorder. I would not see a regular psycologist. They don't really know how to diagnose various childhood disorders either and do no testing because they don't know how. Good luck :)
www.autism-pdd.net/forum/default.asp
MomWI38899.7781134259Have to agree with smallmom. It does help to have a full picture and with the mood disorder history in the family, and substance abuse, I'd want a Psyschiatrist (with the MD) to see her, if she were mine. I'd also want the Neurological exam and also an appointment with a NeuroPsych (they do INTENSIVE testing to get to the core issues--ADHD and beyond). She is young and whatever diagnosis she gets now is very likely to change through the years so getting a total evaluation now is better than a one-person-opinion. Putting this child possibly on ADHD meds could make her considerably worse if she also has co-morbid bipolar. I think she sounds more bipolar than ASD, but ya never know, and we aren't the experts here, just parents. I do know my son's treatment was slowed down by two wrong diagnoses--ADHD/ODD and bipolar disorder. We really did have to take him the gamut of all the best professionals to figure out what was going on. The wrong professional can send you off on the wrong path for a long time. Been there/done that and sorry I wasn't more aggressive about persuing the right dx. early on. bascially, if Mom thinks it's more than ADHD, it most likely is. Good luck :)
Thanks for the advice. Can you explain more about the Neuropsycho testing? What is bi-polar? Is it treatable with meds that do not have those horrible side effects?
Thanks again
My 9 year old daughter has adhd w/o hyperactivity. She has been on and off a couple different meds. Recently we are trying focalin xr 5mg ( can not tell that it is working, will probably be increasing the dose soon).
What my concerns are that maybe she has something else besides adhd. To give you a little background................she was born 10 weeks premature and weighted 1 lb. 14 oz. Was on a heart monitor till 1 year and feeding for 6 months. Had severe apnea and bradicardia episodes for the first 6-8 months of life. Lungs were not developed much when born but was only a respirator for a few days. Was diagnosed with severe gastroesophagul reflux and grew out of it after a year. Other than these issues she appeared to be perfectly healthy. She did not start talking till around 3 years old. When she was around 4 years old she began to throw terrible tantrums to the point that she would lunge at my throat and claw me when she didn't get her way. After about six months, this stopped but she still throws tantrums when things don't go her way. at 7 years old, she started having problems at school paying attention, finishing her work on time. Last year in third grade, she started having more problems at school, not paying attention, not being able to finish her work on time, etc. Pediatrician diagnosed her with adhd w/o hyperactivity. Also, she was having headaches when trying to read the chalk board at school. She now has glasses for that.
The adderall she was first put on for adhd caused her to be very moody, especially in the evening when it wore off. Now we are trying the focalin. My concern is that she has problems controlling her anger with or without meds. She gets mad or little things and blows up, stomps off to her room and slams her door. She complains that she has no friends at school sometimes but other times she seems happy at school. It seems like everything turns into an argument with her. She has meltdowns over the least little thing. I can only imagine how things will be when she is 13 or 14!!
Could this be something else or is it the adhd? Could she have bipolar disorder, depression, ODD? I don't want her to miserable like this anymore.
Hi, your daughter sounds a lot like my daughter at age 9 (my daughter is now 11). She is not socially clueless, but in 4th grade complained all the time about not having any friends. She also got angry and upset over the smallest things. She also had frequent headaches and stomachaches (later dxed as migraines and GERD). In spite of treatment, her symptoms persisted, and she became depressed. When she was treated with the SSRI Paxil, she had a manic reaction. She now has a working dx of bipolar disorder and is doing wonderfully on the mood stabilizers Lamictal and Depakote. In fact, she's away right now for 3.5 weeks at overnight camp!
So in addition to taking your daughter to a neurolopsychologist for thorough testing, I would strongly encourage you to have her evaluated by a board-certified child psychiatrist for mood issues. You need to have an accurate dx before you can put the proper interventions into place. Good luck.
She doesn't have any speech or sensory problems. She does have a problem with change. More so when she was younger. I'm not sure if she is annoying at school but she is at home with her little sister and other family members sometimes. I do know that she is a tattle tell at school more than I would like her to be. Maybe that's why. Yes, she did cuddle with me alot and make eye contact. She won't now though, if she's getting a lecture. I guess that's normal.
Her father (my ex husband) does have some issues though. He can't keep a job, unpredictable, flies off the handle. Has been treated for depression off and on. He also has a history of substance abuse. That is one of the main reason we are divorced. I am on antidepressants and have been for years, mainly due to the crap I went through with my ex. She does take after him in alot of ways.
She sleeps fine at night. She has always went to bed early and did not take long to fall asleep, except for when she is on adhd meds.
With her being premature and my first child, I was very over protective and probably babied her more than I should have, but I don't think that's it. Her younger sister is 3 1/2 and does not act anything like she did when she was her age.
I have noticed that she doesn't take the social cues she should take in conversations with other adults or children. That may be part of her attentiveness.
I want to give her the best chance in life. She fought so hard to get into this world and I just want her to be the best she can be and to be happy.
Thank you!!
Given that there is depression and substance abuse in the family tree, I'd definitely make an appointment with the child psychiatrist. Has she ever been evaluated by a pediatric neurologist because of her premature birth? You might want to have that evaluation as well, and the neurologist can refer you for testing by a neuropsychologist. Your daughter has a complicated history, and you need to know what you're dealing with. Again, good luck.