What would you do? | ADHD Information
Hi! I'm April. I'm not a newbie to ADHD, but I am new to the board. I had a feeling that my daughter (Salyssa) was ADHD by the time she turned 2. No one would even consider my concerns until after she started kindergarten. She's 7 now, and smart as a whip! She finished chapter books like Goosebumps in a matter of hours and in 1st grade she was taking math with the 2nd graders. She's super artistic and can talk for hours about dinosaurs and she wants to be a paleantologist when she grows up. Problem is, she's also very demanding and throws big fits. She would definatly classify as 'difficult'. She got kicked out of daycare this week, I have until the end of the month to make other arrangements for her care while I'm at work. I can't NOT work. I'm a single mom with 2 kids and no child support. My job is the best I can get until I get my degrees, but that's going to be a while. The only other daycare that can also drive them to their school I won't take them to. The tour was enough to tell me that. I get assistance for the cost of childcare and the provider has to be approved by them, so I can't just find a babysitter. My family is all 3 hours away, but even if they lived next door they wouldn't be an option and I don't know very many people in my area except for at work. She's had problems before in home child care settings, I had 3 babysitters quit in 2 years. I've checked around with several different agencies and there's nothing. Plus, I couldn't pay for anything- my cost for care doesn't go down with only one child in care, it's based on income, not it's cost to me.
Any ideas with what to do? Because I'm out of them.
She got kicked out of daycare, but it's not the school's daycare. There are 4 daycare providers in this school district that provide transportation to and from school. The one she just got kicked out of is a no-go, of course, 1 I've never even visited because they always have a several month wait list, and the other 2 are NO's because I've seen the teachers with the kids and I've seen their facilities.
Yes, I must use an accepted center in order it to be subsidized.
No, in-home daycare settings are worse. The more relaxed atmosphere=less structure. She's fine at home, but then again I don't have a whole bunch of kids running around and she's on her own territory here. She doesn't act like that very much with me anymore, but I think it's because we've learned each other
I can't leave work during the day except at lunch, which can be taken no later than 1:30. Work starts at 8, school starts at 9. School's out at 3:30 and I'm off work at 5.
She's had a fit or 2 at school, but none like at daycare. I think she's better at school because of it's structure and because there's a lot of interesting stuff to do that challenges her. Even if the teachers have to make harder work they always have her on task with something.
The only school district that does year-round school is Dayton City schools, which are rated failing by the state report card. Plus, I've heard of some not-so-good experiences with challenging children in Dayton schools, and I'd have to move to the ghetto for her to go there.
She is the reason I know so much about structure and routine and advance notices for smoother transitions in kids! Lol.. She's taught me a lot of creative behavior management skills. I noticed when she was an infant that she did best on a VERY regular routine. A lot of people are suprised that she usually gives me absolutely no problem about going to bed at night because she is so active pretty much all day long. The trick is only the routine- even if she is bouncing off the walls until right before bedtime snack, by the time I tuck her in she's rubbing her eyes.
When she is asleep, she sleeps like a log! Are any of your kids like that? At an old in-home daycare I had to be to work at 6:30am, so I'd wrap up my girls in blankets, strap them into carseats, and carry them into the sitter's. My youngest would wake up, although she'd usually fall back asleep at the sitters, but Salyssa stayed asleep through the whole thing almost every day. She was like a sack of potatoes and is only one foot shorter than I am and half of my weight! Good thing I am strong.
I will look more into Asperger's. I read a lot about all kinds of mental health/illness/disorders, anything along those lines is fascinating to me. I've read some things about Asperger's before, but I'll look more into detail.
Has anyone ever had any experience with neurofeedback?
Have you ever had her checked for Aspergers Syndrome? She sounds more Aspergers than ADHD--most are extremely bright and have difficulties controlling themselves, especially with transitions, sensory overload, in social situations and can seem very contrary (it's really related to the ASD). I would seek a NeuroPsych for diagnosing--they actually do intensive testing and can diagnose ADHD and beyond. A pediatirican, talk therapists, even plain psycologists or child psychiatrists don't test and often just say the standard "ADHD." ADHD interventioins won't help if she has ASD so it's a good idea to give her a complete "check-up." Before you try ADHD meds, I'd go to a NeuroPsych. Good luck.
