Yesterday we had the appointment with the Pediatric Nurse Practitioner who specializes in pediatric mental health. She was wonderful. She took the time to really hear our concerns and asked very relevant questions. I felt like she was present with us in the room and not just trying to get to her next appointment. She spent a whole hour with us.
She agreed with the diagnosis of ADHD (obviously). She also talked about RAD. As completely weird as that sounds it made me hurt to hear her verbalize that. But she also talked about another diagnosis that, as odd that this sounds, gave me relief.
She believed us. As scary as this diagnosis could be, it was huge validation that we are not just raising a difficult kid, it is not our fault that she is acting this way, and we are not making a big deal out of nothing. It is something. It is a big something.
In the mental health field there is a book that has been revised many times called the Diagnostic and Statistical Manual (DSM). It is what we use to diagnose mental health conditions. It is controversial and many many mental health professionals all want their research to be used or to prove that their viewpoint is better than someone elses. The current revision is the DSM-5. A lot of people are unhappy with this revision, but one good change (in my opinion) was the expansion of the Bipolar Disorder category. It used to be that "everyone" was diagnosed ADHD. Then "everyone" was diagnosed with Bipolar Disorder. A lot of people felt they were "garbage can" diagnoses for what didn't fit elsewhere. The DSM-5 revision expanded created a new category that I am much more comfortable with for those kids who don't meet full criteria for bipolar disorder, but also have behavior that is "more" than "just" ADHD.
Behavior that is exactly what we deal with in this house.
Tucked away in some research that I read about it, it says that:
"The SMD group had very high rates (≥85%) of attention-deficit hyperactivity disorder (ADHD) and oppositional-defiant disorder (ODD) over the lifetime"
SMD (Severe Mood Dysregulation) is just the name the research group put on it, it isn't the name of the actual diagnosis as it is currently listed in the DSM-5. But it clearly captures that kids in this category also have a very high likelihood of having the symptoms of ADHD and ODD too, like Grace does. Some researchers argue that it isn't actually any different than "just ADHD and ODD" and therefore there should not actually a new category. But obviously enough argued that it is enough different that it was included in the revision.
Unfortunately, because DMDD is such a new category (only several years old), there isn't a ton of research about it. Especially research on successful treatments. But she was started on a new med and that med has been around for a long time with good clinical trials and results. It remains to be seen if it helps this disorder well or not.
But at the end of the day, I am thankful for a clinician who took the time to hear us. I am thankful that the clinician is hopeful that the medication can mediate the extreme mood swings and constant irritability that she has. I am thankful that there is a medication at all that can be an option other than "just live with it." I am thankful that yesterday, this morning, and tonight's bedtime Grace did well, even with a lot of situations that were outside of her control and routine. She starts therapy on Thursday. We shall see how that goes. It will be very, very weird for me to be on the "other" side of the counseling table lol!
*******
Yesterday we had a pretty good day together, just the 4 of us. Since we had to drive a couple of hours to the appointment we stopped at the Cabela's there and my husband got to pick up some items he had ordered. I played the shooting game with the kids;) Then after the appointment we went to Red Lobster as JJ wanted "big shrimp." He has been asking for "big shrimp" for a few weeks. I cannot believe how much he likes shrimp lol! Grace tried a bite...then spit it out lol!
We rushed home to get to Grace's Christmas concert for school. We had some items we had to get at Walmart. JJ had a tantrum leaving the store (due to the rushing) and we didn't have time to deal with it due to the rush so it got hairy (I am more than a little scared that many of JJ's behaviors are just like Grace's - except he clearly does not have ADHD. I really hope he doesn't have DMDD too...). I got Grace there 45 minutes before the concert like I was supposed to, and waited in the car until closer to the concert to go inside. She came out crying and said that since she missed school they would not let her participate in the concert. She was hysterical. Hysterical. I was livid. How in the world can taking a child to a psychiatrist office mean they can't participate in a school concert? This appointment was a big factor in whether or not the child even remain in our home and still attend the school. How was it that when we told the school she would be gone, that when the teachers all handed her the slip with her homework on it since she would be missing a day, that NOT A SINGLE PERSON told us that she couldn't attend the concert? We had the option of this appointment or one in February, so obviously we were going to take the first appointment available (who looks at a calendar to see if their kid has a school concert when making psychiatric appointments?!?!). It was a total reminder of why we started homeschooling in the first place (opposed to a school board decision when Beautiful was to start kindergarten...) But, if we would have known ahead of time we wouldn't have rushed home (and would have avoided JJ's meltdown. I was shocked I didn't have to carry him out of the store - only my fear that security would have thought I was stealing him kept me from doing it - at least as he was chasing me and hitting me they knew he was coming willingly...) and would have avoided Grace's meltdown. Ha. Meltdown. Their tantrums are soooo much bigger than a "meltdown." Anyway. It is over now. Done venting. We will be better prepared next time.
Deep Breath...
However, amazingly, I got her calmed down within 30 minutes and held her while we drank hot chocolate and watched a movie together. Half way through the movie she said "this is better than the concert" lol! She went to bed (with her new meds) later than usual but didn't have any problems. This morning she actually said, "I am in a good mood." She was surprised that she felt good - and I was elated at a drama free morning!!! She also had a good bedtime tonight. 2 consecutive mornings and bedtimes is as rare as a unicorn. The meds should take full effect within 2 weeks - just in time for Christmas break. Praise God!!!!!
Thanks again for the support and prayers. They are tangibly felt and MUCH appreciated!!
Showing posts with label ADHD. Show all posts
Showing posts with label ADHD. Show all posts
Wednesday, December 13, 2017
Sunday, June 7, 2015
My Current Crazy Life
Uggg, so much!
My mother in law is in the hospital again. She was in for 5 days with pneumonia, then got out for 3 days, and is back in with a blocked/kinked small intestine. She is in a hospital 90 minutes away this time. Due to the diabetes, dementia, and sun downers her treatment is very complicated. She is non-compliant. She is delusional. It is sad. My husband wants to be there with her, but she doesn't know who he is (thinks he is her husband) and that is making her very agitated and it does not help. It is hard to know how to proceed. We are just agreeing to what the specialists say at this point. Her veins keep collapsing so they are putting in a picc line right now. Hopefully she will not pull that tube out too...
So, in addition to that craziness, I had agreed 2 months ago to be the camp Psychologist for Royal Family Kids Camp this week. That means that my husband won't get the support from me that he needs this week, and I won't be home to help with kids like he is used to W - F. We got last minute approval that 2 of our kids get to go to Royal Family Kids Camp, a HUGE blessing, and that should help his stress level.
I am stressed about camp. My idea of being outside is to go hiking for a short period of time, or opening the windows of the house lol! I am also known, as I have told you before, as the "fun sucker." So "camp" well, the idea of it just stretches me beyond any area of comfort. But, I am excited to teach the counselors/staff about TBRI and how to work with these kiddos differently so I am doing it.
Grace did tolerable for 3 weeks! And the past 4 days she is dysregulating again. I am SOOO glad she is going to camp this week... Even before she was 2 we noticed the cyclical nature of her dysregulation. I have not found her symptoms to be consistent with bipolar disorder, but we are about ready to try anything... It is extremely hard to live with her. I feel terrible for the trauma the other kids go through. Beautiful is ready to be away from it (in all honesty, we all are). Very ready. That breaks my heart.
