ADHD or Puberty?

[missva]

I realize professional opinions will likely be needed, but wanting some thoughts. DS (15) is a late bloomer and fully in puberty. Lately, he has been extremely forgetful, way more than he has been in the past. Examples - forgot jersey for final game, left backpack at home, lost wallet, left phone at friends house, and this is all within the last week. He's always had a bit of forgetfulness, but over the past few months, it has increased. He's always been an A/B student, but has several 0's in classes for not turning in work and a C in one class. I wouldn't say it's "sudden" but has definitely increased over the last year. He's very social, generally seems happy, has just come a bit apathetic about school and other responsibilities. Does this sound like normal teenage stuff or something else? Curious on other's thoughts. 

[mala]

Puberty can make ADHD symptoms worse. Does he hit any of the other criteria for ADHD besides the forgetfulness? If he's just forgetful it's probably not ADHD, but there is a lot more that can point to ADHD than just being scatterbrained.

Big Kid is 12 and she's been SO MUCH WORSE lately with the ADHD symptoms. She's a straight A student, for what it's worth, but it has become increasingly obvious in the last 3 months that she has ADHD. As we dive into her behavior and why she's doing the things she's doing we are uncovering more and more evidence that reinforces the ADHD diagnosis. We have an appointment to begin the official evaluation at the end of May.

[circa1978]

I mean, that was me as a teenager but I had ADHD so 🤷‍♀️. I honestly just needed to have natural consequences and I figured it out eventually but still as an adult, if I told my family that I lost my phone and forgot my keys and had no idea where the coat I wore Tuesday was, they'd be like, that tracks.

ETA: Sorry, LOL, I didn't realize he wasn't diagnosed with ADHD. (see above) I still think it's pretty typical teen behavior but you could mention it to your doctor. 

[erbear]

A lot of that is very typical. I teach 8th grade; this happens to all of my boys somewhere between 13 and 15. That said...it's worth checking out if you're concerned.

[missva]

Thanks all! So looking at ADHD markers, he's not fidgety and he's fine sitting still when we're watching tv or something, but he's always been very active. He rocks his chair back on its legs when he's in school (I know b/c his friends joke about teachers constantly reminding him "all 4 on the floor"). He has several AP classes and can do work at home for hours, but it's usually only when he is on group videos with other kids. He rarely can just sit by himself and do work. He's not impulsive, but does seem to frequently change tasks.

His dad "ex H" thinks he's just lazy and doesn't care enough to remember things and to turn in assignments. I disagree, but just don't know next steps.

[mala]

How's his emotional regulation (including when he was little)?

Hows his sleep?

What about eating habits?

You said he sits still for tv, but does he pull out his phone or do a project while he's sitting?

Does he constantly have music/podcast/audio book on?

EDIT:

Does he have trouble estimating the time a task is going to take?

Is he often late for things?

If you give him a verbal list of things he needs to do, like chores, does he remember them all or will he forget some of them?

[missva]

Emotional regulation - great. He was very competitive in sports when he was younger and would freak out when he would lose, but that improved around 8. He's extremely stable now. Rarely cries or loses his temper, loves to hang out with us and our friends, considered a leader amongst his friend group. Organizes most activities. Has a little teenage angst (I'll catch an eye rolls or a muttering under his breath) but nothing crazy. We travel a lot and he's very flexible.

Sleep - Also great. Goes to sleep from around 10 to 7:30 on week nights and 11-9 or so on weekends. He does not like to stay up late.
Eat - Very good, eats regularly and lots of variety. He's small, but eats a LOT.
When watching TV, yeah, he usually will pull out his phone unless it's a sports game and then he's all in.
He frequently has music on and wears airpods while doing school work.
On estimating time for a task, he definitely does things last minute and is a procrastinator, but not sure he estimates it wrong.
Never late - hates being late. Just often forgets the things he needs to bring. He drives himself to school and has never been tardy except last week when he had to come back b/c he forgot his backpack.
If I give him a verbal list of things to do, he often forgets some of them. Or else he chooses not to do all of them, not sure.

(Thank you for taking the time to ask those questions)

[Jalapeñomel]

It could be ADHD or it could be normal teenage stuff.

I see this in my students who have ADHD, but I also see it in students who don't.