Re neurofeedback...My sil is doing that for her son. VERY $$$$$. We spent a week with them last week and to tell you the truth, I did not witness any miracles wrt his behavior and he has been doing nf over a year regularly. Yet, I respect my SIL, so I say if it works for them, great. But I'm not interested. The cost/benefit ratio is not very good IMHO.
As an aside, SIL asked me to ask my neuropsych his opinion about neurofeedback, which I did this past May, and his opinion was that it had more of a placebo effect. His opinion was that a lot of times, when a family starts neurofeedback, they also make other lifestyle changes at the same time that further support the ADHD child, improving his/her behavior. Therefore, you can't really attribute the behavior improvement to neurofeedback. And yes, there are lots of studies which I haven't read, but my neuropsych has, so I'm going with his opinion on this one.
Perhaps on the alternatives board you can find more experienced neurofeedback families.
Do you have a YMCA or boys and girls club? We have something called SACC which stands for school age child care and this is a program that they have before and after school as well as in the summer
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Medicaid doesn't cover neuropsych. When she's not on Concerta, she's very hyperactive, twirling and chewing on her hair, not able to sit for more than 2 minutes, never being still, can't sit long enough to listen to listen to Goodnight Moon, let alone read herself. She 'chatters'- talking and talking and talking and jumping from subject to subject. A friend mentioned once that it didn't seem like she could even string more than 2 thoughts together.
We're going to an intake appt. at the mental health center here, she'll likely have some kind of counselor and a psych.
Yes, there are a couple Y's but they all cost money.What a nasty logistical problem you've got.
Is this right?--
She was kicked out of the school's daycare.
There is only one daycare center that transports to and from school in the area and they are not an option.
You must select an approved daycare provider to subsidize the cost.
She has not done well in home daycare settings before.
I would find the closest daycare center located between the school and your office, and transport her there after school, then come back to work and finish your day. She'd only be there for what, 2.5 hrs? I would also sign her up for a social skills class or group to see if she can improve in the area of managing her emotions--proper responses-- and whatnot. I've seen social skills computer games for kids also.
Hi and welcome. My first reaction was similar to MomWI. She sounds like she could be a "little professor", in other words Aspergers Syndrome. Maybe that is why she is demanding and throws fits (perhaps due to inflexibility and inability to "switch gears"?). Anyway, you need to get her diagnosed. It is interesting that she is doing well in school, but not in daycare. Why is that? Maybe she needs to go to school in the summer also. (Any school districts nearby that do year-round school?) Perhaps she needs the structure that school provides. Wherever she ends up, she will need structure, she will need a routine that doesn't change. She probably needs advance notice before any event or activity coming up during the day. Now I feel way out on a limb, but it's just MHO.
And I'm so sorry that you are really in a bind. I hope you find some short-term help while working on a long-term solution. I hope you can find a way to build a safety net of friends. Being as isolated as you are now is a potentially dangerous situation. Good luck.
Hate to be redundant, but I was also going to suggest that you look into Aspergers. From what you have said here, she totally sounds like an Aspergers child, and almost all Aspergers children have ADHD symptoms. A large majority also have sensory issues, and don't do well with to much stimulation (like a daycare setting), and do things like chewing hair and clothes, twirling hair to get more stimulation. Transitioning tends to be a huge problem with children on the spectrum. Many Aspergers children try to be social too, but they just don't do it well, outside of their family. They don't read people correctly, and they tend to talk "to" you, not "with" you.
Please read more into it, and make sure you read several things. The information can be a bit confusing, and don't explain the disorder in much detail. So just search around and read up on it.
Good luck!