Right now she is screaming at me such vile and venomous things as she has been put in her bedroom until she calms. She argues about EVERYTHING. She threatens. She is exasperating and exhausting. We really need prayer for her to be healed and for us to be able to endure her/enjoy her. There are no words to explain how difficult things are with her. She can be so precious, and in public she never displays the full extent of her venom. But then...
JJ is doing AWESOME! He loved music therapy last week! He clung to me and did engage as long as I was right there. He actually yelled out his name right away when they were doing introductions!!!! He is doing so much better with talking. In fact, we have had to laugh several times in the past 2 weeks as we have, for the first time, wished that he DIDN'T talk lol!
My husband and I took Beautiful (and JJ) to her wedding dress fitting and then to Red Lobster for lunch. JJ loudly announced his need to use the restroom (not in those nice words) and has done so several times in other public venues (like church). We try to keep our mortification to a minimum and just be pleased he is speaking his mind, but sheeesh! Aside from that we had such a precious and sweet time with Beautiful. 61 more days and she will be married and gone. I try not to think about it...
There was a car accident next to our house this week and I was getting everyone ready to go to the pool. JJ went outside and went right up to the police office and talked to him (while the guy was trying to do the police report...). We have never taught him to beware of strangers as he is scared of everyone, so when I talked with him afterwards about that he just kept asking "why" he shouldn't go up to strangers and talk to them. He has been priding himself on waving at everyone on our walks and says every time, "Mom! I waved at someone!" It was hard to figure out how to tell a kid who has been terrified of strangers, to be afraid of strangers now that he is getting more bold. I am still not really sure how to address it that won't put him back into his shell.
JJ loves to move his body to music and get really wild. Last night we went to a dance and he danced for hours. It was so fun to see him be that free with strangers!!
He is also getting amazing with articulation and word retrieval! I am shocked with the words that he is able to retrieve. For example, twice in the past week I asked him what a bunch of colors were...and he retrieved the words spontaneously and correctly! Praise God!
With this new found vocabulary explosion (again, he had it receptively, now it is expressive) is also some serious independence asserting itself. He sees Grace rebel against us 24/7 with words and actions and he emulates her. He spews the same words at us. He is too smart and thinks up things to push limits, some of which Grace never even thought of. Sigh...
For example, as I was typing this Faith came running in and told me that JJ was stuck up in a tree. I went to him and asked him why he was in the tree, he said he was chasing a snake and got stuck and was scared (impressive word usage!). But, when I firmly reminded him that it was good he was scared as he was not to climb a tree as he could fall down and get hurt he said, "why Grace climb it?!?!" I reminded him, again, that Grace is also not supposed to climb the tree. He doesn't understand why he isn't allowed to do what he sees his 5 siblings do, whether their behavior is due to them being older...or due to their rebellion.
Wedding announcements went out! That really makes it real... The guest list was my most stressful part of this process (thus far). We have so many people on the list that our church will not hold them all. It was hard to figure that part out hoping not to offend people. But, it is figured out to the best that we could and we will just trust God with the rest:)
Well, I am off to try to enjoy my last night of rest before the next 5 days of chaos. I look around and think I should get the bathrooms cleaned, the laundry put away, etc before I am gone. But then I think...naaaaa.... I will just hunker down with the kiddos and my husband instead;)
My mother in law is in the hospital again. She was in for 5 days with pneumonia, then got out for 3 days, and is back in with a blocked/kinked small intestine. She is in a hospital 90 minutes away this time. Due to the diabetes, dementia, and sun downers her treatment is very complicated. She is non-compliant. She is delusional. It is sad. My husband wants to be there with her, but she doesn't know who he is (thinks he is her husband) and that is making her very agitated and it does not help. It is hard to know how to proceed. We are just agreeing to what the specialists say at this point. Her veins keep collapsing so they are putting in a picc line right now. Hopefully she will not pull that tube out too...
So, in addition to that craziness, I had agreed 2 months ago to be the camp Psychologist for Royal Family Kids Camp this week. That means that my husband won't get the support from me that he needs this week, and I won't be home to help with kids like he is used to W - F. We got last minute approval that 2 of our kids get to go to Royal Family Kids Camp, a HUGE blessing, and that should help his stress level.
I am stressed about camp. My idea of being outside is to go hiking for a short period of time, or opening the windows of the house lol! I am also known, as I have told you before, as the "fun sucker." So "camp" well, the idea of it just stretches me beyond any area of comfort. But, I am excited to teach the counselors/staff about TBRI and how to work with these kiddos differently so I am doing it.
Grace did tolerable for 3 weeks! And the past 4 days she is dysregulating again. I am SOOO glad she is going to camp this week... Even before she was 2 we noticed the cyclical nature of her dysregulation. I have not found her symptoms to be consistent with bipolar disorder, but we are about ready to try anything... It is extremely hard to live with her. I feel terrible for the trauma the other kids go through. Beautiful is ready to be away from it (in all honesty, we all are). Very ready. That breaks my heart.
Right now she is screaming at me such vile and venomous things as she has been put in her bedroom until she calms. She argues about EVERYTHING. She threatens. She is exasperating and exhausting. We really need prayer for her to be healed and for us to be able to endure her/enjoy her. There are no words to explain how difficult things are with her. She can be so precious, and in public she never displays the full extent of her venom. But then...
JJ is doing AWESOME! He loved music therapy last week! He clung to me and did engage as long as I was right there. He actually yelled out his name right away when they were doing introductions!!!! He is doing so much better with talking. In fact, we have had to laugh several times in the past 2 weeks as we have, for the first time, wished that he DIDN'T talk lol!
My husband and I took Beautiful (and JJ) to her wedding dress fitting and then to Red Lobster for lunch. JJ loudly announced his need to use the restroom (not in those nice words) and has done so several times in other public venues (like church). We try to keep our mortification to a minimum and just be pleased he is speaking his mind, but sheeesh! Aside from that we had such a precious and sweet time with Beautiful. 61 more days and she will be married and gone. I try not to think about it...
There was a car accident next to our house this week and I was getting everyone ready to go to the pool. JJ went outside and went right up to the police office and talked to him (while the guy was trying to do the police report...). We have never taught him to beware of strangers as he is scared of everyone, so when I talked with him afterwards about that he just kept asking "why" he shouldn't go up to strangers and talk to them. He has been priding himself on waving at everyone on our walks and says every time, "Mom! I waved at someone!" It was hard to figure out how to tell a kid who has been terrified of strangers, to be afraid of strangers now that he is getting more bold. I am still not really sure how to address it that won't put him back into his shell.
JJ loves to move his body to music and get really wild. Last night we went to a dance and he danced for hours. It was so fun to see him be that free with strangers!!
He is also getting amazing with articulation and word retrieval! I am shocked with the words that he is able to retrieve. For example, twice in the past week I asked him what a bunch of colors were...and he retrieved the words spontaneously and correctly! Praise God!
With this new found vocabulary explosion (again, he had it receptively, now it is expressive) is also some serious independence asserting itself. He sees Grace rebel against us 24/7 with words and actions and he emulates her. He spews the same words at us. He is too smart and thinks up things to push limits, some of which Grace never even thought of. Sigh...
For example, as I was typing this Faith came running in and told me that JJ was stuck up in a tree. I went to him and asked him why he was in the tree, he said he was chasing a snake and got stuck and was scared (impressive word usage!). But, when I firmly reminded him that it was good he was scared as he was not to climb a tree as he could fall down and get hurt he said, "why Grace climb it?!?!" I reminded him, again, that Grace is also not supposed to climb the tree. He doesn't understand why he isn't allowed to do what he sees his 5 siblings do, whether their behavior is due to them being older...or due to their rebellion.
