if it's not adhd?

[erinsoul]

My 5 year old has been a evaluated by a psychologist from our county's IU early intervention department.  He was diagnosed with ADHD or ADD.  Her feeling was that he is a strong, stubborn personality who may have social emotional delays and he is very adult oriented, he doesn't realize that he is a kid.  His behaviors are: non-compliance, very sensitive to peers approval of him and fitting in, very active,quick aggression when upset, need for control.  He has been getting 3 hours a day of play therapy from a behavioral therapist at preschool.  He does very with her guidance and positive reinforcement.  However, when his regular teachers are unable to provide him with the same level of guidance, consistency, and reinforcement he resorts back to his regular undesired behaviors.  He shows some of these behaviors at home, but not as frequently.  My husband and I very consistent with our demands on him and discipline which I think helps a lot.  
So my question is, if it's not ADHD and meds can't help as part of his treatment, what can I do?.  The school environment is not going to be able to provide him the level of attention he needs, so how can I help him?  Both my husband and I work fulltime, so home schooling is not an option for us.  And besides,... I want my son to be socialized and learn how to behave and interact appropriately with peers and authority.

[Sandman2]

  Really agree with most of what you say.  But to discipline a child at this age at home for what they did in school  hours earlier is very ineffective, and probably harmful.  As they get older, certainly it is something that can be done.  Not now.

[jmk1138]

Sounds like he's had some bad experiences with kids/peers and good experiences with adults.  That, and like any other person, he likes personal attention.  

Along with discipline, praise him profusely for positive social interaction with his peers (or any other small thing he happens to do right).  Discipline alone can frustrate, but praise alone builds a false sense of confidence that is easily shattered.  Couple the two (e.g., rewards for sitting still and toilet-scrubbing for disruptive behavoir in class) and you can get good results.

What I've found in working with teachers is that they need almost as much praise for working with you as the kids need for performing well.  It really shouldn't be that surprising.  Everyone needs/wants positive reinforcement -- at every age.  Don't be patronizing, but make sure to thank the teacher that takes extra time.  Sure, it may be his/her job, but everyone likes to be appreciated.  When the teacher helps you follow through on your system, give your heart-felt gratitude.  It goes a long way.

[Sandman2]

     Opps, forgot to say that kindergarten could be a completely different situation then preschool due to the teachers experience and the amount of kids/peer pressure involved.  But do take  the time to do some research on the teacher if you have a choice.

[Sandman2]

  You said it best when you said, "but needs a system to help him succeed until he matures and gains better emotional control."  Meds are not a system, and really I haven't seen much in your description of him that makes me feel at this point that they would help.
   What would help is a system.  That means teaching him how to work with kids/adults.  There is a wonderful set of books called the "learning to get along" paperbacks, that are aimed at the 4-8 age group.  You can see them here - http://www.amazon.com/Talk-Work-Out-Learning-Along/dp/1575421763/ref=pd_sim_b_7.    This will give you the system you need.  
    Get them for yourself and buy a set for the preschool.  
    And yes, with a 3 year old sister, he probably is competing for attention.  Also a 3 year old girl is so much easier to work with then a 5 year old boy, he probably is getting some of the wrong kinds of attention.  So do try and work in some positive attention for the little guy.  His behaviors are things that his sharp little mind has learned how to do to get what he wants.  You can show him other ways to achieve the same results.  Just remember that you are changing a learned behavior (not a genetic defect that needs meds), and that won't happen overnight.  Experts say it takes about 3 weeks of immediate,consistent reinforcement to see a change.  If you use Lynn Clarks book (SOS) with the other books, you will see that happen.   Best wishes and good luck!
    

[erinsoul]

I'm just not sure what else I can do to support the teachers he has now and how we're going to get through kindergarten.  I'm not an advocate for meds, but have to wonder if they might be able to help him?

[erinsoul]

Thanks for the advise.  He does have a 3 year old sister that he gets a long with very well.  I would say typical sibling squabbling.  My son does want his peers to like him, but he tends to be bossy or a little "pushy" might be the word and then he gets very upset when he is rejected or excluded and yells or can get aggressive.  This behavior isn't nearly as often as it used to be, but it's the behavior I'm most concerned about.  Much of his actions are for attention.  I think he really feels the need to compete with the other children in the class. When he gets recognition and reinforcement he is proud and needs to know he is on the right track.  When he is left to his own devices with no one reinforcing the demand he pretty much does what he wants.  He is one of those kids that just really feels the need to control the environment he is in, although he can't always control himself.  
Basically he needs clear directions, he has to know the follow through will be consistent, and the positive reinforcement afterwards to be successful.  If any of those elements are missed...success is not so likely.  It's a lot of work for a teacher to keep up with, I know, I'm the director of the school he attends.  But honestly, it's a lot MORE work not to do it.
He is VERY CAPABLE, but needs a system to help him succeed until he matures and gains better emotional control.

[Sandman2]

   My guess is that he is an "only" child with pretty good intelligence.  If you look at the child behavior forum, you will see that he is not that unusual (at least from those posts).    Sounds like you are doing the right thing.  You might want to check out the book,  "SOS Help for Parents," by Lynn Clark.   And see you can pick up any additional tips from her.  Her system of discipline is very good.
   I would make sure that he is age appropriate for school when he starts.  Talk with the principal and make sure that he has a good, experienced teacher.  The fact that he is sensitive to peer approval and fitting in is a benefit.  It means that he won't want to stand out at school, by doing things that would lead to him being disciplined.  It may well be that his current teacher is simply not able to effectively deal with him.   Also, try and get him involved in something like soccer.  Hope this helps.

[erinsoul]

My typing skills are horrible.  I meant he was NOT diagnosed with ADHD or ADD.  and that he does very WELL with the play therapist.  Yes, we have CHOP, Children's Hospital of Philadelphia.

[Marebear74]

Do you have a "Children's Hospital" there near you? My name is Marebear74. If you would like drop me a E-Mail or note. I may be able to help you. I went through this with 2 of my 4 children!