OK, this is weird. I was flipping through a local magazine and it had a list of national agencies to contact about child care. Here they are:
National Assoc. of Child Care Resource and Referral Agencies, naccrra.org or 703-341-4100
Child Care Aware, childcareaware.org or 800-424-2246
National Resource Center for Health and Safety in Child Care, nrc.uchsc.edu or 800-598-KIDS
National Assoc. for the Education of Young Children, naeyc.org or 800-424-2460
National Assoc. for Family Child Care, nafcc.org or 800-359-3817
Get the school to fork out the bill. We are getting our district to cover our sons bill. I get them to pay for what we can't afford. I here the feedback thing is great. Does ins.cover this at all?
Actually what you described in regards to her peer relationships can be fairly typical of Aspergers children. You have to realize that they don't have to fit every single symptom, and there is also a "spectrum" of severity. Most of them very much want to, and try to be social, while others don't, but they tend to not be able to do that once they are not on the topic of the Aspie child's interests. My son can play with his peers if they are running, or playing tag. It's when they stop doing something of that nature that it all falls apart, and he generally ends up mad, upset, withdrawn, or in a fight. Because, he simply doesn't know how to play beyond that. He seems at times pretty aggressive, so he's had the ODD label himself, but when you look at WHY he is getting upset, it looks very very different.
That is not a normal peer interaction. It is much more pronounced now at 9, then it was just a few years ago, and I'm sure will be even more evident in the next few years. Most Aspergers children aren't diagnosed until the later years as others are forming friendships and they keep failing at it. The older they get, the more their peers notice they are odd, and friendships fail.
There is also PDD-NOS for those children that have many Autism traits, but don't exactly fall right into a specific area. Aspergers though tend to have the unique trait of having average to way above average IQ's, excelling academically in a specific area, and being experts in a specific area. One of which, that was mentioned by some of the authorities on Aspergers, is dinosaurs, just so you know. Many Aspergers will fall under the category of "gifted" in certain area's.
My son also has strong interests, but doesn't exclude other things. He is not obsessive, but his interests are strong enough that it's also not typical. That is exactly what I told his doctor, no obsessions, but outside of "normal" too.
The chewing on clothes, and twirling hair is very much a stimulation type thing. This can go with ADHD, but is more often seen with Spectrum disorders as they typically have more problems with sensory issues. I'm a hair twirler though too, and I only have ADHD. My son chews on his sleeves, and my youngest daughter with sensory issues, is a persistent hair twirler.
LOL, I've said the same line a million times about my son, that if things would just go his way, his world would be perfect
. Children on the Spectrum can have very rigid thinking. Oppositional Defiant kids also of course want everything to go their way. This is generally seen with everything though, and this isn't the case with my child, not sure about yours? With my son, he wouldn't be one to challenge a teacher, or a principle, or a doctor. He's just not that defiant. It's when he has an expectation of something and it doesn't go as he expects, that he gets upset. This type of thing can be seen with Bipolar children as well, but it tends to send them into a rage. My son doesn't rage. He has some good tantrums, but they are over within about 10 minutes.
I realize you don't want to diagnose your child, none of us can, but researching different things, does give you an idea of what is normal and what is abnormal. Being aware, allows you to observe your child more for those things to see if they do or don't apply. Then you can keep note of that, and hand it over to the experts. I think it's good for parents to at least have knowledge of all the different things their child's symptoms could mean. As parents, we tend to be the ones to know if a diagnosis "fits" or not. Ask anyone here that has had a wrong diagnosis, they were the first to know. If a doctor ever expected me to play dumb, I would walk right back out the door.
That's really all I would suggest. There were a great deal of people in this thread that thought your child sounded like a typical Aspies child. You don't have to listen to that, but I hope that you will at least consider the possibility and read up on it more. You know her better then anyone. I just suggest that you write down all these things that you told us here, and give a list of symptoms to your doctor. You are much more likely to get an accurate diagnosis that way, then having the doctor ask a few questions, you answer, doctors wanting to know what the biggest issue is, you answer, and the picture looks different then it does if they looked at ALL the issues. So just write everything down, in a list format, and if they want to ask more about a specific thing, they will. My child's doctor was thrilled that I had a two page list of all of my concerns over my son. He said he wished that every parent would do that so that he could get a clearer picture of the children he sees. If a doctor has an attitude about something like that, then I would think they aren't so great
Good luck at her new appointment :)
I do not like to try to diagnose my kids for many reasons. One is because if I take her to some kind of psychiatric professional with an idea of what might be wrong and I seem to know a lot about it, they tend to treat me like I've read too much and blow off my opinions. Especially when they find out that I'm a student of psychology and nursing, they think I'm doing what many psychology students do- diagnosing self, friends, and family by exacerbating things that they do to fit into the diagnostic criteria for disorders just because I'm learning about them.