Wedding announcements went out! That really makes it real... The guest list was my most stressful part of this process (thus far). We have so many people on the list that our church will not hold them all. It was hard to figure that part out hoping not to offend people. But, it is figured out to the best that we could and we will just trust God with the rest:)
Well, I am off to try to enjoy my last night of rest before the next 5 days of chaos. I look around and think I should get the bathrooms cleaned, the laundry put away, etc before I am gone. But then I think...naaaaa.... I will just hunker down with the kiddos and my husband instead;)
Saturday, March 7, 2015
Update on Grace: The Good, the Bad, and the Struggle to Not Become Hopeless
ADHD is a very disruptive and difficult disorder. I have often mused how the criteria that I use when I diagnose people with ADHD are so sterile and concrete. Living with a person with ADHD is chaotic, overwhelming, maddening, and...at times it feels hopeless.
I have talked with several people over the past week, and read a blog post from a sweet friend, about the topic of hopelessness. I have been struggling with it for years and certain events occur that bring it more to the fore. I am usually able to beat it back eventually, but lately I have been hit hard from a variety of directions and hopeless I have been for awhile.
6 weeks ago we decided to put Grace in public school because her oppositional behavior was constant (at least 95% of the time) and it was preventing her from learning and the other kids from learning, or even feeling safe or calm in their own home. It has taken a bit of an adjustment but we will all tell you that we are so thankful that we made this decision. Grace LOVES, LOVES, LOVES going to school. She loves that she gets to play and be with people. I don't know that she is academically improving but she wasn't here either. We will see what the standardized tests indicate at the end of the year.
After 6 weeks, life at home during the day has become remarkably...calm. The house is quiet. Kids actually venture out from their bedrooms and join everyone else to sit quietly at the kitchen or in the living room to do their school. The constant tension is more intermittent (we still, of course, have JJ to content with). It is what I hear from other home school moms that a day actually looks like. I am struggling to remember back to when we just had Beautiful and Buddy when I actually got to engage with the children and do projects and fun things rather than just discipline all.day.long. I have been finding the energy and motivation to deep clean the house and take pride in my home again.
Two weeks ago Grace was...I am not sure that I can even put words onto what she gets like. No one would believe me if they just saw her "public" behavior. She is a different child at home. The easiest way to talk about it is pure contrary and oppositional behavior at every moment. There are times of reprieve, but they last minutes to a couple hours and are not daily. We realized at the end of a terrible week with her that we had run out of the supplements that we use for her neurotransmitters. I didn't realize we were out until we were out, then it took time for them to ship. She has improved (meaning longer stretches of more compliant behavior) in the past week since they came in. Last autumn we increased her ADHD medication. It has been 4 months and there has not been one single noticeable improvement. However, there is clearly improvement from the neurotransmitter supplements (and she is equally terrible if she doesn't get her ADHD meds - it is just that the increase in dosage provided no decrease in behaviors).
The day after she got back on them she and Superman were playing "Ninjas" while I was trying to keep them in the basement with me while 3 kids were still doing school upstairs. Apparently in playing Ninjas, Superman caught Grace and went to put her in "jail" in our bedroom. In the tussle they tripped and he landed on her, but she landed against the metal bed frame and ripped a gash in her lower back. I yelled for Beautiful to help who stopped the bleeding while I called the clinic (thankfully it was 5 to 5 and they were still open!) and went to deal with Superman. Superman is an extremely sensitive child and he was hysterical. I found him in his bedroom rolled into the fetal position sobbing and repeating over and over that he had hurt his sister. I just held him, made him look me in the eye, and repeated over and over that I loved him and that he was not in trouble (although they know not to play in our bedroom the accident could have happened anywhere). I didn't know what had happened then but I knew there was no way that Superman would maliciously hurt her...or anyone for that matter. I knew that Superman would retreat further into himself if I didn't handle that immediately. So, after 5+ minutes of reassuring him we got Grace to the clinic and got her 10 stitches done.
The next day she already popped one stitch. By Wednesday it was 4. Thursday we went to the clinic to see what could be done as she kept unraveling the stitch by not being still. Ha, this child cannot be still. When she next gets stitches it will have to be tied off each stitch. Her last 7 stitches in her toe months ago only had 3 left when we went to have them taken out. Sigh...
We did that in the morning, then took her to school in the afternoon. When she got home she was hyper and wanted to ride her bike. We told her that it was not OK for her to ride that day since the steri strips had just been put on a few hours before (Grace on a bike is anything but sedate and calm). She was not happy with us and just ratcheted out of control. The things she screams, the constant back talk, the putting her fingers in her ears to not listen to us is maddening.
So, we did something we had not done before. In the middle of it, my husband and I retreated. We fed the children, separated them all, apologized to Beautiful and left her in charge, and left.
We were utterly hopeless. Nothing that we do seems to help. All of the money, time, new ideas...nothing seems to make it better.
We went out to a new Mexican restaurant that we had not gone to before but had heard good things. And we talked. I don't know that since having children we have ever gone out to eat (due to where we live going out to eat means driving to the next town) and just ate and come home without running errands. But that is what we did.
We talked through her behavior. We talked through what we have tried before. We talked through what we can attempt in the future. We talked through what is realistic given everything else that we have to do. And we came up with a plan.
At a minimum it gave us a glimmer of hope that maybe this time it will be manageable. Time will tell. We came home and held a family meeting telling everyone what the new plan is and to ask them to help us implement it. It will require the help of the other kids.
Essentially, the new plan has to do with frequent (every 30 minutes) rewards for not opposing us in the prior 30 minutes and hourly intentional sensory stimulation. Consequences mean nothing to Grace, as every parent of an ADHD child will tell you. ADHD is a disorder of time. The past (thinking, "oh, I got in trouble for that before I shouldn't do it again"), the present (they are so impulsive that they do what they want while thinking it - not gap time to consider if it is right or wrong) or the future (oh, I will lose that if I don't obey) are time concepts. So, we will hope that 30 minute rewards will be effective. We are not even 24 hours into it and, so far, we have behavior from her that is less than the type that makes me want to pull my hair out and beat my head against a rock wall. She is outside riding her bike right now. Her steri strips are already ripped off. But, this child just cannot be still and the sensory stimulation keeps her calmer so ugly scar or not (it is healed shut, just not pretty) it is what it is.
We hope that this will help. On the one hand we keep wanting her to get older to mature and get some control over herself. On the other hand I work with a lot of ADHD kids who are older and it is not better. I struggle with not getting hopeless while imagining her at 10, 12, 14, 16+. I keep reminding myself that I have to stand before God and giving an accounting for what I have taught her, not what she has actually learned. That is between her and God. But God sure did give her to us for a whole lot of our own sanctification work to be done and not for calm and ease lol!
She is a constant reminder that our Hope is to be in Him and not in anything in this world.
I have talked with several people over the past week, and read a blog post from a sweet friend, about the topic of hopelessness. I have been struggling with it for years and certain events occur that bring it more to the fore. I am usually able to beat it back eventually, but lately I have been hit hard from a variety of directions and hopeless I have been for awhile.
6 weeks ago we decided to put Grace in public school because her oppositional behavior was constant (at least 95% of the time) and it was preventing her from learning and the other kids from learning, or even feeling safe or calm in their own home. It has taken a bit of an adjustment but we will all tell you that we are so thankful that we made this decision. Grace LOVES, LOVES, LOVES going to school. She loves that she gets to play and be with people. I don't know that she is academically improving but she wasn't here either. We will see what the standardized tests indicate at the end of the year.
