A couple of years ago, I posted about my very young-for-his-class son's serious attention-based challenges and struggles in a very strict charter school kindergarten. We have since changed to schools to a public neighborhood school and he re-did kindergarten as one of the oldest in his class instead of one of the youngest. He was having some focus issues at the beginning of the school year, but the K teacher worked with him and he was at grade level in terms of focus and attention by the end of the year. We were super pleased with how the year turned out, and really like this school. We are committed to staying.
Fast-forward to first grade: last night was conference night. We had a pleasant conversation with his teacher; DS is scoring very high on his assessments and seems to have a good understanding of the material. No behavioral issues and the teacher said that he has good ideas and is interesting to talk to...when he participates. Here's a direct quote from the conference take-home sheet: "[DS is] often off-task during class discussions and work time. This causes him to have no idea what is going on in the classroom, even multiple reminders do not tend to focus his attention." She said that one time, the whole class moved from their desks to the floor in the front of the classroom, and DS didn't even notice and the teacher had to specifically get his attention to have him move as well. I have also seen this 'space cadet' behavior in his sports as well. He loves hockey and is a pretty good player. However, when they run drills and the coach gives the instructions, DS is skating around behind the coach, looking the other direction, etc. and has NO IDEA what the drill is. After a few repetitions and watching the others on his team, he finally figures it out and does well. But it takes a while. I have told him multiple times - before almost every practice - that when the coach speaks, he needs to stop skating and look at him, but it never seems to 'stick'. DS's primary issue is absorbing information when a leader is speaking to a group. He does well one-on-one and at home.
DS was on a low dose of Adderall for some of that first kindergarten year at the charter school. It didn't seem to have much of an effect at the original dosage. We increased the dose and he did seem to pay attention better for the short time we had him on the higher dose. But then we discontinued the meds since we wanted to see if a school change and some more maturity would help - which it did! But now we seem to be back in a similar pattern with not paying attention in a group setting. So...here's my question. Should we be content with the fact that somehow he's learning what he needs to learn in school without appearing to pay attention? Or should we revisit resuming medication to help him be able to focus better and maybe be even more successful in school and sports? I'm really against medication in general, but of course want my son to be all that he can be. Thanks for your insight!
Thanks, all, for your thoughtful answers and input. It was really helpful to get some perspective from those that have 'been there'. After a not-so-great Tuesday, DS had a really good rest of the week and weekend. So the jury is still out. I think I will wait until after report cards come out mid-November and see how the other staff feel about his attention span in other classes (gym, art, etc.). If indicated, I'll make an appointment with our pediatrician then. It's tough to call when the situation is so borderline!
This is a really close one and I think you have more information than we do.
I teach Sunday School for this age and there are quite a few spacey kids out there at this age, lol! It's my job to bring them back to class. I'd give it till December before I consulted with the teacher and made the decision to medicate him.
I can be lost in thought, too. What looks obvious to adults can be overlooked by kids, pretty easily.
The teacher should be able to handle this. I would speak to her before resorting to drugs. He is learning. So I would work with the teacher. Not all kids are the same. They are individuals. Different does not mean drugs.
I would really consider posing this question on an ADHD board. You're going to get advice here from people who have no experience with ADHD.
That said, I've been dealing with our son's ADHD for seven+ years now. Medication has given our son the best chance at a normal life. Why not eliminate the struggles for your child? It's kind of like telling me to read without my glasses. Yes, I can squint really hard and make out the words, but it's a heck of a lot easier when given the right tools ... my glasses. Just think of the potential for your son if the dots in his brain are connected the way they're supposed to connect!
Once he is formally diagnosed, yes, you should utilize medication to help him.
I was diagnosed with severe ADHD in 3rd grade after 4 awful years of school. It took another year or so to get my dosage/medications right. I really wish my mom had gotten me assessed much sooner. It would have changed my childhood.
There are so many great options out there today. Start with a non-stimulant like Intuniv or Strattera if you're nervous about meds. Also, understand that "low dose" isn't better when it comes to stimulants. He'll need a dose that is appropriate for his weight and metabolism. A low dose can actually make symptoms WORSE than a higher dose that works for his body.
There's no one-size fits all medication cure. You might have to try out a few different ones to find one that doesn't have negative side effects or that helps his focus. Don't give up. Be an advocate for him and read up on his diagnosis.
