ADHD and School-Aged Kids

Parent Q&A

  • Looking for other ADHD kids!

    (2 replies)

    Hi all -

    Our 10-year-old son is desperately looking for other ADHD kids. He longs for a kindred spirit to talk to and spend time with! I have not been able to find any groups that offer this in and around Berkeley. Looking for any tips -  or, if your son or daughter has ADHD and would like a buddy, please feel free to get in touch by leaving contact info in your reply!

    ADHD mom 

    We have an almost 9 year old son with ADHD and we just moved from Berkeley to Oakland (he’s a 3rd grader at Berkeley schools). We would love a play date! Also, my friend just told us about this conference this weekend we are going to attend:

    Hi. My child has not been medically diagnosed but we are going through that process now. We live in Berkeley. Where are you located? I am open to having our boys meet but would like to communicate with you about our boys' likes and dislikes so they know a little about each other before meeting. 

  • Coming to terms when your child is diagnosed ADHD

    (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 :)  

    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.

    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 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.

    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.

    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.

    I would love to talk more! Please contact me! 

    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!


    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.

    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. 

    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

    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.

    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.  

    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.

    New replies are no longer being accepted.
  • 2nd grader with ADHD not getting support he needs

    (3 replies)

    My son is in 2nd grade and just got a504 accommodations because Of ADHD. the school didn't provide the information for over 2 years. I complained with Department of education and they just said sorry.  They don't want to change the bad grades in behavior he got. His teacher mistreated all the time, unprofessional.  I requested a change of class and the school placed him in another class where there's a bully and he is hurting my son frecuently. I assume it's retaliation because I complained. What can I do.  Do I need a lawyer or do I have a case?  Any suggestions? Anybody with similar situation? Thank you

    I wouldn't worry about grades for a second grader.  When they get older it's more important.  Try to be nice about it.  If there is a bully, consider writing an email to the teacher with a copy to the principal and say something like:  "Thank you so much for placing him in this other class, he seems to doing much better, but he has told me about a kid in the class that is bothering him.  His name is X.  Not sure how to handle this, perhaps you guys can check in to this."

    You obviously have checked with a therapist and determined he has ADHD and maybe he is on medication now or not.  The therapist should be your guide.  When you have a meeting for your 504, bring the therapist along too.

    Good luck.

    Hello, Totmom.  I had a similar situation with my son in first grade.  I didn't have funds for a lawyer, but I did use vacation and FMLA time (you are eligible because your son has a medical condition) to take time off work and visit his class room - a lot.  I called lots of conferences with the teacher and the principal if there were reports of bad behavior.  I asked "what are you going to do to fix/change/stop this?" a lot.  In other words, I was all over the unprofessional teacher like white on rice.  It got so acrimonious she was inviting her union steward to the meetings.  I didn't give a flying rat's ass, frankly, her poor teaching skills and job performance were the whole reason we were there.  Every time we met, I got the 504 updated and signed with what ever they said they'd do to fix the bad behavior, then I followed up at the next meeting.  Example:  "So you said you'd separate my child and bully, but they're in math group together.  Why is that?  Isn't that a violation of the 504?"  Because I was in their face so much, the bad behavior declined.  Downside:  The other parents in my child's class treated us both like pariahs.  Upside:  Ineffective teacher was gone a year later so at least she couldn't treat someone else's child so poorly.  What this experience taught me is that you are your child's best advocate at school.  As you have experienced, you will get the civil servant shrug unless you push, push and push.  My child is in eighth grade now and I still have at 504 meeting at the beginning of the year, one mid year and a month-before-school-ends check in.  I've also escalated up to principals or other administrators immediately if I felt the teacher was blowing me off.  Am I everybody's favorite PTA mom?  Heck no.  Is my son getting the education and accomodations he needs?  Heck yeah.  I'd rather be *that* mom with an educated kid than everybody's friend, I guess.  YMMV.

    I feel your pain. You just have to stay in constant contact with the school. Ask for an SST meeting at the beginning of every school year to get the new teacher on board with techniques that work. Stay on them. Ask for a weekly email from the teacher about how things are going. Involve your school's principal and guidance counsellor.

    In my opinion, you should only be looking forward and trying to figure what needs to happen to help your son succeed in school. Forget about what has already happened. Who cares about the bad behavior grades of a small child? If it will impact your ability to get him into a fancy private school that school probably wouldn't be a good fit for him anyway. Understand that the school didn't give him ADHD and he's probably very challenging to have in class (my son is). Just focus on what you can do to make sure that he doesn't hate school. My son is allowed to move around the classroom when he needs to as long as he doesn't bother the other students. If he wants to stand to do his work that's fine. We have a lot of different agreements like that with the teacher. Believe me, if you can figure out an accommodation that will work, the teacher will do it because her life will be easier. 

    Treat the school like your ally in this instead of the enemy. I've found that sitting down with them, acknowledging how difficult my son is to have in class, asking them for suggestions for things that I could be doing at home to help them, have really worked for us. My husband approached the school with anger that they weren't doing what they were supposed to do and it took me a long time to repair the damage that he did. 

    New replies are no longer being accepted.
  • When do you start to worry?

    (16 replies)

    Hi Fellow BPNers, 

    I am not sure if I am looking for advice or reassurance but am feeling a bit overwhelmed by a recent situation. 

    We have a wonderful kindergarten boy who is on the younger end (late April) due to a large amount of children participating in TK. He started kinder just over 6 weeks ago and it has gone as smooth as we could have expected. The class is great, we really like his teacher, only 17 in his class, etc. 

    However, we have begun to notice that our son is a bit more "distracted" than his classmates. We volunteer in class and notice that he seems to be on the later end of finishing work, he is always the one talking and worrying about what others are doing and just not being able to sit still for any length of time. When he entered kinder I realized that he would be on the younger end in our district and that our own focus on play and discovery in preschool may leave him slightly behind, but now we are concerned less about academic gains and more about his lack of focus. Don't get me wrong, 5 year old boys never sit still but I have noticed he struggles to stay keyed in on a task for more than 4 or 5 minutes. We brought this up to his teacher and she said she did see some of our concerns and would be happy to provide some tools to work on expanding his focus. 

    My husband struggled with ADHD his entire life and was not diagnosed until late elementary school. He feels that his lack of diagnosis early on made him feel like he was simply a bad student and that he would always struggle in school. I certainly do not ever want our son to feel like he is struggling, behind or "different" but also don't want to push for something like an ADD diagnosis that may simply be him being an immature boy. 

    So my question BPN is what should we do? Is it okay to just say, we will wait for a few months and see how things progress? Or should I ask the school to have him tested ASAP with the understanding that if they find something early intervention is always best?

    We really want our son to love learning and don't want him to stress out but also are not interested in giving him unnecessary labels that could follow him in the future...

    Any advice is greatly appreciated.


    Confused mama

    RE: When do you start to worry? ()

    I have a 12 year old son with ADHD. We knew in kindergarten that he had significant focus issues but it did not cause issues in school or with his self-esteem until 3rd or 4th grade when things become more academic.  A formal diagnosis by a child psychiatrist and medication have helped him enormously. 

    I would suggest that you go through your Pediatrician and get recommendations for a child psychiatrist or developmental pediatrician who can make a definitive diagnosis.

    Once you have a medical diagnosis of ADHD or ADD in hand,  request a meeting for an IEP in writing to your principal. The school District is obligated to respond to this written request within 30 days. It will speed the implementation of your IEP once you have this medical diagnosis from a doctor, and you can begin to implement some accommodations in the classroom like:  

    1) longer time to complete tasks  2) time outs to run around outside 3) more frequent snacks 4) a rubber ball to sit on and bounce in class at his desk 5) preferential seating in the front of the class

    You can then wait and decide when to begin medicines but I would wait till 3rd or 4th grade. Once you have the medical diagnosis in hand, things go much easier in the school setting.

    I would not go through the schools psychologist as a first step for a diagnosis. You could waste a lot of time in getting an IEP with that route as school districts can claim that there is no formal medical diagnosis. 

    RE: When do you start to worry? ()

    If you are concerned about ADHD, I would ask the pediatrician. S/he may be reluctant to make a diagnosis at such a young age, but you can see. At the same time, you can request to schedule a SST at school. They will share tips and strategies.  If the concerns are more about the attentiveness than the academics, probably not much will happen until you have a diagnosis, but it can't hurt to get the ball rolling. Good luck and hang in there. 

    RE: When do you start to worry? ()

    My husband felt as yours did, that everyone just thought he was "bad." Our own son has ADHD, and you can't really "push" for a diagnosis, because he either has it or he doesn't. But I do think you should start the evaluation process. Be warned that your district will likely push back even though they are legally responsible to evaluate (OUSD principal at our neighborhood school said falsely, "Oh, they don't do that testing until 3rd grade when there is a wider discrepancy between what they should know and what they do know." This is NOT true. Your request-better put it in writing-is what gets the ball rolling.) Also know that if you don't agree with the district's evaluation and feel that they might just be going through the motions and hoping you will drop it, you can ask for one from someone you choose and in fact, you may start with that offer and see if they take it. (Can't hurt.) Here are 2 sites that will help immensely: and Good luck!

    RE: When do you start to worry? ()

    My son (born in August) was the same last year in Kindergarten. This year he is doing so much better. He is more able (and willing) to focus and the teacher has noticed the change and how well he's doing. I think your son probably/hopefully won't be that aware yet of how well he's doing compared with the other children so I'd be inclined to leave it alone and see how he gets on this year unless you see or the teacher raises something dramatically worrying. I think as a parent we can overthink things sometimes and maybe we should just let our kids be - hopefully he'll get there in his own good time. Obviously, I'm not saying you should ignore your instincts, but maybe just sit back and observe for a while before you spring into action. 

    RE: When do you start to worry? ()

    You've already taken the perfect first step -- speaking to his teacher. She sees kids year after year, and probably has a great sense of what falls within neurotypical parameters. As you know, a lot of kids -- a lot of boys, especially -- just take longer to mature. 

    But I don't think that you, as a critical and well-informed parent, would fall into a false ADD diagnosis. You can have the kid assessed and even assessed again before settling on a diagnosis. I know a lot of people moan and cry about over-diagnosis and overuse of meds, but everyone in our circle -- the BPN-type parent -- seems to be so aware of this issue. I'm saying this to reassure you. There are a lot of parents like your husband who went through years of feeling like crap, like absolute crap, because they simply couldn't do what came naturally to their classmates, and I applaud you for watching so closely. 

    My advice? Continue what you're doing right now, and give positive reinforcement. Be encouraging and psyched about his progress, wherever he is. That way even if he does eventually end up being diagnosed, it will be much less of a big deal and not layered with regret and pain. I think you're doing great. Just keep watching, and set a deadline of like six months, and promise yourself you won't worry during those 6 months. Then see where's he's at then. 

    If he missed out on TK but qualifies for it, consider having him do K twice. 

    RE: When do you start to worry? ()

    My son has Inattentive ADD. We had no idea until we consulted with a developmental pediatrician when he was in 3rd grade. We knew something was off - all his teachers from preschool on up had remarked how he seemed not to hear them, it was hard to draw him in to classroom activities, he couldn't complete tasks, and by 2nd grade he was still not reading well. We thought it must be a combination of extreme shyness and dyslexia, because we didn't know anything about inattentive ADD. I wish we had looked in to it in kindergarten, because he really missed most of what was happening K-2 and had a lot of catch-up once he began meds in 3rd grade. It's easier to diagnose ADD when they are in the 2nd or 3rd grade because they are reading then, and school is getting more academic. But my advice is do it now, don't waste anymore time, especially given your husband's history.  If he does have ADD, you will be amazed how much the meds help.

    RE: When do you start to worry? ()

    My son just started second grade and I could easily have written your question two years ago (in fact I think I did!). I decided to just wait it out since although he had trouble focusing he was still able to learn (basically his first grade teacher uses that as a guideline for intervention). He struggled moderately all through first grade and had some times toward he end of the year when he said he hated school. He was late learning to read as well. He kinda clicked on the reading over the summer and he seems to have matured a bit and now he's fine. When I talked to his guidance counselor late first grade she said that they really need to be getting down to business by third grade (when they start getting actual grades) and so if he hadn't kinda matured into things by mid second grade, he should be evaluated. But like most things, he was simply a late bloomer and he's doing fine. My relaxed attitude about it helped, I think. Rather than single him out for testing and freaking out I just gave him room to grow and I'm glad I waited it out. 

    RE: When do you start to worry? ()

    The best place to start is with your pediatrician.  Talk with your pediatrician about your concerns and make sure to tell him/her about the family history of ADHD. Your pediatrician can rule out ADHD or give you a referral to another physician or psychiatrist that specializes in ADHD.  When our child was diagnosed, the evaluation was very thorough.  The pediatrician did want to wait until my child was 6 years old and he was having problems both at home and in school to give a definitive diagnosis.  You can talk to your pediatrician and decide if it makes sense to wait and see, but if the teacher already sees the lack of focus, then you might not need to wait.  The school can evaluate your child, but only a doctor can give a diagnosis of ADHD.  

    If you child does have ADHD, then you can figure out  how to support him.  My kid really does well with medication and some accommodations in class.  The idea of getting a "label" was scary at first, but it's up to you who you want to tell.  There is real help available for kids with ADHD, and it's well worth the effort and diagnosis.

    Good luck!

    RE: When do you start to worry? ()

    ADHD diagnosis can be a bit of a racket. It involves a very expensive evaluation. As the mother of an ADHD son, I wish I'd known that there's an inexpensive and foolproof way to find out whether or not your kid has it. See if your internist will prescribe one Ritalin tablet. Then watch your son for the next four hours (the drug will be entirely out of his system after that -- it's short acting).

    If you son becomes calmer and more focused, bingo. If he becomes more energized, he doesn't have it.

    The earlier you can know for sure, the more successful your son's academic and social progress will be. I wish we'd known sooner than 3rd grade -- our kid was developing low self esteem due to his ADHD related struggles.

    I was, like most parents, reluctant to medicate, but it became clear that our son welcomed the diagnosis, and the meds. They helped him.

    Also, I wish I'd given him an extra year of preschool so that he could be more mature when 'real school" started. 

    Hope this helps.

    RE: When do you start to worry? ()

    Hi - I totally get it and wish I'd had my daughter tested right away.  She's now 15 and showed all the signs in kindergarten, exactly like your son (who's just super smart and creative by the way).  I highly recommend that you get him tested and just get on with having him be empowered and love learning.  I was afraid of labeling my daughter and she really struggled through school unncessarily!

