Coping with a Child with ADHD

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  • Coming to terms with 6YO child diagnosed ADHD

    – Jan 25, 2018
    (12 replies)

    Hi Everyone! 

    We are a family of 3 (me, my husband and son) who live in the San Francisco Bay Area. Our kind hearted, inquisitive and energetic 6 year old is diagnosed ADHD-combined. We always knew that this might be something we would deal with as both ADHD and anxiety run on both sides of our family. 

    We feel so blessed that our son has great social skills, lots of friends and has been able to use coping skills (fidgets, special seating and a TON of parental support) to be successful in school. In fact, the school originally declined to even test him and were unconvinced that he needed any additional support, or modifications, in school. 

    However, fast forward to this year and it has been a whole different story. The demands of 1st grade and expectations of being able to sit for longer periods of time have been a huge struggle for him. We find that he often isn't able to stay focused in whole group learning for more a than a minute and it has become a distraction to him and others. Additionally, he has begun to notice that he isn't advancing as fast as some peers so he's resorted to becoming the class clown. 

    After many long meetings with the school, plenty on funds spent on advocates, therapists, psychologists and lawyers the school finally recognized that our son does need some services to help him cope with his sensory issues, executive functioning and general attention span, so they did provide us with an IEP and 180 minutes per week of resource and OT time. We also saw our home life deteriorating into constant battles of will. We would never know if he could make it through bath, reading, dinner and bed time without devolving into pure chaos which usually ended in me yelling, "PLEASE LETS JUST KEEP IT TOGETHER". 

    We began to seek out advice from our therapist, pediatrician and classroom teacher and after a long battle we decided that medication might be the best option for our son. He's now been on Ritalin (time released) for 6 weeks and we have seen so much improvement! I find myself feeling so relieved that his teacher writes me notes saying he was able to participate in classroom discussions, does his best to be an active listener and can be redirected back to tasks more easily. 

    Now I find myself in a weird place between feeling guilty that I had ruled out medication for so long (In my mind I had made it akin to giving in or giving up on his ability to cope) and embarrassed because I never thought that I would have a child on medication. I realize that these are my own issues and adjusting my own expectations is something that will just happen over time, but I still feel bad. Am I making the right choice? Am I setting him up for a life on medication? Should we have tried more behavior therapy first? What if the side effects change as he gets older? 

    Being new to all of this I guess I just wanted to see how other families have dealt with their own personal insecurities about their child's diagnosis and treatment. Did it just take time? Did you seek out help for yourself? Is it just an expectation/image thing? 

    Any advice on the topic is welcomed and appreciated! This whole adventure is new to us and we just want to do the best we can for our son :)  

    Jan 25, 2018

    I am not sure what there is to feel guilty about? You want to try everything that might possibly help your son's medical issue; Ritalin helps, so, great. My 9 year old with a wide array of neurological issues takes a LOT of medicine, and his condition changes with age so I'm sure we will be frequently changing it (increasing dosage and/or adding new meds). I feel grateful during the "quiet" times when the current dosage is working well enough to give him some inner peace and resilience, and I personally feel more anxious during the transition times when whatever he currently is taking is obviously not enough to help him through his day (and night.... we've had lots of sleep issues, sigh). Sounds like you are already aware on a theoretical level that adjusting your parental expectations is important, and my husband and I have to stop and remind ourselves, "he's not 'normal'" at least not as that is typically described. But with our help and his medical team's help, we can get him to a place that's normal *for him*. I guess it's true that when we first added Prozac, that was a "big feeling" for me as the mom; but after a few weeks when it's obviously helping my son... okay! It's okay to take the help.

    You have nothing to feel guilty about.  His brain is obviously lacking some chemicals that the medication adds back.  Think of it this way, if he was diabetic and needed insulin, you wouldn’t hesitate. Mental health is just as important.  

    We have this weird idea in our country when it comes to disorders that affect the brain. We don't expect a diabetic to be able to "pull himself up by the bootstraps" to avoid medication, etc., etc., but, for some reason, we do if something affects the brain. We can't just "will" our bodies into working the way we want them to. You've found what helps your son. There is no shame in that. I hope that you can get yourself to a place where you feel no more shame for having a child with ADHD taking medication than you would if you had a child with asthma taking medication. There really is no difference. Shift to remembering that the brain is an organ, a part of our bodies, just like all of our other organs. Sometimes our organs work the way they are supposed to, and sometimes they don't. In the cases where they don't work the way they are expected to, we have medications that we can take to help. Feel confident that by taking care of your sons medical problem with medicine that you are doing what you need to do.

