Wait and see? Or get testing? ODD/ADHD — The Bump
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Wait and see? Or get testing? ODD/ADHD

I?ve suspected for some time that DS1 may have ADHD or oppositional defiant disorder. The latter was suggested to us by a daycare teacher (rather callously when he was just 3, so I took it with a grain of salt at the time). Since he?s only 5, it?s been tough to know what?s typical behavior and what?s not. He?s been having a really tough time in kindergarten, and now it?s hard to tell what?s typical and what?s a result of unrealistic expectations from a rather-green (although willing to get involved with us) teacher.

 

I?ve mentioned several times that I?d like DS to see a behavior pedi, but DH has been adamantely opposed. He thinks I?m overreacting and that we should at least wait until the school suggests it, or we see how he does in 1st grade. DS seems to have real trouble with impulsivity and defiance. He?s not explosive, he?s extremely verbal and extraordinarily bright (even by teacher standards, not just proud mom standards), and he?s quite loving. But he struggles with personal space issues (he likes to put his face two inches from your face) and he often seems like he?s deliberately annoying people to get a reaction. He's constantly arguing with us. Getting him to do a simple task like putting on shoes can take forever. We have a behavior chart that helps, but not always. When he gets into a high-excitement environments, like school or family parties, it's like his brain shuts off and he will completely ignore what you want him to and completely defy you and do the oppsite. He's currently in a "social skills" class that meets once a week with a social worker at his school without about 4 other kindergartners.  

 

How do I get my DH on board with testing? Or is he right to wait and see what happens?

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Re: Wait and see? Or get testing? ODD/ADHD

  • It's time. My son started Kindergarten this fall, and we started the eval for him last spring. He has a touch of the ODD when unmedicated (especially when overstimulated, like at a party/place with lots of other people), when he is medicated, it's MUCH better, though he's still a stubborn thing... We're using behavior mod and other tools before we look into medicating for that though, b/c at this time, it's not really inhibiting his learning or friendships at school, it's more of an issue at home, so we figure part of it is just that he's more comfortable with us, thus acts out more.

     Put it to your husband this way- The chances of you guys hitting the medicine that works best for him right out of the gate is slim. Most kids trial between 2 and 5 before the one that works for them is finally found. Then you still have to play around with doseage. Starting next year, he'll have a clean slate. Chances of him being in class with all the same kids are slim, and kids that age are WAY more forgiving than they are in the upper grades, and he can start the year not as "that kid", but just as any other kid does.

    You also might want to consider holding him back a year to socially mature- my kid at 5 and my kid at 6, are two competely different souls. We were lucky to have missed the Kindie cut off, but depending on how young a 5 he is, he might benefit from some more time to mature as well.

    On the flip side, if you wait another year, that's just one more year of these behaviors getting ingrained (and while they are impulsive, they are also learned, KWIM? They learn they get attention for them, and sometimes, any attention is worth it). It's one more year of other kids noticing how he's "different", and by the time he gets to second grade, trust me, they will notice. They're oblivious in Kindie and 1st, b/c they're still figuring the school thing out, but second grade is where the social hierarchy begins- by giving him a year of medicinal and behavorial treatment under his belt, you better equip him to navigate through the increasing social demands of school life. If you wait... he'll be that much further behind.

    It sounds like you guys are doing what you can to help him socially- the question is, is it working? Or is he simply unable to put what he's learning into practice because of the impulsivity? Because if the latter is the answer, nothing but medication is going to make that behavioral modification effective. The best treatment of ADHD is both medication AND behavioral modication.

     I'm curious though as to what expectations the teacher has that you feel are unreasonable? If she is noting a discernable difference in his behavior versus the other students in the class, new or not, I'd be taking her concerns seriously.

  • thank you so much for the reply  i am on my phone commuting home but i just wanted to say thanks and that iwill post later withsome more details
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  • U have gotten great advice and I think pp are right. The time to get him tested is now. Heck if I had waited any longer to get my ds tested we would have missed the cut off and lost out on a ton of state funded services. There is no drawback to having the information now KWIM? I'm not sure what tactic will work best with your husband since I don't know him but I think if you decide to become resolved that this is the best course of action for your LO then you will figure it out. Can you enlist your pediatrician to make a recommendation? My pedi is always happy to cover her own ass with a referral of o te L er I am worried- doesn't cost her anything and your dh would see e little slip of paper with the dr recommend on it. Hope things get easier for you guys soon, it sounds like your ds is a smart cookie who needs a little help in some social areas and happily help is out there and it is yours for the getting.
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  • Thank you all for the advice! To answer a couple questions, he is a young 5 for his grade, but the cutoff here is Dec. 1, so he's definitely not the only one in his class. Redshirting isn't very common here. His teacher has actually commented on how mature he is compared with the other kids -- he just has SO much energy and is easily distractable.

