I’ve been doing more research than I should on ADHD. Each new thing I find yields 10 new questions with 10 different answers for each question. Anyhow, I’ve been able to narrow my question into a four part answer. What is ADHD? 1. A chemical imbalance 2. A nutritional deficiency 3. A vision problem 4. A different learning style.
Without making my son a test case, I’ve tried to identify which best defines my sons behavior. (1) He’s currently on Adderal, but it has not provided the focus he needs in school although it has calmed him down quite a bit that he’s no longer making his teacher cry. (2) I’ve tried mineral supplements that have yielded the same effect as the adderal- calm but not focused. (3) I haven’t yet gotten into vision therapy though I’m very interested in Interactive Metronome to get the focus element we are missing. (4) My son is very smart and considered “high functioning ADHD combined”. He excels in areas that are truly interesting to him. Science is his favorite subject. The hands on learning required in Science fuels his excellence. This is the one area the teachers never have a problem with.
So, my question is What is ADHD in your child. I’m beginning to believe for my son it is more a learning style (kinesthetic) more than anything else, but I don’t want my desire to get him off the meds to motivate my belief. Any one out there who can relate? If yes, I’d appreciate any input you may have.—Trudy
Executive dysfunction
Recently I’ve been doing some research into executive dysfunction and its relationship to ADHD. The prefrontal cortex is involved in managing a variety of “executive functions.” There is an acronym that sums up executive functions into 4 categories — ISIS — Initiate, Sustain, Inhibit, Shift. Dysfunction in these areas are common in ADHD children.
And that about sums up my children’s major ADHD issues. Particularly the SUSTAIN one. Can’t stay on task even if they wanted to. Don’t seem to inhibit their impulses. Can’t shift to another activity easily without becoming angry or delivering a full-blown temper tantrum. Get stuck on an idea and can’t put on the brakes.
Lots of information about it on the following site.
www.tourettesyndrome.net/ef.htm
(Problems with executive dysfunction are also common in Tourette’s Syndrome.)
Re: What's ADHD for your child?
I understand what your saying but I’m having difficulty with the thought of putting my son through so much just to realize it something like a learning style. My son is eight now. How long did it take you to find the right track and how many different avenues did u try?—
Re: Executive dysfunction
An interesting thing I learned (from Martha Bridge Denckla, who coined the term “executive function”) is that executive dysfunction and ADHD overlap but are not the same thing. In other words, a kid who does not have ADHD (but who does have, for example, a nonverbal learning disability) might exhibit the same problems with initiating or sustaining that a kid with a fairly classic case of ADHD shows. All the more reason to make sure that the diagnosis is made by an expert who has gathered the type and quantity of information necessary to make the diagnosis.
Andrea
Re: Executive dysfunction
So is executive dysfunction a chemical imbalance? How is it corrected? Or is it part of one’s unique make up— like a different learning style? Who is qualified to make the diagnosis?
Re: What's ADHD for your child?
It started when he was in kindergarten. He was having trouble with reading so we took him to sylvan. That didn’t work so I researched the best reading methods and did phonographix with him myself. He learned to read. I thought our troubles were over. They weren’t…..
I read everything. I have a sensory integration textbook used by OTs that I refer to along with a dozen other books. I have also learned quite a few things from these boards. My son’s vision issues were like a neon sign once I read the description of vision issues from other parents.
I know it seems daunting but the truth of the matter is that as I have developed an understanding of what he is going through it has brought us closer.
It is hard to explain. I just know what his sensory needs are, he realizes this and appreciates it. When he gets edgy I will help him out by having him lay on the floor for a stretch. He says, “Thanks mom, your the best.”
Not that he doesn’t have moments when he just doesn’t want to do certain things but then I just drop it and he is usually the one who insists we pick it back up. It helps that he is extremely motivated to succeed. I have made it clear that this is his work not mine.
I told him he has trouble with his eye movements but we will fix that and we did.
He is just so happy that I am on his side and he is not alone with his struggles.
I am doing this so that I won’t have to do everything for him in the future. He already is pretty independant with homework (it is so nice to not have to go over every little thing) and it takes much less time.
He has a very good brain in there once we take away the things that are holding him back.
Re: What's ADHD for your child?
I feel if the meds are helping-or the supplements are helping-it is irrelevant what the diagnosis or label is.
If you are opposed to meds, and supplements get the same result for your child, by all means go with supplements and lose the drugs(I am planning to try supplements with my son over the summer)
My son had been labeled ADD, CAPD, and Aspergers by 3 different people. I myself wonder how ‘dyslexic’ has not entered the picture.
But the medication helped him, so do I really care? If the Aspergers label will get him services he needs he is not currently receiving I will happily go for that one!
Truthfully, even if you could prove beyond a shadow of a doubt that your child’s issues are simply a learning style, do you think it would change the way the teacher is perceiving or treating him? Probably not. She would still want ‘something’ to help her manage him.
