ADD inattentive type

My 11 year old son is ADHD-predominately inattentive. Like you, I have noticed that most of the information about ADHD deals with the hyper part, and ignores the inattentive side of ADHD. I also believe that inattentive boys are really ignored, as the inattentive side seems to be more frequently in girls. Many teachers are unaware there is an inattentive side of ADHD!)

My favorite books are “Driven to Distraction” and “Answers to Distraction” by Dr. Hallowell. I also recommend Sandra Rief’s book “The ADD/ADHD Checklist, a Reference for Parents and Teachers” which offers good, practical advice for ALL ADHD kids.

At the start of 3rd grade he was finally diagnosed (after Conner surveys, LD screening by the school, etc) and we started him on Ritalin. The change was huge. He was finally able to pay attention, get his work done, and have success. This was a TREMENDOUS boost to his ego!

He’s now in 6th grade, and middle school is somewhat of a nightmare, but he’s hanging in there! Even on meds, he moves at a snail’s pace (unless he’s on the soccer field!) but he’s able to focus and get his work done. It still takes a lot of extra effort on all of our parts, but I shudder to think of what it would be like without his meds!

Good luck to you!

JulieinSC

My 12 year old son has this diagnosis, among others. Except for a preschool period of hyperactivity, he has always been very dreamy and slow-moving. He frequently appears not to have heard what is said to him, although in actuality he did hear and understand but is just very S_L_O_W to respond. Medication plus counseling and tutoring, along with 4 years in a special ed setting, have made a huge difference for him. He has “graduated” from special ed and is doing well at a very small, very challenging private school where he uses a laptop for most written work. His organizational skills, which were once abysmal, have improved as a result of long-term tutoring in this area. He isn’t much good at generating strategies to organize himself, but he is perfectly capable on being taught those strategies and of following them once someone points them out to him. My son has done very well on a stimulant medication. We are convinced that medication was critical to getting him to a point where we could remediate his LDs and teach him ways to get and stay organized. YMMV, of course. As you have probably already found out, most of the studies to date have focused on children with combined type ADHD. From what I’ve read, most inattentive ADHD kids will have good results with the stimulants. (The Amen Clinic website has some good information on the different types of ADHD and how well the various kinds of treatments work for them.) I don’t know how well kids with inattentive ADHD do with the non-stimulants like Strattera. I’m not sure there has been any research yet on that. Some people have theorized that inattentive ADHD is not really ADHD at all, but rather is some entirely different clinical entity. I don’t know what I think about that, but its interesting in any event. I think it is great that you are finding out now about your son’s possible ADHD. Lots of the inattentive types get overlooked and are viewed as lazy. Just knowing of the diagnosis can make a big difference in your child’s life. Good luck!
Andrea

Please look into the possibility he may have central auditory processing disorder, even though his hearing may be fine. This needs to be tested for separately from a hearing test—the testing is not too expensive as these things go and is usually covered by insurance. CAPD would be consistent with having to have directions repeated and difficulty learning to read and often can co-exist with ADD. (Or perhaps he’s not ADD, just CAPD.) A standard language test by a Speech Language Pathologist may be in order as well to see where he stands in expressive and receptive language.

My ds has both ADD and CAPD. Fast Forward was an enormous help for the CAPD. Medication has helped the ADD and also has had a positive effect on his processing skills. We have switched to Strattera from Adderall, which was causing emotional outbursts as adolescence has kicked in. We are getting far less of this with Strattera, which unlike Ritalin and Adderall, is not a psychostimulant.

FFW is fairly expensive, but see Dad’s post of today on the Parenting an LD Child board for a recent study on its effects on dyslexics. A lower cost or stop gap approach before summer for addressing CAPD would be Earobics, a home computer program, and you could possibly look into The Listening Program as well, which is pretty easy to implement. (I have not done either of these, as our success with FFW was very great.)

Do not be discouraged if the pediatrician discounts the possibility of auditory processing disorder. I would insist on him agreeing to have it tested if you need the doctor’s permission to get insurance coverage. Many doctors are just not very up on these sorts of things. If your child had repeated ear infections as a child testing his auditory processing would definitely be called for. (It can also help for getting remediation covered—if a problem like this can’t be pinned to an illness, the insurers tend to view it as developmental and, thus, won’t cover any treatment. Even if it can be associated with an illness, insurers still tend to balk.)

Good luck.

Having an inattentive type child has it’s blessings; they are generally sweet, wellbehaved, high functioning, funny, happy and social. It is these very blessings themselves that are the cause as to why you won’t find as much written about it. They are often not diagnosed and even when it is caught, it’s just not as big a problem in the families lives and in the schools as the other types. I am often hesitant to post about my problems, because it seems the other types have it soooo much worse than us. While my heart aches for these families, I can hardly relate to a lot of what they are going through, and the problems with my son seem petty in comparison. Still, there but for the grace of God go I.

