[chaotic13]

My kids had physicals today. So my H is repeatedly frustrated with my youngest son (9) and his inability to focus, stay on task, follow more than 1 step instructions, etc. My H is not very kind when providing his medical opinion about my ADHD or our son's ADHD tendencies. Anyway, the physicals seemed to be a good place to make an inquiry regarding getting my son assessed.

The resulting discussion with the physician was less than enlightening. He basically had me fill out a 20 item questionnaire and then based on my answers said he might have an inattentive type of ADHD. He went on to rattle off a bunch of basic Wikipedia type statements to me while making eye contact with only the floor. He offered no real information on how I might proceed with ruling in or out the likelihood of my son having this condition.. At one point he said, "well you can wait until school starts and let his teacher do an assessment of him???" I said... "Hum... well... I don't think I want my child's school to be diagnosing (labeling) my child and determining if he should be medicated or not." The pediatrician then gave me some vague statements about potential treatment options including experimenting with medications and a reward system for addressing bad behavior. At that point I held up my hand and said.... "I never said he had a behavior problem. You just assumed that misbehavior was an issue." "The whole reason for me raising this issue is because I want an assessment to determine what his REAL challenges are and to design an appropriate plan for dealing with them."

That is exactly the stereotype that I want to avoid. My son has a problem with focusing, is easily distracted, and has trouble finishing tasks. He does not have a behavior problem. He a really good, compliant, kid who does not disrupt or interfere with other children's learning. After making this point clear, I asked for a referral and left.

It just really pisses me off that even medical professionals seem also be so ignorant.

[sunrise]

chaotic, why do you think the doc answered your questions while looking at the floor? Is he embarrassed to be discussing ADHD? The conversation sounds really unsatisfactory. I think ADHD in kids does require a specialist, so I am glad you got a referral.

[MyBestKids2]

Hi chaotic13,

My son is also 9 and has been diagnosed ODD, ADHD, and depression. His ADHD (inattentive type also) was diagnosed 3 years ago by a county school system psychologist. Of course, it was my decision to take this diagnosis outside of school, and follow up with a psychiatrist and therapist. Medications and counseling have helped him greatly, and we even currently have a once a week in-home team.

I'm so glad you have the referral! Please keep us updated.

Take care,
Dee

[chaotic13]

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sunrise said:
chaotic, why do you think the doc answered your questions while looking at the floor?

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I don't know? It seemed like he was reading from some mental script playing in his head. He was clearly not very knowledgeable about ADHD. I think he tried to pretend to be the all knowing physician, then realized that I wanted more than just to complete a 20-item questionnaire and have him say.. 'he could possibly have a problem' let the school system handle it.

I think what up set me the most is that my son was in the room when I talked about this. Even though I was really positive, highlighted how great of a kid he is, how hard he was working, and how smart he is, I think I embarrassed him by mentioning some of the things he struggles with. It was only when the doctor implied that he was a bad kid who needed to be given external rewards, that I realize I had mistakenly entered into this discussion with the wrong profession. Instead of showing my son that I was really proud of all the successes and was just wanting look for some better ways to support him. I accidentally conveyed to my son that there was something wrong with him and when you seek some help, people judge you as being bad.

I guess today I just wish I had just said, "NO" when the pediatrician asked if I had any concerns at this time. I just blew it and need to do a better job of insuring that my son gets the message that: just because you struggle with something doesn't make you bad or defective.

[chaotic13]

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His ADHD (inattentive type also) was diagnosed 3 years ago by a county school system psychologist.

</div></font></blockquote><font class="post">

Mybestkids2 I know the school system deals with this issue a lot and at least in the US its mission has changed from educating the workforce to now providing and distributing medical and social services. In a quality system, the could be great benefit from having these services working together. Unfortunately, this system is poorly funded and managed by a bunch of bean counters who are only concerned with $ and test scores. These are not the people I want deciding what is in my child's best interest. In my district they start tracking kids "officially" tracking kids starting in the 2nd grade. As an educator myself, I view this is as outrageous and view this as a lose-lose situation for all ability levels. American's are delusional if we think we have no cast system.

Maybe my own background and paranoia is skewing my perspective in this situation. My preferred approach is to hire and work with a specialist to fully assess if his issues are significant enough to warrant medical treatment. If not, then I will continue to help him create a life and learning environment that can help him maximize his potential. I just don't want to look back 10 yrs from now and say... I should have done more to help him.

[MyBestKids2]

Wishing only the best for you and your family

[Perna]

It's unfortunate you were disappointed in your pediatritian; it sounds like what you wanted was confirmation (which you got) that he might have adhd and a referral to a specialist. I don't think the pediatritian would have been the one to make the determination for sure. They're generalists, not specialists.

I do think some of your issues may be getting in the way as "behavioral problems" is not a bad thing. If he does not complete tasks, that's a behavioral problem for some people as opposed to an indication of adhd! That's why the doctor offered a behavioral/reward response. There's no hard and fast way to determine if your son needs meds. No doctor is going to look inside his head and say, "Aha! I see where the problem is and have the exact med to solve it". You might want to go with him to a children's behavioral therapist and together work on some non-medical ways to see if you can help him learn to focus, pay attention, and complete tasks; those are behaviors and all behaviors can be learned! Whether or not meds might help is an "additional" thing to consider after trying some regular things.

