At a total loss. ADHD or something more?

[kab00]

Our son will be 10 in July.  We are at a total loss of what to do or how to help him.  Since birth he has always had a terrible time sleeping.  He is still difficult to fall asleep and wakes up so early, and is obviously not resting well at night. He has very poor coping skills. When he needs even something simple like a strep test done at his pediatrician he "freaks out". He starts crying, jerking away from the doctor and it takes forever to have something simple and painless done. He has always had to same reaction when i would try to cut his nails or even clean his ears, since birth.  When it is time to have blood work drawn it literally took 45 minutes and 3 grown women to hold him down. He screams, yells, kicks, etc.  He is now homeschooled and has a difficult time sitting for long periods to do seat work.  If something is too hard he cannot sit still.  He has temper tantrums about 3x month that result in behavior that is scary to everyone in the home.  These fits will last for about 20-30 minutes. He screams, yells, slams doors,, throws things, hits the wall, etc.  He never hits any person only objects. When it is over he tells me he is sorry and doesn't know why he does what he does.  he is very hard on himself saying he is stupid and an idiot. things he NEVER hears from us!! His disobedience has continued to get worse. He always been a strong-willed child, but it is now becoming too hard to manage. He still misbehaves in the grocery store and often just talks and is loud to just be loud.  He can be socially inappropriate.  He interrupts all the time, talks about things that are not related to the topic.  He is very impulsive and often does not appear to think before he talks or acts, unaware of the danger he puts himself into at times (crossing the street, etc) He still has a blanket he keeps in his bed, but when he gets upset he will bring it out and chew on it. I also notice him chewing on his sleeves and fingers at times.He appears very anxious at times, worrying about a lot of things.
He was born after a traumatic birth.  he was born not breathing and had to be intubated and sent to the NICU. He was off the tube within 12 hrs and breathing normally.   He did suffer a very small brain bleed that the doctor's deemed insignificant and attributed to the vaginal birth and having to use suction.
We have been to 3 different psychologist and getting completely different diagnoses each time. ODD, ADHD, anxiety disorder. However, none agreed with the other except 2 did on the ADHD diagnosis.  
he gets good grades in school. He reads at a th-6th grade level and his IQ is above average. When he was in public school and I asked his teachers questions about his attention and behavior they weren't seeing anything like we were seeing at home. he was NEVER in trouble and a model student.  They did say he does tend to be attracted to the wrong kids and he follows VERY easily. We see this as well.
We move around a lot and my husband is gone a lot.  So, making friends has been hard for him.  
I don't know what to do.  We have him on a very strict diet with no additives/preservatives and he takes multi-vitamins and Focus Factor for Kids.  The outbursts and bad behavior are getting worse.  It is like he just cannot sit still. He is constantly running around. It is like he is in his own world sometimes not realizing his behavior is inappropriate, even with cues.
Could it be ADHD or something more? Please help us. I don't know what to do or where to go. I just want to help my son be  a "normal" kid. He is so sad most of the time because things are such a struggle for him. he wants to do the right thing, but he just cannot stay focused long enough to do what is right.
thank you!

[allmymarbles]

I am looking at "always had a terrible time sleeping." Children need a lot of sleep, and not getting it may produce all sorts of problems. So start with that. Check him out for sleep apnea. One of my daughters suffered from this. It was unfortunately not diagnosed until she was an adult.

[Sandman2]

   I hope you are able to find out what is going on with him.  It makes such a difference in how to treat/discipline him.  It also wouldn't hurt to get the book, "The ADD/ ADHD Answer book," by Susan Ashley. I recommend the book a lot.  And given what the some of his diagnosis have been, the information in the book could be helpful.  Finally, it might be a good idea to find a pediatric psychiatrist - I tend to favor their opinion over the other choices.  (of course, it all depends on the doc and their experience).  Best wishes.

[kab00]

He is being homeschooled now. He does well with Math, but he does get up and down a lot when it is time for a hard Math lesson.  He is in the 3rd grade,b/c of late bday.
I will check out the SPD site. Thank you so much. it is so hard b/c my husband thinks we are just too hard on him and there is nothing wrong. I just can't shake the feeling something is going on.  I really think when he was in school he would work so hard all day long that he was shutting down when he got home. Homework can either be a nightmare or he will fly through it.  It just depends on if he is wore out or still able to focus.
Thank you again!!!

[Sandman2]

  One idea is that this sounds a lot like SPD or sensory processing disorder.  You can get more information here.  http://www.sensory-processing-disorder.com/index.html - or google SPD.  If this looks possible to you - post over on the child behavior forum.  One of the members is really a specialist in working with SPD as her own son has it.  She has a ton of ways to help (and they have made a major difference with her son).  Or if you want, go to the forum and  look for posts by specialmom - about every 7th one or so seems to deal with SPD.   Or you may just want to copy your post and and repost it there, but add SPD to the title.  She will see it and get back to you.  
   In regards to your question.  You cannot turn ADHD on and off.  If he can focus at school, he can focus at home.  However, it is possible that he is working so hard at focusing at school, that when he gets home he melts down.  If this is true, the condition will worsen as school gets harder.  ADD is a possibility.  I have found that about 5th grade, an above average child will finally began to have problems in math.  I would certainly try and find ways for him to burn off his energy once he gets home (I know kinda hard to do in the winter).  But the more physical he can be once he gets home, it will pay off for you.  It also is very good for SPD.    
   How does he do with homework?  Does he whip through it?  or does it seem to take a long time?
   By the way, as another thing to check out.  I have recently seen studies that show that kids with sleep apnea will exhibit ADHD behavior.  Basically, because they have trouble sleeping at night - it really affects there actions during the day.  And the later in the day, the worse they get.  Its probably worth having a doctor check out his adenoids.
   A lot of what he is doing is classic reactions to frustration.  Whether this frustration is caused by something like ADD or SPD is the question.  You do mention his inability to focus.  Do his teachers see any sign of this?  Particularly during a math lesson?  By the way - he will be 10 in July. what grade is he in?   If he is in 5th grade, he would be one of the youngest kids which could explain part of his social problems.  By the way, you also mentioned that "when he was in public schools".  Where is he now?  Private schools typically don't have very good resources for helping children with his problems.
    I am sorry, I have asked a ton of questions - because there is a lot going on here.  The length of your post indicates how worried you are.  Hopefully, you can answer some of the questions.  Do check out SPD.  best wishes!