[mala]

While he hits a few of the criteria for ADHD, from what you've written it doesn't sound like he has enough of the symptoms to qualify for an ADHD diagnosis. Doesn't mean he doesn't have ADHD or won't be diagnosed in the future. If you are concerned it wouldn't hurt to talk to his doctor and get a referral for an evaluation.

I was trying to think of things that are less common signs of ADHD, things that H, I and Big Kid all do. It doesn't sound like your kid does most of these.

Emotional Disregulation: very common in ADHD. It's probably the biggest sign of ADHD behind the fidgeting and forgetfulness. Big Kid has struggled with emotional regulation since she was little. Her teachers have told me she would grow out of it but she never did. At 12, if she thinks she's in trouble, failed at something, or just straight up doesn't want to do something, she completely shuts down. I found her on the kitchen floor curled up in a ball last weekend after asking her to put the dishes away, for example.
Sleep: Usually it's about taking a long time to fall asleep, but can also be putting off bed time because you want to do more things or frequently waking up.
Eating is usually one of the extremes: binging or forgetting to eat entirely. Binging to try to get the dopamine from food (me) or not feeling hunger cues until you have hit massively HANGRY (H and Big Kid).
TV: always needing something to do with your hands, be it phone or craft project
Music: seeking sensory stimulation in audio or using it to tune out. I always have something on because if I tune out whatever I'm listening to I can tune out the rest of the world and focus better.
Time blindness is huge with ADHD. Always late or early. Thinking that a task is going to take longer than it actually will so you put it off as long as possible.

[waverly]

He sounds a lot like my 13 year old DS. Like mala, said DS has some tendencies towards inattentive ADHD, but doesn't seem to have enough symptoms to qualify for a diagnosis. Close as I can see, DS has executive function delays. We do have a cause for his EF delays (sensory processing disorder), but they don't seem to be the same as your son.

[Leeham Rimes]

That sounds like my almost 14 year old, without adhd. My adhd and Wesley’s affects us so much more than what you mentioned, though maybe there are more issues and you just put the highlights.

For us (me and w) the adhd is all encompassing, and looking back we’ve been like this since young childhood.

Completion of any tasks (other than fun ones we like) takes Herculean effort to complete. Our ability to follow through a task completely is next to none without a lot of coping skills (and I’m talking even basic tasks like teeth brushing or making a bed or getting one load of laundry done).

We’re quite fidgety, always needing something to play with in our hands (for me mostly hair twirling, W needs his magnet beads). W is only 11 so this may be age but he needs a lot of stimuli to help control the fidget-ness so he has an exercise trampoline in his bedroom.

Our interpersonal skills aren’t the best and we struggle a lot there, remembering to follow up with friends, keeping on with conversation that maybe our friend is totally interested in but we’re not or is going on and on without regard to if our friend has something else to talk about.

The ability to get started on—-just about anything—-is also abysmal without a lot of our coping skills (and meds)

We have oversized reactions when we’re focused on something and get interrupted. That’s so frustrating for all involved bc we know we shouldn’t get that upset, but it feels at the time that we can’t help it.

On the flip side of not being able to get tasks done, we have hyper fixation on things and then we’ll drop them like a bad habit. For me it’s hobbies, I’ve had so many hobbies where I throw all time, attention, and money (cry) into it and then I drop it months later. It’s all or nothing. Or when I work, I’ll get so focused, everything stops existing, even if it means I miss important things. Again, all or nothing.

If you’re worried then for sure an evaluation couldn’t hurt. Information is always good.

[missva]

Thank you all so much for writing this all out. It really helps a lot.

mala, thanks for pointing out the less common signs. I never woudl have related sleeping / eating issues to it.

Leeham Rimes, he does tend to get hyper fixated on hobbies, and they frequently change over the years (except soccer, which is a constant). Lately, it's golf, though that's lasted several months, so maybe it will stick. I can't tell you how many random things we have in our house though because it was DS's life for a while (ping pong, MMA stuff, an ice bath, etc). All bought with his own money, but I frequently look and laugh like "remember when DS thought he was going to be a champion chess player"...

