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Avatar universal

ADHD in my 5 year old?

My son is a healthy and smart kid. He does have a VERY mild form of apraxia... which he really has worked hard at... and you can barely notice he had any trouble speaking at all, but really, he didn't start talking until he was 2 1/2. I work in a daycare, so he is easily adjusted to being around kids. He had a speech therapist come out about once a month (it was supposed to be more, but they were all flakes) and a developmental therapist that came once a week to our home. His developmental therapist did awesome work with him and gave us tools to help his speech.

We were told that when he was 3 that the only place he could get speech therapy was a preschool across town. We put him in that school. I knew he was one of the youngest in his class, and I knew he would struggle with his apraxia and connecting to classmates. I didn't know he was having a hard time until we would run into other parents and their kids in stores and I would hear "oh that is Eli, he is a bad kid huh". When I went in to ask his teacher about it, I learned from various aides in the classroom that the teacher is rarely actually IN the class and that Eli spends most of the day in time-out. We pulled him out of that class and just continued to have him go to Daycare with me every day.


He started kindergarten this year at the age of 4. He almost didn't make the cut off. He turned 5 in September.

He had a rough start from the first day. He would fidget and bug the other kids at his table. He would color on their papers or mess with their art. He would refuse to do the activities the other kids were doing. His teacher let him wander around the room because he would cry if she told him to sit. He would get frustrated during Math, so he would start crying and it would get so loud she would have to send him out of the classroom. She said he would get violent and kick the wall. He would run away from the teacher, leave the classroom and run down the hall. Run away from yard duty. And cry... cry loud... so LOUD... mostly they complained about his crying.

We had several meetings with the speech therapist, the principle and the teacher regarding the behavior. After about two months the school asked him to leave because we didn't live in the district and they didn't want to pay for any testing.

We put him in a school in our district hoping it would be a better fit.

He has been at this new school for about a month and a half, and he is having the same problems. The teacher has been teaching for a few years (his last teacher was new, it was her first year). He still cries... all the time. When he cries, he usually says he wants Dad. Or he doesn't say anything. He doesn't stop either. Most kids will wear out in 10-15 minutes. He won't he screams and cries non stop until Dad or I have to pick him up. He stops when we pick him up. He knows why he is in trouble. He is remorseful. He accepts his punishment, though he doesn't want it, and will cry about getting a spanking.

He doesn't run away anymore, and he hasn't kicked walls. He just cries when they do math, or an activity he has trouble with. He does get in trouble for being too wild sometimes, like taking his jacket and swinging it around causing it to hit other kids. Or running when they are suppose to be walking to the play ground. He does have trouble sitting and focusing on work. He doesn't like doing work, he would rather play, so he tries to engage the kids around him to goof around. An aide usually has to sit with him to get him to write out his numbers. He is no longer able to go out for recess because he can't follow playground rules. He does bug other kids... like poking them or going up to them and yelling loud in their face. I really see how he has a hard time relating to other kids his age. I see it at the Daycare I work at and take him to, I also see it at the park and such.

We had a meeting with the school therapist, physiologist, speech therapist, principle and teacher. They really want to work with him and find out what his triggers are. Why he keeps crying all the time. They put him on modified days. He is only in school in the morning for 3 hours.

We took him to his Doctor. She gave us (and his teacher) a Vanderbelt assessment for ADHD. After filling it out, his doctor told us that he could benefit from Ritalin. She wants to start him on the smallest dose and re-***** in two weeks.

I am nervous about starting him on Ritalin at such a young age.

I know what kind of kid my son is. He is a HARD kid. He wears me out. He talks non stop. So many questions and things that he just has to talk about. He is active, but not as active as other ADHD kids I have seen. He isn't a bad kid. He isn't "driven by a motor". He is a big kid, his body movements take up lots of space in the classroom and our small apartment home. He is a compassionate kid. He is the most empathetic kid I have ever met... and I have met LOTS of children... had LOTS of different kinds of children in my daycare and preschool classes I have taught. I have never met a kid that was so interested in the well being of complete strangers. My kid is the kind of kid that hears a song, and can sing it back to you word for word, matching melodies... he can harmonize with anything.

He is no angel... he really drives me bonkers. I know why his teachers are so frustrated with him. Some days his sister and him wake up fighting... he isn't violent... even though his litter sister deserves it, he puts up with her beating up on him.