We do have an intake appointment in a couple of weeks at a counseling center with various counselors, psychologists, and psychiatrists. I've never had any experience with this particular place so I don't know exactly how they operate, but in many other 'community mental health centers' treatment is mostly provided by a therapist and if they determine that medications may be helpful, you are set up with a 15 min. appt. with a psychiatrist. I have very limited options for where I can go for her treatment because she is on the state child health insurance program and not everyone will accept that as insurance. And if any specialists are needed I have to be referred by someone such as the psychiatrist.
These are the diagnostic criteria I found about Asperger's:
DSM-IV
A.Qualitative impairment in social interaction, as manifested by at least two of the following:
(1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
(2) failure to develop peer relationships appropriate to developmental level
(3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
(4) lack of social or emotional reciprocity
B.Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
(1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(2) apparently inflexible adherence to specific, nonfunctional routines or rituals
(3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
(4) persistent preoccupation with parts of objects
C.The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
D.There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).
E.There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.
F.Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.
GILLBERG'S CRITERIA FOR ASPERGER'S DISORDER
1.Severe impairment in reciprocal social interaction
(at least two of the following)
(a) inability to interact with peers
(b) lack of desire to interact with peers
(c) lack of appreciation of social cues
(d) socially and emotionally inappropriate behavior
2.All-absorbing narrow interest
(at least one of the following)
(a) exclusion of other activities
(b) repetitive adherence
(c) more rote than meaning
3.Imposition of routines and interests
(at least one of the following)
(a) on self, in aspects of life
(b) on others
4.Speech and language problems
(at least three of the following)
(a) delayed development
(b) superficially perfect expressive language
(c) formal, pedantic language
(d) odd prosody, peculiar voice characteristics
(e) impairment of comprehension including misinterpretations of literal/implied meanings
5.Non-verbal communication problems
(at least one of the following)
(a) limited use of gestures
(b) clumsy/gauche body language
(c) limited facial expression
(d) inappropriate expression
(e) peculiar, stiff gaze
6.Motor clumsiness: poor performance on neurodevelopmental examination
(All six criteria must be met for confirmation of diagnosis.)
If I were the professional responsible for my daughter's care and treatment, I would be hesitant about a diagnosis of asperger's because:
-she has no impairment with nonverbal social cues. She uses eye-contact, non-verbal gestures, facial expressions and seems to understand that of others very well. In fact, an emotional reaction seems to be what she's going for when she's in the midst of any kind of tantrum. She has developed lots of peer relationships, she seems to be able to make friends wherever she goes. She loves to involve other people in her interests, the problem comes in when they do not want to be involved in her interests for one reason or another. She does exhibit social or emotionally inappropriate behavior (the tantrums), but only when her wishes are thwarted, when she doesn't get her own way.
-She does have specific interests, but she doesn't exclude other interests.
-She doesn't display any repetitive or odd motor or verbal mannerisms. When she is not taking medication for ADHD (first Adderall, then Ritalin, now Concerta) she has a tendency to chew on or play with a lot of her hair, but when you watch it, it's more the way an overeater would reach for food, a nicotine addict would light up a cigarette, or an alcoholic would go for a drink. Before she was on any medications she'd always have a chunk of hair that she was playing with, but since the very first day she was taking meds, I've only seen it a couple of times, when she seems to be extra bored.
I know that there is something more going on with her than the ADHD but I would be more likely to 'diagnose' something along the lines of CD or ODD. Other than general hyperactivity, she only has problems when she can't, for one reason or another, get what she wants when she wants it NOW or when her wishes are otherwise thwarted. If things would always go her way I don't think she would have any problems at all.