After 6 weeks, life at home during the day has become remarkably...calm. The house is quiet. Kids actually venture out from their bedrooms and join everyone else to sit quietly at the kitchen or in the living room to do their school. The constant tension is more intermittent (we still, of course, have JJ to content with). It is what I hear from other home school moms that a day actually looks like. I am struggling to remember back to when we just had Beautiful and Buddy when I actually got to engage with the children and do projects and fun things rather than just discipline all.day.long. I have been finding the energy and motivation to deep clean the house and take pride in my home again.
Two weeks ago Grace was...I am not sure that I can even put words onto what she gets like. No one would believe me if they just saw her "public" behavior. She is a different child at home. The easiest way to talk about it is pure contrary and oppositional behavior at every moment. There are times of reprieve, but they last minutes to a couple hours and are not daily. We realized at the end of a terrible week with her that we had run out of the supplements that we use for her neurotransmitters. I didn't realize we were out until we were out, then it took time for them to ship. She has improved (meaning longer stretches of more compliant behavior) in the past week since they came in. Last autumn we increased her ADHD medication. It has been 4 months and there has not been one single noticeable improvement. However, there is clearly improvement from the neurotransmitter supplements (and she is equally terrible if she doesn't get her ADHD meds - it is just that the increase in dosage provided no decrease in behaviors).
The day after she got back on them she and Superman were playing "Ninjas" while I was trying to keep them in the basement with me while 3 kids were still doing school upstairs. Apparently in playing Ninjas, Superman caught Grace and went to put her in "jail" in our bedroom. In the tussle they tripped and he landed on her, but she landed against the metal bed frame and ripped a gash in her lower back. I yelled for Beautiful to help who stopped the bleeding while I called the clinic (thankfully it was 5 to 5 and they were still open!) and went to deal with Superman. Superman is an extremely sensitive child and he was hysterical. I found him in his bedroom rolled into the fetal position sobbing and repeating over and over that he had hurt his sister. I just held him, made him look me in the eye, and repeated over and over that I loved him and that he was not in trouble (although they know not to play in our bedroom the accident could have happened anywhere). I didn't know what had happened then but I knew there was no way that Superman would maliciously hurt her...or anyone for that matter. I knew that Superman would retreat further into himself if I didn't handle that immediately. So, after 5+ minutes of reassuring him we got Grace to the clinic and got her 10 stitches done.
The next day she already popped one stitch. By Wednesday it was 4. Thursday we went to the clinic to see what could be done as she kept unraveling the stitch by not being still. Ha, this child cannot be still. When she next gets stitches it will have to be tied off each stitch. Her last 7 stitches in her toe months ago only had 3 left when we went to have them taken out. Sigh...
We did that in the morning, then took her to school in the afternoon. When she got home she was hyper and wanted to ride her bike. We told her that it was not OK for her to ride that day since the steri strips had just been put on a few hours before (Grace on a bike is anything but sedate and calm). She was not happy with us and just ratcheted out of control. The things she screams, the constant back talk, the putting her fingers in her ears to not listen to us is maddening.
So, we did something we had not done before. In the middle of it, my husband and I retreated. We fed the children, separated them all, apologized to Beautiful and left her in charge, and left.
We were utterly hopeless. Nothing that we do seems to help. All of the money, time, new ideas...nothing seems to make it better.
We went out to a new Mexican restaurant that we had not gone to before but had heard good things. And we talked. I don't know that since having children we have ever gone out to eat (due to where we live going out to eat means driving to the next town) and just ate and come home without running errands. But that is what we did.
We talked through her behavior. We talked through what we have tried before. We talked through what we can attempt in the future. We talked through what is realistic given everything else that we have to do. And we came up with a plan.
At a minimum it gave us a glimmer of hope that maybe this time it will be manageable. Time will tell. We came home and held a family meeting telling everyone what the new plan is and to ask them to help us implement it. It will require the help of the other kids.
Essentially, the new plan has to do with frequent (every 30 minutes) rewards for not opposing us in the prior 30 minutes and hourly intentional sensory stimulation. Consequences mean nothing to Grace, as every parent of an ADHD child will tell you. ADHD is a disorder of time. The past (thinking, "oh, I got in trouble for that before I shouldn't do it again"), the present (they are so impulsive that they do what they want while thinking it - not gap time to consider if it is right or wrong) or the future (oh, I will lose that if I don't obey) are time concepts. So, we will hope that 30 minute rewards will be effective. We are not even 24 hours into it and, so far, we have behavior from her that is less than the type that makes me want to pull my hair out and beat my head against a rock wall. She is outside riding her bike right now. Her steri strips are already ripped off. But, this child just cannot be still and the sensory stimulation keeps her calmer so ugly scar or not (it is healed shut, just not pretty) it is what it is.
We hope that this will help. On the one hand we keep wanting her to get older to mature and get some control over herself. On the other hand I work with a lot of ADHD kids who are older and it is not better. I struggle with not getting hopeless while imagining her at 10, 12, 14, 16+. I keep reminding myself that I have to stand before God and giving an accounting for what I have taught her, not what she has actually learned. That is between her and God. But God sure did give her to us for a whole lot of our own sanctification work to be done and not for calm and ease lol!
She is a constant reminder that our Hope is to be in Him and not in anything in this world.
Sunday, October 21, 2012
Thoughts on ADHD Conference: Part 2 Conceptualizing Attention Disorders
I have written and rewritten this post many times over the past 3ish weeks. I am wanting to communicate this clearly as I believe it is so important to see how these two attention issues are fundamentally different - therefore treatment interventions going to be different (and hopefully frustration levels lowered too:). I give more information on ADHD as that is what has more research, but hope that I have laid out the underlying differences in a way that helps to see them separate issues. If I am unclear, please let me know and I will try to clarify:)
Dr. Russell Barkley has been studying ADHD for many years. As stated in my last post you can check him out at www.adhdlectures.com or read his books. He has compiled and conducted much research in the area of ADHD. He shared that he believes that there are probably 7 different Attention Disorders that factor analysis shows in the research rather than just ADHD as we currently know it. However, at this time only ADHD is recognized by the DSM team, and when the DSM-V (the diagnostic tool that psychologists use to diagnose mental health issues) comes out next year it will still just have ADHD as the only Attention Disorder. There are various reasons for this that I will not bore you with, but they are essentially political. However, just because a particular group of people have not stated that there is a disorder, it does not mean that the disorder does not exist;) On the other hand, what really is a disorder? Just a cluster of symptoms that a subset group of people have that means that they are somehow doing something different than another subset group of people. But...I digress...
Dr. Barkley spoke about how he believes that ADHD as currently understood is actually 2 different disorders. As you may know, a person can get a diagnosis of ADHD and then specify if it is predominantly Hyperactivity/Impulse or predominantly Inattentive (or combined). Dr. Barkley believes that the research shows that there is a disorder that manifests itself as Hyperactivity/Impulsivity and another disorder that looks like what we call Inattentive. He says that it is important to distinguish between them because he says the underlying causes of what is going on with the person is very different, and therefore treatment implications are very different. Again, people who have not studied Dr. Barkley's work will not know about these differences in conceptualization and there are no official differences in diagnosis as the current diagnostic system is set up (other than as stated above). Therefore, the information I am giving you now, as I understand it from the conference from Dr. Barkley, is primarily to help you (and me!) conceptualize the problems that we see with these kiddos and how to help them be as successful as possible.