I see him as an average 5 year old, but I also see that there is something there that he needs help with. Something that he quiet can't do on his own. Maybe it is because he is JUST 5, and he is still making up for lost time with his apraxia. Or maybe he really is ADHD and needs medication.

We have tried incentives to alter behavior. He seems to try more with that. He wants to prize for going a whole day without crying, but simply can not do it. He is aware that he will loose privileges (game-system or playing with a specific toy) and get spankings/time-outs for crying or making poor choices... but it is never enough to alter his attitude. He still cries at school.

It is mostly at school too. In the last year he has cried only once like that at Church, where I had to get him from his Sunday School and take him to big Church with us, but he wanted to be in the class, so he cried. When I brought him back to his class, he cried still... so we left, and he got a spanking and lost game-system privileges.

Then I saw the crying behavior when we were doing family pictures. He just couldn't handle it. He broke down and cried hysterically. He just DID not want to do pictures.

He was born 3 weeks early via c-section due to Hypertension. He was 9lbs 2 ounces though, so he wasn't a tiny baby. He was healthy... and stayed healthy. He couldn't breastfeed because of the apraxia. He really is a healthy kid, and pretty easy going.

I am at loss. Is this ADHD?
7 Responses
5914096 tn?1399922587
Here is the ADHD diagnosis - http://www.cdc.gov/ncbddd/adhd/diagnosis.html.  It sounds as if the doctor feels that it might be ADHD.  If you question the diagnosis, you probably should get a second opinion.
189897 tn?1441130118
COMMUNITY LEADER
  I will have a lot more to add later on once I have read your post over several times.  But, my first thought is that he is very, very young.  Probably the youngest in his class.  You might want to ask the teacher about how he compares age wise to the other kids.
Avatar universal
Thank you for taking the time to read my post.

I have Googled and read and read and Googled until I just couldn't read anymore. I know that he isn't the same as other kids his age. I see that. I just don't know if it is ADHD though.

He is much younger than most the kids in his class... but much bigger than most. He has always been a big kid, which makes people expect more out of him... which frustrates him because he just can't reach their expectations.
189897 tn?1441130118
COMMUNITY LEADER
   Boy, I believe you when you said, "I have Googled and read and read and Googled until I just couldn't read anymore."    The length of your original post shows how much you care.  Hopefully, I can help.  And I'm pretty sure I have a few sources on tap that you haven't found yet.   I've got a lot to say and I doubt that I will get it in all tonight.  And then I will be out of town for two days.  I want to talk about the ADHD diagnosis.  His age and place in school.  And maybe most importantly ways to work with him that will be more productive then what is going on now.  
   You ask if he has ADHD.   The answer is probably, but there are a few questions/concerns I have.
    The first concern I have is from a very large study in Canada (more then 900,000 children) that found, " The youngest children in a classroom may be more likely to receive a diagnosis of attention-deficit/hyperactivity disorder (ADHD) than their older peers." The lead author stated, "It could be that a lack of maturity in the youngest kids in the class is being misinterpreted as symptoms of a behavioral disorder,"     from - http://www.medscape.com/viewarticle/759900?src=nl_topic
    Now this doesn't mean that he doesn't have ADHD, but it is something to think about.  Your doctor did the correct thing in doing the survey for both school and home.  Perhaps the only place that did not follow the guidelines was the immediate prescription of medication.  
    The New Clinical Practice Guidelines say,
        Special Circumstances :Preschool - Aged Children
Clinicians should initiate ADHD treatment of preschool-aged children
(4–5 years of age) with behavior therapy and should also assess for
other developmental problems, especially with language. If children do
not experience adequate symptom and functional improvement with be-
havior therapy (most programs are 10–14 weeks long, but the clinician
should check with the therapists about their usual length of intervention), the clinician should first evaluate the adequacy and parental acceptance of the therapy. If the symptoms and/or functioning have not improved and the child is at significant behavioral or developmental risk because of ADHD, medication can be prescribed."    --  American Academy of Pediatrics. Implementing the Key Action Statements: an Algorithm and Explanation for Process of Care for the Evaluation, Diagnosis, Treatment, and Monitoring of ADHD in Children and Adolescents --  http://pediatrics.aappublications.org/content/suppl/2011/10/11/peds.2011-2654.DC1/zpe611117822p.pdf
   I think my main question would be - is your doctor a pediatrician?  The reason I ask is that, your son might well do better with a psychiatrist or a psychologist that has more experience with ADHD kids.  However, some pediatricians have lots of experience - so it all depends.
   I guess the main reason I bring this up is that even though all the symptoms do point to ADHD, there are some things like Sensory Processing Disorder that have very similar symptoms and I would want somebody with experience to possibly rule other factors out.  
       One of the things that I do find unusual is the length of time he crys.  As an elementary school principal, we had kids that did cry in kindergarten.  They usually stopped after a period of time.  His crying is unusual.  And that made me wonder about SPD.  Many of the things that you mentioned are symptoms of SPD, so its probably worth checking out.  And SPD is treated very differently in some respects to ADHD (no meds) This is a good site to look at --  http://www.sensory-processing-disorder.com/sensory-processing-disorder-checklist.html   for symptoms and we have our own specialist on medhelp if you have any questions here.  http://www.medhelp.org/forums/Sensory-Integration-Disorder-SID/show/1396
     So do take the time to check out the SPD site and our own site (just read through some of the posts).
    A few questions now.   (besides what kind of a doc are you seeing?)
    You said, "He doesn't run away anymore, and he hasn't kicked walls. He just cries when they do math, or an activity he has trouble with. He does get in trouble for being too wild sometimes, like taking his jacket and swinging it around causing it to hit other kids."    
      So he is not crying as much in school?  Overall, would you say he is doing better with the shortened day?   Is the staff seeing an improvement?
      Does his teacher notice any of his apraxia?  Is he eager to be called on.  Is his hand up to volunteer answers or does she have to coax him to talk?

