ADHD? Help for my disruptive and talkative daugher!

[Bwo829]

My daughter is 6, almost 7, and in 1st grade. She has always been and wanted to be the center of attention. It was cute when she was 3 but now I am starting to wonder if it is more. She is always getting into trouble at school for excessive talking, distracting others and even saying/doing mean things to other kids in class. She is a great verbal communicator around adults but in a group of kids her age she is clearly behind socially (or advanced I suppose) either way she doesn't fit in. She is constantly talking, moving, butting into conversations, saying inappropriate things (either sarcastic or just off the wall comments) at inappropriate times, and can't sit still. Her teacher says she is on track academically. She does well with homework, her issues is that she gets carried away with herself and makes silly mistakes. But she knows the actual content really well. She also seems to have high anxiety. We recently remodeled our bathroom and she got really upset. She kept saying things like "Why do we have to change it?" or "I liked it the way it is!". This coinsided with episodes of pant wetting, in more than one setting. She still has accidents currently, but it's almost like she forgets she has to go because she gets so distracted. I have read the medical assesments for ADHD and she fits almost ALL the symptoms in each list. I plan on taking further action, but I just feel torn between there being problem and my husband and I needing to be "better" parents. I get so frustrated with her because she in her words "forgets" the rules. She has moments of clarity where she is the most well mannered, sweet girl but most of the time she is just TOO much. It makes family activities or outings really difficult. I am just really confused, even if she gets medically diagnosed, I don't know what that means to me. I know the medications really help some people, but it is strange to think about putting chemicals into my daughter to alter her mood or behavior.

[Rebecca Resnik, PsyD]

Hello,
   the symptoms you describe do sound like ADHD, particularly the impulsivity. Kids with ADHD can also be anxious, so it can be difficult sometimes to tease out the correct diagnosis. Keep in mind that the symptoms you describe could happen for more reasons than just ADHD. I would indeed have her tested, though the school is not likely to want to test her unless her difficulties are having an educational impact. Children who are reasonably bright may not have academic difficulties related to ADHD until about 3rd grade, when the curriculum changes to include multi-step tasks and work that requires sustained attention to task. She should undergo psychological or neuropsychological testing from a doctoral level psychologist or educational specialist.

    As her symptoms and behaviors are interfering with her ability to make friends, use the toilet and participate in family activities, it sounds like seeking psychotherapy will be important. I would ask your pediatrician for a referral to a psychologist who specializes in Parent Management Training or other forms of behavior management. The initial sessions should focus largely on the parents to train you in how to manage her behavior through positive means. She will benefit from individual therapy to learn better coping skills and how to control her impulses. She may also need the emotional support that therapy provides, as it seems that she is struggling. I would be worried long term about her self-esteem.  You can read my Medhelp article on ADHD. Two books you may also find useful are The Kazdin Method by Dr. Alan Kazdin and How to Talk so Kids will Listen and Listen so Kids will Talk by Adele Faber and Elaine Mazlish.

Best Wishes
Rebecca Resnik
Disclaimer: This Medhelp post is written for informational purposes only. It is never intended to replace face-to-face psychological or medical care. This Medhelp post is not inteded to create a patient-cliniican relationship, nor to give or rule out a diagnosis.