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Getting Help For Your ADD/ADHD Kid

Mar24

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Hi Amalah,

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.

-Frustrated

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.

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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20 Responses to “Getting Help For Your ADD/ADHD Kid”

  1. Chayary Mar 24 at 2:43 pm Reply Reply

    I can’t speak to the ADD\ADHD piece, b\c we haven’t gotten a firm diagnosis\services (yet?).  But I have two kids with MAJOR handwriting issues, and we went the private OT route,  it has helped SO much.  Both with the actual help, and in validating for me, the kids,  and the teachers that the writing itself was a REAL issue, not laziness or sloppiness.  And that reduced frustration and anxiety a ton.  FWIW, once the OT evaluation turned up issues, my insurance covered the sessions, with just a small copay.  
     I have also taken to big-time advocating, b\c it was so ridiculous that my smart, motivated to learn kids were being seen\labelled as bad students b\c they were frustrated by the mechanics of writing.  I push for them to be allowed to dictate\write shorter answers\have different paper (primary writing paper with bigger spaces and the line in the middle).\photo copy notes.
    At home, I do the writing for them whenever it is frustrating them (if they start seeming like they are taking advantage, I set a timer–you write for 5 minutes, I will finish the writing for you).
    I haven’t switched them totally to typing yet, although the older one (11) has moved a lot in that direction at this point, because I wanted to make sure that we focused on fixing the writing first.

    • Chayary Mar 24 at 2:49 pm Reply Reply

      Sorry, hit send too early.
      Just wanted to say Good luck!!!  You are doing the RIGHT thing to not Wait and SEE.  Better to give a little support now, then to let things get worse and worse.  When your kid has a sore throat, after a day or so you get a strep test, you don’t just wait and see when there is something that can help.

  2. aadrw Mar 24 at 4:27 pm Reply Reply

    I would start the formal evaluation process at school STAT.  From the day you ask them for an evaluation, they get 15 days to come back to you with a plan.  From they day you sign the plan, that’s another 60 days for them to do the assessments and then come back with the team in an IEP.

    Now, kiddo may not need a full IEP (which will come out in the initial meeting) and just require some accommodations like Amy mentioned (quiet time, fewer questions, whatever).  But since we’re coming up on the end of March already, 75 days is a loooong time.  You don’t want kiddo to go into 3rd grade without this figured out, just because the timing was jacked.  

    Additionally, medical diagnosis or not, they certainly know that there’s something going on with this kid and should have tested him a long time ago.  A kid with no history of problems suddenly has issues that a quick OT eval didn’t identify?  They are not in compliance with Federal law that says they MUST assess for any suspected disabilities. And if they try to hold him back because they didn’t identify a potential disability and then enable him to access the education he has a right to??? UNLEASH THE HOUNDS!

    If this kiddo doesn’t have something medical going on, there is still something making his school experience miserable and he needs all minds on deck trying to sort it out for him.  

    You can do this mama!  Amy’s advice is, as always, right on.

  3. Just me Mar 24 at 4:48 pm Reply Reply

    I don’t have any additional advice to dispense with respect to the ADD/ADHD piece. However, one detail really stood out for me in the original letter:
    ” My husband is minimally involved/present (and may become completely uninvolved/unpresent in the near future).”
    I am wondering if the son is picking up on any of the stress of that situation which is causing some of these issues? It may be worthwhile for an appointment with a child psychologist to talk about some of these things?

  4. A thought Mar 24 at 5:02 pm Reply Reply

    Another thought – Kids with Irlen syndrome present with some of the symptoms of ADD. My daughter was diagnosed in gr 3 and the lenses were a miracle for her. Suddenly she could read without a huge struggle – words stayed put on the page. She can sit and focus now. Something to think about because as far as I know it is not included in the standard testing. Google Irlen if interested and check out the website for signs & symptoms. Good luck!

    • Agreeing Mar 25 at 10:57 am Reply Reply

      Just wanted to agree with this– the potential divorce jumped out at me too. Maybe unlikely to create specific symptoms, but maybe it’s exaggerated an “underlying” issue, and might get better when the stress of the change is somewhat relieved.

  5. Cary Mar 24 at 6:33 pm Reply Reply

    I would not self diagnose so quickly. Get multiple evaluations first. it could be vision, dysgraphia, or a host of other things, that sometimes get lumped into an ADD diagnosis. I think 2nd and 3rd grade are hard for a great deal of kids. Everyone learns differently, and sometimes in our culture we are trying to move so fast that we don’t stop to recognize the individual’s needs. Maybe his brain takes in information better if he can move his body instead of sitting still, or a fidget toy can better help him focus. Let him know it’s all okay, and you are there to help him learn about himself.

  6. Jessica Mar 24 at 10:58 pm Reply Reply

    Get him tested. There is no downside to getting the tests done. If you’re looking at a divorce I would also try to get him into talk therapy. This kind of academic frustration can really weigh on kids so establishing a relationship with a therapist before any major household changes occur could really help.

    What you describe sounds like fairly classic ADD but Cary is right there are dozens of other things that could be contributing to his struggles. Try to keep an open mind but don’t let the school tell you he a “bad kid” or “bad student.”

