Son May Have ADHD????

C.,
I am the mom to a 9 year old who is diagnosed with ADHD. She is not hyperactive, she has difficulty paying attention to anything. I also have a 4 year old son who is very active and has a difficult time controlling his anger. Being the mom to 7, I have learned that dealing with each child is completely different. I don't know if it will work for you but when my son gets angry I do my best to remove him from the situation and speak firmly to him. I'm not mean or rude, I don't raise my voice but I do let him know he was acting out and we need to deal with it together. Another thing I noticed was if my son had o much sugar his episodes were worse. we cut back on sugar and it really helped a lot. as for the ADHD, don't jump now on the testing, the testing would be to o difficult at such a young age. It is usually diagnosed at 7 years and those symptoms will be associated with his education and his learning. as for medication, I too was against it until I watched my daughter fail everything and begin to hate herself and school and friends....the medicine I believe saved her. It helped her attention span and her self esteem. She is on Vyvanse and it works wonderfully. I did a lot of research in regards to the addiction rate and this was the best medicine for that.
Good luck!
S.

Honestly, he's too young to test for this. Typically, a child is diagnosed when he or she is in early elementary school. This is because some of these behaviors are age-appropriate and will go away as he matures. Yes there are doctors who will test at this age and hand out medication like it's candy, but you don't really want that kind of doctor.

That said, your son's symptoms don't scream AD/HD to me. AD/HD can sometime be *just* hyperactivity, but that's pretty rare. There is usually a cognitive component as well, where he can't attend to directions, has trouble with organization and memory, etc. and these will show up in school. These are not really skills that one would expect in a four-year-old but they are critical part of an accurate diagnosis, which is why it's a diagnosis for an older child.

So...what can you do now? I would push aside the thoughts of AD/HD because that will limit the lens through which you examine his behavior. Assume he doesn't have it (for now - revisit the idea if he has trouble in elementary school). The rage and energy are part of his temperament, they are not things that you need to fix. What you do need to fix is his behavior and how he channels that rage and energy. I would strongly, strongly recommend the books "Raising Your Spirited Child" and "The Kadzin Method for Parenting Your Defiant Child."

I would also examine his diet - is he getting enough whole grains, good fats and protein? Are you limiting preservatives, dyes, and refined sugars? I would strongly recommend giving him a high-quality fish oil supplement - Nordic Naturals ProDHA is a strawberry-flavored gel cap that is really yummy.

FWIW, my oldest son sounded a lot like your child, but his misbehavior was (thankfully) reserved for mostly at home. At daycare, he would just refuse to participate in anything. He had a sense of rage that was so disproportional to someone so young, needed very little sleep and would just defy, defy, defy me. We consulted with a psychologist to get some specific tips on how to work with him so that we didn't get locked into knock down, drag out, hours long stand-offs over simple expectations. Thankfully, he outgrew a lot of these behaviors by around age 5, but the intense feelings are still there, still very much a part of his personality at age 13. He was dx'd with AD/HD in 2nd grade but it was the result of learning disability testing and not behavior. He was put on an accommodation plan and later and IEP for LDs. We have also worked with an alternative nutritionist who helped us craft a supplement regimen that really helped during some rough years. Fish oil was a start, but we also gave him things to help with his adrenals, a chemical de-tox, and a whole bunch of other things. We recently tried a process called BIT (Brain Integration Technique or crossinology) and the results are promising. Organized sports have been a huge help as exercise and mood are strongly linked. My son probably has seasonal depression (his nasty moods used to escalate in late winter) but since he's been playing hockey for the past two years, we haven't had the late-winter blues. It's been a long road but I can say that overall, he's a good kid and has lots of friends, has the usual behavior problems from a boy his age, and is doing quite well in school with a lot of support. He is very charming and his teachers love him. Definitely not the brightest bulb on the tree, but he gets by and will do just fine. Ten years ago I was wondering if I had a juvenile delinquent in the making on my hands, and with a lot of work, and trial and error, we settled into a spot where he is comfortable in his own skin and in his own head.