I'm not in an isolated area at all! I live very close to Dayton and Cincinnati in Ohio. There's nothing here like your waiver program there, unfortunately. I'll bet many parents would really be grateful for a program like that. I know my daughter would do well in a setting where there were fewer kids and the care provider had extra training in dealing with 'difficult' kids but I've only seen a set-up like that for MRDD kids as an extension of their school.
I'm going to try to get more information about the YMCA daycamp program they have here. On their application they say that their goal is to never turn away anyone just because they can't pay. But I don't know if they'll be able to get the cost down to
I'll just chime in here and be the minority and say that she COULD totally have ADHD (not Aspberger's). Our ADHD son is extremely bright (which can also be common in ADD'rs) and also displays inappropriate social activity -- mostly related to lack of impulse control. However, he is able to maintain eye contact and can have "give and take" conversation and definitely makes friends. He also has emotional outbursts -- generally b/c he is not patient enough to listen to what I am trying to tell him! 
He also has a tendency to chew on his clothing, fingers, etc. -- I've read (and I"ll try to find the study and post a link) that many ADHD kids need oral stimulation to help a part in their brain -- it's entirely possible that Aspie kids do too (and thus, the assumptions from others that she may be that instead). In fact, this study showed that when children with ADD/HD were given something to chew on while taking a test their scores improved greatly.....
I'll also disagree and say that if you have a good psychiatrist or psychologist that is aware of the differences, you don't need a neuropsych eval. It depends on the practitioner (though I'd definitely recommend a liscensed one!) You might also look at family history -- in our situation we have a STRONG family history of ADHD so the red flags went up for us immediately when his behavior started to separate him from the crowd.
I have no advice for your particular situation with childcare, however, you might take a look at the Alternatives board -- many have found adding in Magnesium or Omegas (in addition to medication or instead of) can help focus, impulse control and hyperactivity.
Welcome and good luck!
MegMaguire38907.6654513889
Yes, family history on my side alone is enough to suggest that there is definately a genetic link to what Salyssa is experiencing. My parents= addiction, anxiety, and depression, though I'm sure there were other things mixed in there that just got missed because they never saw anyone about it. (My dad is clean of cocaine and alcohol now, 15 years!)
I myself have experienced major depression, self-injury, anorexia, bulimia and only now has anyone suggested that undetected ADHD in me may have played a role. One of my biggest problems was that I would get 'stuck' in a negative train of thought, so I'd always have these self-depreciating thoughts swirling around in my head, along with 200 other things and music all at the same time. I've been through lots of counseling and worked through many of my issues, but the negative thoughts persisted, I didn't really believe them, but they were there nonetheless. I started taking Concerta and one of the greatest benefits to me is that I can finally think of ONE thing at a time! I'm not so darn irritable! I can pay attention in lecture and actually process what the instructor is saying! Before I didn't ever really listen, but I did well because of my ability to pick up what I needed to learn in other ways. I am also very smart (not tooting my own horn, just saying that I'm not suprised that my daughter is intelligent since there is a genetic role in that, too) but ADHD was never suggested when I was a child because I didn't cause any problems in school and I always did well academically. However, the fact that I was terrified to get into trouble because of the punishments that would be doled out at home could have played a role. I was also afraid that if I brought a lot of attention to myself, it would bring a lot of attention to my parents, namely my dad, and that he would end up going to jail for drugs.
I can very much relate to my daughter when she is overstimulated by her environment, I have very often felt the same way on the inside that she is letting out through tantrums. I need a lot of downtime, just like her. I know what it feels like to have SO many things swirling around in my thoughts that I just want to kick and scream and punch and whatever else because that kind of activity matches what's going on inside my head. She lashes out on others when she doesn't get her way, I always lashed out on myself. My eating disorders gave me ONE thing to focus on and I got 'stuck' in those sort of thoughts, too. It is very much a blessing to be able to just think about one thing at a time, to be able to remember an entire conversation (before I would get distracted and wouldn't be able to remember a thing that was said), to read a whole book AND be able to tell you what it was about when I was finished and to be able to rationalize the negative thoughts that I do get, rather than for them to 'take over' my whole pattern of thinking.