[raleighnc]

With your other details (especially the hobbies, lol), it sounds like he could benefit from an evaluation with your pedi. Sometimes increased demands on attention as they progress in school make it more obvious than when they are younger. I would do it sooner rather than later because your window of influence is starting to close (and I'm assuming he might start driving). A lot of kids go through a period of denial that the meds help or that they need them (or get frustrated with any side effects) or have trouble remembering to take them and don't have external supports in place. My DDs now are completely in agreement that they have ADHD and the meds make a huge difference and they can feel the difference. They tell me when it's close to refill time and have alarms on their watches to take them. But DD1 swore for years that the meds did nothing and it took a while for her to be convinced. DH swears he doesn't have ADHD, but he checks every box. Our lives would be much easier if he could see that he's exactly like the girls, lol.

[mala]

Leeham Rimes, I call my mom a "Serial Crafter" and have long before I knew it was likely ADHD (undiagnosed). I'm the same way, though not nearly as bad as she is and I often go back to things I've dropped in the past, whereas she rarely goes back to things she's tried already.

The effort to start "boring" or repetitive tasks is SO REAL. And the irritation when interrupted made me so angry while the kids were little and needed something every 10 minutes.

missva, I think you should get that evaluation. More information is always good.

raleighnc, Big Kid WANTS the meds. I get it, though. She hates how her brain functions sometimes and she's very much in the mind of "if my brain doesn't make the right chemicals there's nothing wrong with taking medicine to get them". H is very against stimulants, though, since he was put on them in second grade and hated it. I just want to get her diagnosed to we can understand and teach her how her brain works.

[gardengal]

Another "things people don't realize is ADHD" is rejection sensitivity. I can just (kindly! soft voice!) say "I really think you can do better than a C" in a class that he enjoys & I know is not difficult (b/c he's gotten Bs or As in it before) and he's totally convinced I hate him & he's a failure.

My son isn't very fidgety but will just zone out. I think hyperactive is the stereotype & it's what convinced us that it *COULDN'T POSSIBLY* be ADHD until a teacher advocated for educational testing & he had all markers of ADHD that affect school (executive function, some auditory processing issues, etc). That let us to the pedi for a formal diagnosis. So be aware that ADHD can look really different in kids!!

Regardless if he has ADHD or not, there's definitely some skills he could probably use to help (use a calendar for assignment due dates, daily check classes to to make sure he's turned everything in, have an 'out the door' checklist, etc).

[raleighnc]

May 9, 2024 11:17:31 GMT -5 mala said:

Leeham Rimes , I call my mom a "Serial Crafter" and have long before I knew it was likely ADHD (undiagnosed). I'm the same way, though not nearly as bad as she is and I often go back to things I've dropped in the past, whereas she rarely goes back to things she's tried already.

The effort to start "boring" or repetitive tasks is SO REAL. And the irritation when interrupted made me so angry while the kids were little and needed something every 10 minutes.

missva , I think you should get that evaluation. More information is always good.

raleighnc , Big Kid WANTS the meds. I get it, though. She hates how her brain functions sometimes and she's very much in the mind of "if my brain doesn't make the right chemicals there's nothing wrong with taking medicine to get them". H is very against stimulants, though, since he was put on them in second grade and hated it. I just want to get her diagnosed to we can understand and teach her how her brain works.

Ugh, I'm sure your H had a bad experience, but I hate when people bring their negative experiences to reject possibilities without even giving them a chance. 30-40 years ago, immediate-release Ritalin was basically the only game in town and we had so little understanding of ADHD. DD1 was on IR ritalin for a long time because she metabolizes most extended-release meds so fast, and it wasn't fantastic, but it was better than nothing. Now she's on Jornay, which is released very steadily (and starts before she wakes up in the morning) and it's miraculous. She doesn't even have side effects like appetite suppression. We've done tons of external supports and she's taken study skills camps for kids with ADHD, been in therapy for years for ADHD coping skills and anxiety, but if she ever forgets her medication, life is so damn hard for her that day. I regret that we didn't get her diagnosed and treated before third grade (DD2 was diagnosed and treated starting in K) because she has so much trauma around school and the struggles she went through. I can't imagine if she had to go through middle school without the meds. She's always been a straight-A student, but it took her so much longer and caused so much more stress when she didn't have the meds to help her navigate the external supports.   