     Also, I highly recommend Amy Cheiftetz, an amazing Educational Therapist who specializes in ADHD.  She's all about empowering children, having them love learning and having the whole family thrive as well.  She works with children and families, and she has also has a great support group for parents.  She's been a miracle worker for us!  Her contact info: Amy Cheifetz: 510-207-2995.  Good luck and remember your son is awesome! :)

    RE: When do you start to worry? ()

    Hi Confused Mama,
    I have an 11 year old with ADHD. It was clear he was more unfocused and distracted than other kids even in pre-school, but I waited until he was in third grade to address it. By then we had heard from his Kindergarten, 1st grade, and 2nd grade teachers that he was very difficult in class and then his 3rd grade teacher said the same thing. He began medication halfway through 3rd grade and almost overnight became a kid that all the teachers loved—focused, interested, hard-working in class. And he became much happier as well because he was no longer being shunned by the other kids for being "too much."

    Having said that, however, I don't regret waiting until 3rd grade to have him assessed. I wanted to give him plenty of time to adjust to school, to see if he would grow out of it, to see if he was just taking longer to mature. I do think Kindergarten is very, very young to pigeonhole a kid, even if he does have some symptoms and even if there is a family history of ADHD.

    I would encourage you to give your son at least through 1st grade to just be himself and so if things sort themselves out.

    Best of luck

    ADHD mom

    RE: When do you start to worry? ()

    Hi - sorry to hear you're going through this. I am a former speech therapist and elementary school teacher, who worked with lots of ADHD kids, and I have a teenage daughter who has Executive Dysfunction, mild ADD, major depression and addiction issues. From when she was 5 I knew something was not right, which only increased with the years. It took until she was a teenager to get a correct diagnosis.  So here's my advice to you, coming from both sides of the fence, so to speak:  From what you're saying, your instinct is correct.  What you need to know is that yes, the school is obligated under federal law to assess your child and provide an IEP (Individual Education Program) in a multidisciplinary context that includes you as part of the process.  This does not mean that you are obligated to go to the school for initial assessment. What I suggest, if you have the resources and good insurance, is to find a child psychologist who specializes in these issues and have them assess your young child first. You then have the choice of presenting that to the school for further action, engaging in private treatment that the school knows nothing about, or continuing a wait-and-see approach. At any time in your child's school career, these options all remain in effect. You can pull the trigger whenever you want to.  So my best advice is try private resources first, unless and until you feel your child needs more support in the school environment. And if you don't have access to private resources, then get with the school psychologist to put the wheels in motion. Don't wait, though, the sooner the better. Also get the name of a good education lawyer for future reference, frequently they're needed to push the school district into following the IEP process appropriately. Good luck and best wishes.

    RE: When do you start to worry? ()

    Dear confused mama, There's little downside to having your son tested and learning more information about who he is. But as your husband's experience attests, there ARE downsides to not having a diagnosis and access to available tools and therapy. The early grades are when kids learn to read, and it can be a significant struggle to catch up if they miss out on that early practice. We were in a very similar situation to yours in that my daughter had a late birthday and was coming from a play-based preK, which meant that it was hard to interpret her behavior in K as being truly "behind" or just immature and less experienced with an academic curriculum. By 1st grade, however, the inattentiveness was very clear, and was already creating problems for her academically. I wish we'd tested earlier. Remember also that you can choose to share any "label" you might receive with anyone, or no one. For example, if you test outside the school system, you don't have to tell the school OR your son. If you test within the school system, the school might know, but individual teachers may or may not have access to the information, and you don't have to tell your son necessarily at all. We didn't start talking with our daughter about her ADHD until closer to 3rd grade, in part because we didn't want her to feel different. (By 3rd grade, though, she was starting to notice her differences and wanted to take more ownership of the issue.) So just because you pursue testing and information doesn't necessarily doom your son to being permanently labeled. There are many intermediate steps along the way.

    Best of luck to you.

    RE: When do you start to worry? ()

    My son had similar issues in kindergarten. In fact, it's as if you were describing him when he was that age. We didn't worry about it. We didn't worry because we knew he could focus and concentrate on one thing if he really loved it. For instance, he was able to take apart old electronics with a screw driver for as long as an hour without distraction. Also, he was able to hear whatever anyone said even if he was busy doing something else. So think about whether or not your son is able to focus on something at all, outside school. If he has the ability, then I don't think you have to worry. School is very distracting and only now, second grade, is my son able to fully focus in class. Of course this is purely my own experience and yours could be very different, I'm only explaining what mine was like.
    I would like to add that while it's reasonable to worry about adhd because of your husband, try not to go directly to that assumption. I think we all too easily attribute our kid's behaviors to our own without much thought and that may lead to us having expectations for them to be a certain way which isn't fair to them. I hope this helps!

    RE: When do you start to worry? ()

    Your child could also be acting up a bit because you are in the room.  I definitely noticed this when I volunteered in my kid's pre-school back in the day.  Kids get excited when their parents are present.

    RE: When do you start to worry? ()

    Why not get him assessed?  As the mom of a (wonderful, btw) kid who was diagnosed with ADHD very late, I can only say if there's one thing I could turn back the clock and do over, it would be getting our kid in for testing MUCH earlier than we did. What would be the harm in knowing, getting services  started earlier rather than later, and setting him off on the best path you can?  BTW, April is not a "late" birthday, it's smack in the middle (towards the "older" end if anything) of school district cut-offs. I can't understand why you'd question a his in general, but then with your husbands own experience...

    New replies are no longer being accepted.

Archived Q&A and Reviews

Seeking Advice about Kids who have (or might have) ADHD Related Pages

2010 - 2013 Advice

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: 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 son has received an ADHD diagnosis, now what?

March 2013

My son just participated in a 6 hour neuropsychiatric session with Carina Grandison and the ADHD evaluation through Kaiser. Both reports point to the hyperactive, impulsive child. He has always been strong willed and full of energy but his behaviors have started causing him to be in trouble at school. His kindergarten teachers have been great with daily communication, but he tends to get put on time outs frequently for being silly and disruptive while waiting his turn. He often wiggles, fidgets or displays sillyness to try and cope with his difficulty sitting still or maintaining focus. His teachers and coaches get quickly frustrated with his behaviors and he often has to sit out the very activities we sign him up for to use up that constant energy. I would love to hear from parents who have had a similar diagnosis and what behavior modifications, parenting classes or medications supported your child in participating in his/her childhood with more self regulation. I want nothin more than my son to create good relationships with his friends, teacher, and coaches. I appreciate you sharing your experiences. Looking for some guidance

Hi Mama, My son also has ADHD, he is almost 11 now. This is the short version of what has worked for us, there are a lot of options out there and every kid is different, but here goes. We did put him on medication starting in 1st grade. He was falling behind in class and often felt stupid (he isn't). The impact on his self esteem was awful. We tried EVERYTHING before the meds. We tried putting him in an ''office'' (cardboard cubical looking thing on his desk) so he wouldn't get as easily distracted, we tried moving his desk, he had already been seeing a therapist since about 4 years old and we continued that.

The medication helps my son perform the way he sees himself in his mind's eye. They don't want to be impulsive, lose their temper, be combative about every little thing, etc. They usually want to succeed. As he gets older some things get harder and some things get easier. He also has some learning differences so he sees an educational therapist in addition to his regular therapy. I strongly recommend therapy. Especially since my son loves his therapist, it helps him navigate all the emotions that seem to just burst out of him. We tried social learning groups, those were not for us. It is a slow process with little to no measurable impact. It seems to depend a lot on the therapist that leads the group, but we just couldn't afford the Ed Therapist and the social learning group and in our case the learning differences are a large player in his poor self esteem. Feel free to email if you want more. Hope this helps.

IMHO you can rely on a diagnosis from Carina Grandison -- hers have long been the gold standard.

I suggest that you enroll your son in either (a) active sports or (b) Boy Scouts. Burning off the excess energy will be good for him. Of course, it can be high maintenance for the parents to arrange transportation, and the child may have a difficult transition between the activity and the parent's need to get dinner on the table. Some Scout meeting are scheduled for one evening per week after dinner.

Team sports and Scouting are venues where young males are socialized and trained to support each other, and there is adult supervision. That makes it better than school playground situations where bullying can more readily occur.

Good luck -- he will improve with age! Veteran of the Hyper-Years

Hello, I am sorry to hear your son has received a ADHD diagnosis. As a mother with a son in the public school system, I understand completely how you feel, from every angle. I am also a student of nutrition and I learned there is a strong link between ADHD and certain foods. If I may give a few suggestions, please refrain from giving him these foods if possible: -foods containing artificial coloring or flavoring (this includes candy) -foods that are refined and processed such as crackers, cookies, pre made meals -foods containing MSG or aspartame (chewing gum is a big culprit)

As well, please encourage more consumption of these foods: -clean proteins from pastured eggs and meats -free range and organic poultry -good fats such as avocado, wild salmon, sardines, flax seed

There is so much more I could write but I think it best to make little changes, as you would be more successful. There is no doubt your son would understand the true meaning of this diagnosis, since he is in school every day and is not blind nor deaf to comments made by other people. My son also gets labelled but I have been fighting the system. Ugh! It is important to understand that this is not his fault. Certain children process foods differently and it affects their brains. My own son was 'crazy' two days ago and when I questioned him, I found out they were given marshmallows and jelly beans during science class. No wonder!!!! Please don't give up and give him medication. The medication would not work and would cause more damage in the long run. You have rights as a parent and if it helps, explain to the school that you are making adjustments to his diet. Monitor his behavior with these changes. Good luck. Nancy

The person who told you not to give your son medication made an incorrect and irresponsible statement: ''Please don't give up and give him medication. The medication would not work and would cause more damage in the long run.'' It is possible that she has had some success changing her own child's diet, but she is in no way qualified to say that medication will not work for your child and will make things worse. My own son who is nine has been taking medication for ADHD for 3 years and is also receiving emotional and educational support and these three things together have made an immense difference. I'm not saying you SHOULD give your child medication, but please consider that it might be helpful. Also, my child was diagnosed with ADHD at Kaiser Oakland and we (2 years later) saw Carina Grandison for a neuropsychological evaluation to find out more about his makeup and issues, and we found her to be extremely knowledgeable, thorough and professional as well as warm and an excellent advocate for our son's success. I believe you went to the right person. If you do feel you need a second opinion, may I recommend that you see Dr Raymond Hearey in Rockridge. He is making adjustments to our son's medication and it seems to be helping him a great deal so far. Giving medication is not giving anything up. It might just be the difference between what works and what doesn't. Medication is not evil.

I felt compelled to respond after reading what others wrote. My son also has ADHD like symptoms and we tried EVERYTHING. Our lives were hell. We were unhappy, my son was unhappy, and even worse, was starting to have rock bottom self esteem and feel like he was a terrible person. The stress he and our family were under can not even be described. I also was very resistant to medication after hearing stories about how all he needed was a better diet and ''don't give up.'' Well, now on the other side, I can say that medication truly changed all of our lives for the better. We tried one medication that did nothing (but did not make him worse) and then the second one we tried was very helpful. It is not a magic bullet by any means, we still have to stay on top of keeping a very structured life at home and at school. If sprinkling flax seed or whatever else people suggest was so effective then why wouldn't more people be doing it?!? The research does not support that these diets do much if anyting and trying to actually adhere to it is a herculean effort. This is not to say that your child does/does not need medication, but just know there are serious and unfortunate consequences to NOT medicating and if you do need to go down that road, it isn't that you are ''giving up'' but rather that you are weighing the consequences for not medicating against the benefits of the medicine and trying to help your child reach his potential. I also have to say that the horror stories of zombie like children with medicine were not true in our case. My child has the same beautiful spark as before, he just can control his negative behaviors better and doesn't feel like a failure all the time. We have experienced almost no side effects. The only one was eating slightly less at lunch, but he makes up for it with an after dinner snack. A healthy diet never hurt anyone, but it also does NOT WORK to address behavior issues for everyone (or maybe even most kids). Good luck to you and your son! ADHD mama

Receiving an ADHD diagnosis is so hard on so many levels - I feel for you. I have a 7-year-old boy with ADHD, and I've been on this path for a while. I would work with a trusted child psychiatrist or other specialist to determine what kinds of therapies would help most for your particular child. For social issues, I would suggest looking into a ''Social Thinking'' play group, or some other type of peer group therapy that deals with self-regulation, social interactions, etc.

And, contrary to other advice you received here, I would not rule out medication. While I wholeheartedly agree that good nutrition and whole organic foods are a great thing, I take issue with the advice not to ''give up and give him medication'' and that medication ''won't work''. Medication DOES work for a great many (not all) children with ADHD, and indeed can change their lives. Stimulant medications, typically used to treat ADHD, are among the most studied medications out there, have been in use for decades, and are generally considered very safe. There are many variations that have varying results and side effects depending on the individual child (what works for one child may cause unacceptable side effects in another). It is often a case of trial and error before you find the right medication and dosage for your child. Talk to an MD specializing in ADHD, gather as much information as you can, then make the choice that feels right to YOU.

Good luck to you - I wish the best for you and your son! BTDT

I am very sympathetic to your situation, as we were in the same boat a year and a half ago when my son, then 7, received an ADHD diagnosis from two different sources. This came after two absolutely miserable years of school experience, during which his self-esteem had completely eroded.

To counter one of the previous responses suggesting that this condition can be cured by your intake of food - my son's diet has been stellar since his birth. He is 9 now, and to this day, neither soda nor artificial coloring has passed his lips. His favorite meal is a plate of salmon and steamed broccoli. So if a diet can change ADHD, I would question if this was ADHD in the first place.

Before we ''gave up'' and tried medication we:

1) Switched from a public school to a private one in the hopes of small class size and better resources creating a more positive environment for our son - this did not address the underlying challenges;

2) My son was the youngest child in the classroom, so at the suggestion of the teachers we held him back a year - this had no impact on his academic performance, but made positive changes in his social life, as his apparent immaturity due to impulsiveness seemed to blend in much better with a younger grade;

3) One of us became a stay-at-home-parent in order to be more involved at school and provide a more balanced and calm life at home.

Neither these steps, nor the balanced diet ''cured'' his ADHD. A year after the diagnosis we tried our last option - the medication. It was not the magic bullet as so many people have suggested to me it would be, but it is still the most effective tool at my son's disposal.

I am not suggesting that the medication is the only route, but I thought I would share our experience with you so you have one more anecdotal evidence in your arsenal.

I would like to mention one more thing. If you can, try to reach out to other families with ADHD kids. It is so great to be able to talk to other parents who know what you are going through based on a personal experience, not some book or a college lecture. As a bonus, playdates with these kids are awesome and you don\xc3\xa2\xe2\x82\xac\xe2\x84\xa2t feel guilty, because your child is not the only one running and jumping like crazy. Best and warmest wishes

ADHD-- dd on meds ; no change in productivity

Jan 2013

10 yr old dd has been on various ADHD meds for 2 yrs. Teachers have not noted much improvement on focus and productivity. Still requires lots of one on one prodding to get work done. Evaluated by neuropschy, high IQ thus capable of doing work, but low processing skills (16% percentile). Dislikes and avoids writing, says that mind goes blank when it comes time to put thoughts on paper. Mom concerned about middle school and future. In public school with IEP to help with writing and study skills. Has anyone with similar issues found a way to resolve them. Help worried mom

Been there! Contact Phyllis Koppelman at Strategies for Learning. She got my child writing which was a MIRACLE! ( She is funny, warm and so experienced!