The crux of what Dr. Barkley said was, ADHD is an "Intention Deficit Disorder" whereas the other disorder that has been called in research "SCT" is "Concentration Disorder." People talk about them as Executive Functioning Disorders - essentially the frontal lobe of the brain is the "computer" that takes all kinds of information, integrates it, makes a plan, and executes the plan (tells the rest of the brain to follow through). Specifically with ADHD, the right frontal portion of the brain is not processing information effectively much like a person who has had an injury to that portion of the brain (although there are more parts of the brain than that which are affected in ADHD). I will go into that in the next post...
I will attempt to discuss the differences between these the best way I can. I very much agree that these distinctions are essential to understand and are crucial when discussing treatment implications and long term life planning.
ADHD: developmental delay in inhibition (they are very disinhibited)
SCT: developmental delay in concentration
ADHD: is an OUTPUT disorder - they have no problem with processing information
SCT: INPUT disorder - they are not inputting and processing incoming stimuli accurately
ADHD: the problem is with sustained attention, not necessarily what they are attending to
SCT: the problem is that they do not attend to the correct information (focused on the wrong details)
ADHD: friendships tend to be few and far between, they tend to be rejected by others due to, well, the way they act in relationship to others
SCT: tend to be overlooked and neglected in relationships. They tend to not focus on the "right" information in relational interactions and thus don't "connect" well with others.
ADHD: very impulsive and hyper
SCT: tend to be slow moving/sluggish
ADHD: Their behavior is hard to control and manage
SCT: The kids are very likeable, they just don't get things done
ADHD: it is a temporal disorganization (time management disorder)
SCT: Spatial disorganization (they can get it done but it is unorganized and often not right)
ADHD: a production disorder - they tend to not get things finished, but if they do it is done correctly
SCT: Accuracy disorder - they get it done, but it is wrong (they are not attending to the right details)
ADHD: vast majority will respond to stimulant medication
SCT: less than 20% respond to stimulant medication
Other symptoms of ADHD (aside from constant moving and talking and the inability to control urges lol!!)
* Dr. Barkley shared that instead of thinking of ADHD as an attention problem, we need to think of it really as an INTENTION deficit disorder. He says that these kids can filter information just fine (or pay attention to incoming stimuli), the problem is with how they see the future (their intention of what to do with that stimuli).
* There is an impairment with working memory (holding various pieces of information simultaneously and using that information to proceed logically). It is not that they do not know the rules or they are unable to recall what they were supposed to be doing. The kiddos can tell you what the rules are, but they sure aren't logically using them!
*ADHD show dis-inhibition in all areas of life, not just one or two areas or settings
* The hyperactivity piece is about intention with incoming stimuli (so much stimulation, so little time to do something with it). As an example of this, adults will not have the hyperactivity piece. They report feeling "restless" and experience "anxiety."
*Their emotions are rational - they are intense, but they are rational. This is unlike people with mood disorders (e.g. depression) who have emotions inconsistent with the reality of their lives. When you talk to ADHD people about why they feel a certain way, while they may be making a bigger deal out of something than they need to but it is still consistent with reality.
* They are UNABLE to persist in a task when there is not immediate gratification. What takes them a long time to do when there is not immediate gratification can take a very short time when there is immediate gratification. Outcome is highly variable and not consistent with the persons ability to understand what needs to be done, but rather with what is motivating them to complete the task. This was probably the most enlightening piece of information for me that has fundamentally changed the way I engage my child with ADHD.
* ADHD directly impacts a persons ability to handle delayed reinforcement (e.g. waiting for the reward). It is not that the person is being lazy or oppositional (although that happens often with people with ADHD, it is a separate problem and not a symptom of ADHD per se) but rather that they cannot keep in their mind the concept of time long enough to work for something in the future.
* ADHD people tend to feel pretty good about their accomplishments. They like to normalize their behavior and lives, but that is not a good assessment of their lives or accomplishments (they don't have much of a problem with "confidence.")
* One often finds a readiness to learn, but there is a struggle with the actual ability to learn or the attention to stay on task to learn
* over half by adolescence will be rebellious and antisocial (which is logical due to the impulse control and feeling like others don't understand them even though they believe themselves to not have problems).
* unable to sub-vocalize. Fancy way to say that they cannot think to themselves. They talk...A LOT. This is so evident with our daughter. She talks non-stop. We always giggle when when chooses to pray at meals because she gives God a blow by blow descriptive play of the day...as if He didn't know lol! In just the past couple of months I am thrilled that we actually have certain times in the day where we can get to short periods of quiet!
* these kids know the answers of how to act/what the rules are/what they should be doing. They just do not follow through. It is not that they are "inattentive" to the rules, don't know what they were told to do, didn't pick up on the instructions given, etc. Therefore, simply telling them what to do will not help.
*social maturity is about 30% delayed
My next blog post will be on understanding Executive Function and how that impacts ADHD. The one after that will be on Treatment Implications. Again, if you find this information helpful, or if you don't find it helpful and want better/more information, please check out Dr. Barkley's lectures at www.adhdlectures.com .
Dr. Russell Barkley has been studying ADHD for many years. As stated in my last post you can check him out at www.adhdlectures.com or read his books. He has compiled and conducted much research in the area of ADHD. He shared that he believes that there are probably 7 different Attention Disorders that factor analysis shows in the research rather than just ADHD as we currently know it. However, at this time only ADHD is recognized by the DSM team, and when the DSM-V (the diagnostic tool that psychologists use to diagnose mental health issues) comes out next year it will still just have ADHD as the only Attention Disorder. There are various reasons for this that I will not bore you with, but they are essentially political. However, just because a particular group of people have not stated that there is a disorder, it does not mean that the disorder does not exist;) On the other hand, what really is a disorder? Just a cluster of symptoms that a subset group of people have that means that they are somehow doing something different than another subset group of people. But...I digress...
Dr. Barkley spoke about how he believes that ADHD as currently understood is actually 2 different disorders. As you may know, a person can get a diagnosis of ADHD and then specify if it is predominantly Hyperactivity/Impulse or predominantly Inattentive (or combined). Dr. Barkley believes that the research shows that there is a disorder that manifests itself as Hyperactivity/Impulsivity and another disorder that looks like what we call Inattentive. He says that it is important to distinguish between them because he says the underlying causes of what is going on with the person is very different, and therefore treatment implications are very different. Again, people who have not studied Dr. Barkley's work will not know about these differences in conceptualization and there are no official differences in diagnosis as the current diagnostic system is set up (other than as stated above). Therefore, the information I am giving you now, as I understand it from the conference from Dr. Barkley, is primarily to help you (and me!) conceptualize the problems that we see with these kiddos and how to help them be as successful as possible.
The crux of what Dr. Barkley said was, ADHD is an "Intention Deficit Disorder" whereas the other disorder that has been called in research "SCT" is "Concentration Disorder." People talk about them as Executive Functioning Disorders - essentially the frontal lobe of the brain is the "computer" that takes all kinds of information, integrates it, makes a plan, and executes the plan (tells the rest of the brain to follow through). Specifically with ADHD, the right frontal portion of the brain is not processing information effectively much like a person who has had an injury to that portion of the brain (although there are more parts of the brain than that which are affected in ADHD). I will go into that in the next post...
I will attempt to discuss the differences between these the best way I can. I very much agree that these distinctions are essential to understand and are crucial when discussing treatment implications and long term life planning.
