4 year old with episodes of extreme hyper | ADHD Information

Thanks again, Diane V.

I have thought about an integrated class. THe only thing that makes me nervous is that I was in a couple of these types of preschool integrated classrooms and the ratio of spec. ed. to "typical" kids was just too high and it ended up looking like chaos. I think I am going to take a couple days off from work soon and spend some time observing in classrooms that could be options.

We did a half day at school yesterday and life was much happier. I know it doesn't solve his problems but at least at this point it will make him successful. So we are going to try that for now. I think a full day is just too much for him right now.

Gatorsmom - not sure if you will see this or not. But, I am curious as to what sensory things you see with your ds. With mine it is mostly constantly seeking movement, playing so rough with toys and kids, not respecting others personal space (always hugging, sqeezing, touching), covering his ears when the class is too noisy. He also has some visual things - has always like to put things in front of his eyes, look thorugh them, etc - esp when tired. They all seem like sensory things to me, but he doesn't display them CONSTANTLY so the Ot didn't see anything working 1-on-1 with him. Just curious as to the sorts of things your see with your son. TIA!

shellb,

First let me say - bravo to you for continuing to seek help and advice even when the so called experts don't see it. You know your child best - and you are his best advocate. =) Everyone said I was crazy too, including my family, UNTIL he was finally diagnosed, then everyone could see it.

Second - this is probably going to be long - so I apologize in advance.

My son has or had had all kinds of sensory issues - so I will try and group them by category to make it easier to follow.

Clothing - all tags must either be the satin kind, or they must be cut out. I try and buy tagless shirts, pants and undies to just avoid the problem. The seams on his socks must be the right way, or the shoes have to come back off and readjust - and there isn't any waiting about it - it has to be RIGHT NOW or he cries.

Shoes must be lightweight and flexible or they bother his feet. He currently lives in crocs and vans, much to the dismay of his PE teacher but too bad for her. He has such issues with his feet that he actually slept with shoes on until he was 3 because he couldn't stand for anything to touch his feet - even in bed. I worked with him on foot sensitivity by doing DEEP pressure massage on his feet often, and by standing him barefoot in the middle of the yard and letting him scream until he finally walked over to me. (both ideas I got from the book I suggested before) He still doesn't like to be barefoot outside, but that I can live with. At least his wife won't have to be freaked out by him wearing shoes in bed on his honeymoon. haha!

He has personal space issues. He gets too close to your face when he talks to you, grabs other kids hands and tries to pull them to where he wants to go etc. He doesn't seem to sense the boundaries we all naturally have, and doesn't sem to notice when other kids get irritated. This has gotten a bit better since he started meds, and I think he is finally starting to show a little maturity and sense when other kids are getting mad and backing off. Still a ways to go though.

Noise - Oh my is this ever an issue! He HATES loud noise. He would cover his ears, and even lay face down on the floor and scream when it became too much for him. We have had to leave more things than I care to admit because he just couldn't handle it. He seems to get a bit more tolerant with age, but this is still a definate issue for him.

He is very tactile. He loves different textures and fabrics. But, he is not that tolerant of a lot of them after he feels them. He only sleeps with certain kinds of fabric blankets, he used to only drink out of a certain kind of sippy cup, now he prefers to use a straw everywhere.

He is very into rhythm. Anything with a heavy beat will attract his attention. In fact, pre meds, the only time I ever saw him sit still for any length of time was during an outdoor festival where some guys were doing native american dancing with a heavy tom tom beat. It was like he was mesmerized. It was amazing to watch actually. Music of all kinds revs him up.

Even now that he is on meds, he is a movement seeker. He can't sit still and read for example, he is constantly changing position. When he stands, he shifts from foot to foot, kind of in a rocking motion. He LOVES heavy movement and touch, like wresting, squishing between 2 pillows, trampoline jumping, swinging in a swing, that sort of thing. All those activities are mentioned in that book I suggested as calming type therapies.