Meds should work, period. However, I learned that my kid's doc was not giving him a 'clinically significant dose' that is not enough to help, just enough to disturb his sleep! We switched to Dr. Brad Berman who is heaven-sent.

In both cases it was critical that our child LIKE the professionals. These two really do love kids and interact with them, not just you. Good luck!

My son had ADD and several learning challenges including processing and focusing, as well as severe anxiety. When I put him on a gluten free diet years ago he changed almost magically. We also gave him high doses of Omega 3 fish oil which was RX'd by his wonderful shrink. Previous to that,when he was on meds for 2 years there was NO change except they stunted his growth (GRRRRR....Mama bear comes out) The meds were RX'd by a Kaiser shrink. The meds were more for his anxiety, which the Omega 3 took care of beautifully. Anyway, give gluten free a try. Most Dr's. don't know much about the negative effects of gluten but it can really change one's focus, personality, brain chemistry. Today my son is a healthy and well adjusted 17 yo who has ways to deal w/ his challenges and gets his school work done. If you want to talk further about this, please e-mail me. Good luck. june

People with ADHD have different challenges and to varying degrees. In order to be successful in life it's important to come up with creative solutions. If writing is difficult, perhaps being interviewed or talking into a recording might be a good alternative. ADHD and thriving

Seems like the first thing to do is take him off the meds. Then I would suggest that he learn to use a keyboard. Sometimes that is easier than using a pencil. Then, if a keyboard doesn't work, either, the physical act of writing and the mental act of composing should be separated. While he talks, you write it down. Scribing is a wonderful way to connect with your kids and is wonderful for those who have trouble with the pencil. Then have him copy it so he continues to get practice putting words on paper. Anon

I'd look into getting some voice recognition APP for your computer and let him dictate his stories and then edit them after they've been typed. He could use this type of system at school too. anon

Our son struggled with trying to produce all through elementary school - well, he wasn't really struggling, he was indifferent. He had an IEP. We were very worried. But now he is a successful college senior with a high GPA. While it is true that every special-ed kid is unique and you can never generalize, here's what worked for us: Three things: First, behavior modification. During one of the OUSD regimes with an enlightened head of the Programs for Exceptional Children (PEC) department, they brought in special-ed aides who were hugely overqualified. Ours was a licensed special-ed teacher in another state.

Now, our kid was beyond the stage where he would work in return for stickers. What did our son value? Time off. So this marvelous teacher made a deal with him: he got 15 minutes off for each 45 minutes that he stayed on task writing an essay on the computer. So our son began to negotiate. Could he save up his increments of 15 minutes to have an entire afternoon off? Well, okay. And what would he do with his afternoon off? He wanted to stay in the school library and help the librarian. She, too, was a jewel.

This process made him into a writer who got A's in college fiction-writing. Second thing: Emotional support. When kids are struggling, especially if there are social deficits involved, they need a trusted adult to confide in, so they do not experience ''collateral damage'' of loss of self-esteem and inability to stand up to any bullying. For our kid, a good therapist using sand-tray methods helped enormously.

Finally, Maturity, We parents tend to suspect that speaking of ''developmental delays'' is a euphemism for''not smart enough''. But in our son's case, I am here to say that he has grown out of a lot of the problems we suffered with in the earlier grades. And I am proud to say that we were able to protect him from ''collateral damage''. Yes, there were nights when I went crazy -- sitting over him for two hours trying to get him to complete a simple work sheet in third grade; wondering what medication to try, arguing with my husband who was/is anti-med. I have to say now that the meds had little impact and were not worth trying. The biggest piece of the puzzle was the behavior modification, and to make that work, the teacher or parent must really understand what motivates the kid. Keep your sense of humor and your faith. Alan's mom

10 year old boy with ADD - after the meds wear off

Sept 2012

My son is 10 years old and has ADD. He is on 10 mg of Focalin XR that he takes in the morning. On his meds he is just a super great kid. He is sweet, helpful, kind, behaves well in class, never much trouble. Other parents like him, teachers like him, family members like him...

BUT.....after the meds wear off (about 5pm) its a 180 degree difference!! Like Jekyll and Hyde! He is loud, impulsive, doesnt listen (Stop teasing the cat. Leave your brother alone. Dont splash water--purposely--all over the bathroom, and on and on.) Every 5 minutes he is being reprimanded for something. On his meds he is nothing like this, I swear. He has brought me and my husband to tears many nights due to complete exasperation and/or feeling guilty for how we are treating him (yelling, anger etc).

I know about the ''rebound effect'' of these medications. But we just arent sure which avenue to go to make things better for him and for us. Wondering what has worked for others out there with boys with ADD, who can be a complete nightmare when not on their medication. (Of course we are going to run everything by our pediatrician, but you all are experts too!) Have you noticed a difference in your kid if youve given him an afternoon dose of meds? (Our pediatrician has suggested it.)

Should we bring him to a developmental pediatrician (except the good ones have wait lists months and months long!!) And what would a developmental pediatrician do exactly? We dont need more testing, a diagnosis or someone to dispense medicine, weve already had all that done.

Are there counselors/psychologists that work with behavioral issues of this kind? (I went for an intake at the Ann Martin Center. Left there feeling it just wasnt a good match. I could be wrong.) What parenting classes are out there in the Bay Area for parents of kids with ADD? The only ones I know of are at Kaiser and we arent Kaiser members. Some have said you dont have to be Kaiser members, but every time I go on their website, 90% of their parenting classes say you have to be a member. Any advice would be SOOOO appreciated! Thanks.

PS Oh and yes, we do have reward systems at home with consequences and/or positive rewards. Feeling Sad and At Wits End

Since you say your son does so well on school on meds, would you consider a small afternoon dose to get you through the evening? Focalin XR is a long-acting form of Ritalin. You could do a small (say, 2.5 or 5 mg) dose of regular (4 hour) Ritalin in the late afternoon and that should be enough to get through homework but still not keep him up at night. I am not one to push meds, but I think in this case the advantagese might greatly outway the disadvantages. A pediatrician

I feel for you. Our son is younger (7) and not medicated all the time (wears out by evening and not on weekends). He seems tired and has a hard time controlling himself when he is not on medication. We went to a parenting coach - MARCIA S TROJAN LMFT RN in Berkeley. She helped me understand that I have to stop myself before I get angry. She taught me to notice the feelings - emotional and physical - I have before I react in anger. When I notice these feelings/tightness/pressure I give myself a time-out and walk away - if possible - from the situation to take a deep breath and get a grip on myself. Just an example of how the kid is not always the one who needs the fixing. I can also develop skills and think differently about my reactions, actions, and attitudes. I try to remember every day - and many times in a day - that my son is doing the best he can. That thought encourages me to do the best I can. I try to look at the fun loving nature of my son - who makes everything a play opportunity - and try to laugh with him. I also try to notice when my energy is low, or I feel stressed, and treat myself a little better. I try to not be punitive or shaming while correcting my son. I don't manage to stay positive every time, but I keep trying. Every case is different. I hope this does not sound like its all the parent fault. Just suggesting that parent reaction can make a difference in lowering the tension.

On parenting classes: I see that there are classes for parents online. I don't know how good or bad they may be. Just do a search on any search engine. Kaiser classes - through behavioral health - tend to be both for members and pay-for-service. The classes through psychology department seem to be more members only. I plan to take more Kaiser classes to keep learning how to cope. Good luck to you and to your family. Evelyn

Your life and your son's sound exactly like mine. Our son had ADHD and his meds wear off at about 6pm and we go through exactly the same thing-leave the dog alone, stop harassing your dad or me, please keep the noise down a notch (yelling goofy songs so the neighbors hear, etc) What we have done is something that might seem counterintuitive. We let him play Algodoo (a free physics game you can download which has him fascinated) while we make dinner and while we eat dinner we watch a Star Trek episode with him on Netflix. During the halfway point of the movie, it is 5 mg of chewable melatonin and dessert, and when the episode is over, we brush teeth read and go to bed. We do this every single night, and while the sillies and crazies do sometimes rear their ugly heads during the computer time, he is usually so fascinated by this game that he's able to calm down if one of us asks about what he's doing. I know every family is different but this works really well for us. I think the melatonin does a really good job with helping him wind down and be ready to sleep. He takes Ritalin LA at about 8am and this wears off at about 6pm. On another note, he has been going to the Ann Martin Center since he was five and he is turning 9 in December. It seems to be a pretty good fit, but it took a while to figure out the best method to get him to share information which he does through a method you'd use for much younger children-a duck puppet. Since he is emotionally immature, it works for him. He's brilliant with a 147 IQ and a sponge for anything technical, but this duck, somehow he relates to it in a way that makes him feel safer than a grownup, who he often doesn't trust. Anyway, good luck and if you want to email me, I hope the moderator can give you my info. Know what it's like.

Your experience sounds just like ours--it was IMMEDIATELY obvious to us, teachers, and camp directors for my younger son when he missed even one day of medication. Medication was the difference between his being able to participate and interact vs being thrown out of programs. When he was taking a relatively short acting medication, we had a prescription for a short acting stimulant for the late afternoon-evening. So I would encourage you to see your behavioral pediatrician soonest.

Medication did not substitute for the demanding parenting skills needed for our son--but it made it possible to make progress--and also minimized the frustration and anger that is destructive for everyone in the family. I am astonished at the number of folks on BPN who congratulate themselves on NOT using medications--would they be so proud of dealing with a seizure condition without meds???

And our son has just gone off to college with a substantial merit scholarship. He recognizes the value of medication and manages it himself. Everything is not perfect--but I can't imagine the past twelve years without the assistance of medication. using the help we all need

I highly recommend Russell A. Barkely's book ''Taking Charge of ADHD: The Complete Authoritative Guide for Parents.'' Tracy

We have had that same problem and we've changed meds several times to try to give him enough to get throuigh homework, but not so much that he can't get to sleep at night. It's hard! We got an enormous amount of help from a child psychiatrist at Kaiser who was able to suggest a number of different meds at different dosages until we found one that works for us. As he's gotten older we have revisited it a couple times. Don't give up!

Pre-schooler diagnosed with ADHD

May 2012

My 4 1/2 year old son was just diagnosed with ADHD. I'm not surprised but I am somewhat alarmed by the strong recommendation to medicate him. My husband, mother and mother-in-law are strongly against it but I'm torn. I don't want to medicate my kid for the rest of his life (as the literature would suggest we do), but if he is able to more fully live up to his potential (personally, academically and socially) wouldn't I be doing him a disservice NOT to medicate? I'm really just looking for personal stories from people who have experience with ADHD - either themselves, or as the parents of a child with it. Did you medicate or not? Why did you choose to/not to medicate? What has your experience been - good, bad or otherwise? Besides parenting classes and/or behavioral modifications, did you use or explore any alternatives? If so, what, and did you find it helpful/useful or a waste of time? Thanks in advance. ADHD Mom

Please consider thoughtfully your child's individual situation and the credibility of the medical evaluation/advice you are getting and do what is best for that child--not fall in with doctrinaire ''against medication'' mindsets.

My son was diagnosed with ADD in kindergarten, in addition to focal learning issues. It has been a long and complex route, including parenting classes, therapy, small private schools, social skills, etc etc. But medication has made an ENORMOUS difference for him. With medication, he can participate in academic learning and is able to have social interactions. When he misses a day (inadvertantly), teachers and camp counselors IMMEDIATELY recognize it (he takes a short-acting stimulant), and come running to us to say he can no longer participate in the situation. He recognizes the value himself--from the start, we discussed medication with him and kept him in the decision making loop. Next year he is going off to the college he wanted, with a merit scholarship. We know it will continue to be complex, but I doubt we would have gotten to this stage without the help of medication. responsible parent

I just purchased a computer program and headset from that is specially geared to help kids with ADHD (apparently, all kids can benefit from it, though). The program/game is called Focus Pocus. I can't vouch for it's effectiveness, since we just got it, but the youtube video and the description of the program make it look like a promising treatment option for ADHD. hoping this works

We are struggling with the same decision right now for our 6-1/2 year old due to major distractibility...and ''academic'' difficulties in Kindergarten (don't get me started about that). BUT, the first thing I though when I saw your post is that 4-1/2 is way too young to diagnose and medicate ADD. I feel like 6- 1/2 is too young, really. Many kids will just naturally grow out of behaviors that could be labeled ADD as they mature. It runs in our family on both sides, so my son likely will need medication somewhere along the line if other environmental adjustments are not helpful. Good luck with your decision. I know it's a difficult one and I look forward to hearing others respond to your post. It's just hard to imagine that a 4-1/2 year old is not ''living up to their potential''. -Disheartened by Pressure on Kids Today

My son was also diagnosed at a young age, and I was also someone who hated the idea of medicating my child, but I can tell you with the utmost sincerity that it has changed all our lives for the better. He is able to handle so much more with the medication. I explained to him like the literature says that he has a race car brain with bicycle brakes and that the medicine helps his brakes match his car. It literally speeds up the process to make everything match better and work more efficiently. He is a VERY challenging kid with VERY challenging behaviors and yet is incredibly smart (doing high school levels in testing at the age of eight)so I feel like this is giving him the help he needs to develop the good stuff he has. He takes 20 mg of Ritalin LA (the long acting slower into and out of the system kind)You can try it and if you all don't like it, either stop with your doctor's help or try something else. We were lucky enough to have just tried two (we started with Ritalin LA, tried Focalin, then went back.)Good luck! Best for the brakes.

I want to first off offer you my general support: parenting ADHD kids takes patience and self-awareness beyond what I imagined. I encourage you to get support, especially from other ADHD parents (as you are doing here!) through groups like CHADD and PPSNK (local listserv that offers amazing support for all special needs kids). I also highly recommend the book ''Transforming the Difficult Child: The Nurtured Heart Approach'' by Howard Glasser.

Regarding medication, who is ''strongly recommending'' this and what is their personal stake in seeing you do so? We only recently began medicating our 10 year old, who was diagnosed at age 6. We work with a doctor, Marianna Eraklis, who has been supportive of our decision to hold off. She and others suggested to us that we see how our daughter did with other kinds of supports and accommodations, and keep medicating in our back-pocket (metaphorically) for a time when school seemed especially challenging (and as many predicted, that time came at fourth grade, when school becomes more academic). Our daughter is bright, but has trouble focusing, and the structure of the classroom can be challenging for her (its not really the structure, its the lack of stimulation -- she likes high intensity environments). We have given her a number of other supports to help along the way, including social skills training (Communication Works in Oakland) and briefly Occupational Therapy, and have read a great deal, and learned some tricks for managing things at home (many from the Glasser book). Age 4 seems young to medicate, but I don't know the nature of the struggles your child is having or how they are effecting things. Still, I think trying to change other things first makes sense, as you can always turn to meds later. Is your child struggling at school? It has been very important for our daughter that her schools be places where she can get a lot of stimulation: sitting quietly is not her thing, and some schools/classes offer more opportunities for multisensory input and more chances to move around. I should think there would be a number of preschools that would be great for that. In regards to maximizing your child's potential, I don't know that meds really do that. I think they help ADHD comport in an environment that requires a particular kind of behavior (schools) but their natural potential often blossoms in other arenas (arts, sports, or learning environments that are more hands on and immersive). I'd recommending trying out some of these other things first. Best of luck! Mother of an amazing, creative, sparkling kid

I am an elementary school teacher, I have a high-school age son who has ADHD (Inattentive Type), and I have recently been diagnosed with ADHD with not much surprise after all I've read about it within the last 6 years or so. I have seen almost miraculous results in my students from medication, and medication has also helped my son and DEFINITELY myself.