ADHD: developmental delay in inhibition (they are very disinhibited)
SCT: developmental delay in concentration
ADHD: is an OUTPUT disorder - they have no problem with processing information
SCT: INPUT disorder - they are not inputting and processing incoming stimuli accurately
ADHD: the problem is with sustained attention, not necessarily what they are attending to
SCT: the problem is that they do not attend to the correct information (focused on the wrong details)
ADHD: friendships tend to be few and far between, they tend to be rejected by others due to, well, the way they act in relationship to others
SCT: tend to be overlooked and neglected in relationships. They tend to not focus on the "right" information in relational interactions and thus don't "connect" well with others.
ADHD: very impulsive and hyper
SCT: tend to be slow moving/sluggish
ADHD: Their behavior is hard to control and manage
SCT: The kids are very likeable, they just don't get things done
ADHD: it is a temporal disorganization (time management disorder)
SCT: Spatial disorganization (they can get it done but it is unorganized and often not right)
ADHD: a production disorder - they tend to not get things finished, but if they do it is done correctly
SCT: Accuracy disorder - they get it done, but it is wrong (they are not attending to the right details)
ADHD: vast majority will respond to stimulant medication
SCT: less than 20% respond to stimulant medication
Other symptoms of ADHD (aside from constant moving and talking and the inability to control urges lol!!)
* Dr. Barkley shared that instead of thinking of ADHD as an attention problem, we need to think of it really as an INTENTION deficit disorder. He says that these kids can filter information just fine (or pay attention to incoming stimuli), the problem is with how they see the future (their intention of what to do with that stimuli).
* There is an impairment with working memory (holding various pieces of information simultaneously and using that information to proceed logically). It is not that they do not know the rules or they are unable to recall what they were supposed to be doing. The kiddos can tell you what the rules are, but they sure aren't logically using them!
*ADHD show dis-inhibition in all areas of life, not just one or two areas or settings
* The hyperactivity piece is about intention with incoming stimuli (so much stimulation, so little time to do something with it). As an example of this, adults will not have the hyperactivity piece. They report feeling "restless" and experience "anxiety."
*Their emotions are rational - they are intense, but they are rational. This is unlike people with mood disorders (e.g. depression) who have emotions inconsistent with the reality of their lives. When you talk to ADHD people about why they feel a certain way, while they may be making a bigger deal out of something than they need to but it is still consistent with reality.
* They are UNABLE to persist in a task when there is not immediate gratification. What takes them a long time to do when there is not immediate gratification can take a very short time when there is immediate gratification. Outcome is highly variable and not consistent with the persons ability to understand what needs to be done, but rather with what is motivating them to complete the task. This was probably the most enlightening piece of information for me that has fundamentally changed the way I engage my child with ADHD.
* ADHD directly impacts a persons ability to handle delayed reinforcement (e.g. waiting for the reward). It is not that the person is being lazy or oppositional (although that happens often with people with ADHD, it is a separate problem and not a symptom of ADHD per se) but rather that they cannot keep in their mind the concept of time long enough to work for something in the future.
* ADHD people tend to feel pretty good about their accomplishments. They like to normalize their behavior and lives, but that is not a good assessment of their lives or accomplishments (they don't have much of a problem with "confidence.")
* One often finds a readiness to learn, but there is a struggle with the actual ability to learn or the attention to stay on task to learn
* over half by adolescence will be rebellious and antisocial (which is logical due to the impulse control and feeling like others don't understand them even though they believe themselves to not have problems).
* unable to sub-vocalize. Fancy way to say that they cannot think to themselves. They talk...A LOT. This is so evident with our daughter. She talks non-stop. We always giggle when when chooses to pray at meals because she gives God a blow by blow descriptive play of the day...as if He didn't know lol! In just the past couple of months I am thrilled that we actually have certain times in the day where we can get to short periods of quiet!
* these kids know the answers of how to act/what the rules are/what they should be doing. They just do not follow through. It is not that they are "inattentive" to the rules, don't know what they were told to do, didn't pick up on the instructions given, etc. Therefore, simply telling them what to do will not help.
*social maturity is about 30% delayed
My next blog post will be on understanding Executive Function and how that impacts ADHD. The one after that will be on Treatment Implications. Again, if you find this information helpful, or if you don't find it helpful and want better/more information, please check out Dr. Barkley's lectures at www.adhdlectures.com .
Saturday, October 20, 2012
Thoughts on ADHD Conference: Part 1 Statistics
In September I had the opportunity to see Russell Barkley, PhD speak about the current research and advancement of understanding ADHD. He is the "guru" of ADHD and it was an honor to hear him. I wanted to take some time to share my thoughts on his conference. While I was there in a professional role, after raising Grace I filtered most of it through my "mom brain." I had many different emotions at the conference. I was thrilled that I felt like someone finally understood our journey with ADHD and validated that it is not "just bad parenting" and that it is very, very hard. I was overwhelmed by the realities of the longevity of the situation and wondering how we can help her so she will thrive as an adult (and adolescent). And I was encouraged by specific interventions that we can use to manage the situation.
Anyone can go to www.ADHDLectures.com and watch Dr. Barkley present his information. His information is broken down into 1 - 2 hour lectures. There are 5 for parents that include 1 on how to deal with ADHD in the classroom. There is a cost (about $6 each) to watch the lectures that is minimal considering the information and help you can receive. There is also a book written in layman's terms that I am finding to be excellent called Taking Charge of ADHD by Russell Barkley. If you have a child with ADHD, think you do, or want to help understand someone else who has it, I highly recommend this book.
Dr. Barkley presented a very different way to conceptualize ADHD than I had previously heard. I will cover that in another post. Very importantly in my mind, he talked about how ADHD is the "diabetes of psychiatry." There is no cure or fix. There is only management. The management will help with the symptoms only, but perhaps more importantly it will help to prevent more long term negative consequences.
Some statistics:
How do you get it:
ADHD is highly passed on genetically. However, there are known ways to "acquire" ADHD (about 30+% of cases)
PRENATAL:
*There is a threshold of 10 cigarettes a day below which developing baby is not thought to acquire ADHD from nicotine/tobacco use. Over that nicotine use increased the likelihood of ADHD by 2.5 times more likely than non-smoking mothers.
* There is NO SAFE THRESHOLD FOR ALCOHOL USE!!!
* premature birth - especially if a brain bleed (45% are thought to develop ADHD)
* total increased pregnancy complications
*high phenylalanine levels in mom's blood (but not full PKU levels)
* high maternal anxiety in 2nd trimester (due to the hormone levels on the baby while developing)
GENETICS:
* two genes have been identified so far. 40 genetic sites have been located - all related to issues with dopamine (which is probably why stimulates work well as treatment).
* if a sibling has it, 25 - 25% likely of another sibling having it
* if an identical twin has it, 78 - 92% likely the other twin has it
* if parent has it, 40 - 54% of their children will have it (more likely if it is the father)
POST-NATAL (3 - 7%)
* head trauma
* certain seizures
* lead poisoning prior to age 3
* survival from acute lymphoblastic leukemia
* strep B infection
* elevated but sub threshold exposure to PKU related amino acid
Some more general stats on ADHD:
* 7-8% of kids are diagnosed with it and 4 - 5% of adults.