    Do not beat yourself up for one second. We actually regret the two years of therapy, supplements, etc., that we wasted due to our own 'tude about "never medicating our son." The alternate therapies didn't work, and Ritalin really helped him. We finally realized -- it's about him, not us, and when he professed to enjoy his school day more with the medication, and his self esteem went up, we never looked back.

    Ritalin has been around forever, and doesn't seem to do any long term damage. Our son is now a reasonably successful college student who went off his meds, claiming that they were starting to make him logy, in his freshman year. Kids' brains mature as they reach young adulthood, and some no longer need the extra help.

    My personal opinion is that losing self esteem at an early age -- well, it's a hard road back from that. Please don't worry. You did good.

    --Mom of Combined ADHD Son

    Sister, sometimes I feel like motherhood is one long series of managing our own guilt. This is such a loaded issue right now - the minute I raised the question of my daughter having ADHD with a small group of close friends, I was barraged -- by close friends -- with well-meaning "warnings" about medications and all the alternatives I could try, all of which I was, of course, already trying. That nattering voice in your head? Just tell her to shut up. You can't change the past, and the guilt will hinder you as you go forward to the future. You did a great thing for your kid, and if there's some kind of splash-back from how long it took (hell, I have friends who didn't get diagnosed till adulthood, and they mourn for a lot more lost years than your son), then address that as it comes up -- don't go looking for disaster, as my grandma used to say. You're doing a great job. You made a tough decision. It turned out to be the right one for you and your fam. That's GOLDEN. 

    Hi,

    Parents of a child diagnosed with ADHD here.  I believe you've answered (some of) your own questions.  You've seen the improvement yourself, as have others.  ADHD is a medical diagnosis; feeling guilty about medication for it seems possibly analogous to feeling guilty about providing insulin to a person with Type 1 diabetes - I assume you would not feel guilty about that?  With ADHD, there is no way to know whether he will be on medication for his lifetime, or a portion of it.  The statistic we heard is that about 1/3 of people who received ADHD diagnoses as kids stay on the same medication(s) after they reach adulthood, 1/3 no longer need medication, and 1/3 will need different (or lowered) medications.  You're treating his medical condition which is something you can feel more proud of, than guilty, at least the way we see it.  Good luck with it all, and so glad you made it through the school "battles" that it sometimes takes.

    I have had a similar ADHD journey with my son (now 12), and felt many of the same insecurities early in the process.  ADHD is a moving target, and you will make hundreds of various decisions during his young life with regard to medication, IEPs, therapies, etc.  Remember that no decision has to be permanent. Trust your gut, do what you feel is right, then change course if you need to.  With regard to feeling guilty about giving your child medication, think of it this way:  If he had diabetes, what would you do?  Ride it out and hope it gets better on its own?  Tell him to just "try harder" to create insulin in his body?  No - you would give him the medication he needs to be healthy and happy.  Ritalin and other ADHD medications can vastly improve an ADHD kid's life in so many ways.  If it works for him, it's worth it.  Lastly, you didn't "wait too long" to put him on meds.  You prudently waited until you had done your research and tried other options. Be kind to yourself, mama. You're doing great. It could be a long road ahead - don't waste time making yourself feel bad!

    I would love to talk more! Please contact me! 

    Good for you for seeking out the support your child needs, including medication. Our son also started medication in first grade after being diagnosed with combined type ADHD. He is now in fifth grade and it has made all the difference in the world. He is able to interact with friends, participate in extracurricular activities, and succeed in school, all things that were difficult or unattainable before. We have had to change his medication several times over the last five years and each time we worry, however in the end it is always worth it. My spouse also struggles with ADHD and his parents were unwilling to seek out medication when he was a child. He was determined not to let the same thing happen to our child. You wouldn't require a child to manage diabetes with dietary changes, if the doctor said they needed insulin, would you? Of course not. Medication has been so demonized by the popular press, but you can see the difference it makes for your child. We still use a variety of other supports and it is amazing you got an IEP and other from the school for ADHD. You are doing everything right.

