ADHD moms

[miranda]

My son started guanfacine in first grade and then a stimulant (Focalin) in second due to inattentiveness/hyperactivity. I think it's the Vanderbilt we did a few times while trying out different meds. We saw marked improvement with the stimulant. His teacher said it was night and day.

From the school I'd request an aide to keep her on task. DS wouldn't have been able to keep up in the lower grades unless he had an aide. By 3rd he was down to minimal assistance, now he only has some indirect minutes (someone reviews his work periodically).

[auntie]

Oct 5, 2017 7:50:04 GMT -5 @barefootbarista said:

I need help.  My daughter is super struggling with focus at school this year.  She is 6 and in first grade.

The expectations of first tend to be a real step-up from kindie, in part because well developing kids make a big jump in their self-regulation and maturity. First was really rough here. How is she doing academically? Has she started to read? Is she doing simple arithmetic? Is this a mainstream classroom? Does the school follow a specific educational philosophy or curriculum? 

Her teacher says that she is sweet, kind, respectful and helpful.  She gets along well with her peers.  

How does she "get along well with peers"? IME, girls <especially> with language delays- whether reception, expressive or even just slow auditory processing- don't fare well socially among their same-sex peers because the flow of language an ideas is so swift at this age. DS had a dear friend in preschool and the primary grades who had auditory processing delays, a slight delay in receptive language and delays in expressive language who really struggled in girl groups. Bright girl, ended up graduating from Bryn Mawr but in the early going she struggled. Her best buds are still guys and animals. 


BUT-she is missing soo much instruction because of focus.  She gets distracted by the other kids in the room and things going on around her and cannot follow directions. She is doing work wrong that I am pretty positive that she can actually do.  Would a stimulant help with this?  She took a stimulant a while ago and while it calmed her down for a period I'm not sure it really helped with focus-again this was almost 2 years ago.  

I like the idea of pushing for a complete eval, although you might get more information closer to age 8. Six is the earliest many of the better scales are normed for around ADHD and other LD-type issues. It's also the earliest most would agree to evaluate for an auditory processing delay. All kids have weaker auditory than visual processing; they continue to mature in this area well into puberty. But some kids do have real delays even relative to their peers. The way you describe her- this is an alley I'd go down for sure. 

Sometimes what happens is that a young student realizes they aren't up to their peers and the age-appropriate expectations for processing verbal information which ramps up anxiety around the task and makes it even harder for them. 

My kid struggled too. We pretty much tweaked everything- we did behavior mods, changed his school to one that used a multisensory approach and eventually trialed meds at the end of first grade. We started with Tenex which is worthless and eventually hit on a stimulant for the ADHD and an SSRI for the anxiety. This made him available for the interventions we put in place. Not a fan of Strattera; it seldom remains effective for more than 18 months when it works well. One concern about moving to a stimulant at 6 is that she is more mature and mmore aware in terms of anxiety- so you have to watch for that. 

DS's auditory processing isn't as delayed as some students I know, but he did have trouble slowing down to actually listen and staying focused on the task at hand. Things that helped aside from meds: having instructions read to him personally, having a written rubic or example of the work he was supposed to produce, a teacher checking in while he was doing seat work, being given a chance to start homework (and having progress checked) so he would be familiar before bringing it home. 

DS's lab school did a lot of listening exercises. One of his teachers even did clicker training with them. Like dogs. Practice helped. His public school installed sound fields the year he bridged there for 4th grade. A lot of kids learned better with these installed. 

She also has a moderate-severe receptive language delay. I know this is contributing to missed instructions.  Expressive language is ok.

This could change over time. DS's friend's expressive was average in the testing she did ahead of kindie, but late 2nd testing showed her as delayed in both expressive and receptive language. I think she tested as well as she did for so long because she's really a bright girl. 

She currently takes strattera and guanficine.  Both have really helped her with her anxiety and the behaviors she was exhibiting.

**She goes to the developmental pedi on Oct 9th-what type of questions should I be asking?  I'm going to ask for a full eval.  She has had some partial evals and all it has ever really shown is that she has uneven skills and a poor working memory and slow processing.  She scores really well on tests like the Woodcock Johnson, but poorly on IQ tests.   

Her language delay could be impacting her IQ results especially if she get fatigued in the process. A non-language based may show a different result. 

Good luck.

[akafred]

Stimulants are much better than non-stimulants in terms of improving focus, reducing distractibility, decreasing impulsivity. DD has had trouble taking stimulants because they make her anxiety terrible. (Conversely The one SSRI we tried make her ADHD symptoms, especially impulsivity, much worse).