Borderline ADHD & Wait/See | ADHD Information

Just looking for some friendly chatting and advice. My 5-year-old son is a little smarty pants but has trouble in social situations. It's like the more kids, the more hyper he gets. He has challenges keeping his hands to himself and likes to be physical/wrestle with friends (whether they like it or not). At preschool (but not so much at home) they have challenges with him following directions in that he'll get upset if they stop doing an activity they like -- in other words he doesn't handle disappointment well in that setting. He also responds quickly to situations without thinking. He can already read well above his level (Kall-4 or higher, whatever that means) and is good with math. At home he'll throw an occasional fit but no more so than our other child. The stress of school and the teacher saying she didn't think he could help his impulsivity led us to a child psychologist. We met with her five times and she worked with our son, too, on some techniques -- stop, breathe, think -- to help with the impulsivity. She also did some preliminary testing (as he is pretty young) to rule out any diagnosis of ADHD. Of course, he turned out borderline on this. As she said, the child she already thought was borderline based on our information/her evaluation turned out the same way in testing. She suggested we monitor him for the next few months and wait until he starts kindergarten in the fall before deciding whether he needs to consider medication for the impulsivity or not. She's good, in my opinion, so I respect her opinion. My challenge is I get upset when I hear about negative things he did at school. (His teacher has an autistic child with some ADHD traits and she basically told us she thought our son needed medication; they also can write up a whole page on something our son did that lasted 2 minutes out of a 3 1/2 hour day ... Our psychologist thinks the school isn't as consistent as it should be and overanalyzes "normal" kid behavior.) Just wanted to see if anyone else has a borderline child and how they deal with the "wait and see" game. Also, how do you deal with the teacher vs. the psychologist situation? And above all, how do you reassure yourself that you're doing the rigiht thing? Thanks to all! Also, maybe I'm in denial, but when he's home with the family (husband, me, younger sister almost 3yo), he's really pretty good. He gets a bit antsy pants if watching TV or sitting at dinner ocassionally, but that's about it. He doesn't challenge us the way he does his teachers or talk back. He knows the rules and rarely has to go to time out. If he gets really upset about something -- maybe two or three times  a month -- we'll have him relax in his room until he calms down. But that's about it. THat's when I go back/forth on meds as it seems he only would need them for some situations. I know they don't work that way though. ANyone else have a similar situation -- good at home but more challenging the more people are around, especially peers?

Ok, my kid is in no way borderline, but I work with preschoolers and had a couple of thoughts.

It sounds as if he is having trouble transitioning, like when he gets upset about having to stop an activity.  Does the wrestling stuff tend to happen in between activities, like when arts and crafts are over and he has to choose something else, during clean up time, and getting ready to go outside?  Make sure the teachers are giving plenty of warning about transitions.  All kids need this, but kids with adhd need more.  Ask them to give him a heads- up 10 min., 5 min. and 2 min. before changing activities.  Also ask if someone would stick close to him during transitions so they can head off any trouble by distracting him with a special job or a reminder.

It doesn't sound like he's really doing anything out of the ordinary, so be sure to ask the teachers what they're ideas of things to help him in the classroom are.  A reward system, if you don't use one already, could be helpful.  Check out the marble thread at the top of the board.

Personally, I'd wait and see.  Some of this may be stemming from boredom, so he may do better in Kindergarten. 

My oldest was diagnosed "borderline" ADHD at age 5 and we did not medicate her. She did end up diagnosed moderate ADHD (mainly inattentive) at age 9 and is now 13 and has been on meds since 9. I am still glad we waited. She could not get by without meds now, but I wasnt comfortable with the diagnosis or the meds at 5. My youngest just turned 6. We had some big behavior issues at 3 and 4. She also gets OT for handwriting and some language for interactive play. In Kindergarten this year they are having some issues with not following directions, staying on task, completeing work. ADHD has not come up.....but.....anyway, I started her on Omegas and we already do a pretty solid behavior plan at home and she is progressing and we are not having any significant issues at home. I will meet with school agian in a few weeks to see if things are improving with maturity, they are here (or with a little help form Omega 3 ). Academically she is also at or above grade level.

My opinion is meds under 6-7 should be if things are out of control. Some kids just cannot get by even at age 4 or 5 and in the interest of the child and whole family meds are started. I't such a personal decision. You do not even have a solid diagnosis. Even if he does have ADHD, so far it's not really getting in the wyay of his life. The social stuff can be worked on. Even if part of that is avoiding large group situations that set him up for sensory overload unless it's unavoidable. I think the wait and see approach is VERY reasonable. You're waiting and seeing not refusing.........you do whats feels right for now.....you have the right to change your mind at any time!

 

Diane V39513.706724537

Thanks to both of you for your feedback. Much appreciated! What is the Omega-3 thing that you mentioned? I know what Omega-3s are nutritionally but not sure how/why you use them in this case. Am curious!