    Parenting is the most difficult job in the world!  And when you are the parent of a child with a particular challenge or challenges, even more so.  Some of us are more prone to second guessing and doubting ourselves than others.  I'm the parent of a 2e now teenager - gifted with ADD and anxiety.  I also have a second teenager, more "neurotypical".  I've definitely second guessed and doubted myself with both.  The best you can do is seek out people and resources you trust, do your research, constantly evaluate and adjust as your child develops, and most importantly take care of yourself and parent with love.  There's no right or wrong route, there's just moving forward (sometimes two steps forward, one step back).  There will be those who support you and those who criticize you, but only you know what's best for yourself, your child, and your family at any given moment.

    Medication is a highly personal decision with no right or wrong answer.  It works for some and not for others.  A person's response to it changes over time.  If it's helpful now, great! Go with it.  Medication is not a magic bullet, so continue to work all fronts in parenting your child toward increasing independence.

    Good luck and be kind to yourself.

    Your story sounds very familiar.  My kids are 17 & 15.  We have seen it all & done it all.  We agonized over the meds for the 17 yr old when she was 7 & ultimately it wasn't for her...we worked it out without meds...we decided our 15 yr old was too sensory & needed to figure out how to self-regulate before we went down that path but it got to that point that he really needed it & he's on meds.  I don't think it's about being right or wrong...it depends on your kid & the situation and what their needs are.  You should not feel guilty for doing what your kid needs and not what others who do not have a measure of your kid say he needs.  You know him better than anyone else thinks.

    I think I understand what you are going through.  I am a psychologist and my now 12 year old son was professionally diagnosed with ADHD combined in 1st grade. I always knew it give his extreme energy.   For example, in kindergarten, I took him and his friend to the Zeum in SF via BART.  After 3 hours there, the other boy fell asleep on the ride back while my son was asking if his friend can stay and play for a bit at our house. He had a very tolerant 1st grade teacher and he is very intelligent (as assessed by IQ testing) so issues were not huge at school.  Jump to winter break where we visited with friends on the East Coast and he had a  meltdown in a bowling alley because he lost but did not realize he was losing due to how the score was displayed. I always had battles at home for him to do chores, be calm and less disruptive and accepting limits so he had been in on simple then more complicated behavior plans from age 3.  But after the public meltdowns, I sought medication.  After 2 different tries, we found the med and dose that fit after barely 4 weeks.  I don't usually give it on weekends although there are times that I do.  He eats less and his friends are not the coolest kids in class but they are active like him and he has more than just the core 2 so it's good.  He was a cub scout all the way through, played baseball in a league and bowls.  There were issues at times, such as the scout leader being used to much calmer children so reprimanding him more than I though necessary and the coach thinking he wasn't paying attention because he was kicking dirt but 5 years later, he's well adjusted and decides for himself if he wants the medicine to work on a school project on a weekend. 

    Try to think of it as helping him be a better him.  His brain is wired a little differently and meds help him function better in certain situations.  Schools now are trying different seating and methods of teaching since many children can't learn the old fashioned way of sitting all day.  He's still a great kid but he needs help.  Asking him to do talk therapy or a behavior plan only may not be what he can do.  It's challenging but they mellow and we get used to it.  I try not to get upset when I tell him 3 times what to get from his room since he doesn't always remember after walking in there.  Ask for help, support or just an ear to listen if you need, it helps us too.

Archived Q&A and Reviews

Questions

If your kid has ADHD will things ever be calm?

Aug 2013

My oldest (of three) has ADHD. He's 8 and a great kid, but is super, super distracted (has trouble staying focused and on task) and has a TON of energy. At school he does not disturb other kids, but he is always getting distracted himself. At home he is like a tornado. He's not destructive but he can't seem to settle down and focus on things especially after school. He never stops talking or sits still. Homework is a disaster and he can rarely play or do things on his own unless coaxed. He is always trying to rile up our other two children and his style of playing is not calm. It's exhausting. He is like a constant whirlwind and I find that I have no time to think or feel calm when he's around. We're working with a therapist and have decided not to go the drug route right now and she has helped us with some behavior management. But I'm wondering, from parents who have been there--will our home always be this chaotic? He has set a bit of a crazy tone for our household and my husband and I (who are pretty calm people) just feel burned out from it. Sadly we notice other families with kids our son's age who sit calmly and read (he's never picked up a book and read on his own) or play on their own quietly. He is more like a toddler with all of his needs and it is getting old (especially with two other little ones to take care of). Are we in for a chaotic life for the next 10 years (if he goes to college!)? Our other two kids are not like this, but around him they start to act hyper and have started moving away from more calming activities. We'd love some perspective from other parent's with ADHD kids. -No time to think