* one sees a 2.5x increase in seizures in kids who have it
* 1.5x more likely to be overweight if have it (impulse control issues)
* 39 - 56% have sleep problems
* more dental issues
* more coordination issues
* accident proneness - 1.5 - 4x greater risk for injuries, 3x greater for accident poisonings
* 2 - 3 x the medical costs of other kids - not counting the meds/mgmt of the ADHD itself
* pragmatic deficits in language disorders with 60%
* excessive speech, less logical, coherent, organized speech
* much difficulty with talking "to self"
* less able to understand rule-governed behavior
* IQ is an average of 7-10 points lower (probably due to the executive functioning that I will discuss later)
* 90% have poor school performance (reduced productivity and inattention are the biggest issues)
* learning disabilities in 24 - 70% depending on the study (with reading, spelling, math, handwriting, and comprehension). These LD's are not due to the ADHD, but co exist with it and can improve with ADHD management.
* increased parent/child conflicts
* higher rates of parental divorce earlier in marriage
* since it is highly genetic, many parents also have it which leads to interesting dynamics
* significantly impacted peer relationships: more intrusive on others, verbally impulsive, more anger, more directive of others, less cooperative (wanting things done own way), reduced empathy, etc resulting in conflicts and often rejection by peers of the ADHD child.
Teens:
* 40% of ADHD kids are parents as teens
* 60% of ADHD girls get pregnant in high school
* 40% don't graduate
* 40% fail/repeat at least 1 class in school
* only 5-10% finish college as compared to 35% of non-ADHD students
* 5x more likely to attempt suicide if they think about suicide (less likely to talk self out of the thoughts as are more impulsive).
* much higher risk of car accidents (he even went so far as to suggest not letting 16 year old ADHD teens drive until more maturity is developed. I am ALL about agreeing to that lol!)
*As adults: family stress, strained friendships, more limited educational success, legal difficulties (if engage in criminal behavior), excessive smoking/drinking/caffeine, accidents, job problems, financial problems (impulsive spending), problems in own marriage/parenting, and unhealthy lifestyles, increased risk of heart disease. 3x more likely to die by 45 years old.
Drug use (top 3 that are abused):
1st: nicotine. The nicotine, oddly enough, will "treat" the ADHD as it is a stimulate, and thus unfortunately many people with ADHD symptoms use it to self-medicate
2nd: alcohol
3rd: marijuana these are used not to self-medicate as it will actually make the symptoms worse. However, people with ADHD often use them to help "forget" their problems
My next post on ADHD will be on Dr. Barkley's theory of ADHD, what he says the foundational issues are, and what he says Executive Functioning is that is most impaired in people with ADHD.
Anyone can go to www.ADHDLectures.com and watch Dr. Barkley present his information. His information is broken down into 1 - 2 hour lectures. There are 5 for parents that include 1 on how to deal with ADHD in the classroom. There is a cost (about $6 each) to watch the lectures that is minimal considering the information and help you can receive. There is also a book written in layman's terms that I am finding to be excellent called Taking Charge of ADHD by Russell Barkley. If you have a child with ADHD, think you do, or want to help understand someone else who has it, I highly recommend this book.
Dr. Barkley presented a very different way to conceptualize ADHD than I had previously heard. I will cover that in another post. Very importantly in my mind, he talked about how ADHD is the "diabetes of psychiatry." There is no cure or fix. There is only management. The management will help with the symptoms only, but perhaps more importantly it will help to prevent more long term negative consequences.
Some statistics:
How do you get it:
ADHD is highly passed on genetically. However, there are known ways to "acquire" ADHD (about 30+% of cases)
PRENATAL:
*There is a threshold of 10 cigarettes a day below which developing baby is not thought to acquire ADHD from nicotine/tobacco use. Over that nicotine use increased the likelihood of ADHD by 2.5 times more likely than non-smoking mothers.
* There is NO SAFE THRESHOLD FOR ALCOHOL USE!!!
* premature birth - especially if a brain bleed (45% are thought to develop ADHD)
* total increased pregnancy complications
*high phenylalanine levels in mom's blood (but not full PKU levels)
* high maternal anxiety in 2nd trimester (due to the hormone levels on the baby while developing)
GENETICS:
* two genes have been identified so far. 40 genetic sites have been located - all related to issues with dopamine (which is probably why stimulates work well as treatment).
* if a sibling has it, 25 - 25% likely of another sibling having it
* if an identical twin has it, 78 - 92% likely the other twin has it
* if parent has it, 40 - 54% of their children will have it (more likely if it is the father)
POST-NATAL (3 - 7%)
* head trauma
* certain seizures
* lead poisoning prior to age 3
* survival from acute lymphoblastic leukemia
* strep B infection
* elevated but sub threshold exposure to PKU related amino acid
Some more general stats on ADHD:
* 7-8% of kids are diagnosed with it and 4 - 5% of adults.
* one sees a 2.5x increase in seizures in kids who have it
* 1.5x more likely to be overweight if have it (impulse control issues)
* 39 - 56% have sleep problems
* more dental issues
* more coordination issues
* accident proneness - 1.5 - 4x greater risk for injuries, 3x greater for accident poisonings
* 2 - 3 x the medical costs of other kids - not counting the meds/mgmt of the ADHD itself
* pragmatic deficits in language disorders with 60%
* excessive speech, less logical, coherent, organized speech
* much difficulty with talking "to self"
* less able to understand rule-governed behavior
* IQ is an average of 7-10 points lower (probably due to the executive functioning that I will discuss later)
* 90% have poor school performance (reduced productivity and inattention are the biggest issues)
* learning disabilities in 24 - 70% depending on the study (with reading, spelling, math, handwriting, and comprehension). These LD's are not due to the ADHD, but co exist with it and can improve with ADHD management.
* increased parent/child conflicts
* higher rates of parental divorce earlier in marriage
* since it is highly genetic, many parents also have it which leads to interesting dynamics
* significantly impacted peer relationships: more intrusive on others, verbally impulsive, more anger, more directive of others, less cooperative (wanting things done own way), reduced empathy, etc resulting in conflicts and often rejection by peers of the ADHD child.
Teens:
* 40% of ADHD kids are parents as teens
* 60% of ADHD girls get pregnant in high school
* 40% don't graduate
* 40% fail/repeat at least 1 class in school
* only 5-10% finish college as compared to 35% of non-ADHD students
* 5x more likely to attempt suicide if they think about suicide (less likely to talk self out of the thoughts as are more impulsive).
* much higher risk of car accidents (he even went so far as to suggest not letting 16 year old ADHD teens drive until more maturity is developed. I am ALL about agreeing to that lol!)
*As adults: family stress, strained friendships, more limited educational success, legal difficulties (if engage in criminal behavior), excessive smoking/drinking/caffeine, accidents, job problems, financial problems (impulsive spending), problems in own marriage/parenting, and unhealthy lifestyles, increased risk of heart disease. 3x more likely to die by 45 years old.
Drug use (top 3 that are abused):
1st: nicotine. The nicotine, oddly enough, will "treat" the ADHD as it is a stimulate, and thus unfortunately many people with ADHD symptoms use it to self-medicate
2nd: alcohol
3rd: marijuana these are used not to self-medicate as it will actually make the symptoms worse. However, people with ADHD often use them to help "forget" their problems
My next post on ADHD will be on Dr. Barkley's theory of ADHD, what he says the foundational issues are, and what he says Executive Functioning is that is most impaired in people with ADHD.
Wednesday, May 11, 2011
ADHD
I have written this post in my head many times over the past several months. It is hard to admit when things are hard. I also desire to not embarrass my children. However, I have decided to write about living with a child with ADHD to encourage others who have children with ADHD. For those of you who have followed my blog for a time, you will probably recall comments that I make about our "wild child." We went through screaming for hours, not sleeping, bullying, energy through the roof, utter disobedience, head spinning impulsiveness, and total exhaustion. We really wanted to help her without having to resort to medication. We her her adjusted by a chiropractor monthly for 3 years. We tried lots of supplements, etc. We prayed. We disciplined. We "tomato stake" her (I read a mom's blog on this once about keeping your "difficult" children close to you at all times like one needs to constantly keep a tomato staked to help it grow to it's best potential."