I've also seen how hard it is for young adults (18+) to get started on medication independently when their parents weren't able to help them work out a system, try different meds, help with making appointments and following up. Hell, it took me until I was 44 to start meds because everything was so damn difficult (especially when you have ADHD) and they think everyone is a drug-seeker. Just getting refills on time now is a huge balancing act every month. I can just imagine what a pain it is going to be when DDs go to college and we have to deal with that.   

[litskispeciality]

I should stay out of this as a non-parent, but I just signed up for an initial ADHD screen so I'm trying to read up wherever I can. I will echo the pressure "but you're an A/B student so you shouldn't get C's!" is really hard. Sometimes we don't get it, sometimes it's not interesting and we zone out and miss important information (math) that would have helped with the work. I was sooooooo tired and worn out after the school day I needed a break after school, but my mom would freak out if I watched TV for half an hour before doing homework, so I'd start to make her happy, but eventually give up and she didn't check to confirm I did everything. I did pretty well in school so I think that helped it go unnoticed, but my HS and college grades could have been better with strategies, and maybe even meds. One thing that did help was a daily planner, it was just up to me to write down everything including "math: x homework, French: Y homework", which I could easily miss.

Also I really think kids (girls) go unnoticed/untreated for ADHD because "they're such good A/B students that they obviously don't have anything hurting their learning", when the student at any age may be struggling but not understand why. We just work harder thinking we don't get the material that we might actually really understand with proper focus.

I'm also fascinated by the forgetting to eat thing. I've said that for years and no one has ever put that together. I've told counselors about it assuming I have disordered eating, but it's always a mix including "some people just aren't that hungry". No dude, I'm super hungry when I finally eat, I just prioritize doing anything else over eating. Almost like taking a break to eat will take away my focus and drive, so I'll wait, finish, and then it's time to do something else. There's probably a lot more to it, but also finally sitting down and eating at say the end of the day is relaxing for me, so I eat dinner late rather than eat, then go back to whatever I need to do with more energy...and it's not healthy.

Anyway I  think testing is a good idea if you can get it. Worst case your child doesn't have ADHD but they may have some other resources. Big hugs to all.

[mala]

litskispeciality, ADHD has such a range of symptoms/signs that even as a non-parent you can still add insight! My concern with getting Big Kid tested is that we will be dismissed because she does complete her work, and she gets some of the highest grades in her class. I consistently didn't do homework yet I was still getting As and Bs, so my parents were just like "eh, can't make her do it and she's learning anyway so who cares". When I first brought up that I thought Big Kid has ADHD to my husband he wasn't really convinced. Even listing it all out, he was just like "ok maybe, lets talk to her doc and her teachers." Then when I got to the bottom of why she was so resistant to eating breakfast in the morning (because she doesn't feel hungry yet, but her whole attitude changes as soon as she eats) and told H, he was "oh holy shit I do that too that is 100% an ADHD trait". That was the point he really got on board. Big Kid and H both do it and it seems to be exactly like what you describe.

[litskispeciality]

Ugh mala,. My girlfriend went through that with the youngest (female presenting at the time). Dedicated A/B student, active in sports, theatre, music you name it. The mom fought so hard to get ADHD testing as dad was already diagnosed. School kept saying "but she's got good grades!"...yes but as mom told you, she spends so many extra hours studying and homework etc. to get those grades. Please give her a chance to free up some time and ya know, take stress off. Sadly the mom never won the battle, but the student graduated and is THRIVING in college. I really hope ya'll have much better luck.

With the food thing, ironically I'm pretty sure my DH has raging ADHD as well, but he's more conscious of eating. It's sadly a big of contention when I'm super stressed I'm like just pick food and go with it so he doesn't get hangary, but then I'm not happy and we fight. I'm really trying to work on it as picking the food then becomes a big issue for me. Trying to pre-plan food whenever we can so that it's one less factor in the moment. Also gives me reason to be ready on time as I can't get myself together or be on time to save my life (possible ADHD).

*I understand 100% my privilege in being able to choose when, and what I eat.