Oh boy, can I identify with your situation! It is exactly the same way in our house, with my 10-year old son. The hyperactivity and attention deficit makes it hard for him at school, even though he doesn't have behavior problems there. Tried lowest dose Concerta last year, which helped his focus at school and made him much more compliant at home. He said it made him feel more calm. I'm conflicted about medicating him for school, and wish there was a school more tailored to kids like ours - but we may go back to the medication, if it's just too hard.

He has a hugely active life with constant friends and stimulus, almost continuous high-energy play. I'm exhausted by the end of every day, so I can't offer you any relief there. I can only add that our experience with medication was overall positive, in spite of my reservations. I will be interested in the responses you get. Suzanne

Simply wanted to point you to a good online resource for parents of ADHD, ADD kids: http://www.additudemag.com/. It's a treasure trove of advice and research having to do with behavioral issues, school, alternatives to meds, meds.. and so on. Really good. Best of luck! Sooz

You have my sincere sympathy for the difficult situation you describe with your son. My son has moderately severe ADD, which we have been dealing with for fifteen years. Yes, consistent parenting strategies can help, as can reinforcement for progress, and love.

But why are you unwilling to see if medication can also help? My son has been involved in deciding on,and self-monitoring utility of medication from the beginning and he thinks it is helpful. From the perspective of parents and teachers, it is clear-cut--missing ONE DAY of medication results in inability to participate in classroom activities. We all need to understand more about the underlying neurophysiology--but in the meantime, I think your son's inability to socialize, learn, and co-exist in a functional family will harm him far more than the very well studied medications for this condition.

doing EVERYTHING we can

My ADD son is also super, super distracted, as you describe your son. My son does not have the hyperactivity component, but he has such a severe deficit of attention that it is not possible to have a conversation with him. It's hard for him to read books because his attention drifts away in the middle of a sentence. He doesn't like team sports because he doesn't have the attention to follow the game or hear what the coach is saying. He gets shouted at a lot by people trying to get his attention.

I don't know how my son would be able to live a normal kid life without ADD meds, which he started in the 3rd grade. He is now in middle school. He has few memories of things we did together before 3rd grade because he was in such a fog most of the time. With the meds, he hears what the teacher is saying most of the time, and we can ask him questions about his day and he can answer back. He can interact with other kids and grownups. He is not perfectly focused with meds, but it is so, so much better than without them. I really recommend you speak to your pediatrician about trying ADD meds. local mom

My son has ADHD and nothing was ever calm until we went the medication route. I was dead set against it, but am starting to wonder if it is just inevitable. The hyperactivity and distractibility just becomes more and more difficult to manage the older the child is. I can not believe how much the medication changed our lives for the better. The thing to remember is not medicating also has consequences. Before finding a medication that worked for him, we were frequently frustrated with our son, he had trouble making and keeping friends, and in general was getting the message that he was a bad kid. Now he is very popular in school and a joy to be around. He has his moments like all kids, but it isn't a constant management issue like it was before. Now when I am helping him get through breakfast in the morning before his pill I honestly can't believe we used to live like that. It is a nightmare, much like you describe and even though he is 8 years old I have to sit right next to him and basically hand feed him or he is all over the place being silly or being distracted. I will say the medication trials sucked, mostly because of my emotional feelings around giving my son medication. I was so worried he would lose his special spark. Once we found the right thing for him it has been great with almost no issues with side effects (he eats slightly less lunch, that is it). He still has his exuberant personality, he just isn't aggravating everyone all the time with the silly nonsense energy. Anyway, on the other side of it, the medication is not nearly as horrible as I thought and honestly was needed in order for my son to have the impulse control to apply the lessons he was learning in therapy. Good luck! My heart really goes out to you. I don't think people really understand how difficult it can be living with a child with ADHD unless they have done it. Anonymous

