This is a subject that I had not thought of in many years. But recently, it's been brought up to me several times, and since I'm having my brain picked by others right now, I thought maybe it would be a valuable topic for a blog post.
Back when my kids were small; actually so far back that there were only three of them, DS1 was having some issues in school and it was suggested by more than one person that he might possibly have ADD or ADHD. Our first course of action was to go from public elementary school, to a small private Christian school in search of a smaller student to teacher ratio, hoping that more one-on-one type of attention might help in his wiggliness.
Having a smaller, and multi-grade, classroom helped somewhat, but hadn't alleviated all of the issues. By the middle of DS1's second grade school year (and now the parents of four kids), DH and I were at what we thought were our wits end. (Oh, if only we knew how his educational future would play out! Then again, it's better we hadn't known then because we may have slit our throats and gotten it over with. Truly, getting DS1 through to high school graduation was sometimes that bad.) I took DS1 to be evaluated for ADD. Now, this was back in early 1998 or so, when it seemed like ADD was the scourge of nearly every single boy in school. No kidding. ADD was 'diagnosed' a hundred-fold more times than it had been in the past decade, and more than it would be just ten years later.
Which is a nice way of saying I had my doubts as to the accuracy of these diagnoses. So I wasn't going to be satisfied with a doctor taking a quick 5-minute look at my child and be willing to have a 'professional' label him as ADD and stick him on drugs for the rest of his life. In my mind, I wasn't sure he wasn't just bored with school. He was a quick learner (as I had been; I only went to school for 12 years, completing 1st & 2nd grade in one school year, and doing college classes while still in high school. My father had gotten his diploma even quicker, skipping both Kindergarten and 7th grade, graduating at just 16) and I knew that I'd spent many classroom hours bored out of my skull. What had saved me was that I was a doodler, so as long as my hands could be busy drawing on something--or, when I got older, writing elaborate stories--I could sit still and quietly wait for the teacher(s) to move on to the next lesson. My boy didn't apparently have my affinity for doodling, was too young for writing fanciful sagas, and he was a wiggling, squeaking, beeping, airplane-noise-making mess.
We started with our family doctor, who asked a few questions about the school time wiggles and airplane noises, asked a few more questions about DS1's attention span outside of school, and basically said "Well, he could have ADD or more likely ADHD, but I'm not really an expert. Would you like a referral to someone who knows more about it?"
I took the referral. On to doctor and evaluation #2. More questions, starting with infancy. Had DS1 hit all the typical developmental milestones on time? Yes, and many early. Had he gone to preschool? Yes, sort of, it was a rural area that did Head Start as a weekly home visit from the teacher who after her hour with Mom and Child left a packet of activities for the mother to work on with the child until the next visit. Once a month all the students of that teacher (and their mothers) had a 1/2 day group session where the children interacted with each other and the teacher while the moms were given an informational presentation and interacted with each other. (*side note* I really, really loved how that program was done. I had not heard of one like it before or since then, and I wish more programs were run in that manner.) How did he do in preschool? Awesome; his teacher was challenged to keep him in materials as he ate up the tasks and was always eager for what the next thing was that he was going to learn. In fact, that teacher had cautioned me not to hold him back from kindergarten just because he had a Fall birthday; she felt that he was more than ready at nearly five and would be troublesome in school if he had to wait and was bored. He actually had begun to teach himself to read, and the summer before Kindergarten, he was sounding out small words on his own.
The second doctor also sent home a questionnaire for DS1's teacher to fill out. But he never, ever interacted with DS1 himself, or observed DS1 in any way. So, when he said "Let's try putting him on Ritalin, it might be ADHD", I went off in search of a doctor who would actually look at DS1 himself. I mean, if a doctor wouldn't prescribe an antibiotic over the phone for an ill child just based on the mother's description of how the child was behaving and what it's vitals were, but insisted on the child being brought in for examination first, how in all honesty and accuracy could they prescribe behavior altering drugs without actually watching or talking to the child?
Doctor #3, who if I remember right also had training in child psychology or psychiatry or something, did the testing I had been looking for. A detailed, complete evaluation. One whose questionnaire began with questions about the pregnancy itself (including mother's health and nutrition), any complications during labor or delivery, development/illnesses/injuries of the child since birth, home life, and school history. Then there was a long and detailed form for DS1's teacher to fill out on separate days (I think) three times a week for two weeks running. And, on top of that, two sessions with DS1 and the doctor; one with me in the room, and the second one on a different date of about twenty minutes of just the doctor and DS1 (with a staff member witnessing).
Finally! Finally! Finally! And the outcome of this was that DS1 did seem distractible enough to warrant a trial period on medication. If the meds helped, then he most likely had ADHD and should continue on them. If they didn't help (because for kids who don't actually have ADD/ADHD, this med would make them even less focused and more jumpy) then we would discontinue them.
Well, for two weeks I faithfully gave DS1 his pill. For two weeks, his teacher filled out a daily evaluation form in regards to his classroom behavior (she didn't see much change). For two weeks, I also had sheets to fill out about his behavior at home. For two weeks, DS1 had trouble sleeping. For two weeks, DS1 had a nosebleed nearly daily--and he'd never had nosebleeds before.
At the end of two weeks, we took him off the meds. It pretty much corresponded with the end of the school year, so DH and I decided that for the summer, we'd take a break from any further seeking of medical fixes for DS1's classroom energy issues.
More of the saga to come in my next post.
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