  7. Jen Mar 24 at 10:58 pm Reply Reply

    Okay. I’m a literacy specialist in a 3-5 school. I get so sick hearing stories like this, especially when they seem to come from a teacher’s failure to understand and skillfully adjust her teaching for individual students; here are some thoughts:

    Your child does not need an IEP, 504, ILP or any other individual education plan to receive ability-appropriate education. Request in writing a meeting with the guidance counselor, principal or vp, teacher, and OT. Bring along samples of his work, the report from the OT, and any other data you have. Request that his teacher do the same. Let them know that while you are in the process of testing, your son needs adjusted tasks to help him accelerate growth without frustration. (As an example: we wouldn’t give a third-grade student reading at an early third-grade level a copy of a middle school novel because it is “part of the curriculum” and expect him to learn anything from it. If he is truly struggling with volume of writing, word study work, etc., he needs shortened tasks at his level). Two hours is absurd–it’s not at all your fault that it is taking that long, but you don’t have to deal with it, and you certainly don’t have to accept that his teacher will not adjust expectations for length, etc. If he is a “reluctant writer” (OT should please define) with “frozen thoughts” (???) then he needs a couple things: short, easy-breezy writing with lots of oral rehearsal (“oh, you are going to write about your day/what you’re reading/etc….tell me three sentences about that! Okay, say them again, I”m going to list them off on my hand for you. If you say it, you can write it! Let’s write it fast when it’s in our heads, and then we can go back to add more if we want.”). Unless there is a serious language or processing issue, I’m guessing that his writing issues have more to do with his teacher’s lack of understanding the writing process of seven year olds than anything your son is doing. He needs to write about things he enjoys, and he should receive lavish praise for doing so, and he should set small personal goals for volume of writing. “This week, we wrote four sentences every night! As a writer, what do you think you want to do to stretch yourself next week?” I have nothing against OT/PT at ALL, but those professionals are in no way trained in reading and writing interventions. If your school has a reading interventionist, typically he or she will work with students who have NOT been identified. You should be able to request an observation by the reading interventionist to look for the way he holds his pencils and tracks words across a line as he writes to see what they think.

    Your child’s teacher is not teaching curriculum–she is teaching PEOPLE, and must adjust accordingly. Do not be afraid to continue pushing and whistle-blowing over and over until your basic concerns of homework time, etc. are taken seriously, and until adjustments are carried out with fidelity. There are steps in place to problem-solve issues with kids before they are tested for a reason, and it’s up to all the adults in the building to address those first.

    • aadrw Mar 25 at 5:01 pm Reply Reply

      LOVE this.  Absolutely spot on.

      And I would still be pulling the school assessment alarm just to get them moving and accountable.

    • aibee Mar 26 at 10:01 pm Reply Reply

      YES. THANK YOU. INTENTIONAL CAPSLOCK. 

  8. kari weberr Mar 24 at 11:38 pm Reply Reply

    Just had to jump on here and say: Holy Cow I could have written this post. Except add to the stress of all this- I am a teacher. And I teach AT my son’s school. And… I don’t like his teacher. Socially, she and I are good. But I do. Not. Agree. with her teaching style. And unfortunately, it wasn’t until my son was IN her class that I discovered this. However, looking back, I have seen a pattern in school that has led us to also be concerned for completely OTHER reasons than not liking his teacher. He is a lefty and writing has always been a challenge. He struggles to focus in class, daydreams, doesn’t get his work done… but we overlooked it at home, because he loves to read, and can sit for hours and play quietly by himself. Homework has been HELL since Kindergarten. He is so bright, but has always needed SO much encouragement, help, bribery, etc. to get his homework done. We finally started the evaluation process last week. He was assessed in a group of 5 other children, we got the GIGANTIC stack of paperwork to fill out, and have his teacher fill out… and we will see soon what is going on. His pediatrician thinks it could be ADD. ADHD without the H for hyperactivity, because we know he isn’t that.  If we get a diagnosis, than we are going to fight for our son to get some accommodations. Even if it is to just say, “stop being negative to him, stop expecting the same thing from him when you know he will fail…” etc. If it comes back negative, than… well. We aren’t sure yet.

    It is as if this smackdown reads my thoughts and anxieties. Every time I am JUST about to write to Amy- BAM- perfect letter comes up.

    • Kari Weber Mar 24 at 11:40 pm Reply Reply

      And embarrasingly: I misspelled my own last name and use an UNGODLY amount of improper punctuation in my comment. Don’t judge. I hate grammar as much as the rest of you! I turn it off after school! LOL!  And my computer is using a TINY font tonight for some reason… cough… hard to read and all that…

  9. Jill Mar 25 at 12:19 pm Reply Reply

    I agree with the others that if you think it’s a form of ADD get him evaluated, but honestly I think that that little afterthought of an “oh by the way my husband isn’t really around and yeah maybe we’re getting divorced” is probably causing WAY more of your sons attention problems than you seem to think (admit?).  My thought would be to work on that first (get him counseling, spend more time discussing it with your son, etc) and see if it helps his focus in school any.
    You said 2nd grade brought out all of his school problems; when did his dad start playing less of a role at home?  