Just know that you can try medication for your son and stop it immediately if you don't like it. Nor do you need to use it non-stop. I am someone who is very open to prescription drugs in general, so I was surprised how sad it made me to tell my son we thought he had ADHD and should take medication. But I did it I was even more surprised how relieved -- even happy -- he was to hear this. Before he was treated, he really felt like there was something wrong with him that made him a bad kid (impulse control was a HUGE problem for him). Now he really feels empowered - his brain works in a special way, but it's not going to ruin his life (and it even has positives).

Some other good things about the medication are that because he knows what the medication does for him, he really gets how the food he eats plays into his symptoms in a way that he did not before - it's all about chemicals, right? So I don't have to nag him as much about eating protein, etc.

Also, my son doesn't take medication every day. On weekends, he usually doesn't, but even then his non-medicated behavior doesn't get to me as much as it used to, because I know we can control it when we need to. Because his behavior doesn't make me anxious the way it did before, it's better for all of us. And, the burden of managing his ADHD is not all on me -- everything doesn't turn on my managing him the right way. Good luck

I understand your reluctance to give drugs to your son. I had ADHD as a child and though my parents were wonderful, I was a real handful. Especially in even slightly stressful situations. I even remember my friends and teachers trying to get me to calm down in school. I remember being unable to get homework done, even small tasks finished. I wasn't diagnosed until my own son was tested in late high school and I recognized all the behaviors from the questions. He never took ADHD drugs. I do.

HOW I wish I could have taken something! I am a smart person who ended up knowing I was different, knowing I needed to get it together and not being able to. It has been very hard, personally, to figure out why I couldn't complete stuff, get things done, was always started something new...(on and on).

When I finally got drugs as a 40 year old, it was like night and day. Boom! Those drugs have saved my life! I get things done. I organize. I am normal-ish. I still have to work harder than most I believe to accomplish tasks. Yes, I have learned coping techniques that I can use when I am not taking the drugs. But there is just no comparison. Again, it was like night and day. Any competent psychiatrist can describe to you the difference between the way an ADHD brain operates and ''normal'' people's brains operate. I absolutely believe the doctor when he says that to not provide a person with ADHD meds is like someone being denied glasses for poor eyesight. For me, this has been true.

I encourage you to let your son at least try ADHD meds, and see what the result is. You can always stop. But, you might be saving him and yourselves a lot of pain and heartache.

Glad I take ADHD meds

 

My patience has worn very thin with inattentive 4th grade girl

August 2005

I would like some advice to help my 10 year old daughter who is incredibly bright and talented in the arts and acting and can sing very well despite having had no voice lessons. She does well in school despite not paying attention well at all. I have noticed this problem with her since pre-school but always hoped she would outgrow it. She doesn't pay attention to directions, she doesn't pick up social cues; she loses things; interrupts conversations inappropritaely; does not know how to join a conversation, but will just start talking about a topic of her own interest; will repeatedly interupt an adult conversation to get them to attend to something she is saying; doesn't like to wait her turn; is a perfectionist to the point that it interferes with her test taking ability and so on.

She was tested for ADD in Kindergarten by Kaiser, but I didn't believe the testing was very inclusive. Her school report cards at Elementary school in Berkeley were always the same - her academics were always fine, but with comments from the teachers about her inability to pay attention and her difficulties with her peers. We moved to Martinez where she goes to a fairly conservative public school and again - she really stood out - her intelligence and knowledge are above grade level but her social and emotional functioning are behind. The teacher has to practically stand over her to make sure she is on the right page. I spent a lot of time and money putting her through auditory processing disorder therapy which didn't help much. (A little but not enough that the teachers noticed). Her school did a lot of testing on her that shows an above average I.Q. but placed her at risk for attention disorder, depression and other such things.