I can see why people think this is entirely a different disorder than ADHD, it shares so few symptoms. Don’t get too wrapped up in this debate, I have found it’s really irrelevant. There is something neurologically wrong with our kids and it still is devastating to their learning and self esteem and cannot go unaddressed. At the very least, it is similar or related to ADHD and it is helped by the same meds. Those are the only important facts.

It is obvious that the same meds help all types. But I disagree that amphets are the way to go. There is tremendous success with non amphets for the inattentive and if you don’t have hyperactivity, why go with an addictive med if you don’t need to? Why treat his activity level if there is nothing wrong with it? I have found that amphets make my son hyper and anxious and obsessive, much the way speed makes drug abusers feel. My son had a great experience on Wellbutrin and now, the Straterra has been the answers to our prayers. Unlike the amphets, he sleeps, he eats, he grows. What more could you ask for in an ADD medication? My advise to anyone considering medicating this type is go with the minimal, just address what’s wrong with them. These types respond very well to other therapies, a lot of exercise and tutoring.

He is ADD-Inattentive and 17 years of age. We had success with stimulants such as Dexadrine for 3 years and when Strattera came out we decided to try it. He was never addicted to it he wouldn’t take it oin the weekends only when he needed to focus at school.

Strattera started out ok, he never had any hyper behaviors, he was imaginative, (dreamy and slow moving) but while on Strattera he became lethargic and depressed. We gave it some time and it got a little better but he was tired of feeling exhausted all the time. We talked with the Dr. and he said that Strattera works better on kids who have behaviors and who are not Inattentive. So we quit Strattera. The Dr. thought about trying Concerta but our son decided he wanted to go off all meds. He is still battling focusing and still keeping time to a slower paced drum. We are going to let him go it on his own and then later he will decide if he wants to go back on meds..

My 13 yr old son and I both have this type of adhd. Where the impulsive side came out in my son was in doing things like missing operation signs in math (adding instead of subtracting) or just picking the first answer in a multi choice test without really looking the other choices over. Nothing real obvious though.
I had thought of this when I read you mention no problems with impulsivity.

Also, another source of information I found interesting is an ebook by a pediatric neurologist. The link is www.pediatricneurology.com/adhd.htm
This had more information on the inattentive side of adhd. In addition to lots of other info. Hope it helps.

Had it not been for the reading problems that surfaced early on, my son probably would have fallen through the cracks and been completely lost, he is quiet and shy, doesn’t like to call attention to himself. He has had to be encouraged to ask for help from his teachers and still really won’t do it all that much. He currently takes concerta but has been on some form of methylphenidate since he was 6 and a half.

Amy

Thank you all for such helpful information. It is great to know I am not in this alone I can see I still have a lot more to learn, but I feel that I am on the right track now. You have all provided great resources as well as wonderful personal insights. I would love to hear anything more anyone else has to contribute. Thank you so much for giving me the benefit of your experiences.

I found exectly the opposite and no doctor should be laying down the laws on any med that treats any disorder in which there is so little known about and the and medicines that treat it. It does not only help hyper kids. It does help inattentive kids. It doesn’t work any better on one than the other. It does not work any better on children than adolecents or adults. It has a higher failure rate among adolecents who have been on Ritalin and the like because they need the instant gratification of the speed. This med works very different and anyone used to speed will find it harder to get used to. Like any med or anything with this disorder, there is no rhyme or reason behind who it works for and who it doesn’t. It does indeed work for as many people as amphets work for. There is tons of misinformation going around about it, mostly from ignorant doctors. Like everything else about the meds that work on this disorder, the proof is in the pudding. My child is only inattentive, the sedating effect disappeared in two weeks, completely. I have read boards where people claim the opposite, that it almost always helps attention but sometimes doesn’t help the moderate to severe hyperness. You have to try it to know, just like all the other meds, there is no rhyme or reason. Anyone claiming differently hasn’t had much experience with this med or ADD for that matter.

JWA
If you’re intersted, I can refer you to other boards with wider ranges of ADD and the meds and therapies that work and fail. But i can’t say it will leave you any less confused. This disorder isn’t about the brain as much as the thought process and it’s very complicated, no two kids are alike.