Google "spirited child" and I bet you'll find a lot of kids who seem like yours, and a lot of ideas and resources to help him manage himself. Keep in mind that he's just a little boy and doesn't choose to be this way. He doesn't know what drives him and doesn't do this on purpose.

ETA @MR I appreciate your expertise on this but really, my son saw three doctors in the span of 2 months and each one of them had me fill out the same questionnaire (the one with all of the AD/HD symptoms) and each one of them handed me a prescription for stimulant medication and sent us on our way with advice to follow up in 30 days to see if it was working. The appointments were all 10-15 minutes, tops. When I expressed - repeatedly - that I wanted to rule out other problems and was interested in other therapies either in place of or in addition to medication, I was met with basically shoulder shrugging and blank stares. I wasn't even doctor shopping - the first was my pediatrician, and when I said I wanted to work with a specialist he did the same thing and then I sought out an expert in distinguishing between LDs and ADHD (at Mass General Hospital in Boston, so a guy with some serious credentials) and he did it too.

So yes, C. does need to get an evaluation for her son and consider all causes and treatments. But the over-use of stimulant medication as the first - and often only offered - means of treating what is still a complex set of symptoms with an unknown cause is very real. There is research behind supplements, particularly fatty acids. The study with which I am most familiar is Oxford-Durham and I don't think that the study has been discredited. Let's not jump to the conclusion that every solution outside of stimulant medication for AD/HD is a waste of time and money. It's not. The brain can be strengthened, healed, calmed, and made more efficient by many means.

C.,

If your son has behavioral issues that you need professional help with, by all means, either go to a Developmental Pediatrician or a psychiatrist/nuerophsycholgist combo, and get an evaluation based on the things that concern you, which at this point is only the specific behavior(s) you mentioned. You do not go in for an ADHD evaluation (there is no ADD anymore, there are only types of ADHD.) You do not know what is going on, you just know that you need help.

Your husband is way off the course. If your son is diagnosed with a medical disorder, and ADHD is a medical disorder, then medication may be approriate to regulate his neurotransmitter production so that he can rely on his brain and make important neurological progress that is then expressed in his behavior...but, if your husband rejects all medical care, then that is quite different indeed. Brains are body parts. Brains have disfuction, just like the urinary tract. Have your husband inser the word "pee" for every behavior that he sees that may or may not be assoicated with ADHD, and if he can still deny your son help that works, well, then that is just a shame for your little boy. Medication is an effective tool for many issues in the body, and ADHD is one of them. There is no shame in it; it does nothing like what is frequently feared, so please, have him learn about this option if it is offered to you before he rejects it based on the popular myth about it.

Get a full evaluation, your report should be many pages long, include an IQ test that shows you how he processess information, a test of his executive funcitioning, academic testing, speech and langauge, OT, and some psychological evaluation that includes behavior ratings scales. If you are offered a conors ratings scale in the pediatricans office, this is not a full evaluation.

M.

I say this all the time...the "like candy" is one of the popular myths and unfounded assumtions that lay people make about ADHD medication. As is the antequated idea that kids cannot be diagnosed with ADHD until some particular age. Bunk. That is not even the point...You do not have an ADHD diagnosis, you have a set of behaviors that you need help with. You should not assume that it is anything until a qualified professional evaluates him and tells you what to do, based on data. You don't have that yet, so go get it. You do need help with his behavior. Is it ADHD? Who knows, but at this point, all that matters is that you need help with his behavior, and both you and your husband agree that he needs something. Do not assume that it is ADHD, it may be something else, and from what you described, it would not surprise me in the least if you were on a totally differnet path than you expect. You need an evaluation. Get it. The earlier you know what it is that you are dealing with, the sooner you can get him some help and the better off his prognois and long term outcome. MR

Also, there is zero evidence that any diet related or suplements help whatsoever. People see great placebo effects, because they want to, and there is a correlation between how much money they invested in the supplement or diet plan and what they see as "progress." You can spend a lot of money on this junk, but just go for standard care, it is not flashy or DIY, but it works, and it has data to back it up. MR