I have now come to the conclusion that the child does in fact have an attention deficit disorder and that a lot of her depressive symptoms are caused by her inability to make friends and get along with her peers and her inability to pay attention to instructions and things going on around her. I have been trying to get her into a physician or a clinic that will work with her and do a trial of medication, just to see if it works. She is going to be entering 4th grade which is a big change from 3rd grade. We don't seem to have any control over her behaviour. She ignores what we ask her to do. Reward tactics don't work. Discipline tactics don't work. I am at a loss as to what to do for her. We have tried changing her diet (excluding sugar, refined foods, milk - you name it) counseling, different approaches to discipline, Kumon, fun things, not fun things etc. She is in her own world and is going to slip through the cracks without some intervention. I really can't afford to send her to a private school as her little sister is developmentally delayed and also requires extra tutoring, etc.

She also does everything that she knows that she is not supposed to do. Watches TV when it is supposed to be off, eats stuff she is not supposed to eat. Gets up at night and plays in her room when she is supposed to be in bed (the child doesn't seem to be able to go to sleep and once she is asleep - cannot wake up). Any advice or help from anyone with a similar situation would be appreciated. My time, my funds and my patience have been worn very very thin at this point.

My heart goes out to you! And on a number of the challenges you raise - I've been there and done that.

Call Dr. Brad Berman at (625) 279-3480. He has an office in Walnut Creek. Leave a detailed message. He has a long waiting list, get on it now. The more info you give, the better he will know how challenging this is for you and your daughter. This is more than just ADHD and he tends to respond to the more difficult cases faster. He really likes kids. When I read his recommendations to my son's school I cried. Because he so clearly likes my kid and wants to communicate what a great guy he is to the school. You will need Brad's ongoing support. Things change as your child matures and new issues arise. I TOTALLY sympathize on the not sleeping and then not waking up! It makes your life and theirs sooo hard.

You'll find that since your daughter is very bright, things may bother her MORE because she is aware of more that other kids her age. Being different may bother her and yet modifying her behavior will feel impossible to her. Berman is great at separating the things the kid really needs to take responsibility for (and makes them feel good about it) and the things that they just can't manage. If she needs meds, he'll explain why and what they will offer her in terms of assistance and relief. Believe me, lots of parents know where you're coming from. You are not alone. Get support! Sympathetic mom

I read your post with great interest--it sounded so much like my daughter, now 21. I wish I had tried harder, because it only got worse and worse. In Junior High I had to put her in private school when she got so ostracized by friends from her inappropriateness that life was miserable and the other parents didn't want her around. I mainstreamed her back into public high school (mostly due to the expense of private school)...she continued to act up and again it just worsened and grew into smoking, drinking and being totally out-of-control to get social approval. Her teachers said she never paid attention; she just socialized. She seemed depressed and then started cutting herself.

Continuing to focus on academics, I pressed her into college, sort of avoiding dealing with drinking, behavior issues, etc. except to try ThunderRoad (an adolescent program for alcohol), therapy, and a bunch of other programs that didn't work. I could tell she felt poorly about herself all the time despite the fact that she is attractive, bright, and talented musically and in dance and sports, with an outgoing personality (just an inappropriate one).

Her senior year I found Dr. Gary Landman (925-253-1041)in Orinda. He was happy to prescribe her drugs. Unfortunately her image was so poor she didn't want to take them, and/or would forget them. She spent one year in college, used the drugs to buy/sell/trade...but rarely to help herself. I will never know if they would have worked or not. She continued drinking, showing off, and getting into trouble from poor decision making, impulsiveness and showing off. Her threapist said she had the social/emotional maturity of a 14-year-old. She dropped out of college the beginning of sophomore year at 19, got pregnant with an acquaintance, and now has an infant. Need I say more?

I admire your persistence and encourage you to keep trying, everything, until something works. I wish I had tried even harder, and started the medications, although I was against them, when she was younger and I still had some control over her. I understand a combination of therapy, anti-depressants, and ADD meds work well. I know there is an outstanding doctor in Vallejo I think who has good success with these children. These children are delightful but require heavy management until a solution is found. And no, my experience is that they don't grow out of it, it only worsens as the stakes get bigger. anon