I opted for non amphets as well, I don’t understand why the doctors want our kids on speed if there aren’t indications of hyperness. I have a 7 year old son who is only inattentive and we also are trying Straterra. The Stratterra is the only medication he has used that has ONLY effected his attention span. It has helped his attention much better than Ritalin. Ritalin stinks if it doesn’t work. It often does not for this type. It is up to you find out for yourself. Once you educate yourself on this disorder, you’ll realize, the doctors don’t know anymore than we do. Sharing with parents is a great way to get accurate information about alternatives. But you cannot compare your child to another just because they are the same “type”. I agree, doctors often state their own limited observations as facts. It’s up to us to filter out the EGO coming from our doctors and get the true facts. There are few facts about ADD that hold water across the board for everyone.

If anyone wants to start a thread of just the issues of the inattentive type, I’ too, would feel a lot more comfortable reading and sharing a few days within our type. I also feel silly venting to others.

Meds aren’t always the answer either and each person’s body reacts differently to the medication. I have two sons one does well on Strattera and the other it just didn’t agree with him. He is now off all meds and does fine.

I am not a researcher or an MD., just a mom who has lived with ADD her whole life and my child’s physician has kids who are ADHD and has treated many kids who have ADHD. This same Dr. was the one who helped me see the light on my daughter when all along I thought she just had CAPD…it was ADD-Inattentive as well…He sent her to a specialist to make sure…and his hunches were right. He was also the one who told me about Strattera and that maybe we should try it on my sons…He keeps up on the meds and the treatments..and knows what is happening with his patients. That, Rebel mom, is the proof in my pudding,

That implies that those who give their children stimulant medications for ADHD are somehow abusing them. If you prefer not to give stimulants to your children, that certainly is your decision but there is no call to denigrate those who have reached a different conclusion. Strattera is a great advance, but so far there are NO studies showing that it is superior to, or even equal to, stimulants in treating any subtype of ADHD. It is a new drug and has not been as extensively tested and evaluated as the stimulants have been. What testing has been done demonstrates that it is a safe and effective treatment. It does not demonstrate that it is the safest or the most effective treatment. Some people will respond well to Strattera and some won’t. Some people will experience side effects from it (and those side effects are quite similar to those of the stimulants) and some won’t. If I were just starting out, I would probably try Strattera first, simply because it is not a controlled substance. That doesn’t mean that child who is doing well with stimulants (which have been extensively studied for more than 40 years) should automatically switch to Strattera. Flame away …

Andrea

The stimulants don’t “speed” up a person with ADD. ADD’ers who take stimulants…the effect is just the opposite, the stimulant can calm the brain down and help it work more efficiently allowing them to focus and not be overstimulated. As with all meds there are side effects and one must try different things to see what works for them. Whereas, a person who doesn’t have ADD and takes a stimulant they feel differently, they feel like they are working at hyper speed, their heart races, etc…

I have found that if I have enough time to relax I don’t need medication for my ADD. I have more clarity when I take medication but if I take time to listen to classical music, (it’s motivating and relaxing at the same time), working in the yard or cleaning my house allows me to contemplate and reflect on things, sewing and painting have the same effect as well…I have found that when I am doing “mindless” activities gives me the down time so that I can focus and recharge my attention. I have been teaching my daughter who is ADD how to get her downtime through sewing and gardening and she is enjoying it..

If my life is overbooked and there is no down time that is when I had to take meds in the past. As an adult I have been able to monitor my behaviors, however, many children can’t and that is where structure and lots of it come into play.

ADDer’s who are inattentive need structure and lots of coaching to keep themselves on track. It isn’t easy living with ADD but I through time and patience I am learning to make my ADD a strength.

My 7 year old daughter was diagnosed over a year ago with ADD-inattentive type also. She struggles so much in school. She just can’t focus on her seatwork. Her teacher doesn’t want to pass her on to 2nd grade (private school) because of this. Her grades are fine. I suspect CAPD and we have an appointment for that testing in April. We have tried several ADD meds, including Strattera. The Adderall made her violent, the Concerta and Ritalin took her appetite away and she lost too much weight. She got sleepy on the Strattera. Her teacher knows I am trying to find something to help her with the focus, but she says the school can’t meet my daughter’s needs since she has to be worked with one-on-one to complete her work. (not to understand it, just to stay focused long enough to finish) We love the school and I’ve already looked into other private schools in my area but not many people are willing to spend money for their LD kids’ education when they can get it free from the public school. Has anyone tried any medication that helped with CAPD/focus problems? Her ped wants her to see a psychiatrist and get on Prozac or something similar. She says that might help her. She’s also seemed to build a wall at school and not want to work. If anyone has heard anything about Prozac and CAPD, I’d love to hear from you, or anyone else who can throw ideas my way. I’m also desperately trying to convince the school to pass her and let her try 2nd grade.