    So, in conclusion, this is a pretty long post to say I'm not sure if it is ADHD or not.  Hopefully, you can see why I do have a few questions.  Now if it is ADHD, there is a lot that you and the school should be doing differently.  And that is gonna be a whole much longer post (probably).  And I do have several suggestions on how to change his behavior.  It kind of appears that your way has not been real successful.  And if he does have ADHD or SPD, I can guarantee that what you (and to some extent) the school) have been doing will not work.
     But something to do over the holidays.  The little guy is obviously frustrated.  Kids need to be taught how to handle anger and frustrations.  
Look into buying "Cool down and work through anger" or "When I feel angry". This is part of a series of books aimed at 4 to 7 year olds and meant to be read to them at night (several times) and then practiced.  Kids do need to be taught how to deal with anger.  You do not try and use these techniques while he is crying.  But once he stops or later on in the day - you can refer back to them or pull the books back out.  And at the bottom of the page you will find other books that may also help.
You can find them here -  http://www.amazon.com/Cool-Through-Anger-Learning-Along/dp/1575423464/ref=pd_sim_b_5
     I hope this has not been too overwhelming.  Get back to me if you wish with the questions I asked - (oh quick thought - anybody in your families have ADHD?).  Best wishes.  Once I hear a bit more from you I will suggest a few ways to help him change his behavior (though the books I mentioned will help a bit I think).  Best wishes.
      
    
Avatar universal
Oh my! Thank you for your input!

I am now Googling SPD and  Hyposensitivity To Sounds (Under-Registers). I was thinking about SPD the last few days. I have a friend who's daughter struggles with it... and I keep coming back to that with my thoughts.

My son does see a pediatrician. I am not sure if she has much experience with ADHD though. I thought there would be more to the process other than getting an assessment from the teacher and I before getting medication. I remember when the Dr. and I were talking. My son HAD to touch her otoscope on the wall. He touched it and I said "don't touch that", he touched it again, and again I said "don't touch that". This went on with the ENTIRE conversation with his pediatrician. He would pick it up and I would take it from him, put it back and swat his hand. He just HAD to touch it even though he was told not to and was told that he would not get a sticker at the end of the office visit. That is what cued the Dr in that he might have ADHD.

Even with the shortened days, he is having to spend a large portion of time in the office most days. Some days are great, other days I pick him up and the secretary tells me he has been there for two hours.

Thinking about SPD and his office visits... it is making more sense. Take yesterday, it was a fun day... no school work was to be done... it was a Holiday Party day, and he spent it in the office crying. The teacher said he couldn't follow directions when making a ginger bread house. He was excited all week for this party and making a ginger bread house. He wouldn't stop talking about it for days before.

No one on my side of the family has ADHD... I couldn't tell you about my husbands side. They are back woods Montana people. I know my Brother in law has some serious issues he struggles with and has never been addressed. Him and my husband went to school in a one-room school house with just a handful of other kids of all ages. They both kind of feel through the academic learning crack.