Thanks again!

I think waiting and seeing is great - I mean, hopefully you never stop
seeing, right? My feeling is that there's a whole life ahead of us to
medicate, if we need to, but until we need to, why start? But yes, really
paying close attention to your kid is crucial. Maybe do some reading, see
if ADHD "feels" right to you - or if it's sounding like that's not what's
going on here. There's a lot more to ADHD than impulsivity and "hyper"
behavior. (and vice-versa - there are a lot of ways of behaving that can
look like ADHD but aren't) Have you looked at The Edison Trait, by Lucy
Jo Palladino? That might be a good book for you, with the way you've
described your son so far.

There's a lot you can do without meds, too - it sounds like he'd benefit
from some social skills work as well as some modification on the "taking
directions" aspect of life.

I would say that we're a yes to your question about better behaved at
home than school. In our case my read on it is that home is a calming
influence on my daughter. When she's with me, she's safe, things are
predictable. In school anything can happen and she's on guard, anxious,
absorbing too much information and overloading. It's like as if at home
she speaks our language and at school she's off in downtown Beijing or
Cairo and there's so much going on and she doesn't really understand all
the languages or what all the people want her to do or when it's ok to
cross the street - etc - if that analogy helps at all.

He sounds like he's well within the range of normal for a boy.  You aren't having trouble with him at home.  I wouldn't start worrying about medications yet.  He may mature a lot over the next couple of years, and if he is already ahead academically, he won't miss out on much at school.  It sounds like the psychologist is right in saying that the school is over-analyzing things.  Tell the teacher that they can't diagnose ADHD until he's a little older, just to get her off your back.

A little antsy when eating dinner?  I would not call that ADHD in any way, shape or form.  You should see have seen my son "sit" at age 5!  I don't think he'd ever spent more than 60 seconds in a chair at that age.
look on the alternatives board and you will find information than you could ever want or need (excellent!) on Omega 3 supplements.

I haven't read all of the other posts but I think waiting and seeing is a good idea.  I have nothing against medication (my DS has been on meds since 5 1/2) but if you don't have to medicate, then don't.  Wait until it really needs to be done, if it needs to be done.  I think someone suggested reading about ADHD and looking into alternative therapies (ie., Omega-3).  I think that is a great idea.  There are many good books out there.  Become as knowledgeable as possible so that when he gets into "real" school and the stakes become higher you know a lot about what you are dealing with.  Also, if he is borderline, maybe the alternatives will be helpful.

Good luck!

I agree with all that has been written but I have a few additional points. 

Can you volunteer in the classroom at school?  This would help the teachers and give you a view that you may never have again.  You will be able to see for yourself how his behavior compares to that of other boys.  Girls are totally different at this age so don't compare to them. 

In my state of NY, the preschool teachers do not generally have the level of education that the public school teachers have so there are some really incompetent ones and naturally some really exceptional teachers.  If you get the feeling that your son is harmed by this environment you could just take him out for the remainder of the year or switch preschools if it is not too late.  If the teachers don't know how to deal with your son's issues in an educated manner then they could be trying to "beat the ADHD out of him".  This never works and the kid just labels himself as "bad" and he learns to hate school.  There should be tons of rewards for good behavior at this age.   

If a child is marginal for ADHD then the teacher can make a huge difference.  With one teacher you might need meds and with another you might be able to put off the meds for longer.  I would think about giving your kindergarten school the heads up that he is marginal for ADHD and could they please place him with a teacher that is skilled in dealing with such a child.  Let them know that he has had a formal evaluation and that you are willing to work with them to do what is best for your child.  Some parents might not want to bias a teacher but I find it is better to be up front about the issues. 

     

Thanks again to all! This just makes me feel a lot better whatever the outcome may be. I thnk my biggest struggle is is their an issue or is there not. I'm starting to accept that it doesn't matter either way -- he's my son and he's a great kid. I'll check out the alternatives board and keep watching. I love this site!   I think you have the right attitude.  It would be different if he were really driving everyone crazy with impulsivity, hyperactivity, anger, defiance, etc., but it sounds like he's a normal, bright, age-appropriate little boy.  My child has been medicated since age 5, but as I always say, he literally could not function without it.  If he were as you describe your son, I would have waited a long time.  Your son almost sounds like the stereotypical case of the school trying to make the child sit still and be quiet.  If he is already reading and doing math and is otherwise a great kid, I wouldn't worry at all at this point. I agree with everyone. I think you should wait it out. I think waiting and seeing makes perfect sense.
The only other suggestion I would have is, if you have options as far as where your child will attend kindergarten, check them out and try to find the environment that you think will best fit your child. It can make a huge difference. And even if you really don't have any options as far as where your child will go to  kindergarten, then I would check out the school he will be attending, observe the teachers and, like someone else suggested, see if you can get him placed with the teacher who will be the most helpful for him.