  10. Lora Mar 25 at 3:39 pm Reply Reply

    Have you thought about dyslexia/dysgraphia? Check out bright solutions http://www.dys-add.com/ and see if your son fits the profile. This sounds so much like my daughter at the beginning of gr2 (this yr). She went from being a happy, focused, well-behaved child to unfocused, daydreamer, disconnected, unhappy at school. hours and lots of tears for homework. A lot more is expected in gr 2 than gr 1 and learning differences can come crashing down at that time. We’re going through the home tutoring with my daughter using susan barton’s system. We’ve been doing it for about 6mo and the difference is too huge to put into words. she’s loves writing now, her spelling is probably above grade level, she is full of confidence etc. We’re not involving the school because it’s too complicated and we’ve found our intervention with the barton system is all we/she needs. Your description of your son breaks my heart and sounds so much like what my daughter was suffering. I’d urge anyone with similar issues to check out susan barton’s website and the stats/symptoms/effects of dyslexia (and lack of recognition in schools for this common type of learning difference).

  11. An Easyworld Mar 25 at 4:30 pm Reply Reply

    Hi there, I’m a primary school teacher and I just wanted to offer my two cents worth on the homework: Learning should always, in my opinion, a fun and engaging process. It makes me so sad that parents are somehow obligated to drag their kids kicking and screaming through homework battles (usually boring worksheets that are beyond uninspiring), which is basically a fast track to children rejecting the learning process as a chore. If it is becoming counter productive I would explain the long commute, the tiredness and the battles to the teacher and politely tell them that you have other priorities in the evening such as family meals, quality time together and reading shared story books. I promise that as a teacher I would fully respect this sort of decision from parents. Then, on your own terms do some of the things that Amy suggested like making comic books, and do fine motor stuff for handwriting such as writing in sand or using paint brushes and water or making letters out of playdough. These will ultimately be so much more beneficial and will hopefully keep your son turned onto education, as opposed to learning to hate it. I wish more parents saw homework as optional and  took a bit of home learning into their own hands.

    • Kim Mar 30 at 1:34 pm Reply Reply

      Former teacher here, and I will tell you that my school’s attitude toward homework has been disappointing to say the least. I totally agree with you – I was always flexible with homework, especially in the lower grades.  I would tell her you will practice your spelling words and math facts in the car on the way home, and be done with it.  So what if he gets a lower mark on his report card?

  12. Amy Renee Mar 25 at 10:35 pm Reply Reply

    I have been going through similar homework battles with my 1st grader, and part of it is that he just can’t do homework when he’s exhausted – he’ll spend more time fighting it than doing it. I know Amalah cautioned not to rush into big changes like pulling him from his current school, but a 1 hour commute each day is a lot. 7:30 – 6:30 is a long day for me, let alone a 7-8 year old, and then homework on top of that – it just seems like too much. In the short term, is there any way to get some of his homework done after school (like with a high school or college age tutor/babysitter)? Or could you do things on your commute like have him dictate his writing journal into your phone, to separate the “frozen words” from writing – first do the assignment orally, then copy it down while listening.

  13. Sarah Mar 27 at 12:43 am Reply Reply

    I would just like to comment on the immersion piece since I am actually an immersion teacher that has taught at both the grade 2 level and the middle school level. Pulling him out of immersion, especially if he doesn’t have issues with the language won’t do anything for the issues you’ve stated above. (Even if language is the issue, they’ll usually also have an issue with English and there’s no benefit in pulling them, but that’s a whole different ballgame.)

    I often find that Immersion teachers are much more willing and knowledgeable when it comes to differentiating since we already have to do it between the two languages and class sizes tend to be smaller. I mean, I teach a 3 grade split, having another accommodation or adaptation is not really a big deal. I have students with mental health issues, ADHD and other problems that do very well in an immersion classroom as long as they have the supports required.

  14. Konni Apr 24 at 8:48 am Reply Reply

    I’m sorry I just now saw this, and didn’t read all the notes so this may have been mentioned previously, but this sounds JUST like my daughter in 2nd grade.

    Yes, ADHD was part of the equation, and dealing with that (combination of medication and CBT) made a difference, but the main culprit was actually her eyes. My daughter had a vision problem known as “Convergence Insufficiency”. She still showed up as 20/20 on a basic vision test, but her eyes did not move together properly for tracking (the way your eyes move side to side as you go across a line of text) and because of this sometimes jumped (skipped lines when reading, she lost her place, etc.). 6  months of Vision Therapy helped her muscles to work correctly and in that time her handwriting, reading, focus, etc. all improved. To explain why this particular problem can be so challenging (especially once school hits the “book intensive” phase), imagine this: Put a pair of binoculars to your eyes, spread them out too far, so your eyes aren’t centered, have your child shake the arm that is holding them, and then try to read. 

    If your son tries to read with his head sideways or turning the book in weird angles, understands concepts, but can’t reproduce them on paper, etc. you may be dealing with a vision issue, not just an attention issue. You seem very driven to do WHATEVER is necessary to remove the “roadblocks” that are holding him back from success…don’t overlook this possibility. Good luck!

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