Gifted Issues Discussion homepage Forums Twice Exceptional We had a horrible appt for DD today

I'm trying not to cry as I type this. I took DD5 for an ADHD eval today on the recommendation of her preschool teacher (and others who are familiar with her). She is very impulsive, interrupts constantly, and gets up and walks around her classroom when she feels like it.

The 1st thing the Dr did was refuse to call her by her middle name (the only name she goes by), because I didn't write that down on the sign in sheet. I wrote it on every other piece of paper! But for insurance reasons I always put her 1st name on sign in sheets. I almost walked out of his office right then.

He asked me just a few questions, and didn't ask DD anything. And then said "here's a RX for Ritalin, come see me in 3 weeks."

I tried to tell him about her sensory issues. She cried for 45 minutes this morning because she has her 1st loose tooth. She says "I don't like how it feels!" But he didn't want to hear about any of that.

So now I don't know what to do. Try the meds? Get another opinion? If you have tried meds with your child, did it help with impulsiveness, and interrupting? I don't feel like she has any problems with attention. But she is a little hyper, though.

((hugs))

It sounds like you don't feel that the Dr. gave your DD a thorough evaluation or that he answered your questions. I would definitely get a second opinion.

Wow! That's awful. She's only 5? You know, most physicians aren't that schooled in sensory stuff. There are two ways to get help, from my personal experience. One: do it yourself using one of the awesome books out there on it (Sensory Smart Kids, Out of Sync) or Two: find an OT or gym that SPECIALIZES in sensory therapy.

I would also second the second opinion. I am not against meds at all but I am against using meds without looking at the whole child. Some of the ADD behaviors could be caused by the sensory issues, giftedness, and lack of a good enducational environment.

I would definitely get a second opinion. There are some people on here that have kids dignosed with ADHD and being a little impulsive isn't on their list of complaints!

Hopefully some of them will chime in.......?

Recommend a second opinion with someone who's read Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, bipolar, OCD, Asperger's, depression, and other disorders by James T. Webb, Edward R. Amend, Nadia E. Webb, Jean Goerss, Paul Beljan, F. Richard Olenchak.

Here's an excerpt:

http://www.sengifted.org/articles_counseling/Webb_MisdiagnosisAndDualDiagnosisOfGiftedChildren.shtml

I don't have much time to type -- just saw your post and wanted to tell you that my DS5 cried for at LEAST 45 min the other day because of a loose tooth too. A combination of not liking the way the root edge felt on his tongue and not wanting to lose his tooth (because that is Change and therefore a Bad Thing). He falls apart like this sometimes, don't know if he's hypersensitive or has an emotional OE or what, but I don't think he can possibly be ADHD because he can sit for half the afternoon working on a single project or reading a book if it's something he's interested in. So ((hugs)) and no specific advice, I just wanted to let you know that your DD is not the only one who has done that. And I don't mean to discount your concern at all. BTW, DS's tooth came out this a.m. and he's totally OK with it, even though he is not buying the Tooth Fairy line at all. lol. Good luck to you -- I'd get a 2nd opinion too.

Definitely get a second opinion. I have had psychiatrists try to do that. I have found that the really good ones will go for a few appointments and then recommend testing (neuropsych, IQ, etc) before jumping to any conclusions.

Well, my son has been diagnosed with AD/HD but I'm not happy with the diagnosis. I've come to believe that AD/HD is really just a collection of behaviors that teachers don't like. There are so many different subtypes that anyone can truly be diagnosed with AD/HD now. Underneath that AD/HD label, there could be sooo many different things going on. Examples are the things listed by crisc: sensory, giftedness and also, immaturity. So, I think what you've really learned here is that your doctor isn't going to help you. That's usually the case, I think. So, you are going to have to get to the bottom of it yourself AND you're going to have to do something right now to make things better.

For right now, I'd try fish oil and 123 Magic (the book) and remove most dairy. I'd also find someone to teach you the wilbarger protocol. Amazing results with impulsivity. None of these things can hurt a normal child but you may get results with one of them.

For long term, I would try to figure out what is triggering her. What excites her and makes her impulsive? It could be a certain type of activity or sensory stimulation. It could be something that just cycles with time. You'll have to put those days on the calender and see what's going on. Also, what's going on with her intelligence and academic needs? Does your daughter suddenly behave when she's learning something interesting?

I'm glad to hear DD is not the only child to freak out over a loose tooth. You would have thought the world was coming to an end, the way she was crying. She asked me in a break between sobs "but HOW does the tooth fairy know?!?" So I don't think she's buying it either. LOL. DD can also sit for hours playing her leapster, and things like that. So I always second guess myself on the ADHD.

What a terrible experience - sorry that happened. This was not an acceptable length or detail for investigation for something as serious as using medication for a five year old. I would not go back to that doctor and if your pediatrician made the referral I would give him/her feedback on what happened.