My son was diagnosed in middle school, and he is a HS senior right now. He was a very high scorer all the way up to 5th grade or so, always Advanced on the CST scales. None of the teachers EVER mentioned a problem because I think he's not hyperactive, just not focused. Because of his age at the time of his beginning the meds, it was a battle against a certain level of resistance on his part. I don't think it will be as difficult with a small child. It's very sad to see children unable to read by 3rd grade because they are unable to focus long enough to even listen, or they are totally unable to stop talking. I was totally against medication for a long time because of the ''urban legends'' about it, but I have made a 180 degree turn.

I would suggest you approach the pediatrician with a request for the smallest dosage possible, and work your way up. This could amount to say, 5 mg of Adderall perhaps given twice a day. Take a look at this wonderful website: To find the right medication is not an easy task, but keep trying. If you are able, go in and observe your child at school to get a clear picture of how the medication is affecting him/her. If you can't go yourself, ask the teacher(s) to give a report daily in a notebook that goes back and forth between you and them. This doesn't have to be an essay every day, just a note to let you know their opinion on how your child behaves with the med. I've seen kids on too high a dosage almost fall asleep (from a stimulant!), and I've seen kids who obviously need the medication increased or changed. Don't believe alarmist statements. It's a slow process to find the right med, but it is WORTH it. Good luck. ADHD and happy to have found out

hi - i've got 2 kids with ADHD. both are taking medication. when my youngest was diagnosed he was 5. he was in preschool and getting ready to go to kindergarten. he was in a special, full inclusion (BUSD) preschool for his special needs. i remember this vividly because it was April and the teacher sadly told me he was not on track to attend kindergarten in the fall because he just couldn't grasp the curriculum he was being taught.

he started meds that month. by June she said he had the most dramatic turnaround she had seen in a kid. the medication allowed him to calm down enough to 'let the learning in'. she recommended he go to kindergarten with no reservations.

its not all honey and roses - he still has issues. but i found medication allowed him to just slow down, focus and have the attention needed to learn in our schools. he is not a zombie by any means. he can simply stay focused at school to sit on the rug and listen, learn and then do his work effectively.

the days i've run out of his meds or somehow forgotten (rare), his teachers tell me they had to peel him off the walls and no work got done. they were in triage mode with him.

my son has a BAD case of ADHD, so may not be the same as your child. but i doubt my son would have progressed as he has if i chose not to medicate him. just another mother's story

My oldest son has ADHD. He is now 14 yo and been on medication since he was about 9 yo. He is much more successful in school on medication, currently Vyvanse. He has never really had trouble with academics, more with social situations, talking out of turn, joking, argumentative, etc. Outside of school, he is happier and more fun off the meds, but has alot of energy. As he gets older, he is more able to be sucessful without medication. He had a psych eval last year which indicated he had some ADHD issues and IQ scores in the genius range. This was interesting because when he was evaluated when he was 8 yo, the doctor who tested him at that time said his ADHD was severe, which we felt was absolutely incorrect.

You do not address what kinds of behavior your son presents relating to his ADHD. When my son was in preschool he had trouble with empathy,cooperative tasks that involved focus on other children, and biting (yikes!) There were lots of meetings at school every year regarding his behavior, I think Kindergarten year was the worst. After moving him from private school to public school, we started trying medication and he was much more successful which boosted his self esteem considerably.

Another note, my neighbor's son is in first grade and is taking Adderal during school but not in the summer or on weekends, and is doing quite well in school. He is very bright and recognizes the focus the medication gives him in school.

I would trust your instincts with the meds, without knowing what issues you are facing with your son it is hard to give advice, but preschool seems so early to start meds but only you can know for sure. East Bay Mom


Nov 2011

I was wondering if any of you parents out there had experience/advice about your child being on ADHD meds and their heighth being affected by it. Our son is on the short side (the shortest one in his class and his athletic teams as well) and while he has always been on the short side, we wonder if his meds are going to continue to slow his growth rate. We dont know if its just genetics, the meds or both. We have been told by the doctors that the meds DO affect growth rate *temporarily* but that the child eventually does catch up, that its not a permanent state (ie, they wont always be shorter/behind just because of the meds.) Do any of you with older kids perhaps, have any experience with their growth being temporarily (or permanently??) affected and then they caught up to their peers eventually? Thanks much. Concerned mom

I had to chuckle at your request. My daughter is on ADHD meds and is 5'8'' and still growing. She wears a women's size 10.5 or 11 shoe. She's been on meds since 5th grade and is in 8th. There is at least one girl in her class who I believe is on similar meds and is of the same height. So, I would hate to see how tall they would be if the meds stunted their growth. I fully understand your concerns as I am still short, and would have hated to take anything that could have potentially stunt my growth, but I have not seen that as an effect. On the other hand, my daughter has next to no appetite at lunch. I've had to reassure many people at her school, family, friends, etc. that she makes up for it at breakfast, after-school ''snack'' and dinner. She eats a healthy mix of food so I feel her good nutrition offsets any issues resulting from many skipped lunches.

Good luck with your son. My daughter says that starting meds was ''the best.'' Totally turned around her grades, her behavior, etc. She has thanked me many times, and I'm only sorry I did not follow the suggestions to do it earlier. Mom of Tall Girl

Many parents worry about this. Steve Hinshaw,PhD,Chairman of the Psych. Department at UC Berkeley was one of the leading researchers in the NIMH Study of ADHD. This 5 year study with thousands of kids found that there was only a slight difference between children taking stimulants and those who didn't. The difference was calculated as 1 inch. Personally I feel that is a small cost for the great improvement found with proper treatment. It is important to assure that your child has proper intake of calories to maintain weight. This is especially true with entrance to puberty. There is a necessary balance. Modification of dosage or switching to another stimulant may help. Robert

Dear Concerned Mom, I can appreciate your concerns for your son and I hope our experience will help put your mind at ease. My son, who is now 15, has been taking ADHD medication since he was 7 years old. He is now the tallest one in the family, at over 6 feet. He is on the slim side, as the medication did suppress his appetite, but it definitely did not slow down his growth in terms of height. And now that he has entered adolescence, the medication is still working for him in terms of allowing him to concentrate when he needs to, but it doesn't seem to be affecting his appetite as much as it used to when he was younger. He eats all the time, as most teenage boys do! I hope this helps. A fellow mom

For what it's worth - a close friend of mine whose son was on ADD meds for a while had your same concern, and her child did appear to be on the short side. He has since had a big growth spurt, however, and is now very tall (though pretty thin). The meds did help him a lot.

My 12 year old has been taking ADD meds for 4 years. He is now and has always been off-the-charts tall and generally runs a head taller that other kids his age. Right now he is approaching 5'10. So, I have not observed any stunted growth although I sure do hear a lot about it from people who disapprove of ADD meds!

ADHD: Meds stop working?

Oct 2011

Has anyone had experience with this? Our 8-year-old, diagnosed last year with moderate ADHD, had an amazing response to Vyvance (one of the stimulants) -- big increase in ability to focus and follow directions in school, major decrease in agitation at home. But after about 2 months we noticed at home and teachers independently noticed at school that her response significantly decreased. Although she didn't go back to her pre-medication state, her focus and behaviors are only a small amount improved now. (There weren't any other life changes or environmental reasons we could identify.) We've been consulting with a doctor about adjusting dose and type of medication and other factors. But we are just wondering if anyone had an experience with a change in efficacy of these stimulant meds and what worked for you. Thanks.

My daughter has been on ADHD medication for about 4 years. We've had to change or adjust dosages -- and even change medications -- several times over those years. I wouldn't be overly concerned. After trying a couple that didn't work well, she was on the Daytrana patch for a few years - it worked great but we changed dosages as she grew. She is now on Vyvanse, and we had to play with the dosage for a few weeks to get it right. The start of the school year, any changes in her height and weight, a lot of things could affect the effect of the medication. It is hard at your daughter's age, but you will need to check in with her on how well she perceives the effect on her symptoms.

It is worth sticking with it. My daughter has thanked me multiple times for having her start taking medication. She is at the age where she realizes how much it helps her scholastically, socially, etc. Anon.

In a word: Yes. Meds need adjustment. Kids grow, things change. Our child's meds were changed (new medication) and dosages changed. As they get older the child (young adult) tunes in to their response to their meds and they eventually work directly with their doctor to get the best drug and dosage. mom of a college kid with ADHD

We've changed meds several times and also increased doses as my son has grown and as puberty kicked in. Be aware that there is a tendency with some docs to be overly cautious on the initial dosage and not give a kid the dosage that he/she really needs. This could explain why the teachers noticed an amazing difference when she first went on the meds - it was enough of a dose that teachers noticed a dramatic change when she first went on the meds, but not enough to get your daughter where she needs to be. Talk to your doctor. Meds adjustment is the status quo for us parents of ADD kids!

8 year old may have inattentive ADHD

Oct 2011

Hi fellow BPNers. I have an 8 year old 3rd grade daughter. She has a mid-September birthday and started kindergarten when she was four so she has always been the youngest in her class (we attend a school district where many parents hold their children until they are 6 to start kindergarten). Her preschool teachers said she was ready for kindergarten and she was from a social (making friends) and academic perspective. However, from the beginning we had some issues with behavioral situations (wanting hugs from the teacher, not wanting to sit in circle when it was time, etc.). First and second grade, however, she did fine--she is an avid reader and performs at a satisfactory or above satisfactory level on most benchmarks. However in second grade and now in third grade, her teachers commented that my daughter is frequently distracted and often misses important instructions for completing an assignment. In addition, she talks a lot when she is supposed to be working on an assignment which prevents her (and others) from finishing her assignments.

Another potential piece of the puzzle is that there is a strong ADHD predisposition in my family...My grandma, Mom, sister, nephew and niece have ADHD, and another sister has ADH.

I am looking for advice from other parents of other easily distracted children on how to help my daughter focus better. And how to get her to stop with the chit chat during school time. And if your child was diagnosed with ADH, were these signs that your child exhibited prior to being diagnosed? Thank you!! anon

ADHD is frequently diagnosed in 2nd or 3rd grade because of the increased academic demands. You need to get her evaluated, especially given your family history. Talk to your pediatrician. - mom of an ADD kid

I took a long-acting ritalin daily from age 12 to age 19. Other siblings took ritalin from kindergarten until college. There was never a need to increase the dose - ever. I stopped the drug at 19 and was able to integrate my learned behavior (focus, concentration) into my life well enough that I didn't have any problems as an adult. However, probably none of us actually had ADHD. We were diagnosed in the sixties and not a lot was known. Possibly there were just too many kids in our family and not enough parental time. I have mixed feelings because I accomplished a lot due to being on ritalin, but I think any normal person would have better concentration skills on ritalin! Your fears about long term consequences, and the need to increase the dose are unfounded, at least in our family experience. Your son's self esteem will probably be boosted by doing well and being able to behave and concentrate better. anon

My son started Ritalin when he was 8 too. He is 10 now. I posted about ouexperience to the other question in this newsletter about the inattentive 8-year-old.Your son is taking a really low dose, and it sounds like it's working for him, so that is great! The kids do not ''adapt'' to the ADD medication; it's not like heroin where they need more and more and more. It's more like your 2 cups of coffee in the morning. You don't add additional cups over the years until you're drinking 30 cups a day because the two cups works for you! Once you find the right does, they stay on that dose. We had a hard time figuring out dosages. We started out like you with a low dose and then went from there. For us, the problem wasn't so much the number of mg's as it was the ''delivery method.'' It really took almost a year of trying different brands of Ritalin before we found one that worked. There is the time-release kind, which lasts for the whole school day, and then there is the regular kind that your son is probably taking, which is out of their system by about lunch time. With the regular, he had no focus in the afternoons,which was ok in 2nd grade, but it started to be a problem in 3rd grade. Homework was impossible too. The time-release OTOH would last for the entire school day and he'd have no problem with homework, but then it seemed to hang around in his system for hours after dinnertime, and he wasn't getting to bed until 10:30 or 11. We tried using the regular kind and having the school give him a 2nd dose at lunchtime, but again we found it was interfering with his sleep. So we finally went to a child psychiatrist at Kaiser who figured out that our son has a very slow metabolism and this was the problem with the time-release meds. It was hanging around in his stomach and continuing to dribble out over a much longer time period. He prescribed a different time-release that delivered more in the morning and less in the afternoon. It worked great. In our case, we changed him to a new school that had more running around time and less stress, and in the middle of 4th grade he stopped taking meds and it was fine. Now in 5th grade we are all taking about trying them out again because academic demands are picking up, but we'll see. His older brother's focus got better by 7th grade, so there is hope! a mom

I have experience with both my son and having been inattentive and hyperactive myself as a kid myself. When I was a kid I got worse when I was around large numbers of children or around other hyped up kids. It took me quite a while to unwind afterwards. But I did unwind if I was around someone calm (like my uncle or my dad). Having quiet time to play by myself helped too. I also realize that another aspect was being upset or angry about something someone was doing - which made me aggressive. Mostly it just took me longer to make the transition active to quiet. Also I needed more running around and playing time than some kids. The more I played outdoors, the easier it was to appreciate quiet time after I burned off the excess energy. It took me a few years, but I eventually got it right. I also strongly suspect that food was involved, because what I ate made a difference. I completely outgrew my issues and went on to become a successful manager and college instructor. When my son came along, I saw that he was like me in some ways, so we decided to home educate (supplemented with lots of supervised social activities, sports, choir, and so on). No ADHD issues have occurred. I think a calm and patient authority being present is a big factor like in the ''Santa parenting book'' (which is currently free online)at a parenting site Happy parenting! grown up ADHD kid

Activities for 7-yr-old boy with ADHD symptoms

Sept 2011

I have a sweet, bright and inquisitive 7-year-old son with impulse-control/immaturity issues that have been causing him a lot of grief in structured settings, such as classroom or even camps. The issue is not necessarily the structure alone, but rather abundance of stimuli - lots of kids, lots of noises, etc. In one-on-one settings he is definitely more focused and more manageable (from a teacher's standpoint). As I said, school has been a challenge in that regard, the teachers get easily frustrated with his behavior and he's received enough criticism/reprimand to last an average child a lifetime. As a result, we've been shying away from extracurricular activities. We tried tae kwon do when he was much younger, but the teacher had to spend a disproportionate amount of time on him, leaving other kids stranded, so we discontinued with the class (and our son wasn't that into it). We tried Lego camps and despite the fact that he is REALLY good at building with Legos (the teacher had a hard time coming up with projects that were challenging enough for him), we still ended up frequently getting an earful regarding his impulsiveness. I was hoping to get recommendations for classes that you found to be excellent for a boy with these characteristics. Or more specifically, if you know (or if you are) an instructor who LOVES all kids, including ''challenging'' ones, that would be even better. He is a pretty bright kid who gravitates toward science, engineering, not so much sports or art, but we would be open to anything. anon

I could've written your post. Sigh. Its tough for our bright and boisterous boys, no? We have recently (last six months or so) started a couple of things that are really working for us. One is that we're taking swimming classes one on one. Less stimuli than all the kiddos in the pool and his swimming skills have really improved. Then recently we started taking tennis lessons, also one on one. Email me off list and let's chat more. julie

Sorry to hear the challenges your bright and inquisitive 7 year old is having. I can relate! My beautiful compassionate and intelligent 10 year old went through an extremely rough year last year in 4th grade that did a tremendous amount of damage to his self esteem and confidence and desire to learn.

