What to Do First If I Suspect ADHD Behavior?

I know that Dr. Bierma in shorewood is a behavioral specialist. He is great and straight forward and mixes wholistic (nutrition) with meds to fit the needs of the child.
Good luck,
C. n.

The first thing I would do is switch doctors. He wanted to prescribe ritalin by phone call alone? That sounds beyond outrageous to me. You have some good advice in all the posts here, but I would certainly question a doctor who is willing to make a major diagnosis and prescribe meds for it for a 5 year old by phone.

My son's first 3 teachers ( he attended Catholic school from PreK through high school) mentioned he might have ADD (without hyperactivity) at parent/teacher conferences. I dismissed their complaints (that he daydreamed & moved around a lot) until 3rd grade when he developed a habit of scratching his arms & legs to the point of making scabs. When my doctor diagnosed it as anxiety we had him evaluated. They told us he had anxiety but didn't find ADD. Our insurance didn't cover it & it cost us $1500. We did family counseling for several years under their advice. He struggled through grade school even with a tutor. He basically had one friend. (I know now that with ADD they can be less mature & may not pick up social cues.) Luckily I was a SAHM. It took a lot of energy to find ways to support him in his studies as well as his 2 siblings. In high school he joined the cross country team to lose weight. That year was the first he made honor roll. (Regular vigorous exercise has a positive impact on the brain & actually changes body chemistry.) A new family friend who had been a school counselor recognized ADD in my son & husband. He recommended we have him evaluated again & to consider meds before he took his college entrance exams. So we made the difficult decision to try Ritalin. He used a timed release med, Concerta & scored higher than some of his classmates without learning disorders. He was accepted at the college of his choice & is now a year away from a degree in psychology! We have tried every med for ADD except the latest, Vyvanse. Now he takes Adderall & by his choice will continue to until he is done with school. My dream for him is to eventually go off meds & use lifestyle changes like daily exercise & stress management to offset the challenges of ADD. Yes, having a child (and husband) with ADD has been very challenging at times. I recommend educating yourself. My favorite books include anything by Dr Amen & THE ADD ANSWER by Frank Lawlis.

Lynn, You can go the public school route which is free, but can be slow depending on the school district. If your health insurance or pocket book allow you may want to look into seeing a pediatric neurologist who could diagnose add/adhd upon evaluation. At the age of 5, they can give a diagnosis before age 5 legally they cannot.

Another mom recommended reading. I wholeheartedly agree. Get as much info as you can to educate yourself and see what you see and can do for your child.

Also, don't take offense, but you may consider changing pediatricians. In my medical opinion, one who initially prescibes medication as their first intervention may not be putting the patient first, just convenience.

Who's more important? The doctor or your son?

There was a study recently published about kids who are often misdiagnosed for ADD/ADHD, that they really have sleep apnea or enlarged tonsils. Please get that checked out first before you get a misdiagnosis. I posted the study on here last month. What happens is that they are not getting sufficient sleep, which can lead to behaviorial problems in children. I would also go the holisitic route, even if there is no sleep issues. Many kids have food intolerances and/or food allergies which can alter their behavior and have to change their diet. Nightline News had a thing a few months ago about food dyes and how it can greatly effect kids behavior. www.drrapp.com discusses this in her book, Is This My Child? It is a great book to have on your shelf.

Good Luck to you.

J. W. MPH
Lifestyle and Wellness Consultant

I am responding as a mom, school psychologist, and administrator to this question. I caution you to too quickly jump on the bandwagon of an IEP, neuropsych evaluation, or medication. These are all options, if observations and behavioral modificaitons do not work. I would encourage you to call the school psychologist and write a letter requesting time on task observations and rating scales be completed. Also, ask if your school has a FLEX or problem solving team. This group can help to see if your son really is different than other five year old boys in the school setting. please feel free to e-mail if you have further questions, or want more specifics.

well if you do end up doing medication, I believe ritalin/conserta are stimulants and if you child is truely ADHD it actually slows them down to focus. If your child is NOT ADHD it makes them hyper. ask the doc, i think that's a sure way to find out. but first i would cut out ALL caffeine and sugar and make sure they get alot of run around time!

Dr. Amen has an evaluation online that is actually quite good. It may give you an idea of whether your little guy is actually ADHD or just very energetic. If it looks like he might be ADHD get him evaluated by a specialist, psychiatrist, neuropsychologist or someone else who specializes in ADHD. My grandson is on Amantadine, not Ritalin and it works well. There are other medications that are good for ADHD that don't have addictive qualities like Ritalin. Good luck!

