How does one know if their child’s inattention is due to a true lack of the neurotransmitter dopamine, or because of other learning disabilities (for example, avoiding school work because reading is difficult)?
What tests besides the Conner’s (which does not seem entirely reliable to me) are used to help with diagnosis?
American Academy of Pediatrics
American Academy of Pediatrics
“Diagnosis and Evaluation of the Child With Attention-Deficit/Hyperactivity”
http://www.aap.org/policy/ac0002.html
Re: How do you know when it's ADD?
I looked through the articles and also went to various websites, but still, reading through them it seems to me that many of the symptoms could be attributable to other LD’s.
I understand that for some children the diagnosis might be more easily made. Particularly when hyperactivity is involved (the less active, dreamy kid is less likely to be noticed).
Of course ADD and LD’s can very likely coexist. But is there any reliable way to figure this out? I noticed on Dr. Amen’s website he uses MRI’s to test brain function. I’m wondering if there may be other similar ways to help make as accurate a diagnosis as possible. Maybe a “med trial?”
I have a child I occassionally suspect of having ADD (without hyperactivity), But it’s difficult for me to figure out if his symptoms are due to dyslexia, possible dyspraxia, or ADD. Many symptoms characteristic of dyslexia could be attributed to ADD.
Re: How do you know when it's ADD?
It is tough with a kid with LD. Last year (third grade) we got many complaints about attention. We had the same thing in first grade but Fast Forward made a big difference. But increasing demands were obviously coming into play. He had always been inattentive with us but one critieria for ADD is that it has to be present in more than one situation. So a starting point is asking teachers what they observe.
Our Neuronet therapist thought it was processing issues, not ADD. She asked me to have his teachers observe him when he was doing things that he could do as well as things that were tough. His resource teacher told me that he spent a good portion of his time staring into space. Her extra attention on the issue made her think he was even more ADD-like!!
So I went to the pediatrician last summer. He sent me to a neurologist who diagnosed him as ADD-inattentive as well as having a right brain deficit. He told me most severely LD kids, like my son, were also ADD.
In the summer we did Interactive Metronome and Neuronet therapy.
This fall I wanted a baseline for medication from his teachers. Bottom line—both, including resource who he had last year, said no inattentive behaviors. His resource teacher told me he is like a different kid. So we haven’t medicated (have added vitatmin, higher protein diet which Amen recommends).
Did he have ADD that was “cured” or was it processing issues alone that were “cured.” I actually think he has mild ADD and more significant processing issues. But that is just my gut.
Beth
Re: How do you know when it's ADD?
Yes, we are in the same boat. I think my son has mild add. He was fidgety in class last year. He never was one who liked to sit still in restaurants and almost always jumped on the furniture at other peoples houses when he was little. He went through some impulsivity with his little brother that drove me nuts.
IM helped stop the fidgeting and he can now sit in restaurants and baseball games, in class etc. He stopped the impulsivity too but that was not helped by IM. I am not sure what helped that maybe the new high protein diet and the omega 3 he gets everyday.
He still has organizational issues and trouble focusing when things are difficult. He just shuts down. He doesn’t get spanish and his spanish teacher asked me if he has add. So one more thing I need to help him with at home so he can pay attention in class.
Re: How do you know when it's ADD?
Laura,
A couple of thoughts: First, ADHD cannot be diagnosed based on how a child responds to stimulants. Some kids who do have it will not improve on stimulants. Some kids who don’t have it will show improved focus because that is what the medication does. A knowledgeable physician will not urge a trial of meds as a diagnostic tool. Second, it can be very difficult to distinguish between LD and ADHD, or even between ADHD and something like depression. Just to mix it up more, there is a strong association between LD and ADHD, and where you find one, it is common to find the other. There is also a strong correlation between ADHD, LD and psychological problems like anxiety and depression. Some kids have all of them. I’d recommend that you have your child evaluated by an expert. Look for someone with in-depth knowledge of LD and ADHD, perhaps a developmental pediatrician. The best would be someone with expertise in neurology, psychiatry and pediatrics who specializes in evaluating children for potential LD and ADHD. Third, so far it is not part of the routine evaluation to conduct MRI studies, although you might be able to find a study where this would be done. Instead, diagnosis is a matter of considering the child’s history and test scores, along with Conners’ scales or other scales measuring conduct associated with ADHD. This is where a truly knowledgeable evaluator can make all the difference.
Andrea
Andrea
Thanks for the responses!
Thanks Beth, Linda and Andrea,
Beth, I’m still thinking about doing IM this summer regardless of my son’s test scores. If he does have Attention Deficit, IM might still be helpful. Also, I have a hard time believing his SID is fully integrated. He still has tactile defensiveness. That’s a sign of some SID. I waver between thinking his attention difficulties are due to processing issues (which I believe he does have), or a personality quirk — rather than ADD. I just don’t know.
Linda, I don’t think of my son as impulsive. The only time I notice him being real figety is when he’s reading, but reading is extremely difficult for him. Although isn’t that a sign? Many people, even when given very difficult tasks don’t get super figety. And yet he can focus on difficult tasks he enjoys. But isn’t this too typical? Kids with ADD have no trouble focusing (or even hyperfocusing) and doing things they enjoy?
Andrea, thanks for the suggestion to find someone who specializes in ADD. Also, in pointing out to me that a “med trial” won’t necessarily give us an answer (there never is an easy answer!). Awhile back an educational psychologist who I brought my son in for testing (who doesn’t believe my son has ADD), mentioned that we could easily do a quick “med trial” and we’d know within days whether he had it or not due to his response. I guess not!!! I’m going to try and get a hold of Dr. Amen’s book and also look around for someone who specializes in ADD. Maybe I can find some answers.
Again, thanks!
Re: Thanks for the responses!
One book I found helpful was “Beyond Ritalin” by Garber, Garber, and Spizman. It talks about what drugs will and will not do. I personally found it disapointing how many things drugs won’t do!!! I was hoping for an organized child. Frankly, we got more from doing IM than from what these folks say medication will do. My son still isn’t organized but much better than last year.
Beth
Re: Thanks for the responses!
If you give me a difficult job to do and I feel I can’t do it I will be nervous. As an adult I don’t fidget but I think that is because I have learned to hide my nervousness.
Children are an open book. I think you have to ask is the fidgeting related to nervousness because it is difficult and there is pressure to perform.
I think it is very difficult to tease out vision problems, sensory integration problems and attention problems. I think if you get results from OT or vision therapy you have your answer. I also think family history is important. If there is vision related ld in the family definitely go after that before starting meds for add.
There are some good articles in the ldindepth section of this site. I just looked through it and found at least one article that describes characteristics, how it should be evaluated, how it affects school, etc. A kid (or adult) can have add without being hyperactive.
If you have concerns about your child’s academics , you can have the school do a full psychoeducational evaluation. That way you can rule out or in any learning disabilities. It is possible to also have both adhd and ld’s.
Amy