Do you have the option locally of seeing someone who understands gifted children? Has she had an OT evaluation? Those might be places to start.

http://www.incrediblehorizons.com/mimic-adhd.htm

I did not read your entire post, but my dd was supposed to be ADD/ADHD. We did a ton of testing and discovered that she had a visual perceptual issue. Maybe you can look at this list and knowing your DD as only YOU can, something will pop out at you!

Good Luck.

Thanks We started fish oil about a week ago, and I have noticed an improvement. I didn't think about cutting out dairy, though. I have always used the 1 2 3 magic with my kids, and I will look into wilbarger protocol.....can I google that?

As far as what excites her and makes her impulsive......she just seems to not know how to stop herself from grabbing things off a shelf at the store, coloring on things she shouldn't, and basically doing things she knows are wrong/not allowed. At 5, she is still putting non-food items in her mouth (marbles, money). And I can't let her play with any type of scarf, boa, pet leash, rope because she will wrap them around her neck or body. Sensory issues??? It scares the junk out of me.

She loves older kids, and seems most engaged and behaved with them. But she will tend to show off, and be very hyper too.

I would definitely get a 2nd opinion(or 3rd...) and keep digging until your gut tells you you're on the right track. You may end up back where you started, but then again, you may not! Based on your post I sense you feels somethings not adding up.

I thought ADHD couldn't really be diagnosed until 7 y.o.? Anyway, I agree with everyone above about getting a second opinion. Other things I'd look at, if you haven't already: the DSM criteria to see if *you* think they apply http://www.cdc.gov/ncbddd/adhd/diagnosis.html , and yet another book, the Eides' The Mislabeled Child. And as someone mentioned, it might not be a bad idea to have the vision angle checked out with an optometrist from http://www.covd.org/Home/AboutVisionLearning/ADHDVision/tabid/112/Default.aspx .

Dumb question re: impulsivity that you've probably already thought of, but is she getting enough sleep? (could there be allergies getting in the way of sleep? This is something I'm currently exploring with one of my kids who is driving us all nuts for no apparent reason in an impulsive sort of way; he has allergies and really swollen tonsils for months on end and it finally occurred to me - duh - that perhaps it's interfering with his sleep, making him overtired - he's super-wired. I'm anxiously awaiting our next checkups with the ped and allergist though of course they aren't for a few more months)

Putting things in her mouth does sound sensory (I agree about finding an OT place that specializes in SPD - try here http://www.spdfoundation.net/directory/index.html )

As for the strangulation hazards, that doesn't seem out of the ordinary to me - I'm constantly telling my kids to take them off lol.

just my two cents

We had her vision checked at a ped opthamologist (all was good), and she sleeps like a log at night. She meets 90% of the criteria for hyperactivity-impulsivity ADHD.

Yes, dairy makes DS6 act nuts! We'll have trace dairy in packaged goods and the occasional buttery cookies but milk, cheese, ice cream and yogurt are out. Unfortunately, I couldn't find the wilbarger protocol demonstrated online but it might be on youtube. Have you checked out websites like these?

http://www.specialkidszone.com/

I don't trip over the sensory issues stuff. Everyone has sensory issues. It's just that in certain kids, they're a little more intense or the kid is just an intense person and reacts strongly. People grow out of it. I would try to identify though, whether it seems to be visual or auditory stimulation that excites your child. For example, I've noticed that when it's quiet, my son behaves. So, he does well out in nature and in generally quiet environments like montessori. He does badly in large stores or crowds. A big auditory experience will overload his system and he'll misbehave for days. Putting stuff in the mouth could be a tactile seeking behavior. You could buy her a water bottle with a straw to replace that or provide some other appropriate fidget. The Wilbarger helps with tactile stuff.

On the vision angle, a ped opthamologist, for the most part, is not going to find the things a behavioral optometrist will - it's not the same type of evaluation (there are rather few opthamologists in covd.org; most are optometrists, long story). My DD8 was checked by a ped opthamologist a couple years ago and all was good; that same month when we took her for IQ testing, the testers said she might have a vision issue. Took her to an optometrist (this was about two months after seeing the opthamologist), and lo and behold she had an eye tracking problem. It's fixed now thanks to vision therapy. Of course, that doesn't address a lot of the adhd symptoms but I just thought I'd throw that out there, just as a little FYI.

Besides the second opinion, the other, probably less desirable option is to try the medication for a limited time to see if it helps. But I were in your shoes I'd probably feel better if I felt sure about the diagnosis first. Is there something specific from the diagnostic criteria that she's missing, or does your 90% figure just come from your not being 100% sure? What kind of doctor was it?

Good luck, I hope you get this mystery figured out soon!

I meant to say it was an optometrist that she saw. They did a bunch of tests. We originally went there because of a blinking/facial tic. On the CDC list she meets all the criteria for the hyperactivity section, but only 1 for the inattention section.

I'm so sorry. I would definitely get a 2nd opinion! I'd be very wary of getting handed an RX after a single appointment that went so badly. Especially with such a little one! Drugs are necessary for some kids. But definitely seek another opinion! Find a doctor that really tries to "get" your child. I think that is so important.