Obviuosly you know your child better than anyone but unless he is just unmanageable I would give it more time. I also felt the same way about my son when he was five. He was a high maintanence child from birth! I really do give credit to what a previous writer stated about tonsils. My son snored very loudly from the time he was a baby and never slept well and later frequent bouts of strep throat. He had his tonsils out at 5 and his behavior greatly changed for the better. Kindergarten was a little rough (a few trips to the office, minor stuff really) but by the time he hit first grade he seemed like a totally different child. He is now in 3rd grade and his teacher raves about how smart and how well behaved he is in class.

Don't have any answers for you just thought I would share my experiences. Boys and girls can be so different. Looking back now I realize my son was just so full of energy he just didn't always know how to use it. I started him in soccer and basketball at our YMCA at age 4 and that helped him focus some of that energy. Good luck and enjoy your energetic little boy!

Check your sons diet, his activity level(make sure he is active for the part of the day he is not required to "study" or learn). Alot of times parents opt for the drug and really all their kids needed to do was get involved in a running game with their friends. Also check for eye sight and hearing problems as these will lead to hyperactivity if they don't know how to tell you what is going on. Enroll him in something that is very active and maybe something that is more disciplined like soccor and martial arts.

Lynn,
Perhaps you've already done this, but get educated about ADHD. Some kids have extra energy and trouble staying focused, others have a serious learning disability like ADHD. Read as much as you can about it before you diagnose. Ask people who are close to your son. Relatives, babysitters, and especially teachers. I'm guessing your son is in Kindergarten this year. The teacher SHOULD tell you if she's got a suspicion that he has ADHD. It's never too early to start interventions.
These would b my first steps. If your son attends a public school they will have special ed. teachers or coordinators that should be able to observe your son and his behavior. They should be able to at least give you an idea if he has ADHD. This should come at no charge to you.
I'd be very hesitant to start him on Ritalin. Like I said, read, read, read! There may be some other strategies you can try before medication! Change in diet, chiropractic care, etc.
Good luck with your research. I'm a teacher and am concerned by the over-diagnosis of ADHD. I also know that it is a very real disorder and children who have it benefit from supportive and understanding parents.
J.

If I was you I would not put him on medication because a lot of times that medication zombitize children. Through research it has been found that children that are diagonosed with ADHD seems to have a vitamin deficiency so go to the Health Food Store and they should be able to direct you to the vitamin that is absent I believe it is Vitamin B. I hope everything works out for you and your son.

I would call your public school district to find out what kind of evaluations they may offer (free of charge). I would question a doctor who would prescribe over the phone. Second opinions are always good. Good luck!

My son is 4.5 and his doctor said there's really not going to be a way to determine it until he gets a little older and in school.

Lynn,

I have a teenage son with ADHD amongst other things. ADHD must be medicated for, anything else is just cruel... if it is in fact ADHD. My experience is that there are some pediatricians and physicians who prefer a simple approach - give them some ritalin and if they respond well they have ADHD. This, in my opinion is just wrong on every level.

ADHD, diagnosed properly must be done by means of an evaluation that involves multiple office visits to a PEDIATRIC NEUROLOGIST and/or psychologist / psychiatrist. ADHD diagnosis requires a complete psycho-physical evaluation - it basically involves a lot of observing on the part of the professionals over a course of time. Of course it is quite expensive but if you get the proper referrals, your insurance should cover most or all.

Quite often ADHD is accompanied by other things that are not so easily recognized or the symptoms turn out to be signs of something entirely different .... I love my childrens' pediatrician, but a pediatrician alone is not qualified to make that diagnosis. Certainly they can recognize signs and symptoms and recommend an evaluation.

I would start by contacting your pediatrician to ask what sub-specialists you can be referred to for a formal evaluation. Just pumping meds into him and slapping on a label is not what your little guy deserves and could end up causing more harm than good.

best of luck to you,

W.

I've read all the mom responses and they are excellent. I have a 10 yr old with ADHD. First, I would get rid of that doctor immediately. Your child is young and all the options that they other moms suggested especially starting with the public school for evals. You can go private as well (check insurance) and make sure you get a psychologist that is highly recommended. I had an eval done on my son some years back. The woman was not on her own yet and the eval was totally wrong. She had all of our info wrong and ended up suggesting my son go to a "special" school. He is already in special ed (LD problems and anxiety) and he is definately not a "special school" candidate. The report was so full of misdiagnosis that the head doctor didn't make us pay for the services which totaled over five hundred doctor. Anyway, my story aside. Beware of doctors who push the meds. Get the eval from the school as a starting point. Good luck

A true diagnosis can't be made over the phone by mere parental suspicion. I am actually a little surprised and disappointed that your doctor was so quick to offer Ritalin. You are wise to a want more involved evaluation. There are several diagnostic surveys that can be used to assist with a diagnosis as well as a blood test to rule out a thyroid problem. Often a pediatrician does not have enough experience to really make an accurate diagnosis.