He HATES soft touch. A light breeze or misty rain is enough to send him over the edge. Every coat or jacket he has comes with a hood so he can put it up when he can't take the breeze (that no one else feels btw) or mist or whatever. He doesn't like to be softly caressed, he prefers deep massage. Getting a haircut is quite the experience, because the clippers buzzing tickles him, and the falling hair drives him batty. I did work with him on this using an example from that book which was really helpful. I got a big bin and filled it with rice (a lot of rice!). I put some of his favorite toys in the bottom, while he watched. Then, when he wanted them, he had to dig them out of the rice. He HATED it, and he screamed the whole time, but he eventually got them out of there. And over time, his arms seemed to be able to tolerate light touch more, and being outside in a gentle breeze became less of a problem. Sometimes he still has issues, but it is a lot less.

Food - oh where do I start with food. He eats VERY little. And what he does eat I try and make organic when possible as he is very sensitive to food additives and dyes. I am finding now that he is going to school that he is a little influenced by his peers. Today he came home and asked to try a peanut butter sandwich (no jelly). I almost fell over! But, I made him a half of one for a snack. We will see if he eats it. Food has to look right or he won't eat it either. By that I mean, if you make Kraft mac & cheese, and then try to make Kraft Shells and cheese, he won't eat the shells and cheese because it looks different. He won't even taste it to see that it tastes the same. Fish sticks have to be a certain brand, because if the breading looks different he won't even taste it. His lack of eating drives me to distraction because it is so hard to keep his weight up with the ADHD meds. I gave up fighting food battles long ago because it just wasn't worth it. I make something he likes with every meal, and if that isn't possible I make him something quick and easy that he does like. I take a lot of flack for that, but I'd rather that he ate.

That's all I can think of at the moment, but I am sure there are others I have forgotten. If you get all the way through all this - you are a saint! I just hope it is helpful!

Good luck and welcome - you will find friends and amazing advice here. =)

gatorsmom39556.5961111111

Thanks so much for all of your responses. He actually had his OT eval yesterday & it did not sound encouraging. She is not. rec. services because his academic learning is not affected and she did not observe any sensory issues. I am pushing for a Sensory Profile to get done so that at least our concerns (mine and the teacher's) are documented in her report. He can be really"on" sometimes but when he is "off" it is just uncontrollable, hyper-active behavior.

I have to really weigh my options for next year. He still has another year of preschool but I may have to move him to another school where the behavior program can be tried. And I am going to continue to explore the medical/diagnosis route. The teacher brought up putting him in a self-contained classroom which I DO NOT want at this point. I think I would loose him forever then - lost among the behaviors of the other children. There would be no going back. That is not to offend anyone who has a child in a spec. ed. class, but for him, at this age, I think it would be downhill for my ds. Thanks again for all of your kind words.

I am discouraged because I DO see so many sensory things but the OT who evaluated him just didn't agree. I am going to order the books you rec. today! Thanks!

I agree to not put him in a self contained classroom. I can non judgementally say that becasue I have a daughter who is about be transferred to a special ed school, so cant get more self contained than that . For her it what she needs to be successful though. Regular Ed is WAY too hard. At FOUR with no diangosed disabilities it makes no sense. So many of these bahviors will settle down closer to age 6. Whether he's got anything or not, it JUST does get somewhat better.

That said, an integrated class may be beneficial. You can have the best fo both worlds, the help and experience of SPED teachers and para's, plus the positive socila role models of typical children. Don't close the door completely on SPED, especially for preschool. You'll find the teachers more patient and willing to work on behavioral issues. He wont spend his whole day getting in trouble. They know how to distract, redirect, us epostivie reinforcement. Just a little less pressure. Less stress better ability to compensate for symtpoms and less sensory overload.

Chiming in late...

My son Maddox is going to be four next week and sounds just like your son. He was crazy hyper since the minute he learned to walk (then run...) and, against everything we believed in, we had to buy a leash for him or he'd run into traffic, get lost or get hurt. He NEVER stayed in the stroller and when he was restrained he'd just scream. The tantrums were awful, the impulse control wasn't there, and he was generally irritating to live with. (Contrast to my other son who is SO well behaved that his teacher wishes we could clone him! We used to think it was our stellar parenting skills...) NO discipline methods worked on him and it was embarrassing to take him in public.