JMO
Re: Executive dysfunction
As I understand, EF is a brain-based problem, specifically in the frontal lobes, which control planning and organization, among other things. It probably does involve brain chemistry, specifically dopamine transmission and perhaps norepinephrine. These are things that are still being researched. I don’t think you would call it a learning style, at least I don’t conceive of it in that way. Some kids are kinesthetic learners, for example, and that is a learning style, but difficulties with initiating and sustaining effort tend to appear in all settings, although the problem is likely to be more easily dealt with in a smaller, more hands-on environment. Denckla, who came up with the name “executive function,” practices in the field of developmental cognitive neurology and I tend to think that the best person to diagnose a condition that may be treated with medication is a medical doctor. Nonetheless, some people get the ADHD diagnosis from a psychologist. I would not favor having the family doctor or pediatrician make the diagnosis because ADHD is hard to diagnose correctly and a generalist might not have the background or experience necessary to make the diagnosis and rule out other possible diagnoses like CAPD or other LDs or even a seizure disorder. A good choice might be a developmental pediatrician (different from the regular pediatrician we take out kids to see) but really, anyone who specializes in LD and ADHD (and knows how to distinguish between them) would be alright. A children’s or teaching hospital is often a good place to find experts. I think that if more pediatricians would refer parents for an evaluation by an expert instead of just whipping out the prescription pad, we would see the claims of over-diagnosis evaporate. This is probably more information than you were really asking for, but I hope it helps.
Andrea
Re: Executive dysfunction
DD’s primary challenge areas are sustain and inhibit with some shift. Her shift/fixation problems seem normal to me b/c I’m so used to them. She initiates a helluva lot though LOL. She is diagnosed ADHD Inattentive - those who know her best laugh at that one b/c she at least deserved the Combined diagnosis for hyperactivity.
Just like people are different, no two ADHD’ers are the same. The ADHD affects kids differently too. One may have no school and limited social problems, but hyperactivity and impulsivity may cause major safety problems. One may be no behavior problem at school, but absorbed nothing while there either. Barkley has described it as too much attention, not lack of and a matter of self-regulation.
My dd’s ADHD affects her most at school - she has learning differences. It was explained to me that if she had one and not the other she probably would have made it through school ‘ok’ with struggling - she is bright so could develop compensation skills for one. I don’t know to what degree and when she would have “crashed” if she had just the ADHD b/c we didn’t let it get that far. There are certain points that can trigger a crash - 4th grade organization, Kind. reguiring kids attend and follow class structure, middle/high school independence.
The fact that dd has both was a double whammy causing her significant hardships. We addressed the learning differences and she has come around brilliantly. ADHD-related struggles remain in school though (forgetfulness, rote memorization, disorganization, sustaining mental effort, self-regulation/control) with symptoms apparent during her non-school life (slowing down to connect with others, sustaining play activities, impulsivity in social situations, perpetual motion and throw in the occasional MAJOR safety concerns like riding her bike into moving cars).
ADHD is heritable. I have it, dd has it. It has been explained to me it is neurobiological, irregularities in dopamine levels or neurotransmitter functioning.
I think today’s overly scheduled kids, ‘hyperparenting’ and school demands tax ADHD’ers more than ever before, but ADHD has always been around. It’s not a conducive time to be a kid with ADHD - causing the hardships of those who have it be more apparent. I don’t think it is contrived by some sort of medical or gov.’t conspiracy (we as a society are just not that smart/together to orchestrate vast ‘conspiracies’).
Lack of good teaching can exacerbate it, but not cause it. Same for bad parenting. Allergies can mimic ADHD symptoms - so that is a possibility but unlikely so you need good docs. It is not a learning difference although ADHD can affect the way kids learn plus there is high comoribidity with LD’s -again need good diagnosticians.
We know more than ever before but in this info. gathering process discovered how much much more we still need to learn.
Re: Executive dysfunction
The multi-factorial nature of this disorder certainly complicates diagnosis hence the ADHD lable can be misleading, inaccurate and misunderstood but more importantly misdiagnosed. Even with an “accurate” diagnosis treatment and intervention present other problems.
From everything I have read on the subject D-1 and D-2 transporters are only part of the equation with the distinct possibility that dopamine transport and dopamine and epinephrine receptor sites degradation may end up being a scientific wild goose chase. Unfortunately, many of the studies were done on brains that were exposed to long time methylphenidate use so in my way of thinking comorbidity possibly exists. Therefore any conclusions should be viewed with some healthy skepticism.
Here is a well know fact. One in three children are iron deficient. As iron deficiency effects alot more than red blood cells. Iron deficient children are cranky and inattentive.
Re: What's ADHD for your child?
It definitely has some component in the brain-there isresearch being done on the link between children with ADHD and a family history of Parkinson’s. My son has ADHD and a paternal great-grandfather who dies from Parkinsons, and I have a friend whose son is ADHD and her father has Parkinson’s so I am hoping some conclusive evidence in either directions evolves soon.