I would ask him to refer you to a child psychologist that has experience with ADHD. If your son does have ADHD a psychologist may not prescribe anything at all and may suggest some behavior modification therapy.

Hi, my doctor gave us a questionaire to fill out about my son's behavior. Its usually filled out by the mom, dad and a teacher or daycare person. That way they get different perscpectives from people. After they look at it they will suggest your options. Most doctors don't want to put children on medicine until they are 6 years old. Hope that helps a little. My son has been on meds since he was 6 but was suspected of ADD at 4 by his pre-school teacher and me as well. Good luck!

I'd be questioning a doctor who would suggest ritalin without even seeing a patient first. I would see a pediatric psychiatrist or neurologist who is well versed in diagnosing and treating children with ADHD. They will run tests to rule other things out and make their diagnosis based on those findings. If your child needs help in school with services or modifications (a lot of ADHD kids do) you will need a diagnosis to start the process of getting an IEP in place in school. I would begin that process ASAP b/c it can take a long time and your child will take ahta with him throughout his school years.

Lynn,

My nephew was diagnosed at the age of 9 with a chemical imbalance after years of destructive behavior. He was born with a severe vitamin and mineral deficiency that was undiagnosed from birth. Most of his acting out behavior was caused by this. They had to put him on a shoebox full of supplements,and anti-depressants. He seemed to improve but they had to fight with him to get him to take it. They also recommended changing his diet, unfortunately he would literally break into the kitchen cabinets to get the foods he wanted. He has had problems his entire life and was in a school for behavior disordered children. After he was brought back home his behavior improved to some degree but because of his earliest years when he was undiagnosed, the only way he knew how to get attention was by acting out. I disagree with a lot of what my sister and her husband did to deal with him because it made the situation worse - long story in that but as a adult he refused to be medicated, refused to even try to deal with his ADHD in spite of negative consequences upon neg consequences.They basically enabled him in many ways and gave up on him instead of putting forth the effort to get him the help he needed. He is going to be 28 this Oct and about 6 mos ago he moved out of state to live with relatives. He is finally doing well now that he is away from home. The moral of this story is to possibly check for chemical imbalances and there are several books out on dietary changes that have
eliminated the need for medication. Some people believe that early medication with Ritalin have caused kids with ADHD to turn to other drugs as they get older or un-medicated kids that have been diagnosed with ADHD had used street drugs to medicate themselves which is what my nephew did as well. Pfizer clinic (I think that's how it is spelled) is in Wheaton area and they do blood testing for imbalances etc.
I hope you find a solution but I would turn to medication as a last resort.
M. K

Hi,
I also have five kids!

WOW You got a lot of great feedback.

I can tell you I have a seven year old who has had cognitive issues in school and also would regularly have "meltdowns" as I called them. I have a nutritional product, which includes a cleanse drink, that I gave her each night and both have significantly improved--her teacher even noticed. That is one suggestion (contact me if you would like info on it-- ____@____.com)

As others have said, I would definitely: find a new doctor; remove sugar; high fructose corn syrup; artificial sweeteners and dyes and wheat and dairy for good measure. Then re-introduce the dairy and wheat one at a time and watch what happens. Also ensure all nutrients are in his diet, and enough sleep.

There is also a website you can take a look at: http://www.cchr.org/video/ as far as educating yourself on psychiatric drugging of children. This will enable you to make an educated decision for yourself, too.

Hope you find the best solution for your family.
Best wishes,
T.

Most doctors do just prescribe the meds without a complete workup. I just paid out of network to go to a dr (pediatric psychiatrist) in Deerfield who I cannot say enough about. He believes it is irresponsible to prescribe without a proper exam. He ran bloodwork, a uranalysis and an ekg on my son. His exact words were, "I do now believe in trial and error on children". He is expensive, but you will leave with definite answers. He will also let you know if there are any vitamins or supplements that would be helpful. It ended up for us that our son was on a prescription that was very bad for him, because he has a slight heart issue (that is normally not an issue, cut could be on meds). I cannot say enough about him. He is very good with the kids, too. Contact me if you would like his name and number.