My solution was to find a place where he was emotionally safe, accepted and nurtured. Like your child my son was criticized and reprimanded for behavior he was not in control of which did a TON of damage. He was also over stimulated by all the stuff in his classroom not to mention the 28 students packed into the small classroom. I actually moved my son to an amazing school that is doing wonders for him. He LOVES going to school and is happy. He no longer talks about being angry and not knowing why or feeling dumb because he learns differently. The school is known for looking at the whole child and finding solutions that work for each child. They teach them how to manage themselves, even those who are challenged doing so and practices differentiated learning, reaching children from where they are not where they are supposed to be. The classroom sizes range from 9 to 15 students, which gives the students breathing room and the teachers the ability to work with those who have special needs.

Here are some of the things that have helped my 10 year old in just 4 weeks since school has started. He was provided a netbook to use instead of having to write to address the low turn issue and the feeling of not being able to write and think at the same time. He and his teacher use a private signal to let my son know when his behavior is not working so that he can then do a breathing exercise or move himself to the break chair, which gives him the time to regroup and come back and participate in a respectable way. The teacher and the librarian have taken my suggestions about what style of books work best for him when trying to find reading material for my son instead or forcing the typically 5th grade reading material on him. The teacher used a conflict resolution process with my son and a friend within a day of an incident happening that left my son feeling hurt and unmotivated. These are just a few examples. I have many more. For life long skills that will help your child excel and learn to be accountable without being punished I highly recommend looking at Windrush School. What happens at that school is truly MAGICAL in all grades and all classes!!!! Good luck to you!!!!!!! lynne

Hi. It sounds like your child, you (and undoubtedly the rest of your family) have been dealing with a complex and likely to be ongoing situation. My son was first evaluated at age 5 for ADD--he is now 18--one excellent piece of advice from our pediatrician --this is a marathon, not a sprint.

Reading your post reminded me of the feedback I received about my son in the early days. And while classes may be helpful, I wonder if you are also exploring evaluation and if appropriate, medication.

Some in the Berkeley community seem to automatically denigrate use of ADD medications--would they be so negative about a diabetic taking insulin?? Medication made an immediate and dramatic improvement in my son's ability to participate in his''journey'', as well as school and social interactions. He himself sees medication as useful and has been involved in discussions about its utility and judging the right dosage since he was 5. The effect is so dramatic that when he has failed to take a dose one day for one reason or another, his teacher or camp counselor has recognized the difference (without knowing he was on medication). Without the medication (primarily stimulants, in various forms over the years) he is basically unable to participate in or benefit from school and social interactions.Currently we see Brad Berman for medication and periodic assessment/encouragement.

I am not suggesting that medication alone is the answer. My son also is in ongoing therapy with Betty Tharpe, MFT (510) 549-2092 who has been invaluable for my son, and our family--she is positive but clear thinking and pragmatic about what we all need to be doing. Over the years, we have also done social skills groups, etc etc. fellow marathoner

6 year old was recently diagnosed with ADHD - your thoughts?

Aug 2011

Hello there. I have a 6 YO son who has sensory processing disorder, and was also recently diagnosed with ADHD (combined type). I'm looking for thoughts/experience in two areas:

1) We are looking for a good psychiatrist or pediatric behavioral therapist to help us with a plan to help our son. Brad Berman is someone we'd LOVE to see (and I see recommended here quite often), bur unfortunately, he's not available until MARCH! So, I've made an appointment, but need help before that. I'm overwhelmed by the long list of doctors to choose from, and wondering if any of you have experience with (or heard of) the following Blue Shield of CA-contracted doctors: Diller, Akindele, Zuberi, Simon, Levine, Towery, Kokade, Isenstadt, Massie, Fink, White, Hartog, Michel, Pollatsek. Any feedback you can provide would be greatly appreciated.

2) Also, dare I ask the question: to medicate or not medicate? I'm not looking to stir up controversy or get super strong opinions... I respect both sides and just want to hear different thoughts - and would especially want to hear from other parents in our situation with a really young child. Part of me feels he's too young to start meds, but the other part of me just wants to make it a little easier for him as he starts school (he is very aware of his issues staying on task, focusing, sitting still, etc.). And if you were in our situation with a young child diagnosis, what did you do, are you glad you did it, and what would you have done differently? I should also say that there are other things we're going to look at to create a full treatment plan for him/us.

Thank you in advance for any help/guidance! anon

Hi, We used Dr. Lane Tanner with Children's Hospital Oakland and he was awesome, although I don't think he was on your list. Same deal with the long wait. In terms of medicating - we didn't medicate for years because we were already using lots of asthma meds. But after many years of fighting over homework and school being a let down for our son, we started using adderal. The very first day (he was older than your son, maybe 11 or so) he said ''wow - everything made sense.'' So in retrospect I do wish we'd medicated earlier. Although we do have to really watch the appetite and we don't medicate on weekends or holidays unless he has a big soccer game or something. We were told we could probably stop medicating at around 14 or 15, and I can see that being the case. He just turned 14 and he is much more capable of monitoring his attention. Good luck! another mom with an ADHD kid

If you are considering meds, I highly recommend reading the recent articles in the New York Times Review of books (June 23 and July 14). I debated whether or not to use meds for both of my children, now in their early teens. The argument ''for'' was that meds would work quickly and help them focus more in school. I decided to take the slower approach, which was a combination of neurofeedback and academic coaching. Academic coaching gives kids specific strategies for focusing in class, doing homework, etc, and a good coach understands strategies that are age appropriate. Neurofeedback is a way of training the brain (giving feedback) to do what it takes to be more focused. Research shows that results are long lasting, while with meds the benefits stop as soon as you stop the meds. For us, the results have been a complete turnaround in school performance. Several friends of mine tried meds for their kids diagnosed with ADD and ADHD, and report that it ''seems to help a bit'' - weak praise in my book. Another friend tried them for her child, and is already on a second set of meds to manage the side effects. I'm really happy about the path I took. Good luck

Medication Question Response: My son was diagnosed with ADHD (inattentive type) as well as sensory issues and many OT issues at an early age (3 1/2). I was adamant that my child would not be medicated and so we tried *everything* (as well we should), and some things did help him. He was fortunate to have great teachers that were willing to constantly redirect him when his attention wandered, and I spent nearly all evening redirecting him so that he could get his homework done. Finally in 4th grade I was willing to consider medication since there had been no real improvement and the increase in workload/expectations was becoming very challenging for him. His teacher at the time was very supportive, and a comment she made about the reversibility of this decision is what finally convinced me to give it a try. Her point was that we could stop medication at any time (if the side effects were unmanageable, if the desired results weren't achieved, etc.), and no harm would have been done. Well, in his case the results were immediate, positive, and the best thing I could have done for my son. His new found ability to focus and work independently were an immediate source of pride for him. It is 4 years later and he still takes medication, and it is a very conscious choice on his part. He is very aware that his ability to focus is greatly compromised without it (as evidenced by weekend days when he has forgotten to take it and then had homework to do--it takes us right back in time). My only regret (with the benefit of 20-20 hindsight) is waiting so long to give it a try. Just Our Experience

I was diagnosed with what is now considered ADHD very young, but that was in the early 70's when it was still being referred to as mild brain damage and hyperactivity. First, how lucky your child is to have parents and a medical community who will support and understand, it will make all the difference! I started with Ritalin at 7 yrs old, but it made me so spaced out and mellow that the teachers decided they would rather do things like give me structure, routine, and no sugar. 33 years later, those still seem to be the most effective things for me, along with a cup of coffee! The drugs are so much better now, available in lower doses and time released doses, and a variety of combinations to experiment with. I have taken them all over the years to some advantage, and you should be prepared to be patient and know that experimenting for the right drug and dose is a long journey, but can be very worthwhile. I would say that as a kid, the social problems of being not very self-aware caused more grief than the focus issues of not getting work done. Just so you know, I have a masters degree and am highly regarded in my field, and have a great husband and child, while always managing ADHD. ADHD also has it's benefits, as a totally different neural thinking path allows for really creative problem solving. ''attention deficit'' is such a misnomer; it should be called ''attention abundance'', with everything being so interesting and stealing our focus! I wish my parents and teachers had given me insight as to the benefits and treated it as just a different way rather than a curse. Good Luck!!!! anon

Just thought I'd chime in on this one. I, too, ''fought'' the concept of medicating. At the end of 4th grade, on the recommendation of several people ranging from my daughter's therapist, physician, friend who is psychologist, etc. I finally started meds over the summer. The next school year was amazing. While she still has ''executive function'' issues, her homework was getting done in record time, I had zero disciplinary notices sent home from the school (except one for not wearing the correct uniform socks - lol), she made more friends (because she was no longer engaging in ''annoying'' behavior), and her grades went up such that she was on honor roll (this was an academically strenuous school in another state). My daughter thanked me for having her take the medications. She is about to turn 14 and is still on them, although we recently switched meds following a huge growth spurt.

As several people pointed out to me, if she had another disease (such as Type 1 diabetes) would I hesitate to give her the medication she needed? Keep in mind, it may take a few months to figure out what ''works'' for your child. Some of the ''extended'' meds don't work that way on all kids. (My daughter ''crashed'' after lunch on one that was supposedly all-day ''extended release''.) Also, some of them gave her an upset stomach, others not. But it is worth it in the long run, for your child, on so many levels: educational, social, etc. Wish I'd done it sooner

I think that my son might have ADD

Aug 2010

My husband and I have been in marriage counseling for a year now. We're doing really well, but last week our therapist suggested that my husband might have ADD. We did a lot of research and think that he does have ADD. Now, he's waiting for an appointment with the doctor and possibly psychiatrist. Well, I've also said for a long time that our oldest son is a mini version of his father. My husband agrees and we are also taking a close look the possibility that out son could also have ADD (neither seems to fall into ADHD catagory). My questions are to anyone who has been through this process. To medicate or not to medicate? How do you discipline a child with ADD? Any proven methods to help them remember things? How do I cope with this condition? I want to support them both, but it's so hard to not get frustrated when I see them constantly forget or put things off. Are there any good support groups in the Dublin/Pleasanton/Livermore area? Any advice on good reading material for both coping (them) and handling it better (me) is appreciated. Thanks! Trying To Find Help

My 10-year-old has ADD, inattentive type. He has been helped a great deal by taking Concerta and he can now actually interact with the teacher and students in the classroom, participate in discussions at the family dinner table, and play on a sports team. He could not do any of these things before, because of all the distractions going on inside his head all the time. You should have your son evaluated by either a developmental pediatrician or a neuropsych to see if he does in fact have ADD. If so, you can discuss the options with your doctor. There is a lot of info about ADD on the internet - in particular try the CHADD website.

Hi, I'm a coach who works with non-linear thinkers like people with ADD and many artists. A great resource is It stands for Children and Adults with Attention Deficit/Hyperactivity Disorder.

I can only answer part of your question and stay within the maximum character limit... sorry... I have a son with ADD or ADHD depending on who is doing the talking. I'm sure this will buck most of the advice given here, but medicating him has been the best thing we've ever done for him. It is not a decision we made lightly. In fact when he was first diagnosed in 2nd grade and we refused medication outright. We had a hard time accepting the diagnosis; he seemed just like all the other little boys we knew. However, by the time we got to 4th grade it was obvious that he had more difficulty concentrating and sitting still than his peers. Between the ADD and his learning disabilities school was a struggle for him and constantly being in trouble was wrecking his self-esteem. Once it became apparent that he was having trouble in social settings as well as academic ones we decided to give the medicine a try. What a difference. His reading got better, his writing got better, he was able to concentrate and remember things. His self-esteem improved as he saw his academic struggles diminish. Don't get me wrong... he still has learning disabilities and memory problems... but things are much better than they were. Overall I'd say it was truly a wonderful thing, and I wish I'd done it sooner. Give it a try and then worry about techniques, you never know what results you are going to get. converted

See my response to a question above about ADHD. Ed Hallowell and his wife have a new book out about being married to a person with ADHD. anon

Resources & Books about ADHD

Aug 2010

Our 10 year old son was recently diagnosed with ADHD (inattentive type). We are looking for recommendations for resources, groups, classes, books, playgroups, IEP etc. to educate ourselves so that we can nurture our son and be good advocates. We would be most grateful for any feedback or recommendations. We live in Castro Valley.

Dr. Edward Hallowell has written many excellent books on ADHD: Driven to Distraction, Delivered from Distraction. He has ADHD himself, as does at least one of his children. He is an MD with a vast knowledge on all aspects of the subject, a compassionate and respected voice, and his books are easy to read. This would be a great place to begin learning about this topic. anon

I am an adult with inattentive type ADHD and I have found Dr. Amen's books helpful. You should be able to find them at most major bookstores, but here is also some websites - or

I think it is also important to emphasize to your 10 year old that he is not ''dumb'', nor that his brain is dysfunctional, nor that there is anything wrong with him. Your son simply thinks in a way that is different from many other people and such thinking style can be a great strength, but sometimes is also be difficult. The difficult part is a challenge which he is cable of overcoming. Here are some website which show famous people with ADHD ( OR Hope that helps, good luck. Anon

Active 2nd Grader or ADHD?