We still do all of these things. But...we also added.........medication. Yes. We did it. We did the unthinkable and give our child Ritalin every day. I had such trepidation. I felt like such a failure as a mom. She was making everyone's life incredibly difficult and was bullying (physically and emotionally) her age mates that have significant abuse histories. They were regressing and beginning to act out themselves. It was time. It was necessary. I felt like I was "sacrificing" her for the sake of the family. During this a wise person told me that it probably was not very comfortable for her to be bouncing off of walls either and perhaps the medication would help her feel better about her...
He was right...
She is a totally different child on the medication. She sits for 30 - 45 minutes at a time now. She LOVES to color!!!! In the past of she sat to color she would be coloring on everyone else's pages, flipping through her book all of the time not finishing a page. Of course getting up all of the time and running around. She doesn't hit the other children as often now. She is more "motherly" and gentle. We have discovered that art is an area of giftedness for her. She draws things that actually look like what she is trying to draw lol! She colors beautifully. She is clearly calmer and feels better about herself (not to mention she isn't being disciplined every 5 minutes - that must help lol!!) I will admit that she continues to be the child we have to keep our eye on the most lol!
For those of you wondering what we have done...here you go.
1) We maintain chiropractor visits every 1 - 2 months. This helps.
2) We have her on many supplements:
Ambrotose, Phyte Aloe, Acidophilus, Multi-vitamin, Vitamin C, an anti-fungal to kill fungal/yeast overgrowth in her gut (grapefruit seed extract), and the most important...DHA. We have her on 1100 mg of DHA a day. When she first started the DHA we noticed that if we said "smile for the picture" she actually smiled long enough to get the picture taken instead of getting distracted and running off right away or fighting us. And, while we are waiting for these things to work on her biology for long term improvement...
3) she is on Ritalin. We have her on a low dose and do it 2x a day. We tried the suspended release at the same dose but she was far more agitated on it, bedtimes included temper tantrums again, and we didn't see the calmness we saw on the immediate release. We could have upped the dose but decided to just go back to the twice daily dose and see how the summer goes.
4) I read a book from Focus on the Family called something like "ADHD doesn't have to mean Disaster." It was a very good book who helped me to see her outside of my box:)
5) we had her formally evaluated and diagnosed with ADHD...she scored out at the 95 - 99 percentile of behaviors (we knew that lol!!!)
One of the biggest lessons for me was: ADHD is REAL. I had secretly believed in the past that ADHD behaviors could be curbed with good, consistent, and thorough parenting. While I still believe that some ADHD behaviors can be fixed with that...not our child. That was very humbling...
The other big lesson for me: ADHD medication can curb impulsiveness, distractibility, and agitation...but it does not effect the strong willed personality that defines our child:) It is just that now the discipline to help her learn to submit to God's will and our will hopefully sinks in and is considered before it flies out her other ear lol!
Is life perfect now? No:) Do we still need to remind her to look at us and hear what we are saying? Yes:) Do we still need to talk extra loud to get her attention? Yes:) Do we still "tomato stake"? Absolutely yes!!!!! Do we trust her outside of our sight? A little bit more:) Does she still bully? Yes. Does she still insist on doing life her way? Of course:) But...considering what the past 3 years have looked like...this is bearable!!!
Finally, we also have been constantly reminded that God made her. He gifted her. He loves her. He has a plan for her. She is such a precious child. She has amazing gifts of art and motherliness ( in fact, it is usually her desire to "mother" the other children that results in her "making" them obey her lol!!!). We will wait on the Lord, trusting Him for each step...and being thankful that for now the medication is giving us an appreciated reprieve:)
We still do all of these things. But...we also added.........medication. Yes. We did it. We did the unthinkable and give our child Ritalin every day. I had such trepidation. I felt like such a failure as a mom. She was making everyone's life incredibly difficult and was bullying (physically and emotionally) her age mates that have significant abuse histories. They were regressing and beginning to act out themselves. It was time. It was necessary. I felt like I was "sacrificing" her for the sake of the family. During this a wise person told me that it probably was not very comfortable for her to be bouncing off of walls either and perhaps the medication would help her feel better about her...
He was right...
She is a totally different child on the medication. She sits for 30 - 45 minutes at a time now. She LOVES to color!!!! In the past of she sat to color she would be coloring on everyone else's pages, flipping through her book all of the time not finishing a page. Of course getting up all of the time and running around. She doesn't hit the other children as often now. She is more "motherly" and gentle. We have discovered that art is an area of giftedness for her. She draws things that actually look like what she is trying to draw lol! She colors beautifully. She is clearly calmer and feels better about herself (not to mention she isn't being disciplined every 5 minutes - that must help lol!!) I will admit that she continues to be the child we have to keep our eye on the most lol!
For those of you wondering what we have done...here you go.
1) We maintain chiropractor visits every 1 - 2 months. This helps.
2) We have her on many supplements:
Ambrotose, Phyte Aloe, Acidophilus, Multi-vitamin, Vitamin C, an anti-fungal to kill fungal/yeast overgrowth in her gut (grapefruit seed extract), and the most important...DHA. We have her on 1100 mg of DHA a day. When she first started the DHA we noticed that if we said "smile for the picture" she actually smiled long enough to get the picture taken instead of getting distracted and running off right away or fighting us. And, while we are waiting for these things to work on her biology for long term improvement...
3) she is on Ritalin. We have her on a low dose and do it 2x a day. We tried the suspended release at the same dose but she was far more agitated on it, bedtimes included temper tantrums again, and we didn't see the calmness we saw on the immediate release. We could have upped the dose but decided to just go back to the twice daily dose and see how the summer goes.
4) I read a book from Focus on the Family called something like "ADHD doesn't have to mean Disaster." It was a very good book who helped me to see her outside of my box:)
5) we had her formally evaluated and diagnosed with ADHD...she scored out at the 95 - 99 percentile of behaviors (we knew that lol!!!)
One of the biggest lessons for me was: ADHD is REAL. I had secretly believed in the past that ADHD behaviors could be curbed with good, consistent, and thorough parenting. While I still believe that some ADHD behaviors can be fixed with that...not our child. That was very humbling...
The other big lesson for me: ADHD medication can curb impulsiveness, distractibility, and agitation...but it does not effect the strong willed personality that defines our child:) It is just that now the discipline to help her learn to submit to God's will and our will hopefully sinks in and is considered before it flies out her other ear lol!
Is life perfect now? No:) Do we still need to remind her to look at us and hear what we are saying? Yes:) Do we still need to talk extra loud to get her attention? Yes:) Do we still "tomato stake"? Absolutely yes!!!!! Do we trust her outside of our sight? A little bit more:) Does she still bully? Yes. Does she still insist on doing life her way? Of course:) But...considering what the past 3 years have looked like...this is bearable!!!
Finally, we also have been constantly reminded that God made her. He gifted her. He loves her. He has a plan for her. She is such a precious child. She has amazing gifts of art and motherliness ( in fact, it is usually her desire to "mother" the other children that results in her "making" them obey her lol!!!). We will wait on the Lord, trusting Him for each step...and being thankful that for now the medication is giving us an appreciated reprieve:)
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