But presumably if the school sees attention problems like you have described, they too could help teach him skills and learn to stay on track (since he's there the majority of his day and that's what they are in business to do) and if those don't work, a child psychiatrist/specialist could add meds and see if they help. But no matter what a specialist concludes, the school will probably be involved in some way to help your son.

[chaotic13]

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I do think some of your issues may be getting in the way as "behavioral problems" is not a bad thing.

</div></font></blockquote><font class="post">
Are you saying I might have been a bit "reactive" to his use of behavioral problems?

[Simcha]

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chaotic13 said:
My kids had physicals today. So my H is repeatedly frustrated with my youngest son (9) and his inability to focus, stay on task, follow more than 1 step instructions, etc. My H is not very kind when providing his medical opinion about my ADHD or our son's ADHD tendencies. Anyway, the physicals seemed to be a good place to make an inquiry regarding getting my son assessed.

The resulting discussion with the physician was less than enlightening. He basically had me fill out a 20 item questionnaire and then based on my answers said he might have an inattentive type of ADHD. He went on to rattle off a bunch of basic Wikipedia type statements to me while making eye contact with only the floor. He offered no real information on how I might proceed with ruling in or out the likelihood of my son having this condition.. At one point he said, "well you can wait until school starts and let his teacher do an assessment of him???" I said... "Hum... well... I don't think I want my child's school to be diagnosing (labeling) my child and determining if he should be medicated or not." The pediatrician then gave me some vague statements about potential treatment options including experimenting with medications and a reward system for addressing bad behavior. At that point I held up my hand and said.... "I never said he had a behavior problem. You just assumed that misbehavior was an issue." "The whole reason for me raising this issue is because I want an assessment to determine what his REAL challenges are and to design an appropriate plan for dealing with them."

That is exactly the stereotype that I want to avoid. My son has a problem with focusing, is easily distracted, and has trouble finishing tasks. He does not have a behavior problem. He a really good, compliant, kid who does not disrupt or interfere with other children's learning. After making this point clear, I asked for a referral and left.

It just really pisses me off that even medical professionals seem also be so ignorant.

</div></font></blockquote><font class="post">Heck, I'd change the pediatrician after that round. There's no way you can trust him to properly assess anything IMO...

That wasn't a proper diagnostic exam... many things can look like ADHD for one, and two, there isn't anything objective about what he did. He was probably ready to medicate your boy in 10 minutes.
Take your boy to a child psychologist. Child psychologists are far better than pediatricians and child psychiatrists at assessing ADHD and in determining treatments. They aren't into simply medicating, but they will refer you to a trusted psychiatrist if you and the child psychologist thinks it necessary.
Teachers are the last people who should be making any kind of psychological assessment on the kid. I would stay away from the referral doctor he gave you, and instead look at your insurance benefits and get another one (if you need a referral at all), but make sure it's a child psychologist, not a PDOC.
How annoying. I hear this all of the time, even in my adult ADHD friends. I even experienced a little of it myself once--and I promptly left that evil psychiatrist. Ack. I hate this kind of ignorance and stereotyping. Scary.

[Simcha]

Don't trust schools to "help" your children with ADHD. Parents are in the best position to help their children succeed, not teachers, administrators, and school counselors.

Please carefully consider letting anyone in the school know that your son has ADHD---- they will be labeled, stereotyped, and forced into a "IEP" or Individual Education Plan. Those really just single out the ADHD children and isolate them with a label. Stigmatization is damaging.

There are varying degrees of severity in ADHD. You as a parent know the child better than the school.

[sunrise]

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chaotic13 said:
[I think what up set me the most is that my son was in the room when I talked about this....

I guess today I just wish I had just said, "NO" when the pediatrician asked if I had any concerns at this time.

</div></font></blockquote><font class="post">
I agree, I think it would have been better to not have this discussion with your son present. No one likes to be "talked about" when they are present. I'm not sure you should have said "no", though, when asked about concerns, since you did have some. You could have said, yes, there is an issue I'd like to talk about sometime, just between adults. Or something like that. Then the two of you could go off to his office and have the discussion without your son present. Or you could call another day to schedule some time with the doc. When I wanted my daughter to be assessed for depression, I conferred with the doctor in advance. She did some diagnostic questioning when I was present, during my daughter's annual physical exam, then had me leave the room and gave her some more questions, normalizing this for my daughter. Then we went home and she called me the next day so we could have a doctor-to-parent talk on the phone, without daughter present. I'm not sure daughter even knew she was being assessed, since the doctor slipped it artfully into the physical exam.

I hope the referral works out. What type of professional was the referral for? I would agree with some of the opinions here--don't start with a pdoc. Their first instinct is to medicate. To start with, could you choose someone with a broader view? Perhaps your son can learn to manage his challenges by other means than meds. I have heard that schools sometimes apply pressure on parents to medicate their kids, especially when class size is large and teachers are stretched thin. Best of luck.

[chaotic13]

The doctor I was referred to is a pediatric neurologist. He only accepts referred patients. His office called me yesterday to set up an EEG. At this point I scheduled the appointment but I have some reservations yet to workout. Jumping right into an EEG test without even meeting the neurologist 1st... I don't know maybe it is considered the same thing as getting an x-ray before begin evaluated by the orthopedist. I just don't want my son thinking something is wrong with him when maybe I am just being hypersensitive. I'm going to have to work through these issues before I subject him to a bunch of testing.