Best of luck
C.
My daughter was just tested the other day for ADHD at our HMO's psychiatry department. It was a 3-hour long battery of tests where they assessed multiple children at once. All of the parents had a class during that time where we learned about the latest research on ADHD.
So, what I found really interesting was that the cutting-edge research on this shows that this is actually a structural brain issue. A breakthrough that researchers had about 3 weeks ago was an extensive study of behavioral therapy (rewards, etc) vs. medication only vs. medication + behavioral therapy. Apparently, kids who received medication only did just as well as those who did medication + behavioral therapy, and both of those groups outperformed behavioral therapy only. So... bottom line, medication is really the only thing that will make a dent in ADHD, according to the research, and behavioral therapy simply isn't as effective as previously thought. This is most likely because ADHD itself is caused by neural transmitters not transmitting information to certain areas of the brain. These areas remain "asleep" when they should be receiving and processing communication. Stimulants help "wake up" these parts of the brain. No amount of behavioral therapy will accomplish this (again, verified by peer-reviewed research). It is a brain structure issue.
Something else the psychiatrist told us was that ADHD is almost totally unpredictable. These kids will go for a period of time and be a lot better, and then suddenly be a lot worse, seemingly without any rhyme or reason. He did say that Omega 3 fish oils seem to be promising as a dietary addition, but other than that, nothing has really been proven to help in terms of diet.
As far as the medication goes, it is metabolized very quickly through the system, so for most kids, they take it in the morning (say, 8am), and by 1-2pm, it is completely out of their systems. There's not a whole lot of downside to taking the medication if your son hasn't had any adverse reactions to it so far.
Has your son been tested for any sleeping disorder?
Does he wake up in the middle of the night thirsty?
Does he snore?
Lack of sleep mimics ADD and a child will be totally hyper during the day so they don't fall asleep - or be a space cadet.
I would go back to my pediatrician and ask for a sleep study to be done. Especially if your son snores or wakes up in the middle of the night. Not all ADD is "true" ADD - some of it is sleep issues.
Good luck!
I would do another trial of the medication. It is only a trial. If you see positive effects.. then you can continue.. if the drug is not working.. stop.
But what if the medication really helps him to focus and learn. >>
the work gets harder quickly in school. he needs to be able to pay attention.. or he will get lost and fall behind...
This may be a stupid question, but have you had his hearing tested, too?
As he gets older not listening is going to be a bigger problem.
In a few years not following instructions can make the difference between acing a test or failing it completely.
I'd revisit the medication - see if low dose will work this time and if it doesn't then try the slightly higher dose.
I am a 50 yr old woman with similar symptoms- I can totally relate to what he is doing.I have a hard time focusing in a group. No problems in one on one , or a group of 2 or 3. But it is not an attention issue. I can give it attention, ...it is a hearing and processing issue. My brain processes the world a little slower than others. I have a creative brain, not a math brain. I think that this side of the processor may just be like that. I can blow people out of the water with my landscaping, interior design, cooking, drawing, medical research abilities, etc.... But i might not follow instructions properly ... Mostly, because have a hard time HEARING when there is a lot of back ground noise (groups and parties are the worst!) and I tend to read lips to help me hear. Because i am so focused on watching lips, i can miss facial expressions and other clues that are part of communication. I am different than others, I am unique, I am very intelligent, I am more on the ball than most (as far as logic and intelligence..my husband says I have uncommon common sense ) I would advise you to NOT medicate, You would be ruining who God made him to be. He is amazing and special jus the way he is. It would be a catastrophe. Also, I will comment a little on the meds since I have researched them. Those meds can and often do cause permanent changes and damage to the central nervous system. Shoulder rolling, tics, eye blinking, stuttering, tourettes, and more... can show up after long term use or too high of a dose. Many eventally get 'serotonin syndrome'.
In regard to seizures, I just wanted to tell you that many seizures are caused by BLOOD SUGAR DYSREGULATION. Low or high blood sugar both cause a mini or absent seizure where the kids will 'zone out.' My daughter has hypoglycemia, I sdidnt realize it whens he was little but looking back there was signs- zoning out! You should have him tested with an A1C test, the best test for blood sugar but even then, blood sugar dysregulation is hard to find on a test, symptoms are the best indicators. Look up hypoglycemia symptoms online . check several sources as they all might list different ones.