Never accept a doctor who does not do a good job, even if it is for a splinter. I have never had such bad luck with my pediatricians, they know that they are not qualified to evaluate or diagnose ADHD. I was sent to a Developmental Pediatrician, and that is where most people should start. There are plenty of bad doctors, bad butchers, bad bankers...stimulant medication is but one small part of ADHD treatment, even if you are only looking at medications, which is not a good practice anyway. Please folks, if your pediatrician treated you like this for any illness, go to another, don't assume that bad care is all you can find. It just isn't. MR

Ditto everything Martha R. said. She offers terrific input and really knows about ADHD.

People who say four is too young to get help haven't been through the process. Our son was kicked out of preschool at three for his ADHD symptoms and we were already getting help through a child psychologist and behavioral therapist then (which didn't work at the time because he couldn't control his behavior). It wasn't until he started medication at age four that his life turned around. When things are extreme, the doctors can help. With medication combined with behavioral therapy, our son was able to focus, have normal activity levels, lose the aggression, lose the impulsivity -- he just seems like a normal kid. People see him for how smart and wonderful he is, not his ADHD.

First step, though, is to get in with specialists for a thorough evaluation. A pediatrician can't do this, but the specialists Martha mentions can. You may be dealing with ADHD, another condition entirely or just a very spirited child. The experts can give you a definitive answer and at the very least, some strategies for managing his behavior.

Best of luck to you!

He's very young to be diagnosing ADHD unless you have tried MANY behavioral interventions with both consistency (every time) and fidelity (the right way) and there still are no changes.

I would suggest starting with a referral to a behavioral therapist who can work with you and your son. If that doesn't make a difference, then talk with that person about a diagnostic evaluation.

Be careful not to diagnose him too quickly.
My son was the same way (tons of energy, short tempered, etc), and when he got into kindergarten, the director of the school, rather than thinking he was ADHD, actually suggested that he might be gifted. Gifted children can often be very high energy and strong willed and (in my case impulsive). Your son may be a little young to go through a full blown intelligence tests (usually not good to test before 5 years old). I have been reading about "gifted" children since I found out last fall and they are often very intense and energetic. I would suggest you not jump to conclusions too soon and perhaps see what else might be going on. Perhaps read online about the characteristics of gifted children (e.g., intense curiosity), and if you see a lot of them in your child then think about getting him tested. Good luck!

C., have you checked into Omega 3 supplements? We use a product called K48 Plus and love what it is doing for our family (our kids do not suffer from ADHD, fyi). There have been a lot of studies about the effects of Omega 3's, including this one. http://www.nutraingredients-usa.com/Research/Omega-3-agai...

I hope this helps!

I agree with those who say four years old is very young for this diagnosis. Our son, who is almost eight, was just diagnosed with ADD and after much debate, we started him on medication this past Tuesday. I strongly recommend Dr. John Hosterman, in Wilmette. First of all, he is very conservative; he believes that ADHD is widely overdiagnosed. One of the things he told us was that, even though he has no doubt that our son is a clinical example of the disorder, that we were right to resist attempts by teachers and caregivers to get him diagnosed earlier. He said that it's very difficult to distinguish between ADD and other factors prior to age seven, and he only advocates medication for children as young as your son when issues of physical safety are clearly present.

There are a lot of diagnosticians out there - one reason we chose Dr. Hosterman is that he is only diagnostic. In other words, he doesn't treat the disorder, so has no financial stake in the result.

I would also recommend Dr. Benuck, in Evanston, who is prescribing our son's meds (all of four days now). I am very impressed with Dr. Benuck and his partners.

We have a childcare and educational system that is increasingly attempting to be one-size-fits-all. The reality is, children are so different from one another, and it's terrifying how many of us are pressured to medicate our kids to make life easier for others. Find a physician you can TRUST and also trust your gut instinct about your child. One of the reasons I finally agreed to try medication was that, for the first time, during the last few months it became clear to me that something outside of our normal controls was going on, and that our son needs help. It's a hard journey, no matter what the diagnosis, and you have to trust yourself.