We used one on our daughter who has CAPD and ADD. Because she wore the trainer she was able to focus on what the teacher said and get her work done, and she also learns auditorially thanks to the auditory trainer. Also the auditory trainer hid her ADD-Inattentive behaviors until 5th grade. By that point we had to do meds and Concerta has been a lifesaver for her. She too wanted to give up, she was overwhelmed. She tried so hard but it was tough to keep her spirits up. We eventually tried meds and it worked for us. But I think your daughter may do well with an auditory trainer, especially if you suspect CAPD. I have used an Auditory trainer in college instead of meds and it helped me with focusing and retention of college lectures. My grades went up too. There have been studies using Auditory trainers with younger ADD students and it has shown that their ability to focus improves as well. Feel free to e-mail me…I work with an audiologist who specializes in CAPD and I do the speech therapy for some of the kids..

Your daughter would probably benefit from lots of structure as well in the classroom and in her daily routine.

Also has she had any speech and language assessments? I will be an official SLP in May, when I get my masters degree… so I can help you there too…

In addition to Pattim’s good suggestions, have you had her specifically evaluated for learning disabilities? Sometimes a child with LD may demonstrate ADHD-like behaviors that improve when the LD is dealt with. Of course, some kids with ADHD just don’t respond to medication, but your description of your daughter’s response to meds and her school behavior really makes me suspect an undiagnosed LD, even in addition to possible CAPD.

Andrea

Ds has CAPD, ADD, as well as strep-induced OCD, tics. He was given prozac for the latter. It seemed to help the tics at first, although given they were strep-induced they may have gone away on their own. But…side effects included weight gain (regardless of what docs say, it is very common) and constant feeling of being hot (required a fan on all night long summer and winter). When the med seemed to lose its effectivenss after a new strep infection, dosage was increased, leading to serious itchiness and constant scratching, resulting in horrid scars on arms and legs.

Everyone reacts differently to medications and your dd may not have these side effects, but I have never heard mention that prozac could help CAPD. My experience has been that prozac can cause very difficult to manage side effects and is not worth trying just to see if it helps on an off chance in the absence of any documentation that it has helped kids with CAPD. A couple of people on these boards have indicated success with dealing with anxiety with Wellbutrin, which you may want to look into if that is a problem.

Unlike prozac, Adderall did help my ds with auditory processing—it helped him attend better to sounds and that helped the processing. He now takes Strattera—if I were doing it over and it had been available it would be the drug I would try first. I don’t know low long you tried it, but my ds (who weights about 85 pounds) took about a week to get over the sleepiness. Perhaps you didn’t give it long enough (or the teachers didn’t give you long enough?)

Pattim:

My 8 yr old daughter just got finished with all the testing that I requested. She has a mixed bag of issues. I have the actual PPT meeting next week but I did go over the test results briefly with the school psychologist yesterday.

The Woodcock-Johnson Cognitive tests in a nut shell showed weakness with auditory attention, processing speed and working memory - auditory. After doing research her in the LD indepth I found she has symptoms in many of the area’s covered. Visual sequencing, visual motor integration and one of the catagory’s that I thought she had most was the spacial orientation. She said that the tests given did not really indicate that , but, according to the description on this web site-difficulty oral reading, unorganized, difficulty judging time, reading and math we have problems with, confusion with the bd and pq also 2 and 6. She thought her inattentivness had more to do with this.

My own diagnosis is add with inattention and maybe some degree of the hyperactivity part but nothing that keeps her from staying in her seat at school. It’s the dinner table (and it’s not my cooking!) Her organizational skills are non existant and this is also a problem.

What is this Auditory trainer? I think it sounds like something that would help my daughter.

Darcy

http://groups.yahoo.com/group/ADHD_Bulletin_Board/

http://home.earthlink.net/~mcoleman/cpdadd.html

I am so grateful for all the support and ideas. I will try to answer or address all the issues that were brought up. First, what is an auditory trainer? I’m very excited about this idea and as you can probably tell, I am willing to try just about anything to help. My daughter had a speech/language assessment several years ago when she was admitted into the public school’s Early Childhood program for her pre-K year. She was diagnosed with hundreds of absence seizures a day (upwards of 300-400) and I thought she was so far behind because of that. Anyway, she had speech with the rest of her class although I wasn’t sure why since her speech and cognition was fine. Her seizures were controlled for over 2 years and she was recently taken completely off all meds for that. She was on stimulants at the same time and I suspect the interaction between them may have caused some of the negative results. She was tested at the end of that year and tested at or above her age level. The elementary staff who tested her (including an SLP) said they also tested for LD but she didn’t have any. Of course, I don’t believe that now, although I realize some problems manifest themselves as LD. This is another reason I’m anxious to try something like prozac or zoloft…to see if her focus is not a result of ADD.