    I really don't think he's on the asperger's spectrum. Obviously I don't know as much about it as you do Auntie, but that's something that's never even been so much as a passing mention or concern. ADHD, yes. ODD, yes.

    This hits the nail on the head, though:

    Often these kids struggle to read social communication and will seem to goad others with misbehavior in order to elicit a responses, even a negetive one, that's big enough for them to percieve. This can be complicated by poor understanding of the socially constructed hierarchy of the classroom that puts adults in charge. A lot of these kids don't understand that they aren't adults themselves and that they must do what is asked of them by those who are. This trait is sort of amusing at 4 and 5, but by 7 teachers will come down hard on this.

     

    He is drawn to trouble in the classroom like a moth to a flame. If someone is being silly or disruptive, DS sees that as his cue to join in. He does much better when he's seated by himself and can focus on his work, but obviously a huge part of school is working in groups. We've been told that he's a natural leader but also that he can be manipulative to get what he wants.

     

    DH believes he had/has ADHD, and he definitely struggled in school, and he said he sees a lot of himself in DS. I don't know why he would wants DS to struggle like he did, but that's a good way of getting him to be more receptive to intervention, I think.

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  • I have to echo Auntie on this post.  You just described my 6 y.o. (also in K) with AS to a tee.  He is an incredibly bright, social (though inappropriate), seemingly mature boy.  I think at this age, children with AS seem so mature because they can have very adult conversations with adults.  This is exasperated when you have a child with a high IQ.   

    When you say that your son is drawn to trouble in the classroom, I also think of my little guy.  What I have learned is that those social behaviors are so glaringly obvious that he finally sees them and reacts to them.  Does that make sense? For my little guy, he doesn't see the more low-key social cues and behaviors and only picks up on them on his own when pointed out to him.

    Please make some calls now.  You are entitled to ask for an evaluation from the school district at any time.   I would get that ball rolling right away.  If he qualifies under school services, which sounds likely, he will get an IEP that will afford him a lot more services throughout the day.  I would also get a call in to a Dev. Pedi right away.  Here, the shortest waiting list you can find for an evaluation is 6 months for an older child and often times closer to a year. 

    Good luck in your decision making.  

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  • It's time. DD1 is almost the exact same age as your DS and we recently had tested after 3 separate Kinde teachers brought up concerns during K warm-up and pre-K summer school. Until I heard it from multiple people, I just blew it off as her just being unusually hyper and energetic. We started with an OT eval where she was diagnosed with sensory processing disorder (which often accompanies ADHD). She is a sensory seeker which explains why she can't sit still, is always fidgeting or wanting to chew on something. From there we had neuropsych testing with a neuropsychologist and he diagnosed her with ADHD.

     She too is a very bright, caring girl but has issues sitting still and getting easily distracted. She is also has issues getting in other peoples' personal space. We haven't had any behavioral problems...just problems with not listening due to her distractibility.  

    The cut-off here is Sept 1 and DD1's bday is Aug 8th. Our school district offers a young 5 Kinde for kids that are age eligible for K, but not quite ready. It is pretty common to redshirt in our district, mostly I think because they offer this option. The summer school K teachers recommended holding DD1 back and having her enroll in the young 5 K. I am so glad I did. Her teacher is a special ed/early childhood teacher and she has been WONDERFUL in working with DD1 and offering her "school tools" to help her sit and focus. And they are flexible in letting her stand while she works or sit on a bouncy ball at circle time. I am thankful she has this year to learn about her body and learn some ways to cope before we enter full time K next fall. We aren't medicating at this point since it isn't necessary and the "school tools" are helping. We will revisit this when she really has to sit for long periods in 1st and 2nd grade. We are seeing an OT who has been giving us tips to fulfill her sensory needs. Due to her ADHD diagnosis she qualifies for an IEP, but not any other extra services like OT through the school unless it begins to interfere with her learning-which is isn't at this point.

    Good luck in what you decide to do! 

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  • It's time for testing. My daughter was tested in 1st grade and she is ADHD/Dyslexic. The best thing I did was get her tested when it first became a problem, it is so not worth it to wait. I wish I could have tested even earlier! As far as getting your husband on board, honestly I wouldn't ask. I would tell him you're doing it and he needs to jump on board or keep his mouth shut.
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  • Early intervention is so important.  In K and even 1st grade, his fellow students will be understanding of bad behavior - - but as kids get older your DS will have fewer friends if he can't control himself, and it will be harder for him to get playdates, etc.

    I agree with PP - TELL, don't ask your H about the testing.  A test is just a test.  You are not forced to make any choices once the results are in, but you will have a range of options, and may even get low-cost, state funded, or insurance-covered options once you have the results.  AND if you start early enough, you can have greater results with behavior modifications.

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