Getting Help For Your ADD/ADHD Kid
I think my second grader has inattentive ADD/ADHD. What should I do to get him the help he needs at school?
I have an older-kid question for you that you may or may not have insight into. Of course it pales in comparison to all the interventions you’ve managed with Noah, but it’s weighing heavy on my mind. I have a delightful boy of 7.5. He’s never had any developmental delays and was fairly average in school, until BAM. 2nd grade. Now it’s nonstop emails home, behavior notices, poor progress reports and report cards. Poor attention, lack of focus, doesn’t complete assignments, has terrible handwriting which makes him take way too long to complete written work (or makes him so frustrated that he gives up/refuses to do the work altogether). I’m seeing this at home too. Homework – which is one math worksheet and one “word study” (spelling) task per night, plus 15 minutes reading – often takes around 2 hours. Oh, he also has to do all the unfinished work from the day, usually his writing journal. That alone is probably an hour to eke out 5 sentences. (The teacher knows how long it takes and says “of course we don’t want it to be 2 hours” but doesn’t allow any more time to complete it, so….)
His teacher requested that an OT from the school district observe him back at our first p/t conference in early November. 2 months later I got her report, which basically said he’s “a reluctant writer” with “frozen thoughts” and send home a packet of Handwriting Without Tears worksheets for us to do as homework. We’ve been working on it, but (a) it continues to be frustrating as hell for everyone involved, and (b) I’m seeing no improvement and still getting notes home about it.
I’ve asked both his main teachers, his guidance counselor (who is a good buddy of his in the school), and his pediatrician about ADHD and they all said they didn’t think so because he doesn’t have the hyperactivity or the impulse control or many of the other hallmarks. I’ve been reading about the Inattentive type of ADHD that sounds more like my kid. I’m working through the process of potentially getting that diagnosed with the psychotherapy part of my doctor’s office. The teachers also know that, since they had to fill out one of the questionnaire’s for diagnosis.
Naturally I feel crappy and blame myself because I have to work and he’s in after school care for the first time ever and we have a long commute. We leave home at 7:30 am and get home at 6:30 pm and then it’s all homework battle and then bed. My husband is minimally involved/present (and may become completely uninvolved/unpresent in the near future).
SO, my question, that I’m eventually getting to, is – what happens now in terms of getting services? I have friends whose kids have IEP’s and 504 plans and stuff, but they were universally getting services from the county before Kinder started so they kind of just eased into it. Ideally, I’d like some OT time during school to help with his handwriting and some support during the journal writing time. I’ve raised this question with multiple people at the school and have basically just been told “well, let’s keep an eye on it.” I want ACTION. How do I make that happen?
Also, he’s in an immersion program and although the language isn’t the part he’s having trouble with, maybe that’s too much for him? Should I pull him out of that? That would mean going to our not-great local school. We also have to drive an hour each way to school, so maybe the solution is to move closer so he has more time to play and then work won’t be such a pain? Or should I think about holding him back?
GUIDE ME, AMALAH. YOU’RE MY ONLY HOPE.
Okay. Let’s hack this up into some baby steps.
First step: Lay off yourself, with the guilt. This is not your fault; you (nor your schedule/commute/educational choices) did not “cause” this. Despite all the stigma out there about ADD/ADHD being some kind of catch-all designer diagnosis for kids who watch too much TV and bad parenting, it is a real disorder that exists in the wiring of the brain. We clearly have a really long way to go in this country in terms of our collective understanding/empathy/treatment of all this mental health stuff (says the mom who still gets “helpful” books from family members about ADHD being a myth and if we’d only try [thing we totally already tried] or [completely bizarre quackery thing], he’d be “cured.”), but rest assured, you did not cause this.
Second step: Get the evaluation done. A full psychoeducational evaluation will give you a complete look at your son’s strengths and weaknesses, and bluntly assess the educational impact of his attention/focus issues, and hopefully uncover the exact cause of his writing challenges (i.e. motor skill delays vs. too-many-ideas-to-get-on-paper-and-I-can’t-organize-my-thoughts-because-I-have-a-million-of-them-oh-look-SQUIRREL). It will also conclude with the psychologist’s recommendations for educational accommodations and additional interventions/therapies.
(Yes, yes, I’m probably jumping the gun here and assuming that yes, your son does have a form of ADHD. Sure does sound suuuuuuuper familiar, everything you’re describing. It could certainly be a bad teacher/student fit as well, but second grade seems to be The Year that’s the tipping point for ADD kids, when it clearly differentiates itself from “typical little boy wind-up” and becomes a more obvious problem. It’s the year when school and homework get Super Hardcore Real, so kids who were maybe floating a bit under the radar suddenly come to the surface, completely flailing.)