Fortunately my daughter is very well behaved at school and never gets out of her seat. She’s one of those very quiet kids that look like they are listening.

About the Strattera, I only tried it for the weekend. She was so sleepy that I knew she woudn’t be able to function at school like that. I might try it again over spring break in a few weeks or wait until summer.

Thanks again for all the great ideas.

Sherri, A few things. I can’t address the seizure thing. I still question trying prozac as a way of finding out that perhaps her focus problems are not ADD. Prozac take a number of weeks to kick in and I’m skeptical about its helpfulness for inattentive ADD. Pattim has written above about a student for whom zoloft (not unlike prozac) was helpful, but she had a hyperactive component that it helped, while you have indicated that your dd does not have the H symptoms.

If I were you, I’d try to get the CAPD testing done as soon as possible. Call up the testing place and see if you can get on a list for cancellations. Also indicate you cannot wait for a full written report and ask that the scores be sent to you as soon as they are compiled along with a basic indication of whether CAPD seems to be a problem. You clearly need to act quickly to make sure your child is not held back needlessly.

People differ on whether holding back is a good idea or not. My own view is that it should be avoided, particularly in the case you have described where your dd’s grades are fine. (This is also the view of Dr. Mel Levine who wrote “All Kinds of Minds.”) If it is done it is preferable to switch schools to prevent social fallout. However, this is heartbreaking if yor child really loves the school she’s in. (Due to bureaucracy I was unsuccessful in fighting, my dd was held back in K so we switched schools. She cried every night for six months.)

Once you have a CAPD diagnosis, you should consider an auditory trainer, as well as other types of remediation like The Listening Program, FFW, and Earobics.

I would also give Strattera a try over spring break. My ds was sleepiest the first two or three days on this medication.

Is it possible you could get the scores from your dd’s earlier testing? If you post them on the Parenting an LD Child Board, there are often people who can offer insights.

ADD and CAPD. My daughter and I have them both and kids like this have the hardest time learning and focusing. It takes too much energy to listen and when that happens you just check out and the ADD-Inattentive behaviors begin. I like the Auditory trainers as they have been proven to help kids with both CAPD and ADD. I placed a post at the top of this BB about auditory trainers which are also known as Assistive listening devices.

Thanks for your suggestions, Marie. We have an appt with a psychiatrist next Friday. One thing I probably should have mentioned is that she was in the Discovery program (program in the private school for LD kids) until semester. It required too much extra work (that she wasn’t getting done in the first place) and she was falling behind in her regular class. So I dropped that. But the Discovery teacher noticed she was building a wall and was getting less responsive, even to direct questions. Her regular teacher noticed this at about the same time. There had been an ugly situation with Nikki and her dad (we’re not together but that’s a whole other story) at about that same time and that might have been behind that. So I think both teachers and even her ped think there might be some psychological issues bothering her. It’s so hard to mention everything in her history in a short posting. That’s why her ped thought it might help with the inattention/wall thing. But I will discuss it thoroughly with the psychiatrist before doing anything. The last thing I want to do is put her on any meds that she doesn’t need.

I’m excited that you mentioned that the FFW program helps. I just recently found out that a girl in her class has started the program. She leaves class 2 hours early each day to do it. But this girl’s grades are good (honor roll) and she doesn’t have any attention problems. Anyway, her mom told me she’s seen improvement in just a few weeks. I’m already in the process of investigating this program. I plan to implement it ASAP, but probably won’t have the time until summer.

I am also looking into the auditory trainer. I probably have a copy of her scores from previous tests. I do know that her performance and ability were not very far apart. However, I have read many places that PDD kids (yep, Nikki again) do not test well and therefore do not have accurate IQ tests. I know for a fact that she is smarter than her IQ tests have indicated. Besides my own observations, several professionals who have worked with her have said she is very smart. (Even the Discovery teacher who she shut down on said once in awhile Nikki lets her get a glimpse of how smart she is.) I think because her scores were pretty similar is why the elem people said she didn’t have an LD.

I am encouraged, though, by the school allowing the other girl to actually leave school to participate in a program to help her. I am getting an appointment with the principal to discuss options.

Pattim:

What is co-morbid? I am not sure about some of the terms I am reading about.

Thanx,
Darcy

Co-morbid just means that the conditions (such as ADD and LD) exist in the same individual….that no one diagnosis completely describes the issues an individual is faced with. Definately educational jargon. I certainly had no clue what it meant the first time I heard it in a graduate class either. Good for you for asking!
Casey