I downloaded one of those books to my Kindle and ordered the other. He loves to sit and read with me, I think it is a good way to get information to him. Thank you!

I just really want to make sure that this is ADHD and nothing else. If he needs medication, then ok... I want him to succeeded in life. He shouldn't have to struggle this much at the age of 5... holy cow!  I also don't want to ignore other issues that will not be fixed with medication. I guess it is just my Mom gut nagging me to exhaust all avenues first.

I can't not express my gratitude for your responses. You are being so helpful!!! Thank you!
973741 tn?1342346373
Hi there, sorry your son is having a hard time!  It breaks a mother's heart to think of our kids struggling like that during the school day.  I've been there and feel your pain.  And you are one smart mom to know that getting to the root of it can help.  I really believe in my heart of hearts it can.

I totally agree with your looking into sensory for your son.  My own son has sensory integration disorder.  You mention things that remind me of my son.  

My son was diagnosed with sensory at 4 years old.  He was diagnosed by an occupational therapist and it was occupational therapy that he then did to learn coping strategies and to overcome aspects to the sensory issues.  Some are still there but he knows what to do to make them better and to cope.  he's now 9 and we do not have many issues in the school setting at this time.  I can't say enough wonderful things about OT.

My son has never been on medication as we found the occupational therapy and all of the sensory things we do at home and he now has learned to do himself at school to have worked for him.  But I'd not be opposed to medication if my son needed it.

But you describe something that I'm just not sure medicating with add/adhd medication would solve.  Being to the point of tears and not being able to calm down does not get better with what is happening on the inside by a pill.  You have to address the inside.  Teach him how to self sooth, find out where the melting point is.  Is the school work too hard for him?  Does he have trouble with handwriting?  Has he actually figured out that crying gets him out of the classroom and these expectations for him and he may actually get to go to his safe place/home if he keeps crying?  

I guess when I think of my son---  I know earlier school was not a good fit for him.  That is the case with many kids but especially a child that struggles.  Does your son have trouble with fine motor?  You mention loud noises as a problem--  what about touch?  How does he do when you brush his hair or when he brushes his teeth?  

By the way, parties are notoriously difficult for sensory kids. They are hyped up and over excited and their nervous system can not deal with it.  Parties to this day are hard for my son.  

I'm here any time if you would like to talk more about sensory.  peace
189897 tn?1441130118
COMMUNITY LEADER
    A Happy New Year to you.  
Just wanted to touch basis and see how the little guy has done over the Holidays.  Hope it has been peaceful.
   Had a couple of other thoughts - most involving his school.  I am not sure what they are doing when he falls apart.  But, if all they do is send him to the office ...... ?  I would get Specialmoms ideas on this but there are things that they should be able to do in the classroom to try and sooth him.  Some pillows in the back of the room for example where he could go and hug a big bear or something like that.  And what happens to him in the office?  He just sits by the secretary's desk and cries?  Do they send him back to class if he stops crying or just keep him there?
   The other thing to start thinking about is - he is already missing a large part of the school year being out of the classroom so much.  Given that and his age - repeating the next year might be a good idea.  However, if you haven't done so - I would definitely visit his classroom and see how his teacher works with kids.  Does she have patience, is loving and kind - or kind of strict, no nonsense type?   You may want to start the process for a 504 plan so that the teacher is more helpful (if she is not that involved).
   And finally, if he does have ADHD or SPD, at least some of your discipline techniques simply won't work.  The last thing he needs after a hard day at school is to come home and get punished.  
   Kids of his age need constant and immediate reinforcement.  Trying to do something after the fact simply will not work.   And, if he does have SPD it a whole different ballgame in terms of helping him.   Point being - the spanking will not work for what you are using it for and really is counter productive.  If he messes up at home, use an immediate, short timeout and be very consistent with that for a particular behavior.  But do be careful not to overdo which behaviors you are working on.  Some times its best to overlook some behaviors to concentrate on a few more important ones.
     Hopefully, those books I suggested have been helping!
   I think the hardest part is going to be to figure out which is sensory and which is ADHD.  Although medication will help (to some extent) with the ADHD, but not with the sensory.   Did you decide to try the meds she suggested?  If so there are some important guidelines to follow.
   Hope the holidays were peaceful for all of you.  Keep in touch!
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