Every six months from the time he was a year-and-a-half, I went to the pediatrician and told her something was "off". She kept telling me he was "high energy" and within the range of "normal" toddler behavior. I got incredibly frustrated. We went to a family therapist about 8 months ago and the first words out of his mouth were, "Have you had him evaluated? He sure seems hyperactive to me..." That's where my path to diagnosis really started. I got on the internet and started researching ADHD and was completely convinced that he was a severe case.

Since my health insurance requires a referral to see a mental health professional, I started keeping a journal. I diligently logged everything he ate, his sleep patterns (or lack-of-sleep patterns), and every incident or tantrum throughout the day - what caused it, how long it lasted, etc. I did this for three months and then went back to the pediatrician armed with my "proof" that I don't have a "normal" child. She looked through the journal and immediately got me referred to a pediatric behavioral psychiatrist. (THANK GOD!!!)

It's been a slow process, but we did decide to medicate him and life has gotten SOOOOO much better! He's on dexadrine 2x per day (which lasts 4 hours) and takes risperdal at night. His sleeping has improved a little, but his behavior during the day is almost that of a normal child. When I tell people now that he's ADHD, they think I'm nuts. But you should see him unmedicated... It's REAL obvious...

I didn't mean to write so much, but hope this helps you with the path to diagnosis and to tell you that you're not alone! Feel free to PM me anytime if you want to commisserate. This is a tough age, but I'm optimistic that it will just keep getting better.

Incidentally, we applied to Montessori school and were NOT accepted. While I was there filling out the application, my human tornado destroyed their classroom and ran around like a lunatic. I think the minute I left there, they put my application right into the trash. We never heard from them! We are now at public preschool that comes with VERY patient wonderful teachers who have been extremely supportive of our situation.

Hang in there!

Thanks so much gatormom! Yes - I did read your whole post & it was very helpful. Alot of the things you described with your son are simlar to what we see. It is not constant though so working 1-on-1 with the OT, she saw nothing. And the OT is basically refusing to do a Sensory Checklist cause SHE didn;t see anything. She asked me "Why do you think it is sensory?" and it was a hard question to answer without having a checklist to refer to but I found some lists online & I am gong to make a list of the things I see with & tell her to include it with her report. I at least want our observations docmented in some way. Your list triggered some things for me, too. THanks so much. I am finding this forum very helpful. Earlier in the week I was feelng VERY emotional about everthing but I think at this point I am ready to just tackle it, matter of fact to get done what needs to be done.

Thank you once again!

Babygonz - thanks for your response. I am still mulling over what to do with movign him to a new class. His class IS actually very structured and his teacher is a former spec. ed. teacher who has invested so much time & thought with him I am reluctant to make a move. It is such a hard decision! THank you though![QUOTE=shellb06]

My 2nd question is that althoguh he is generally a highly energetic child, he has these episodes at school about 2-3 times per week where is is just completely out of control. It seriously looks like his brain is not communicating the right way with his body. He runs around, bothers people, is defiant, and just appears to not be able to comprehend directions or consequences. Has anyone had experience with this? I have always suspected that he has "sensory issues" and it appears to be getting worse lately. SOmetimes he is able to "come out" of the episodes within 15 miuntes or so, other times it takes hours.

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I could not have said this any better myself! My son will be four next month and this exactly descirbes the kind of thing I see several times a week! I have no advice for you but it made me feel better to hear that I am not alone.

I encourage you to really push the OT thing or just bite the bullet and pay
for it yourself. We didn't push when I felt we should and are just NOW
getting the OT help my son needs - he is 9!!! I shutter to think what could
be if we had started it when he was 5.