[raleighnc]

May 9, 2024 14:10:37 GMT -5 mala said:

litskispeciality, ADHD has such a range of symptoms/signs that even as a non-parent you can still add insight! My concern with getting Big Kid tested is that we will be dismissed because she does complete her work, and she gets some of the highest grades in her class. I consistently didn't do homework yet I was still getting As and Bs, so my parents were just like "eh, can't make her do it and she's learning anyway so who cares". When I first brought up that I thought Big Kid has ADHD to my husband he wasn't really convinced. Even listing it all out, he was just like "ok maybe, lets talk to her doc and her teachers." Then when I got to the bottom of why she was so resistant to eating breakfast in the morning (because she doesn't feel hungry yet, but her whole attitude changes as soon as she eats) and told H, he was "oh holy shit I do that too that is 100% an ADHD trait". That was the point he really got on board. Big Kid and H both do it and it seems to be exactly like what you describe.

Well, for the actual ADHD evaluation, it focuses a lot more on signs of inattention and hyperactivity rather than the overall outcomes (like grades). It's well known that a lot of kids with ADHD (particularly girls) can get great grades until they can't. Whether they are gifted in academics and things are easy or they have parental support that helps them keep track (but still causes stress/anxiety for them and the parents because OMG how can you forget another project and now we spend all night doing it).

As for actual support in school, I won't lie that with good grades, it can be challenging to get accommodations or supports. That's why medication is such a key part of the overall strategy, along with establishing external supports that the kid can use in any situation (calendars, phone alarms, etc.). We can control the medical treatment and try to implement supports. We can't control the school.

DD1's first principal (a former special Ed teacher!) was vehemently opposed to any kid who wasn't below grade level even getting evaluated for learning issues. DD1's 3rd grade teacher refused to grade her incomplete work as below grade level, so she was doing all these accommodations in the classroom but denying it in the meetings. With the second principal (who had two kids with ADHD), it was a completely different story.

More information is always better.

[circa1978]

Yes, gardengal! My DS really struggles with this and seeing him deal with it makes me realize it has been a big part of my life too.

[litskispeciality]

Also to gardengal, point, documentation of any known learning limitation can potentially help with future education. I worked for a community college with a big Disability Support team (hooray!) and they often pointed to get your most recent testing (typically from high school) as a starting point. I wasn't in the conversation after that about testing documentation time limits and things, but it was something to start with.

Thinking about this further I've always struggled with sleep as well. I'm more of a night owl, but often will stretch my bed time and try to sleep in the morning instead. In my college days I stayed up really late and was just tired all the time if I had early morning classes. I wake up a lot during the night too. Naps are really important for me whenever possible, although lately I've been able to get down to about 2.5 hour naps on the weekends where they used to be 3+ hours. I thought I read on another ADHD thread that someone felt more even energy distribution throughout the day/better sleep once medicated. I haven't been tested for sleep apena, but I have thyroid issues, and a lot of bad dreams and process stress in my sleep. I'm sure I'm a cross pollination of things, but the sleep thing above checks a box for me.

[mala]

May 10, 2024 9:33:39 GMT -5 litskispeciality said:

Also to gardengal, point, documentation of any known learning limitation can potentially help with future education. I worked for a community college with a big Disability Support team (hooray!) and they often pointed to get your most recent testing (typically from high school) as a starting point. I wasn't in the conversation after that about testing documentation time limits and things, but it was something to start with.

Thinking about this further I've always struggled with sleep as well. I'm more of a night owl, but often will stretch my bed time and try to sleep in the morning instead. In my college days I stayed up really late and was just tired all the time if I had early morning classes. I wake up a lot during the night too. Naps are really important for me whenever possible, although lately I've been able to get down to about 2.5 hour naps on the weekends where they used to be 3+ hours. I thought I read on another ADHD thread that someone felt more even energy distribution throughout the day/better sleep once medicated. I haven't been tested for sleep apena, but I have thyroid issues, and a lot of bad dreams and process stress in my sleep. I'm sure I'm a cross pollination of things, but the sleep thing above checks a box for me.

My sleep improved dramatically when I started meds. We're still figuring out what works best, so for a few weeks I was taking the ADHD med later in the morning (10-noon) instead of first thing and my sleep went to shit. Switched back to ADHD med as soon as I woke up and I'm back to great, restful sleep. I also used to nap a lot, or fall asleep in front of the tv/movies.