For my son, meds have been a miracle. We did Behavior Mod and supplements and diet for years when he wsa a pre-schooler and then for kindergarten and half of first grade. It did not work, he was inattentive unless he enjoyed the material (science and math), he was disruptive, impulsive, and a major behavioral problem. I spent more time in the principal’s office during his kindergarten and first grade years than I care to remember. He could not read because he could not remember “the code” from one word to the next (would read ran with help but then could not read man…..and then after helping him, he could not read fan).
I can tell horror stories about him sneaking out of the house at 5am when he was only 3, climbing the hot water heater to get to the iron and then setting the carpet on fire, the deadbolts added to the front and back doors to keep him in, the gates across his bedroom door, the time he realized that I had added deabolts so he went into the garage and into my car and opened the garage door with my remote, so then another dead bolt, and finally his bedroom door knob being turned around so that we could lock him into his bedroom at night before he killed himself or the rest of us.
Meds half way through first grade solved all of the behavioral issues, we moved to get him out of Catholic School and into a highlyrated dictrict and Corrective Rading solved the decoding issues. BUt then the eye teaming and visual processing issues became more apparent. Vision Therapy solved those issues.
My son described it best himself last summer, before fifth grade he had to have read an assigned book and do a time line on the events in the book. He had been taken off his meds for the summer and was having difficulty reading the book to begin with, and then completely melted down when he sat down to do the timeline. He banged his head on the table, and described his brain to me as “I open one door to find the answer, but I see another door and I HAVE to open that because it’s there, and then I find another door, and by the time I realize that I am off track I can’t find my way back”. He requested that I call the doc and get him back on his meds immediately. This is a child who swore he did not need them and that I was making him take them
It was quite an epiphany for him. He still can be looking right at me and has all the appearances of a child who is listening intently but then has no recollection of the conversation a few minutes later. Only now, he believes me when I tell him that we already discussed “why” or “when”. This most often occurs after 6pm when his meds have worn off.
And again, ADHD is different things to differnt people. He has the ability to focus in school and is now in a gifted program for students with high mathematical abilities, but busts his butt to get a B in communications (reading, grammar, spelling). 5 years ago I never would have expected a B, let alone that being his only B in a swarm of A’s. But he is purposely grouped in a team setting (3 teachers) that includes gifted and ADHD children so the teachers teach to their talents. If he had other teachers, or was still in Catholic School, he would be adrift. Find the right mix for your ADHD child (or any child for that matter) and they can do anything.
Re: What's ADHD for your child?
Thanks everyone— u’ve helped me so much. This summer will be my big trial and error period. Wish me luck!
Re: What's ADHD for your child?
Beverly,
The Parkinson’s connection is intriguing. Parkinson’s affects dopamine levels, and dopamine transmission is a factor in ADHD. My mother-in-law has Parkinson’s and my youngest son has inattentive ADHD and developmental coordination disorder, which is considered to be a movement disorder. He has right-sided hand tremors as well. Parkison’s is a movement disorder and obviously involves tremors. The parallels certainly are there. It will be interesting to see what can be developed through research.
Andrea
Re: What's ADHD for your child?
Interesting. No Parkinson’s on either side of our family. Just some diagnosed/undiagnosed ADHD.
The scariest thing for me is seeing two SIL’s as adults. I’m again layman, not MD - but they definitely exhibit ADHD symptoms. One SIL has insulated herself from external problems and really takes care to look after her own needs/functioning, but the other has some major external problems - self-medicating/alcoholism, job issues, obsessive shopping (FIL has bailed her out many times to the tune of $30-40K per crisis). That’s part of my resolve to give dd every possible support I can so SHE can develop into responsible self-sufficient adult.
ADHD can be an explanation, but shouldn’t be an excuse.
Re: What's ADHD for your child?
I have questioned my pediatrician about trying the Parkinson’e medications for my son’s ADHD but my insurance won’t cover it since it would not be an approved usage, he is also concerned about the fact that usage in children has not been approved. I would love to find something other than the stimulant meds. My son is super thin but even off meds last summer for 2 months (and eating everything in sight) did not gain any weight because he could not stop MOVING!! A non-stimulant med would control the issues without causing a loss of appetite so I would hope he would gain weight. The pediatrician is of the opinion that myson was genetically meant to be thin and switching meds, when the meds aren’t the cause of his thinness, is not an option.
I was told about the study by a School Psychologist that I met at a continuing education seminar last year but have not been able to find further information. I would really be interested in having my son involved. It is even more interesting to hear from someone else that they have ADHD and Parkinson’s in their family.
I would really like to hear from others with the same familial connections.
My first answer would be there is not one answer. Each child is different with different needs.
My high protein diet in the morning suggestion may not work for you just as your magnesium suggestion did not work for me. It is still very much trial and error until more is learned about the brain.
I don’t think that vision therapy is the answer for all kids with adhd but it has done wonders for my son.
I think interactive metronome works best with kids who have motor issues/sequencing issues. Some have not seen big gains with this intervention.
It is all very child specific and we as parents are often the only ones who can figure out what works for our child.
I have found these boards very useful for this purpose. There is still some trial and error but I seem to be on the right track for now.