As stated before, 4 is the worst. You are really smart to push for help now. I
would also switch to a more traditional preschool either in the public school
system or with some other organization. They provide lots of opportunity to
run energy and the teachers are usually really receptive to behavior plans
and working with the child to discover what type of learning interests him.If you get the books I suggested, there are checklists in them to help you make a list. It helps to get everything all together like that. I went through with a highlighter and was amazed at how yellow the checklists were when I got done. Kinda freaked me out - hehe! But, it was the jumping point that got us on the road we are on today and things are much improved. So, there is hope!

shellb06
This brings back so many memories of my son at 4. But, let me tell you that there is a light at the end of the tunnel. My son is 12 now and life is so much better, but still a struggle in different ways. At 4, I was told he was just a diffficult child. At 7, he was diagnosed as ADHD-combined

First off, I don't always believe the school district evaluations. They tend to look for ways to provide the least services. Find a specialist to work with to do the full evaluations, including an autism evaluation.

When my son was 18 months old, he pretty much stopped talking (he only used 3 words). We were involved with EIP (Early Intervention Program). He was in speech therapy at 2. The speech therapist taught him two signs to use to communicate with us (more and all done). He stopped verbalizing completely, developed 12-15 signs. The speech therapist was completely baffled when I ordered her not to use sign laguage with him, even after the explanation. They told me he was 9 months behind on his cognitive development at the first evaluation. He started talking again at 30 months and hasn't stopped since. Before we left EIP just before 3, the exiting evalution was said he was 6 months behind.

We went to the school district to have him tested him for speech services. The evaluation was done during his naptime and he was not very cooperative. We went to the waiting room to talk and let him play with the toys. He found a book on heavy equipment (his favorite) and brought over to me. He was able to name every item in the book. You would have loved to see the evalutor's eyes pop when he pronouced "articulated dumptruck" and "excavator". She had just been telling me that he would not qualify for speech theraphy (making all the appropriate sounds) but should qualify for language therapy. At our parent meeting, he was now one month behind.

Two evaluation took place about 2 months apart.

Part of your son's problem might be that full day is just too much for him, he is over-stimulated and the lack of structure just adds to it. I looked at Motesorri for my son and decided against it. It looked overwhelming to me. (I am ADHD, too.)

I like the idea of the mini trampoline, that will help him burn off some of his energy. Exercise has a relaxing quality about it.

These children are really brilliant and thrive on stimulation of whatever they are interested in. They are not like other children, which is what makes life with them so much fun and challenging. He will keep you on your toes. Most people do not understand them because they are so different from other 4 year olds.

How is his eating and sleeping? Both were nightmares for us. He is still a very picky eater. He only eats about 10-11 things and there are rules about them. Sleeping improved when we discovered he had allegry to dust and mold. He started Zyrtec and that helped. He slept like a dead person the first night, it scared me.

I mentioned autism eval because some of these comments sound like Asbergers. My son is now being evaluated at 12 because his psychiatrist (ADHD Specialist) suspects it. I switched to a specialist at 11 because we started going backwards. The pediatricians missed it the possible signs of Asbergers. Pediatricians can manage simple ADHD, but most cases of ADHD are not simple.

reruho39557.5499652778Montessori didn't work for my 4 year old. He is now doing well in a private
school and is 7 1/2. Also, he is on medication. Montessori wasn't structured
enough for him. I loved the school, but it just wasn't a good fit for him.

I think moving school's is probably inevitable. You will most likely get better suuport, expecially on rewards charts and behavior plans at the public school. If it is the school's OT evaluating him it may be hard. You may want to do a private eval also.

A suggestion, buy The Out of Sync Child and try some of the techniques in it and see if you see a change. Generally OT therapies only last a couple of hours. So for example, if he benefits from things like jumping a trampoline or swinging on a swing (both GREAT sensory tools) you may see calmer behavior for a couple of hours. Instead of a weighted vest, you cant try "squishing" him. Put him on a body pillow with another one on top of him and bear hug him, we would actualyl lay on my daughter, but sometimes she didnt like it, so you have to satrt with light pressure then increase to their liking. some kids want to be "SQUISHED", hard .

I agree with Diane - Get the book The Out of Sync Child. There is a companion book called The Out of Sync Child Has Fun - which gives you TONS of play therapy type things you can do with your child to help with the sensory issues.

I swear I could write a book about sensory issues having dealt with my sons and I promise you that book will be a great help. We did a lot of the things in that book with my son and helped him immensely with his sensory issues. He still has some, but we have come a LONG way towards a happier day for him.