The kidneys do a lot of blood sugar regulation and when you give a person drugs, the kidneys have to filter them out. All drugs are nephrotoxic to kidneys and the liver and can damage them. Yet another reason to stay away from them.
I think Ritalin is a miracle drug. It's the one that's been around the longest and has the least side effects plus it's cheaper than some others.
If your doc say's it's okay to try it then why not give it a try just to see if it makes a difference.
But from what you're saying I think I'd have his hearing checked by a professional that only does that sort of thing. He may not be hearing them very well.
Personally I'd exhaust all other options before I consider medications. Besides the other ideas given is he getting enough sleep? I know that can be hard with school schedules being what they are and recent studies have noted the connection between sleep and adhd type behaviors. Just a thought. Good luck.
This may sound like it's out of left field, but I just want to ask if it's possible that your son might be having petit mal seizures. If you haven't asked the doctor about the possibility, perhaps you should.
I think you may need to consult with a doctor/specialist so you can sort out what's driving the inattention. School, sports, childhood in general are about much more than learning material and skills--they're about learning how to function in society. From what you're saying, your son is facing some significant challenges in that department, and even if he IS doing fine in academics, his behavior is getting in the way of working with others. Ignoring it doesn't seem like a good idea. Maybe those challenges are due to brain chemistry, however it's not clear, because you said that the medication helped before AND so did changing schools. I'd say you need to talk to the teacher and to a trusted medical person to help you sort out why he has 'regressed.' Good luck!
I was thinking the same thing as Doris Day. My nephew would do the same thing, and often times he would appear to go along with the group, but have no idea what is going on and have no memory of what had happened. It turned out he had seizures. The good news if it is seizures, he maybe able to out grow it and not need to be medicated all the time. Talk to your doctor about all options for diagnosis and treatments. If it is ADD, it's hard for a child that young to understand his behavior and consequences of the behavior. I would think about medicated him, and when he is medicated and in a better place to focus and follow along, teach him different methods that he can use to maintain his focus. It maybe difficult to try to get him to learn different methods when he is already struggling to focus.
Hello:
We have a very, very similar situation with our daughter. Sometimes, she seems to not even know what's going on around her and sometimes she is more "tuned in".
Recently, I have been researching (non-medication) related options for our daughter .....I read that food sensitivities (not food allergies) often create adhd behavior in kids and adults. Wheat has proven to be particularly offensive. Have a look at this ADHD study which details the link between ADHD and diet. http://www.webmd.com/add-adhd/childhood-adhd/news/2011020...
The more you know.....
Best to you,
C.
I may have a slightly different take, and if you're not excited about medication, this may work for you. I have absolutely no basis for this other than my experience with my own children, so I'm definitely not an expert! I believe that in the last number of years--10?--we as a society have started to need to label and box up children that don't fit into the holes we want them to. A friend of mine has a son who has mild Aspergers, and when she and I were talking about symptoms and how they were working on it in therapy, I realized it sounded a lot like my oldest. A few weeks later, she met my oldest, and commented that a lot of his mannerisms were similar to her son with Aspergers. Do I think my kid has Aspergers? Doubt it. Does he have some of the same tendencies? Yep. He also has some ADD/ADHD tendencies. But, he struggled in kindergarten, and first grade, and even into second grade. Now that he's in 4th, he can focus, most of the time. He's still impulsive. I've also coached young kids' soccer; many of those kids are spacy. I'm surprised he's the only one in hockey like that! Anyway: my take: Kids are different. They develop differently, different things interest them, and different things hold their attention. Maybe your kiddo is a kinesthetic learner and needs to be moving. Maybe the material isn't "worth it" to him (my middle is learning letters right now, and tracing them is not "worth it" to him, and he does a very sloppy job, despite poking and prodding and pleading). If the teacher is not seeing severe problems, and it's not a huge issue to you, let it ride. Work with him on focus. Oh the other thing: does he focus on things HE likes? It could also be a matter of stimulation: when I was teaching, a teacher friend of mine had tons of posters and interesting things posted in his room. It was amazing, but when we had teacher meetings there, I couldn't focus on the meeting; I was so busy looking at his room! Maybe all the kids and excitement are a lot for him. None of these has clear cut, easy answers; you can't just fix those things. But you can be assured that more than likely, he'll outgrow them, or, if he doesn't, you can work with him on strategies to manage them or to turn them into positives.