Sounds like a horrid experience with an uncaring doctor. My son also goes by a middle nickname - and they always call him by it even when I put his first name on the insurance forms - and that's whether I write his nickname down or just tell them.

We took DS6 to see the certified neurologist chiropractor Friday. He recommended up for 2000mg a day of Omega - and you have to know whether its 2000mg of the actual Omega, or just 2000mg of fish oil in general. He gave DS6 exercises to do to strengthen the right side of his brain after doing several physical tests.

I agree on the eye issues. Behaviorial and sensorial therapists are trained to see more than an Optometrist. I would never relay on just an Optometrist anyway - always go to ped. Opthamologist/Surgeon if possible - for more training/better opinion. If we had only relied on an Optometrist or the Pediatrician who checked hearing, eyesight in general DS6's amblyopeia (SP) (wandering eye) issue would probably have gone overlooked as they kept on telling us from birth onwards that infants and toddlers eyes don't always behave correctly when they are young! I suspected from birth that one eye was moving way too much!

I still haven't put DS6 on drugs - not even to try them. I know that's worked for some Mom's here - but it should be the last resort.

I would get a second opinion. I would be against putting her on medicine based on that appointment.

On the facial tic/blinking......a friend researched this extensively. ADHD meds are contraindicated w/ tics or family history of tics. If she already has tics/blinking, the meds could really exacerbate this. My son's pediatrician wouldn't even discuss ADHD before age 8.

And the tics don't always go away after meds are stopped.

I almost sound like she might have Asperger`s Syndrome, an autism spectrum disorder with the sensory issues, interrupting, and impulstivity. Many AS kids are really smart too, but they don`t often have long attention spans and can`t concentrate as your child can.

Your DD sounds just like mine. However, my DD may be a bit better at staying put in class. I firmly believe that my child's greatest gift is her energy and enthusiasm. I have found her trigggers and try to work with them.
People can slam me, but she still uses a pacifier at 4. It calms her down. She is very oral and would go right to her thumb. Everything is touch. She always want to hold my hand.( a little annoying while driving my manual car).
Because she is sensory, I use alot of touch. We have a twenty minute cuddle session every morning time permitting. When she is agitated I get down on her level and hold her. We work as a "team" and I tell her Mommy is always on her team because I realize that she must feel out of control sometimes and I want her to know that she is not alone.
She definetly is sensitive to some red/blue dyes. Blue dye makes her an absolutely crazy lady. I cut out dairy and she gained weight (she had been very skinny)
But the best thing I did was read
http://www.amazon.com/Raising-Your-Spirited-Child-Perceptive/dp/0060923288
I am not against medication but I think everything has to be ruled out first. My ped. requires an 1 hr appointment to renew ritalin and I think that is how it should be.
I was just thinking that my brother, who is 45, would be pushed into medication if he went to elem. school today. He is very sucessful and it is exactly the drive and energy that use to drive his teachers crazy that got him where he is today.
Good luck these things always seem worse in the beginning.

I read the above book also - when DS6 was 4 and always in trouble at Montessori. The County Counsellor we worked with evaluated him as highly spirited - again - lots of correlation with highly spirited kids and ADHD kids - and when they are younger than 6 or 8 - really hard to diagnose them accurately as ADHD.

Even the nurse at the Opthamologist's last week told me "if you put him on drugs - he will be like this "did zombie impression of passive child". That was despite the fact that we went through another 3 hours of hell waiting and transitioning between waiting room with play room, first computer test, exam room, - he wanted to touch every instrument, lense, door knob, light swtich, swivel in the chair, raise the other chair up and down, pretend the equipment was a Periscope (gotta had it to the kid - it sure looks like a periscope). Even 1, 2, 3, discipline, threats, treats, holding him down - didn't work! And he screamed blue murder when they were dumb enough to tilt him backwards and put "stingy drops" in his eye only to tell me afterwards that next time they'd do the "no stingy drop" eye test. 3 of us were holding him down - before I really realized their plan I was in a nightmare. He can't abide bright light and refused to let them look in his eyes anyway. I don't think they've successfully seen the back of his eyes in 3 years and they are Pediatric Opthamolgoists !!

All this to illustrate my point - that if a nurse that sees thousands of kids says don't jump to medicate after going through that type of appointment with my child - who would be easier to cope with drugged ....I figure she knows what she's talking about. But this isn't the same type of behavior as the Mom's on the board who really have had to use medication with success report.

I also hope it illustrates that there are many kids with severe sensory issues - or just like DS6 - particular hatred of certain enviromental stimulae. He acts up a lot in class too - and I still don't know if we've ignored a deeper sensory issue. But it all seems tied together with their brain
development/sluggishness & immaturity in certain areas - and giftedness or intelligence/advancedness in others.

RJH,
Ritalin took away the impulsivity and interrupting. This enable him to make more friends at school because he wasn't annoying. His grades shot up.
Hoping for the best,
San