ADHD diagnosis but lacking some symptons

[Charo]

My 11 year old was recently diagnosed with ADHD.  He is a quiet, straight A student at school.  The teacher said he is a model student! He pays attention and is focused all the time.  Nevertheless, at home he is a different person.  He is impulsive and hyperactive, ultra sensitive and has a short temper.  He is very good at expressing his thoughts in writing. He has just finished writing a freedom of speech and a short story.  Nevertheless, he has difficulty in expressing his thoughts verbally.  He gets very frustrated when other people don't understand him.  Could he have something else than ADHD or ADHD in addition to a speech disability?  Suggestions of books/articles on this subject would be very helpful.

[Kevin Kennedy, Ph.D.]

Your son's school performance, particularly given his age, makes it unlikely that ADHD is a major feature of his makeup, if it is present at all. Sometimes we see young children who do display ADHD, do well early in school (e.g., first-third grades) in spite of it, and then show more problems as the curriculum demands increase in fourth, fifth grades etc. Do the school personnel suggest that your son has a speech or language problem? It's not likely he could be receiving all A's in school if he has any significant S&L problem, but check with them to see what they think. Also, address a question to whomever diagnosed the ADHD: if the condition is anything but minor in severity, how is he able to succeed at such a high level in school? Now, it's not impossible that the two (i.e, ADHD and good school performance) can go hand-in-han - it's just a bit unusual. Is it being suggested that you try your son on some medication? A several-month trial would be reasonable to see if it is useful.

[Charo]

It is because of his behaviour at home (has a short temper, is ultra-sensitive to criticism and lately wants to hurt himself) that his dad and I took him to see a psychologist who diagnosed him with ADHD and suggested medication.  The psychologist did extensive testing on him (questionnaires and asked my son questions for 4 hours).  My son score on the I.Q. Math part of the test was over the charts but it was average on reading comprehension (my son only took 20% of the I.Q. test.  The psychologist did not think he needed a complete I.Q. test because he said my son was very smart.  He got this information from another psychologist he first treated my son 5 months ago).

I am not a psychologist but I suspect my son might have a learning disability as well as some emotional problems.  His dad got married a year ago (we separated 3 years ago).

I want to make sure my son indeed has ADHD.  I am reluctant to drug kids for a minor problem.

[Kevin Kennedy, Ph.D.]

If your son displays any serious learning disability he would be unable to achieve at such a high level at home. Your description of his behavior indicates that it is his mood, more than his activity level/attention that poses a problem at home. If this is so, he might indeed benefit from medication, and a medication like Wellbutrin could both improve his mood/temper and ameliorate the ADHD-type symptoms you observe at home. You should definitely continue your evaluation/treatment process, and a next reasonable step would be an appointment with a child psychiatrist. The doctor can make his/own observations and also make use of the evaluations that have been completed already.

[Charo]

Thank you for your comments.  My son will be seeing a child psychiatrist in a couple of weeks.  He has already seen two child psychologists: one believed he had oppositional behaviour and the other diagnosed him with ADHD.

[CSkill]

Hello
I am writing because I am curious about the opposing nature of the behaviors described. Your son exhibits one extreme at home, and the other at school.  I would be very careful of jumping to conclude that medication is THE remedy, when it is difficult to even pinpoint the cause of his varying behaviors.  I also think it is wise of you to consult yet another child psychiatrist. Especially for children, answers are not black and white or cut and dry. I wish you the best.

[lol1308]

A related discussion, ADHD was started.

[Lisa40370]

A related discussion, could my son have ADHD was started.