There's lots of news about attention deficit, and much of it confusing. There may be many causes for Attention deficit. It is not necessarily a ''disorder''. For a bright child, it could be as simple as a very fast mind, who is always ahead of the present situation. Or because she is so bright, she is easily bored with the present situation. We are also a society that does not treasure slowness or patience. She sounds like a willful child, which can also be characterized as independent, a strong sense of self, etc. It is not necessarily a ''problem''. I too have a child who is very smart, very perceptive, and very difficult at times. There are many approaches to this situation. I DON''T RECOMMEND DRUGS. My step-brother drugged his kids, and they turned dopey. There may need to be simultaneous multiple approaches to your daughter's situation. 1. What is your child's learning style. Is she visual, kinesthetic, audio, Here's an interesting on-line article: www.drpaulschenk.com/articles/what_looks_good.htm 2. I would also strongly recommend homeopathy in conjunction with a good diet. My son - when he is out of sorts - angry, acting out - usually has been eating too much sugar - and starts going on sugar binges. When he's calm, reasonable, social, happy, his sugar cravings goes away. Call Dr. Roger Morrison, he's an Md. and a homeopath - he is fantastic. 510-412-9040. There's a long waiting list to see him, but his wife is also a homeopath, Nancy Herrick. 3. I would recommend regular physical activity. Kids who live in another world are not in touch with this world. And this world is physical. If she won't do something regularly - dance, swimming, etc. do massage on her. I don't know a single person alive who doesn't like massage. Get her in touch with the here and now, which begins with her body. 4. Be honest about your own issues. Check out Byron Katie. www.thework.org When I finally learned to accept my son, and not be angry, miraculously, we started communicating. Here's an example. Me:''Please bring in the dishes from the table and wipe it off.'' 5 minutes later, a few dishes have been brought in, and the table isn't wiped. I repeat the first request. Son: ''I didn't make the mess.'' Me: ''Even so, you need to bring in the dishes and wipe the table.'' Son: ''Well, I just wanted you to know, it wasn't me that's so messy.'' ''OK''. In the past, I would have blown up, and yelled, ''I clean up after you, you have to help clean up around the house.'' I used to get angry because I took everything he said personally. By not taking it personally (I'm not a bad mother because my kid didn't wipe off the table) I can now just ask him to do what needs to be done, and hear what he's trying to tell me. Hope this helps.

Your daughter certainly sounds like she has ADD. I would recommend seeing a behavioral pediatrician that can assess and treat her. My son sees Dr. Josephine Lindt in Albany. We are also in Martinez and it is not too far a drive. I've also heard good things about Dr. Brad Berman in Walnut Creek. Dr. Lindt's initial evaluation was covered by my insurance, but the follow- ups are not--and are $90 for a 1/2hr appt.--just to give you an idea. I just read a very good book about ADD--Driven to Distraction by Edward Hallowell. Be glad that your daughter has hung in there academically so far. Many kids with ADD fall behind or have accompanying learning disabilities. in the same boat

I suggested reading up on Asperger's Syndrome, as a potential diagnosis. Here's a fine place to start: http://www.ninds.nih.gov/disorders/asperger/asperger.htm parent

It certainly sounds like something is going on with your daughter, but not like Attention Deficit to me, but my knowledge is mostly anecdotal. The problems my kids had with peers at this age were with distraction (their own and others) and with wanting more fun in class... they NEVER consistently did what they were told not to do (or what they were told TO do, for that matter), because they would have become distracted either way (sigh). For us the battles have always been about homework, chores, consistent behavior.

You're right that 4th grade will be harder for her than K-3, and that she's overdue for a really good evaluation. I think you might need to find a behavioral pediatrician or psychiatrist who deals with a wider range of possibilities though, not just ADD. It is certainly the case that your daughter's depressive symptoms would be a logical side-effect of everything else that's going on. It does also sound to me like she's manipulating you. Some of what you described is normal behavior for any 10 year-old who can get away with it. Also, since she's smart and knows you've tried so many things, she may be feeling like there is something intrinsically ''wrong'' with her.

If you have to go off your medical plan to find the right person, even if it means paying cash out of pocket, I'd do it. I know Brad Berman is highly recommended. We see Gary Landman, because he's an ADD expert and there wasn't ever any real doubt that that's what it was, just if it was.

Where you say your child was found to be ''at risk'' for ADD or other behavioral/learning problem --- I'd say she is more ''at risk'' if she's not properly diagnosed and treated for a condition that is making her life, and yours, miserable. I can't tell you how liberating it is to actually find out what's going on, and that there are ways to make it better. Good luck! Heather