Salyssa is very much like me in lots of ways. Our hospital baby pictures could be mistaken for one another (I showed them both to her dad at once and he was confused about where the 2nd one came from because the edges were worn and it had yellowed a bit.) I am also very stubborn and determined and can be defiant. These traits will be great for her when she is older, no one will ever be able to walk all over her! However, they are causing problems now because she CAN'T always get her own way (and she shouldn't, either) and then she gets worked up and 'stuck' in being mad about it and ends up having a tantrum.
Even though it's my opinion that she doesn't have Asperger's, I would never throw that option out the door just because I thought it. I read everything I could get my hands on about all sorts of disorders when she was an infant because I knew there was something different about her. If a professional thinks that she might have that and can show me exactly why he felt that way, then I am all for it. Whatever it takes to get her the extra help she needs because she very obviously needs SOMEthing. I know that as a parent I might not see things as objectively as another person so I would never say that only my opinion is right. It's just that I have done a lot of research on asperger's and other autistic spectrum disorders, both just because I wanted to know and for school. And in my opinion a major part of the diagnosis is the social aspect of the disorder and repetitive behavior in some way and Salyssa just doesn't have that. She has no problem expressing emotions or interpreting those of others. She's never avoided eye contact and the only problems she's had in conversation is that she can talk so non-stop that no one else can get a word in edgewise. She doesn't display any kind of odd or repetitive verbal or motor behavior. Like I said, if further investigation by a professional proves me wrong, then I will freely accept the diagnosis and search everything for treatment that might help.
Meg, your description of your son sounds very similar to my daughter. Impulsive is not a strong enough word to depict her decision-making style..lol She's driven by a motor that has more horsepower than my car and her gas pedal always seems to be stuck all the way to the floor. When she's being given instructions she needs to be told one thing at a time, if you try to give all of the instructions at once she will miss everything after the first step because she's already moved on to the actual project in her brain.
So I will wait to see what our upcoming appointments bring about. I just pray that she can make it through the end of the month in her daycare because a 1 day notice to make other arrangements is definately not enough.
Thanks!
I don't know if I can be of much assistance, as it sounds as if you may live in a rather isolated area. However, I am a child care provider in Iowa, and our state has a waiver for special needs children called the HCBS Waiver. Since you are on child care assistance for your children, you might qualify for it if it (or a similar program) is available where you live. Many children with ADHD qualify for this. It is governed in our state through the Department of human services. In this program, the providers are paid at a higher rate for caring for special needs children, and there needs to be a much smaller provider to child ratio. There would be fewer distractions and frusterations in this type of setting. The providers recieve special training and support in dealing with the children's behaviors. If you were able to find a provider who lived a little farther away from the school, she might also be eligible for school bus service. I have had children in my care who have been transported to and from school by the bus when they are here regularly before and after school.
Good luck!
I'm going to be redundant about my redundancy . I would look into Aspergers, which is not a Psychiatric disorder at all--it's neurological and requires interventions. NeuroFeedback probably won't do squat if she's an Aspie. I recommend this site to chat with parents who have kids with Aspergers...you can talk to them about what they think. All their kids are on the Spectrum, and they can tell ADHD from Aspergers by symptoms. Here's the site. It's exactly like this one. Only the disorder is different.
www.autism-pdd.net/forum/default.asp
You sound like a very loving mother, and I'm sure you will find her what she needs. You know her best :)
I had to comment on the 200 things going through your mind and being irritable, that is exactly how I am. I also take Concerta, and that was the first thing I noticed was how quiet my head got. Not constantly processing a million thoughts at once was amazing to me. The ability to filter through more then one thing at a time instead of just blowing up from being overwhelmed has been a huge turn around in my life as well. I was a lot like you as a child. Never a behavior problem, so I just went unnoticed. By the time I was having major issues in school and behavior wise as a teen it was chalked up to depression, which I knew wasn't the case even then.
Anyway, I'm glad you are doing so well on your Concerta :)
Good luck at her appointment.