Third step: Take the evaluation to his school and request a formal meeting of some kind. (He’s in a private school? Or special immersion charter-type school? Sorry I’m not 100% clear his current placement.) At a minimum, you’ll want: his teachers, a principal, a school psychologist/guidance counselor and possibly any resource/special ed teacher his school has who typically provides pull-out services like handwriting or tutoring. This is when you will tell them that the “wait and see” portion of the proceedings are over, as you have a diagnosis. It’s time to work as a team to turn things around for your son, before this frustration leads to 1) him falling behind academically, 2) him aiming his anger inwards at himself, which is why many undiagnosed ADD kids get depressed and feel “bad” or “worthless”, or 3) him aiming his anger outwards at peers and teachers, which is why OTHER undiagnosed ADD kids get simply written off as bullies or behavior problems.
Now, I have no idea what kinds of services your son’s school is equipped to provide for him. I think your desires sound perfectly reasonable, but you never know. Most ADD-centric services at public schools are pretty…underwhelming at best. So be prepared. It’s simply not a diagnosis that immediately brings in the Big Guns. (Sample accommodations might include: A graphic organizer for writing assignments, permission to type his writing or allow you to dictate, testing alternatives, a special spot in the classroom where he can take a time out, 30 minutes a month of handwriting help, etc.) If they outsource OT/handwriting help to the district, well…you’ve already seen what they’re willing to offer (nothing), and I can’t promise that an official ADD diagnosis will change that. Even in our wonderful, well-funded public school district, several friends of mine have all tried and failed to secure IEPs or 504 plans based on an ADD/ADHD diagnosis alone, since it wasn’t causing enough of a educational impact, particularly once they started medication.
(Note: No school is allowed to demand that you medicate him, by the way. This is a weird myth I keep hearing in support of “not telling” a school that your child has ADD/ADHD because they’ll “make” you medicate them. No. That remains a personal choice. It’s one that I really encourage you to keep an open mind about, however. The right medicine can really, really help these kids. Our experience has been nothing short of transformative.)
So with that said, you may need to accept the idea that many of your son’s needs will have to met privately, by you. If you’re lucky, you might be able to find some help through your insurance (like private OT, or weekly talk therapy), but you might also have to pay out of pocket for things (homework help, tutoring, etc.) This can be true for any parent, no matter what school they’ve chosen or what district they live in. Even we’ve usually assumed that the services we get from the district represent the bare minimum, and we prefer that our son get a few more pieces of flair, as it were.
But oh, I’ve gotten so far ahead myself here. The evaluation with your doctor’s office should be priority one, right now. Make sure they are doing a very wide, wide range of assessments and be patient. Communicate with the evaluator so they understand that you’ll need a full report with recommendations to take to his school and to base your own private plan off of. (You hint at some marital problems/absent father issues, so that should also be considered when assessing his behavior problems/acting out over homework. He might need someone to talk to about that.)
As for your final questions about changing schools or holding him back…dude, those are Big Decisions and I do not know. I am sure there are pros and cons to both, but it does feel a bit premature to be even bringing them up at this point. Find out if your gut is right about ADD first, and see what your school can do if you push beyond mentioning services in a casual, hypothetical way. Don’t approach anybody looking for a fight (this is a mistake I’ve seen other parents do, going on the blisteringly offensive from the get-go — it really doesn’t help anybody to be combative). Instead, be firm but unfailingly willing to listen, communicate and compromise. Understand that every school and district has its limitations and you will probably want to engage with additional resources elsewhere.
Finally, for the short term, it might help your nightly homework battle to go ahead and read up on ADD/ADHD tips and tricks. Since you’re doing regular Handwriting Without Tears worksheets (holla! we’ve done that! stick with it, they do help!), perhaps his teacher would be okay if he dictates his five sentences to you, or types them on a computer. Give him frequent breaks (ideally before the frustration builds) and let him break assignments down into small little nuggets. If he likes to draw or read comics, buy him a blank journal or comic book pages and let him draw whenever possible — it’ll still help his motor skills and teach him that there is joy to be found in expressing yourself on a page, and eventually he might WANT to accompany his illustrations with some words and a story.
We had a terrible nightly battle over the reading journal this year too — but then he’d happily take a composition book or comic panes to bed with him and doodle and create long, complicated and ultimately beautifully organized stories. The dialogue and plot only existed in his head at first, and after awhile he began writing a few words, then titles, sentences, beginnings, middles and ends. It’s all messy and not perfectly spelled/formed, but it’s spontaneous and enjoyable to him. Which is more than half the battle, in my opinion.