Aug 2010

My child will be entering second grade this fall and I'm beginning to wonder if she's just active, or if she has ADHD. She's always been on the very active end of the spectrum - jumping up and down when she sees friends or spinning when she hears music she likes, dancing, moving constantly, running. She's never been a kid who can sit and do a puzzle, or color quietly. She's constantly exploring drawers (childproofing was a must), opening bags, dancing, filling containers with dirt and beans and pouring them into smaller containers, stuff like that. Her temperament is kind, and she makes friends easily. We've worked hard not to restrain her natural curiosity, because it's messy (but natural) and there's no malice in it. But she's clumsy, fidgety, and simply can't sit still for long. In restaurants, she's literally rolling on the seat, her arms are like tentacles, she's kicking, and despite our attempts to demand she sit still, she can't. Her last year's teacher did not see any indication of ADHD but did indicate that she ''spaces out'' sometimes. My partner's relative said we should give her time outs for not sitting still in restaurants -- should we? Or can she help it? Is all this movement a result of bad parenting? Where's the line between temperament and disorder? Help! She's Digging in the Backyard

My soon-to-be-fourth grade son has a similar temperament. He mostly seems unaware of what his body, and his fingers, are doing -- and they are generally doing quite a lot; he's especially bad with picking stuff up and handling it after specifically being asked not to. For a year or more around 1st grade he seemed to be walking into people on the sidewalk on purpose -- I must have said ''Be careful, don't bump into people...'' a thousand times. He's also clumsy, though that has improved considerably over the past year. He's quite tall, and I often describe him as ''a half-grown golden retriever puppy, not knowing quite what to do with all his arms and legs.'' He's not quite as bad in restaurants (but full disclosure -- we give him iPhone games to help him wait!). He can't yet entirely control his sheer physical energy, so we don't punish him for it. And he does not have ADHD. His second grade teacher described him thus: ''He hears every word I say. He may be hanging upside down off his chair when I say it, but he hears me.'' And I think that's the difference. Kids fidget (some more than others). The question is whether or not they can attend when asked to.

I'm certainly no developmental psychologist, so if you are concerned, you should have your child evaluated. But do know that there are other kids out there with very active temperaments. It's normal, and not necessarily a problem. They may have trouble because the school wants them to sit still, but it doesn't necessarily indicate a need for punishment, therapy or medication.

One thing I've definitely found (just FYI) that has helped with body awareness is that he has taken regular martial arts training for a couple of years now. He's much more able to control fidgeting, and not bump into stuff, than before he started. the puppy's mom

Your daughter sounds extremely active, but I wouldn't jump to a conclusion about ADHD unless her teacher begins to express concerns and she isn't learning what she should be in school. Activity level is a temperament trait that is not necessarily a problem, except that our society expects children to sit still. I wouldn't create problems for yourself by expecting her to sit still unless it is really necessary for the situation (a haircut, for example). As she grows older she will have an easier time sitting still but will probably always need more physical activity than other people. You might try helping her to get more intense exercise (gymnastics, sports, etc.) in order to get some of her energy out and make your life a little easier. I am offering a support group for parents of spirited children, so contact me if you are interested in that. Meri

Hi. You will probably get lots of letters with similar advice. I would definitely take your daughter to an occupational therapist with experience in sensory disorders. Your daughter sounds very similar to mine (who is younger), and also to me as a child. Our daughter is also extremely active and ''clumsy''. She was diagnosed with a mild sensory processing disorder in the areas of vestibular and proprioceptive processing. How this plays out with her is that she craves extra input in these areas and is challenged by activities such as sitting still in a chair for a long time. Of course I don't know your child but from the things your wrote I think it would be really worth your while to get an evaluation. We ended up getting the evaluation and then sharing all the suggestions with our daughter's school, which really helped both my daughter and the teachers. I know the restaurant thing is annoying, but it probably really is hard for her. I feel lucky we were able to kind of figure out this problem early because I work in special education. Feel free to contact me. jamie

I don't really know much about adhd, but I know my experiences. You're describing me when I was a kid. It took me until about 3rd/4th grade to finally be able to reel in my energy and sit still for any real length of time. In fact, it took a great 3rd grade teacher to figure out to give me books to read during class because otherwise I was disruptive due to my energy (even though my grades were perfect). This taught me how to always have books with me so I could ''sit still'' in certain situations. I always did great in school, but it was boring and easy. I'm in my 30s and I'm still hyper by most people's definition, however I can control myself when the situation requires it (hours of boring meetings). My hyperness only appears that way to others when it's expressed in a physical way because I can just as easily sit and do 3 hours (or many more) straight of work (software engineer) or read for just as long or longer. I need to be doing something, either physical or mental or I go nuts. I think for small kids it's harder to have something that can mentally stimulate them for long periods (or realize they want/need it), so it looks like hyperness instead of physical action (which they can provide for themselves). I think it's good to point out to her that other people are sitting still in a restaurant so she can too, but I would encourage you not to make it a battle because this might be her nature and you don't really want her to learn how to turn her energy off/tune out. bad parenting? no way. Bad parenting would be you constantly trying to get her to sit still. There is a very fine line between temperament and disorder - it's all perspective. My parents think I should be ''reigning'' in our child too, but I don't agree most of the time. I'm giving her until late elementary and then I'll start explaining that society will take her more seriously if she's not bouncing when she's talking to somebody. Until then, who cares? --hyper and happy

The truth, in my opinion, is that the line between temperament and disorder is very very very gray...

Whether or not she has ADHD, her activity level is not a product of bad parenting, it is just how she is and it will likely be a valuable strength later in life after this awkward stage is over. Its very easy for others to judge when they have not truly experienced it, but its not right for them to do so. I think it is fine to give children with ADHD (or non-ADHD kids) timeouts, in fact I strongly suggest it as it gives them a break from all the stimulus. The various books on ADHD may be helpful on this subject and just about every bookstore has a ton of them. I found Dr. Amen to be helpful - ( What is harmful is to call a child with ADHD ''lazy'', ''spazy'', or try to force them to focus when they are already tired or are not interested in the subject. If you do determine she has ADHD, then I would learn about all the accomplished famous people who have had ADHD (and there is many) and ADHD as well as other ''learning differences'' are just a different way of thinking, not a ''disorder''.

If your child seems to be suffering, such as doing poorly in school or feeling bad about themselves, then maybe getting tested for a learning disability by a qualified professional is a good idea. I am sure your school can provide recommendations. Such testing is not cheap and insurance rarely covers it (although I think Kaiser might), but such academic testing will give you a much more thorough and professional opinion on how your child learns best, and if she has an LD, how best to approach it. I am personally very weary of medications for ADHD, so I suggest being cautious if ADHD is the diagnosis, but you can read about the pro and cons of medication if and when a diagnosis of ADHD is confirmed.

Good luck, I am sure your a great mom. Anon

Worried that grandchildren may have ADD

March 2010

Recently we started suspecting that my grand daughter (and maybe my grand son too) has ADD. The problem is: their father died recently from mental illness and they know he had ADD and depression (among other things). The subject of perhaps them having ADD is really scary for them. Any suggestions about how to approach this? They are both already in therapy for grief counseling. Feel free to email me directly.

I am an adult with ADD. I was diagnosed as an adult when applying to law school. It was a scary thing to learn since I had also heard so many negative things about having ADD, as most of us have. I think when exploring the possibility of having ADD, it is important to keep in mind that ADD does not mean mental illness or one is unintelligent, its just a different way of the brain operating. In some circumstances, thinking in a different way can be a big advantage. Many successful people are reported to have ADHD or learning disabilities including Charles Schwab, Erin Brockovich, Gavin Newsom, Nelson Rockefeller, James Carville, Anderson Cooper, Michael Phelps, Tony Bennett, etc. (see There are challenges associated with having a learning disability such as ADHD, but with a supportive family such challenges can certainly be overcome and one can lead a very normal, if not extraordinary life. anon

ADHD in a 3-year-old?

Feb 2010

Hello All, I have a good friend whose son was diagnosed with ADHD, and he's 3. We both find this rather crazy, as most three year olds are well, a little crazy. Although she does say that while in preschool she can see he's different. Here is the issue, the pediatrician.

The doctor said because of the aggression and his flight response he wants to do meds and then come up with a plan. She feels the exact opposite.

Calling all parents of kids with ADHD. Books, websites, tips whatever you got. She does not want to do meds, he is only 3 after all.

I recently moved here from Washington state where I was on a team that conducted developmental evaluations of children under the age of three. I strongly encourage this parent to seek the advice of another pediatrician and/or pursue a developmental evaluation through your local school district. I do believe this is much too young to make a diagnosis of ADHD and to medicate on that basis alone. If the child's behaviors are truly dangerous to himself or others, medication may be warranted (a second opinion would certainly be appropriate), but there should be severals attempts at behavior modification before that point. A thorough evaluation would work to rule out sensory processing differences and medical anomalies, including vision or hearing concerns first. In addition, I would expect that preschool teachers and parents be interviewed at length and the child observed in both home and school settings if possible, to gain a thorough understanding of the problem behaviors -- both what the triggers and typical consequences are (sometimes called a Functional Behavior Analysis). Good luck to your friend. Amy

In my opinion a parent should not give ADHD meds to their 3 year old child unless that parent is comfortable doing so. My child was diagnosed with ADHD at age 4. Both the doctor and I opted to wait until my child was in Kindergarten to determine whether or not to prescribe meds. My child is now 6 and I'm convinced that medication is the right way to go, however, I needed time to research and evaluate my child before becoming comfortable with this decision. Good luck! ADHD Mom

Your friend is right to be extremely cautious about medicating a 3-year-old and I applaud her for finding other ways to deal with her son's behavioral issues. A few thoughts: 1) You said the pediatrician wants to medicate because of aggression and flight response. Neither of these is a symptom of ADHD. And aggression, in general, does not improve when ADHD meds are given. Aggression needs to be treated behaviorally (with rewards for not being aggressive, and carefully administered negative consequences when the child is aggressive). 2) Pediatricians who do prescribe meds for ADHD do so because that is their only resource. They can't provide behavioral therapy or other alternatives. Your friend should find a psychologist or psychiatrist, or even a developmental pediatrician, who is not inclined to medicate and can offer other treatment strategies. She could start with the San Francisco Bay Area Center for Cognitive Therapy ( 3) Websites: and Liz O.

Since his mom sees his behavior is ''different'' from other kids in his class, it would be good to help him in whatever way seems best to the family. I think this little boy is very lucky to have people like you looking out for him, and staying on the case, because you want this child to have positive experiences at school in the next several years.

My main point is, you want to avoid the scenario where everyone decides to wait-and-see, and in first grade the child is still hitting a lot and ends up being avoided or in trouble at school. We have one good friend with ADHD, whose behavior is mostly fine, and who is on medication (but is much older than your friend's child.) It has been a lot of work for the parents, but their son is doing well. anon

Po Bronson (''NurtureShock'') has written about the connection between ADHD and sleep disruption caused by snoring and other problems. He says that 25 % of cases of ADHD have been helped by having the child's tonsils removed. Evidently some very serious brain development occurs during certain stages of sleep, and when that sleep is disrupted, it can have long-ranging effects. Lisa in Oakland

Three years old is probably too young to start most medication. I started trying to get my daughter diagnosed when she was about 4 years old. It tool several years just to get hte diagnosis to get medication. Meanwhile I tried auditory processing therapy which did do some good and you might try that for a child under 5 with ADD/ADHD. You might also try cutting out all sugar and certain other foods. Cut out as much television and video and computer games a possible and no TV, etc. for at least a half hour before bedtime to let their brains rest. (This is actually the hardest thing to do because if spouse is in there watching a football game or someone is working on the computer, its very hard to get junior to NOT do the same thing as everyone else in the family.) There are certain neurological stimulation therapies that some clinics do also. I think that normally, most kids won't start medication until age 5 or 6. For most insurances, the diagnosis of ADD/ADHD has to indicate that the problem satrted before they were age seven and rule out any head injuries or other problems. My daughter was in the 4th grade before I got a diagnosis and then I had trouble getting souse on board with the medication. Some kids cannot handle the medication. Some kids recognize that it makes them feel better. Both parents have tobe positive about the medication. By itself, it won't fry your child's brain and studies show that children with ADD/ADHD who are not treated as children are more likely to use drugs and alcohol as adults to ''self medicate.'' I think it is pretty well accepted that most people do not ''outgrow'' ADD/ADHD. Some people just learn to handle it better as they get older. Others need medication throughout their life. It is also familial. So medication - if the child can tolerate it - is a good thing if other avenues don't work but its also important to get them started early because once those kids hit middle school things get really tough. I think 4 to 5 years old is the best time to start medication - you could wait until part way through Kgarten to see if adding medication improves his attention and behaviour in that environment so that you have a basis to go by. parent of ADD child

Has anyone thought about speech and language processing issues in this child? I would at least suggest a consult with a Speech and Language Pathologist. Frustrated communication can manifest in behaviors like this. There was lots of good food for thought in the other posts. Linda

2007 - 2009 Advice

Inattentive ADD in School-aged Kids

Oct 2009

I am looking for references for Inattentive ADD. Any good books, resources in our community, etc? Advice on getting public school to work with child? Any success using supplements and diet restrictions to aid child's ability to work with issue (s)? Thanks Juliette

My son has inattentive ADD. It's like a very interesting movie is playing inside his head all the time. As a result, he does not hear his family talking to him, the teacher talking to him, he can't follow the steps in a board game or a game of baseball, he has a hard time interacting with other kids. He is just not present. We got a lot of insight about this type of ADD from a developmental pediatrician in Orinda, Dr. Marianna Eraklis. After consodering all our options, we decided to try Ritalin for our son, and we have been very pleased with the results. He is playing on a sports team for the first time this year, we can have family conversations now, and his academic work has shown an incredible improvement - he caught up quickly once he was able to focus. I would really recommend that you consult with one of the developmental pedi's in the area - there are many excellent ones. Good luck -

I expect you will hear from many parents with ideas on this, so I will be brief. Two great books to start with are: Delivered from Distraction by Hallowell and Ratey, and Spark by Ratey. CHADD is a good national organization with local referrals. Omega 3s are helpful, but not a magic bullet. I'm happy to talk with you more if you like. ck

Last year, after our 9-year-old daughter was flagged by her teacher as having processing/attention/learning issues, I saw a BPN posting about a research study, conducted jointly by UCSF and UC Berkeley, looking at exactly what you're asking about: ADD without the hyperactivity. The study is called ''CLAS'' for Child Life and Attention Skills.

As part of the application process, our daughter was tested (for free!!), and it was confirmed that she did have inattentive ADD. Then we were randomly assigned to a small group with whom we met on a weekly basis. The meetings were facilitated by a CLAS staff member (Ph.D.) who introduced several very specific strategies designed to help children with inattentive ADD. We tried the strategies, came back together and talked about how it was going. We got to know and compare notes with the other parents. We were able to get suggestions from the researchers tailored to our specific circumstances. Last, but not least, the project actively involved our child's teacher, and she got paid for her time! It was an excellent experience for us. We are continuing to use the materials and strategies at home and with this year's teacher.

CLAS is a 4-year study, and they recruit a new group of participants each year. (Last year was the first year.) You can contact the Project Coordinator, Adriana Nevado, about possibly joining this school year. Her number is 510-643-3437. Be aware that families are randomly assigned to one of three groups; one is the control group which receives little to no information or support. B.