Hi Diane

Yes - he is getting an OT Eval. THe OT is not optimistic that he will qualify because his academic skills are so far ahead but I am really going to advocate for him. I really want to explore the Sensory aspect before moving on to meds, but it is such a long process. I think he needs a weighted vest, brushing, the whole nine yards. But I am not an OT, so who knows! I am hoping once the eval is done, we can get suggestions on what to do in the classroom for him NOW rather than waiting for his meeting and to see if he qualifies.

THanks so much for your reply. I do agree about the behavior plan. Home is really not a problem. It is school where most of the issues & episodes occur. But, I am having diffiuclty getting a behavior plan in place with the teacher. I think part of the problem is that a behavior chart (which I think he would really respond to) conflicts with the Montessori philosophy of intrinsic rewards. Right now his consequence for bad behavior is having to sit out of recess or other play time which causes a downhill spiral because he CANNOT sit and it causes his behaviors to get worse & more defiant. Ugh!

To be honest, your son will probably struggle whereever you put him, until his needs are met properly. You must be the advocate for your son. You will probably have more success in your local public school due to special education laws.

My school was extremely reluctant to provide OT services. You'll need a great doctor who can help you advocate for your son. The earlier you start the better. The more prepared you are the better. Do alot of research on special education rights and advocacy.

Unfortunately alot of times the academic skills are far ahead at this age, they learn very quickly and the material is presented slowly. However, it will be extremely difficult for such a hyper young man to succeed in the classroom with the social behaviors that are expected.

Get a firm diagnosis, a doctor who can provide a treatment plan, and work with the school before your son starts kindergarten to have them ready to implement the plan and provide whatever needs your son has in order to succeed in school.

Research on your part will be the key. If you have any friends in special education use them for as much info as possible. Its a difficult path to navigate, but if you are firm and polite and try to work with the school as best as possible you can have a successful experience for your son.

hi and welcome.

The first thing I have to say is 4 IS THE WORST!!!! It is such a difficult age. I think you're doing the right thing by having evaluated by the school system. They will place him if he has any issues. Is he getting an OT evaluation? If not you may want to try to get one privately. If he has sensory issues they can help a great deal and if he's in an integrated preschool program, they can have OT work with him in school, and impleent sensory breaks into his IEP. 4 is a littel young for an ADHD diagnosis and your med options are pretty limited even if you get one. BUT it does happen and successfully. I think you're on the right path. Start slow, work things through and have him properly evaluated. Even if it's "inconclusive" at this age it certainly doesnt hurt to begin documenting and tracking your concerns.

A behavior plan is also a MUST tool for all 4 y.o. IMO. Espeically for "spirited" children. Read Ogram marble system, the book 123 magic and other discipline books and incorporate a system that will work for your family dynamic.

My 4 year old son has been on the go since he started to move. I've read some threads and he sounds so similar to many of your children. He is extremely bright, happy, and enjoys life. However, this year in a preschool classroom has been a disaster. He attends a full day Montessori program at the school that I work at ( I am not a Montessori teacher).

My 1st question is does anyone have expereince with your own children and Montessori? I thought it would be a good fit for him, but I am now wondering if the structure is just oo intense for him & perhaps he needs a classroom that focuses more on the social development that he is lacking at this age. I am afraid to move him for next year because I fear it would be so disruptive but I also wonder if the Montessori approach is just too much for him.

My 3rd question is related to abnother thread that I read carefully - best path to diagnosis. He is currently going through the process of being evaluated through the school distict but I am considering taking him for a pyschiatric eval. as well to explore if meds would help. I feel horrible haivng to medicate my 4 year old, but I am at a loss as to what to do next. We cut out all red dye from his diet and for the 1st few weeks or so it seemed to make a difference. Now, things seem to be getting worse than ever. I have been up for hours without sleep and I am just heartbroken over what he is going thorugh. I am so thankful to have 2 healthy, happy children but it is so hard to watch my ds have such difficulty at school. I am sure you all can relate.

Any advice, experience, or answers to my questions would be so appreciated. Thank you in advance!