Have you considered over your childs diet? Most of us try to provide healthy choices for our children, which I'm sure you do. I have the opprotunity to help families with better health thru nutrition. Avoid artificial sweetners, preservatives and colored dyes. Increase his diet with whole food, fresh fruits, veggies and whole grains. My son was in a similar situation. Hard to focus during school, mind wandering. We addressed his diet and saw immediate changes, so did his teachers. Some children do need medication. Try a wholelistic approach if you can. Best of luck.
N.- Nutrition Naturally
www.jp4ahealthieryou.com

I would suggest doing everything possible to keep him off medication or even being label with this. Once he is label in the school system it's hard to get him away from that. I actually use an amazing food supplement that has great results controling this and many other issues people have. I would be glad to put you in touch with someone that has had your experience and results with the product. Let me know if you have any questions or inquires. Good luck! G. Chambers

Look into diet change first. I have heard that items with red #40 contributes to ADHD sypmtoms.

Lynn,

First of all, I am not sure why your pediatrician would offer medication over the phone without first having you fill out a survey checklist of behaviors for your child. (I am a mom of two boys as well as a special education teacher for the past 14 years.)

ADHD is not something that has a specific "test" but there are specific surveys that your doctor should have you fill out in order to determine if the symptoms are frequent enough to warrant checking into. Another thing that I am concerned about is that you stated that your child is 5 1/2 which is just at the beginning of school age and a difficult age to officially determine much less attempt medication for ADHD.

If your son goes to school daily, talk with his teacher about anything that he or she sees as "out of the ordinary" attention behavior for a kindergartener. At this age, a child's attention span is very short depending on what the child may be interested in. If your son shows severe signs of not being able to sit still ever, or having severe difficulty following even one step directions, then I would ask your doctor for a survey checklist, or you can ask for a referral to a psychiatrist. (that can prescribe meds.) Depending on your health insurance plan, this should be covered, but it may depend on how the doctor words it in the claim. I would seek the advice of a psychiatrist if you do feel that your son may need help or medication with ADHD. This is a specific area for psychiatrists, and many times pediatricians may not go the extra step to diagnose correctly because of the amount of patients that they see on a daily basis. If your child does need medication as a doctor recommends, please talk in detail about they types of medications that are now available. Some work better than others depending on the child's weight, diet, and activities. Vyvanse is an excellent medication for children in that it is a daily long lasting drug, that leaves the system each day making it what many doctors call a "clean drug."

Please e-mail me if you have any further questions. I cannot emphasize to you enough that the over the phone recommendation is definitely a red flag, make sure to do your homework and not just accept Ritalin as a definite answer.

Lynn,

My 10yo son has ADHD and my 15yo daughter has ADD. The first thing we did is talk to our pediatrician. They gave me a questionare to fill out and one for the kids teachers and also any full time care givers. Based on the answers of these questions, they can identify if they think it's ADD/ADHD. I would be concerned if a doctor wants to medicate without even a physical or even seeing your child. Also my suggestion is to stay away from Ritilan. It needs to build up in your childs system to work. There are other meds out there that don't build up. They work for 10 hours or so.

Also I was under the impression that teachers CAN NOT suggest to you that your child has ADHD. But that said it was my daughters 4th grade teacher that made us aware of it. I do remember her saying that she could loose her job for saying something to my DH and I. But since she (teacher) had ADD she knew the signals. We were in denial but talked to our doctor anyway and what'd ya know, ADD.

Read up and research as much as you can on it. Some parents do the meds some do a change in diet. Look into it all and decide what is best for your situation.

Good luck!

Oh, my. It sounds like you have a pill happy pediatrician. You might consider going to another ped. or seeing a child psychiatrist so the proper evaluations can be performed. I am a teacher and have had to fill out many a Conner's form for parents who believe their child to have the same symptoms as your son. This form asks teachers to list the behaviors we notice in the classroom that are sometimes indicative of ADD/ADHD. If he is in school, talk to his teachers about what they see there.

It is also quite possible that your son is just being a five year-old boy, too. They take longer to settle down than girls sometimes. I have known people to delay starting their son in school by a year so an extra year of maturing could take place. Do your research (there is plenty online) and really consider getting a second opinion before you give your child a heavy duty drug.

A.

Hello- just curious, what makes you think he shows signs of ADHD behavior? I also have a 5 year old who I think has trouble focusing sometimes. COuld you e mail me with your thoughts on what you see with your son? ____@____.com Thank you -- if you have the time.

I would suggest that you discuss this with your child's teacher. Is she seeing the same issues? Is your child missing out on things because of his inattentiveness? You will want to contact your child's school to have an evaluation begun. What they will do is send someone into the class to observe him. You will also be given a form to complete that rates your child in over a hundred different categories. Your child's teacher will do the same. Then, all of the information collected will be used to determine if he is at risk for ADD or ADHD. You would then take that information to your doctor or psychologist to determine the best treatment.