I have heard a small cup of coffee will calm down a child with ADD. not alot just a small amount.

This doesn't solve the whole problem, but perhaps he shouldn't be going to school, for starters. He's only 4. To me, it sounds more like he needs more guidance on coping with his feelings and expressing himself calmly. Also, ADD/ADHD is still very hard to diagnose at his age-especially since it is natural that a lot of kids are hyper at that age. Another thing to consider his diet and possibly too much sugar in it. Also, kids should be having absolutely ZERO caffeine. Just some stuff to consider before going out for a diagnosis. A lot of things can be "cured" by altering the diet and putting a little more time in helping him cope with his feelings.

good luck

C.,

Martha in the previous P. have very good information. Our son is 4.5 and has been offically diagnosed with ADHD, ODD and depression. We had hours of evaluation and forms to fill out and test run to come to this conclusion. We have tried a few medications and finally found one that helps some but we are still working to find the right mix of medication, behavioral teaching and our knowledge of these conditions. Good luck and dont give up. It is a very hard situation to be in because you first and for most want to help your child but you also want some peace in your home. If you have any questions, need a shoulder to cry on, someone to bounce ideas off of or just need someone to talk to please message me.

Good luck

A.

It might also be Sensory Processing Disorder. No matter what the issue is, the school district should help. You are eligible for assistance from the school disctrict's experts, psychiatrist, occupational therapists, social workers, etc..

We are in this same boat and I know how frustrating and exhausting it is. I feel like I have tried lots of different things and we are continuing to explore options to help him. Here is what we have tried so far.

My son is seeing an OT for sensory issues and regulatory issues. It has helped some. He does listening therapy twice a day that helps with the self regulation. We also plan to do Brushing (an OT can explain). We did this awhile back with fabulous results, but it turned into a battle, so we stopped. But I would like to start that again.

We have also recently started Theraplay (www.theraplay.org to read about it and to find a provider near you - We see Dr. Phyllis Rubin in Oak Park) and I am hopeful about this. When I asked his Theraplay therapist about ADHD, I have also been told that 4 is too young for a diagnosis.

I also plan to take him to see a developmental peditrician and I would like to hear their opinion on ADHD testing too. I have heard good things about Dr. Msall and Children's in Chicago evidently has a good program. His ped is at Loyola, so I think we plan to see Dr. Lauren Boyd also at Loyola.

I am also seeing a physcologist for myself to help M. deal with it all, which I have found very helpful. Everyone has tons of book suggestions and I have a long list of books I should be reading. The Out of Sync Child is the book everyone talks about for Sensory Issues if you want to see if that describes your son. And I am currently reading Raising a Spirited Child. I so feel your pain and I am sorry you are also going through this. Believe M. I know how it can cut at our confidence that we are being good parents.

We came about the OT and the Theraplay a little backwards, but I am learning that the developmental ped would have been the person to point us in these directions as well. Good luck and I would be interested to hear how things progress for you.

CAwritermom i know EXACTLY what you went through!! my son was kicked out of the preschool i worked at! he was diagnosed about 2 months ago with ADHD...we have found a wonderful dr who doesn't just want to pump him full of meds she works with him one on one a lot. since he started treated we have seen a HUGE difference in him, and best of all hes still my creative spunky little boy :)

Sounds moe like sensory issues whre he cannot self regulate himself. I would take him to pedatrician , he can forward you to an OT evaluation and a neuropsych eval to see what it is and how it can or maybe afecting his learning as well. Hope this helps. many people and even drs in the olden days say it is adhd when it is jus the sensory issues, the sensory issuses can be treated with Private occupational therapy and they work, trust me if you have good therapist, keep trying to find one that works for your son. you will be amazed that the adhd is minimized. its sad many kids were put on meds in the olden days when all it was was something like this.
J.
J.