Binocular Vision Test & ADD

March 2009

Has anyone taken their child to UC Berkeley's School of Optometry for a Binocular Vision Test recently? Planning to take my 6yr old daughter there. Her school had a doctor from UC Berkeley who did the eye exam and had mentioned about Binocular Vision. I've taken her to my regular eye doctor, who said she was fine. She?s not doing academically well in school, so trying to see if there's any relation in vision. I took her to the doctor and was diagnosed with ADD, just by the questionnaire completed by the parent and her 1st grade teacher. That?s it? Just by a questionnaire? Does anyone know what other tests there to test her? I?m not sure what direction I should start looking into. I've written an email to her principal to see if the school psychologist can give her a test. My daughter now freaks out when you tell her to do homework and hates school. She use to love preschool & most of Kindergarten. Sylvia

My son was also referred to have the binocular vision testing done when he was about 6. His teachers at school suggested he be evaluated because he wasn't doing well academically. The binocular vision testing was part of a larger diagnostic work up (he was ultimately diagnosed with ADD).

The binocular vision testing is very thorough and somewhat exhaustive at UCB, and they have a pleasant manner. The multiple tests look for any problems with visual perception. My son tolerated the tests well, as UCB works well with kids. Good luck

I took my daughter to the UCB Binocular Vision Clinic two years ago. I was very impressed with the process and the recommendation they made. My daughter is a good student who's a terrible speller. They found her to be perfectly normal with no vision or attention issues. I also took her to the Linda Moode Belle center in Berkeley. It was probably overkill but I felt like I had dotted the i's and crossed the t's when I had both opinions. Best of luck to you

My son, age 10, just finished testing at UC Binocular Vision. They found all of the same issues his ed therapist had found. We are in the process of getting testing done through the school district. Once we have that report we'll go back to UC to begin therapy. The supervising professor at UC encouraged us to wait so that we wouldn't have to pay for them to do certain tests or initiate therapies that would be done/included by the school. Unfortunately that clinic is incredibly busy... we had to wait more than two months to get in initially, and had basically no choice with regard to day or time. Also, this is the second time we've gone through testing there. The first time was three years ago and the results were ''normal'' however I got the impression from the professor we worked with this time that the screening done on the weekend (when we went) is less thorough than that done on the weekdays. Perhaps some of his issues would have been caught sooner if we'd done screening on a different day, but honestly I think he was too young then for any of the screening to be effective. There is a huge range of what is developmentally normal at 5,6 and 7. It's just really hard to tell if there is a learning disability or if the problem is attention, or if the kid just isn't ready yet, but will be in six months. My son was within normal ranges for almost all of the tests he did, including those with an audiologist and testing done by a private ed psychologist... it wasn't until late in second grade that we were able to get any real diagnosis from any testing.

As for ADD... it is not uncommon for children to be diagnosed using no other measures than a survey. Sometimes if it is done by a school psychologist the child is also observed in class. I've spoken to one who recommends brain scans, though I haven't had a chance to persue how one would get that done. We waited about two years to do anything about our son's diagnosis... it seemed arbitrary at the time, borderline at best. The psychologist who presented the results had no credibility since she couldn't even read the graph to us correctly... So we decided to wait and see. This year it became obvious that the other kids aren't ''just like him''. It was impacting him socially and acadmically and really hurting his self esteem, and since we'd tried addressing evey other issue we decided to start medication... it has made a world of difference already and we aren't even through experimenting wiht dosage to see what is best. Still trying to figure it out

I took my son to the binocular vision clinic, where they found trouble with his horizontal tracking. We worked with a piece of software, and over a period of a few months, his tracking became much better, and his reading improved quite a bit. Shortly thereafter, he began to enjoy to read. I don't know how much of that was him developing, and how much of that was the help with tracking -- but it certainly didn't hurt, and it wasn't that expensive.

With regard to ADD, just a couple of questionnaires seems like an incomplete diagnosis. That would work as a screening test -- saying that your child needed further evaluation, but not as a complete diagnostic tool. It seems like you might want to consult with a developmental pediatrician, developmental psychologist, and/or the school psychology team at your school (you can get an evaluation through your public school by formally requesting it, and I believe it must occur within 60 days of the request). They usually do a very thorough testing of your child, including IQ tests, academic tests, classroom observations, as well as questionnaires.

In terms of your child hating school, some of it may be a mismatch between how she learns and the teacher. You might want to do some talking to other parents who have spent time in the classroom to see if there's been any friction between your child and this teacher. My child had trouble with the teacher in one particular grade, and it was a total nightmare, for him and me. Since then, however, he has done very well, loved school and the teachers, and all has been well. Karen

ADD or just 7-year-old phase?

Jan 2008

My 7-year old son has always been ahead on the learning curve, was an early reader, has great fine motor skills, and good focus. Recently, however, he has been having trouble comprehending instructions at school and at home, and can't seem to focus on any school related tasks (he does fine when playing). He is struggling in school and with homework, and seems to be forgetting even the simple things he has known for years. His teacher is concerned that he has ADD. However, he can focus intensely for long periods when doing legos, drawing, or doing other non-academic activities. I get frustrated helping him, because it seems like no matter what I say to help him he doesn\xc2\x92t grasp it (and being frustrated with him clearly doesn't help him). Should I be concerned or is this just a 7 year old phase? confused and concerned

I am a first grade teacher and see that many boys have ADD-like symptoms in this age group which disappear later. This observation comes from many years of experience. In my first years of teaching I would overreact to things because I had not seen enough children over long periods of time to know any better. I would refer kids to testing and nothing would come of it but that they were in a phase, just as you suspected. How many years has your son's teacher been teaching? Has she administered any testing for him? Has he been referred to any specialists? If she is making off-the-cuff remarks to you during conferences or in passing w/o back up data, this is a BIG no no. You never should say anything like this to parents if you have not gone through the necessary steps schools have in place for correctly diagnosing learning disorders like ADD first, then the parents should be involved in every step of the process for testing , creating individual education plans (iep) etc. If you are concerned, you can go get him tested somewhere on your own. Don't be too concerned....It is probably a phase first grade teacher

I hate to ask this, but have you ruled out boredom at school. If he's far advanced, I imagine he can think circles around most of the kids and probably is his teacher too. School is often not a good fit for the genius and genius's often fare as badly as learning disabled in school. They just get too bored. My husband's mother told him to watch his teacher and pretend that he was listening. He said that helped. I don't know if there are alternative programs for your son, or different school possiblities? Good luck

ADD or is school just really boring? It's numbing to be told what to do and when to do it for 6 hours a day, constantly supervised, constantly corrected. Perhaps it's deadening his spark. You did say that his attention is just fine when he's interested in the task at hand. I'd stick with that observation and ask the school to change, not him. The only other question I'd ask is, ''Is he depressed about something?'' Best of luck, Elisa

Is your son getting enough sleep? Maybe his sleep needs have changed and he needs more. Our very bright son went through a similar phase, we were puzzled but realized suddenly one day his sleep had been getting disrupted on a regular basis. We made his sleep a priority - in second grade he would go to bed at 7:30 p.m. and sleep til 7 a.m. - and things turned around literally in a couple of days. My boy needs his sleep

6-year-old shows signs of ADD - how to help him?

Sept 2007

I have a wonderful little boy who just turned 6. Since he was in preschool teachers have been quick to mention they think he has ADD. I've been reluctant to jump to this conclusion because of his age. Boys tend to mature slower and be impulsive. I spent some time volunteering in his Kindgergarten class and quickly noticed that my son was not as ''engaged'' during reading time when the teacher was talking or singing, had a hard time staying focused on his work, and was doing very poorly at socializing. I had some talks with his pediatrician over the symptoms and even though they do not generally diagnose them until they are 8 he is showing signs of ADHD. Here is where I am stuck. He is 6. He is a boy. He is above grade level in math and reading. So, there is not a learning disability, but he is really struggling with his actions (he tends to have poor impulse control), his transitions in the class are very difficult for him, he keeps telling me that ''he was in class and his mind made him think of (insert 50 random things here)'' and that he struggles with concentrating. I was amazed that he was able to communicate that with me. Although, it means that it was on his mind too. I'm careful not to mention things in front of him. I don't like labels, and I don't want him to label himself either. I want to know what I can do to help him, but not overhelp him. I'm not sure if he needs a 504 plan. I'm afraid of him getting labeled and having that carry over and the teachers discriminating against him because of it. Or, him being singled out in some way and not feeling like part of the class. I'm really confused because, having not been through this before I have no idea what to expect, what works, or what else to try. This is where I plead for help. Any advice will be consumed and devoured. I want to be my child's advocate. I love him dearly and want him to succeed in life. It just takes one step at a time. eastbaymom

Hi there, I almost feel like this post is a flash forward for me! My boy sounds very similar to yours in terms of poor impulse control. Tack on trouble with transitions and its him to a tee. Anyway, mine is still in preschool, with another year to go before K, but we already see that his social/behavioral maturity level is a little delayed - not ADD or ADHD, just not what teachers want in school. Academically he's above average.

Anyway, so we took him to see a developmental pediatrician whose advice to us was to hold him back from Kindergarten or have him do it twice, so that he could catch up developmentally to where he is intellectually before he hits 1st grade. We don't want to hold him back or have him repeat K twice, so we're exploring a middle ground - montessori. Montessori schools don't have grade levels per se, and the curriculum is child centered. This means that the teacher will assess my child and provide him with curriula that challenges and interests him. It also means that if he has to do an extra year of school before Kindergarten, it won't be weird for him. He won't be held back while the rest of his friends go off to the next grade.

I wish you well and good job for trying to figure out alternatives to having your child diagnosed with a learning disability - especially since it's possible that he just needs a little more time to catch up socially. anon

So many of us have been right where you are and can relate. I will get right to some quick advice. (I have a 12 year old ADHD boy and a 10 year old year with ADD).

By the age of six, you can certainly have him tested. This is really the first and most important step. A professional can sort through the difference between ADHD and just a ''boy.'' In our case, it was very clear cut and almost off the charts. We retested at age 9 with a different person and same results. In our case, medication was and is essential for daily functioning. There is so much to read and so many options. Medication isn't the only option, but it is often a part of an overall solution. My son really didn't know a label until quite recently.

However, we have worked with his teachers very successfully since 1st grade and they have known of the diagnosis. Overall, better for them to know and work with it than not (although I struggle with the same concern of labeling).

If it turns out that he does have it, there is lots of help out there for both of you. They say one out of nine kids may have this. Maybe environmental? In our case, both the dad and grandmother clearly have it, so genetics is at play.

My main advice, get into the subject. Find out what he really has and then you can create your game plan. Good luck! Anonymous

My daughter has almost the exact same symptoms, is a high scorer in math and reading, etc. She is now 9. We've been dealing with all of this since age 3. I am reluctant to put her on medication but her distratability and inability to sit still is affecting her school work. This is what I did. I spoke to our naturopath and we decided to do neurotransmitter testing on my daughter through NeuroScience. It was just a urine test. It took 3 weeks to process and we found out that she has some fairly serious imbalances. She's on 3 different supplements and the difference is amazing. It's not fixed yet, but we are closer. She can now sit down and pay attention for much longer periods of time. Her self esteem is coming up a lot as well. The other thing I did was I found her an accelerated program at school. The whole school is an accelerated program (I changed her schools). They move much faster than a traditional school and she is doing SO well. She's never bored in school (do you hear that?) and she likes going to school. Those two changes have made all the difference in the world! Paula

I would start with an assessment. Once you have some more specific information about what is (or isn't) going on with your child, you can figure out what the best course is.

I've been through this with both of my kids -- it's expensive, but well worth it. My son was also 6 when issues arose, we had him evaluated, it was ADHD plus other things. My daughter was also evaluated a couple of years later -- no syndromes, but we got great input from the psychologist on how to parent this particular child.

I would recommend Dr. Carina Grandison (sp?) at Children's Hospital (she evaluated our daughter). anon

Your son and your concerns sound a lot like mine. My son had behaviorial and social difficulty at the same age. I struggled to figure out what to do. And, I was concerned about having my son pulled out of class and labeled.

After numerous discussions with our pediatrician, we took our son to a developmental pediatrician for evaluation. Honestly, this wasn't terribly helpful and cost a lot. We learned our son has some of the qualities of ADHD and Aspergers kids, but did not receive a firm diagnosis - he's borderline. The pediatrician confirmed our concerns and observations about our son, but didn't add much to our understanding of his behavior or approaches to handling it. Although, she did make us aware that impulsivity is an element of ADHD and can contribute to social difficulties.

We ended up having our son assessed by our public school speech therapist (for language pragmatics/social skills) and occupational therapist. Some of the assessment was observation or in-class and some out of class. The speech therapist worked to minimize the loss of class time. The kids in his class don't seem to view visits with the speech therapist in a negative light. The results of the assessment and IEP were not surprising, but thorough and provided measurable goals. My child was recommended for the gifted and talented program and other services to address his social difficulties. We weren't pressured to accept any services. I am finding that the assessment and IEP are a good place for us to start conversations with my son's teachers. They lend legitimacy to the idea that my child needs support socially and behaviorally. I spoke with a number of teachers about the possibility of stigmatizing my son by putting him into the school evaluation system. They all felt that he would not be harmed or stigmatized by the process and so far, that has been our experience. Overall, I'm happy with the public school process and found our speech therapist to be a good advocate for our child.

We also are planning to have our son attend a private social skills group this year. They do their own assessment of your child. Although we haven't started the weekly classes, I have been thinking that I wish we would have started with this approach. They would have told us if he needs more, less, or different help. And, we would have started working to build social and behavioral skills immediately instead of doing so much evaluation. Good luck. Anonymous

The results of a large study was just described recently in the New York Times. Kids who ingest artificial colors and preservatives in foods demonstrated hyperactive activity like ADHD afterwards. Try eliminating processed foods like this, especially in his lunch. He sounds like a bright boy. It may help control his moods and behavior. The article is here: Good luck!

I'm responding as both a psychotherapist and an adult with ADD. While it is totally understandable that you don't want him labeled, without help he will have unneeded difficulties. It's important that your son receive the adjustments that will help with his attention difficulties. A good book to start with is ''Delivered from Distraction.'' I also recommend MarRem Remington, a psychotherapist in Oakland who has a background in special ed and specializes in assessments and consultations as needed with schools. Parents are fully involving in the process and she has many helpful suggestions for home and school. Her # is 510-835-4357. Suggestions

Has anyone heard of inattentive ADD disorder?

Jan 2007

I was in my salon the other day and spoke with someone who has a daughter with the same type of problems as my daughter. some were your typical, but some hit right on the mark. She said her daughter was tested and was found to have inattentive ADD disorder. She was givin meds and went from a majority of D's on her report card to A'S. Any input or Recommended physicians who specialize in this hard to detect type of ADD. Ray

Clearwater Counseling and Assessment Services, in Oakland, offers comprehensive psychological ADD evaluations, which include a school observation, for quite reasonable fees. Attention Deficit Disorder is not a medical condition, and it is best assessed by a psychologist rather than a medical doctor, although of course an MD needs to prescribe any recommended medications. Often, symptoms of ADD can be treated behaviorally, with medication added only if there isn't satisfactory progress using behavioral interventions alone. Visit Clearwater's website: or call Dr. Sharon Witkin at 596-8137 for more information. Sally

ADD is a medical disorder that has a higher genetic basis than any of the other psychiatric disorders (including schizophrenia) and is primarily treated with medications. I am a psychiatrist who treats UC Berkeley students with attention deficit disorder. ADD can be with hyperactivity and/or impulsivity but these are not necessary for the diagnosis. The inability to focus must begin before age 7 and interfer with two areas of functioning such as school, home life and social skills. For children the treatment of choice is medications and this is provided by pediatricians and child psychiatrists. Educating the family and teachers how to work with the child and tutoring as needed to keep the child up to grade level are also important. For adolescents and adults treatment choices include medications and cognitive behavior therapy. Depression, anxiety, substance abuse, bipolar disorder and post traumatic stress disorder are sometimes co-morbid with ADD so the treatment of people with ADD is usually complex. anon

In the work I do we have a different perspective on ADD. ADD, whether inattentive or hyperactive, stands for ''attention deficit disorder.'' It implies that there is a lack of attention. What if there was actually plenty of attention and it was just being paid to something other than the outward task at hand? We all have priorities, what we pay attention to first, and our neurological system is no different. We will all make sure we are safe and protected before we deal with anything else. If a person's tactile system is particularly sensitive it might be painful to sit in a chair to focus on the lesson in class, therefore they might squirm to stop the pain in order to pay attention to the lesson. Likewise, if auditory or visual systems do not give clear information, a person might ''space out'' in order to attempt to make sense of what is going on.Meanwhile they miss pieces and look like they are not paying attention. Ever have a difficult time understanding a speaker and get stuck trying to figure out what they said and by the time you do the speaker has gone on and you are completely lost? You weren't being inattentive - you weren't able to attend to what they were saying until you could decipher that. It would surely affect your functioning if this happened all the time! Inefficient or disorganized neurological systems work harder to give messages that make sense to the brain. Perhaps a more accurate name for this situation would be APD or ''attention priority disorder.'' Once the neurological system is organized the priorities shift and the person can more readily attend to the outer world. If this perspective intrigues you, please contact me at 925-934-3500 and we can discuss it. You can also learn more about this approach, called the HANDLE perspective at Best of luck as you look into this complex subject. Sindy

I'm a Berkeley psychotherapist working mainly with teens who have learning disorders of one kind or another. Many of my clients have Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD comes in two varieties. There is ADHD, Predominantly Hyperactive/Impulsive Type, and there is ADHD, Predominantly Inattentive Type. Most specialists now consider the Inattentive Type of ADHD to be a different disorder altogether, not just a sub-type. ADHDI (as it's often called) is hard to diagnose, because people with ADHDI don't show outward signs of distractibility; that is, they don't jump up and down, wiggle, tap pencils, interrupt people, talk ceaselessly, and so forth. They may appear to be quite calm, composed, and focused; but inside, their minds may be racing aimlessly from one thought to another. They are highly distractible: so much so, that they often don't seem to hear what is said to them or to be aware of what's happening around them. They find it hard to get started on projects or complete them. They do things quite slowly; overall they are characterized by what some experts call ''sluggish cognitive tempo.'' In moments of stress they may slow down rather than speed up; occasionally people with ADHDI may even fall asleep during important final exams. Obviously this kind of ADHD can produce severe academic problems, though it isn't as likely to produce disciplinary problems as the other type. I hope you'll find this very basic information helpful. Please let me know if you have questions. Caroline

I expected to see tons of answers to this question, so I held off, but so far the only replies have come from therapists; nothing from parents! Yes, I have indeed heard of inattentive ADHD -- we've been living with it for a long time... ADHD comes in 3 flavors: primarily hyperactive-impulsive, primarily inattentive, and combined. Before you settle down with any particular therapist or doctor with any particular approach, you may just want to get some basic information. There are so many good websites, but here are a few that I have found helpful: CHADD.ORG - extensive information about all aspects of ADHD; some very good basic information sheets. MEDLINEPLUS.GOV - National Institutes of Health (I think...); very authoritative and reputabile; just search on ADHD SCHWABLEARNING.ORG - lots of very informative articles on ADHD, as well as on other learning difficulties. I hope this helps. anonymous

2004 - 2006 Advice

Attention Deficit in 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 reapeatedly 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 throught 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: 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. 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: 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


Sept 2004

Is an IEP appropriate for a 7 year old child just diagnoised with AD/HD? Should I request an IEP from the school? We have not yet tried drugs, but I want to get more information before we try them. I wonder if the school/teacher would give him more attention if he has an IEP in place, or if this would lable him. ANy help is really appreciated. Thanks. Mom

As a parent of a teenager who also was told in Kindergarden that he needed an IEP, I would say to hold off as long as possible. Schools often try to insist on an IEP to put your child in Special Educ. classes, which he probably doesn't need, and where, unless he is extremely slow, he won't learn much. The reason they do this is because they get much additional funding for everyone they put into Special Educ. Putting my son, at the teacher's recommendation, into a special educ. class, even though it was only for a semester, was the worst thing I ever did to him, and put him behind. He is now a h.s. sophomore and doing fine with the regular curriculum because I worked with him at home every evening (he has ADD & is dyslexic, etc.) and kept him out of special educ. They are still requesting an IEP for him, but at this point, I think it would do more harm than good. Don't do it! a former teacher

How is your child doing in school? Is the ADHD adversly affecting his academics, behavior, or social emotional well being? Ask the teacher how he is doing. Ask her/him if you can have a Student Study Team regarding this current diagnosis. A Student Study Team (SST) is (hopefully) made up of a school psychologist, the principal, the Resource Specialist, the classroom teacher, the parents, and possibly others. Here is where you talk about the childs strengths, get/give some information, discuss the concerns, what are some modifications/ accommodations, and make a plan. It may come up that he is showing some significant learning issues that may warrent further testing for an IEP. If not, and you still think you want something more that lists accommodations given in the classroom you can then request a 504 Plan.This is an Accommodation Plan for all students having (usually) health issues that are interfering with their learning. It is not special education but under the Office of Civil Rights. Let me know if you have any problems or more questions. Liz

ADHD itself is not a sufficient reason for an IEP. It is generally not considered to be a qualifier for special education unless it is impacting your child's learning significantly. Generally this is defined as being at least two years below grade level in one or more subject areas. Also, there has to be a discrepancy between ability and performance i.e. if the child is demonstrating an average or above average IQ and has standardized test scores significantly lower than what they should be then he or she might qualify for special education. You can request testing for an IEP but be aware that you are requesting testing for your child to be placed in special education and that you may not want to do that unless your child really has a learning disability. However, if you feel that your child does have a learning disability along with the ADHD and is not getting the necessary help in class then looking into testing would be the thing to do. Many schools will hesitate to test a child who is in first grade or below, but if the parent requests testing they have to comply. However, you can't request that your child have an IEP- only that he be tested for the school to determine whether or not he will qualify for one. Hope this helps and good luck!

A diagnosis of ADHD does not make your child eligible for an IEP. Only students with one (or more) of the 13 disabilities recognized by the Individuals with Disabilities Education Act may receive special education services. So, unless your child has another disability (such as a learning disability, which often occurs concomitantly with ADHD), an IEP is out of the question.

He is, however, eligible for services under section 504 of the Rehabilitation Act (which is a Civil Rights act that deals with access). Called a 504 Plan, this plan is a program of instructional services to assists students with special needs (who don\xc3\x82\xc2\x92t qualify for special education) in the regular education classroom. The plan should detail strategies for helping you child be more successful in his classroom setting. It may include things like: quiet room for testing, seating close to the teacher or away from distractions, assignment modification, etc. Since anyone can begin the referral process for a 504 Plan, I suggest you make a request in writing to the school district/school asking for a 504 Plan referral. In your request, mention the ADHD diagnosis and include a written record from the physician, neurologist, psychologist or other expert who made the diagnosis. Hopefully, the school will comply and ask you to be a part of the process. At the 504 Plan meting, you would offer your suggestions for what would help your child be more successful. Here\xc3\x82\xc2\x92s a link with some more information about 504 Plans.

Medication should ALWAYS be a last resort \xc3\x82\xc2\x96 something you try when you\xc3\x82\xc2\x92ve tried everything else and your child is still not meeting with success. Many teachers and administrators will suggest medication because it\xc3\x82\xc2\x92s easier than trying to implement behavior plans and educational plans and doesn\xc3\x82\xc2\x92t cost the school district anything. As a special educator, I know how important and therapeutic meds are for some kids. But it\xc3\x82\xc2\x92s important to explore all other options.

Finally, I understand your concern about labels. Our culture is very quick to identify someone with a label. Some labels are good, though. Your reaction to your child\xc3\x82\xc2\x92s ADHD will have the most impact on how it is perceived. It is important to get your child the help he needs so that he can be a success \xc3\x82\xc2\x96 that\xc3\x82\xc2\x92s the label you want for him. Be honest, open and loving about his ADHD and help him understand how it makes him unique. Begin to teach him now how to advocate for himself. And by all means, don\xc3\x82\xc2\x92t let a thing like a label prevent you from getting him what he needs. You\xc3\x82\xc2\x92re his voice until he\xc3\x82\xc2\x92s able to have one himself. Good luck! shari

I would like to comment on previous responses to this request for advice. They all had useful information and good advice, but there were also things that weren\xc3\x82\xc2\x92t quite right or partly right. I\xc3\x82\xc2\x92m not disputing anyone\xc3\x82\xc2\x92s personal experience, but adding clarification about the law.

''Schools often try to insist on an IEP to put your child in Special Educ. classes, which he probably doesn't need, and where, unless he is extremely slow, he won't learn much. The reason they do this is because they get much additional funding for everyone they put into Special Educ.''

It is true that districts receive money for each special education student, however, the grants for special education don\xc3\x82\xc2\x92t begin to approach the costs; districts and general ed parents complain that special education ''encroaches'' (the word makes me cringe) on the general fund.

The Individuals with Disabilities Education Act [IDEA] requires that students be educated in the ''least restrictive environment,'' which is the general ed classroom for the large majority. The school is not likely to place a student in a ''special day class'' unless he or she really belongs there. A kid of average intelligence with ADHD, with or without learning disabilities, would not be placed in SDC without some severe behavioral problems, for example.

''Only students with one (or more) of the 13 disabilities recognized by the Individuals with Disabilities Education Act may receive special education services. So, unless your child has another disability (such as a learning disability, which often occurs concomitantly with ADHD), an IEP is out of the question.''

ADHD is expressly considered a qualifying condition, usually as Other Health Impaired without other problems. It was added to IDEA in 1999 because a lot of IEP teams didn't realize that it could fit the definition of OHI without being named. A couple of people noted that ADHD has to adversely affect the student\xc3\x82\xc2\x92s educational performance (which is more than grades) to be a qualifying condition for special education, and that is exactly true. All the other eligibility categories require the same criterion, that to benefit from school, the condition has to adversely affect the child\xc3\x82\xc2\x92s performance *and* the child needs special education to address the problem. OHI students do not have to demonstrate a discrepancy, though students with learning disabilities must, but California does not require a student be two years behind, as someone suggested. Absent needing special education remediation and support, 504 accommodations may cover what the student needs, and either family or school may request evaluation for special ed or 504.

Regarding medication, one person wrote that \xc3\x82\xc2\x93Medication should ALWAYS be a last resort - something you try when you've tried everything else and your child is still not meeting with success.\xc3\x82\xc2\x94

That\xc3\x82\xc2\x92s one opinion. I have seen many, many families grapple with the difficult issue of medication. Another view might say that parents may not want their child to have met failure in everything they\xc3\x82\xc2\x92ve tried before trying medication, which after all, is not an irrevocable decision. That\xc3\x82\xc2\x92s between the doctor and the family. The school can never demand that a child be medicated, though in my opinion it\xc3\x82\xc2\x92s not out of line for a caring teacher to say something like, \xc3\x82\xc2\x93Have you thought of consulting your doctor about medication? Other people might say that a teacher should never mention medication because they aren't professionally qualified to diagnose and treat, and that they\xc3\x82\xc2\x92d be seen to be doing it for their own ends, in order to have a compliant student.

Sorry this was so long, and I hope it made some things clearer. Dana Lear, DrPH Negotiating the Maze Special Education Advocacy, Research, Support

7 yo with ADHD & learning disbilities

Sept 2004

My son is far behind others in reading, spelling and comprehension as he enters second grade (good oakland public school). We have had various tests done, and while he is quite bright, he displays some processing disabilities and mild adhd behaviors. We are wading through all issues, including IEP, behavior counseling, Ann Martin tutoring, Lindamood Bell, further more specific tests on learning. Can anyone offer advice based on their experience? I am looking for experienced professionals who can help us with behavior training (us and him!) and tutoring at our home. We feel by starting early we can get a handle on this, but we would really benefit from some expert advice. Concerned mom

I would be happy to discuss this with you. I'm an Oakland parent with an almost 9-year old who has been receiving services from the district for 5 years. He initially presented with a language delay - still the crux of his problem - but he currently has the most trouble with learning behaviors if in a standard classroom. We tried having him in his local school, but after only 2 months it became a nightmare for him. He's now in a non-public placement with a very small class size and a functional behavior based model, and he's doing incredibly well - testing right at grade level, actually finished 2nd grade in less than a school year. But put him in a class with 20 kids and he dissolves. I think the list of ideas for you to try would be too long to burden this email list. If you want to email me we can discuss offline. Regards Nancy

2003 & Earlier

ADHD and T.V.?

Feb 2002

Have any of you ever heard the idea that too much T.V. can be linked to development of AD/HD? I'm particularly wondering if any of you have read anything by T. Berry Brazelton or Matthew Dumont that supports this idea. Also, does anyone know, have any independent, verifiable, double-blind (i.e. scientific method) studies shown any link between AD/HD and T.V.? Colleen

I am a research psychologist at UC Berkeley specializing in the study of behavior disorders in children and I've worked extensively on 2 studies of ADHD in children. I know of no evidence linking TV viewing to ADHD. There is no theoretical reason to believe there would be a link, and certainly no conclusive evidence that this is the case. ''Proving'' that ADHD is caused by TV viewing would require randomly assigning children to either watch TV or to not watch TV for long periods of time. No one could implement a study like this, and no parent I can think of would agree to have their kids watch TV to see if ADHD develops. I am certainly not advocating a lot of TV watching, but there is no reason I know of to believe it causes or is even linked to ADHD. Note however, that there is ample evidence linking the viewing of violent content on TV or in films to aggressive behavior.