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Forum -> Parenting our children -> Our Challenging Children (gifted, ADHD, sensitive, defiant)
I think I just lost all respect for DS's ped.



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Ima2NYM_LTR




 
 
    
 

Post Tue, Feb 08 2011, 9:07 am
DS is in 1st grade and has trouble focusing. The school district did an eval on him and said he shows "ADHD tendencies" and recommended behavior modification, and if that fails, then to look at further testing and possibly medication.

Sounds good.

Took the report to the ped. office, and he just called me back and said he would think about putting DS on medication (not a high dose). I reiterated the school districts stance on trying behavior modification first, and told him that DSs behavior has been improving.

His response was "If your son had trouble seeing, you wouldn't hesitate to get him glasses"

EXCUSE ME!!! Did you just compare an external corrective device with no side effects with a chemical substance that is ingested to alter brain chemistry?

Am waiting for Dh to come home to discuss with him, and also will discuss with my family members who work with kids, but that just sounds absurd!!!
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saw50st8




 
 
    
 

Post Tue, Feb 08 2011, 9:08 am
Exploding anger
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Health is a Virture




 
 
    
 

Post Tue, Feb 08 2011, 9:19 am
you have to understand where the doctor is coming from. many doctors THINK in medicine thinking mode. The way to deal with problems is medication. A person is going through a rough-time, here, take some antidepressants. A person needs to work on midah of anger, here, take some anti-psychotic medication. (sorry can't remember names of meds). So, having an attention/behavioral issue, take some ritalin. ritalin is 100% safe. if that doesn't work, well, then we'll try another med.

they are taught that medicine is very very safe. Ths studies that they read (and write) are very biased. medicine is very safe. epidurals are very safe. whyw ould you want to feel pain? This is the way many doctors think. Very often they are THINKING people, don't understand emotions...don't understand that exercises may also help. BUT THE MEDICINE WORKS SOO WELL AND THERE'S NO SIDE EFFECTS!!

That is the NORMAL doctor. Go find a good developmental doctor who is willing to work with you. But, wow, the amazing thing is that you have a school that is willing to work with you!! That is amazing. so many schools will say "either meds or you're out!" I guess he doesn't have a behaviorial issue Tongue Out, otherwise maybe their response would be different.

Anyway, I think you should find a good developmental doctor and/or school psychologist that can help you. You should find out if your child has any form of a learning disability because learning disabilities can also contribute to attention issues. Don't lose total respect for your DS's doc---he's just doing his job--disseminating meds
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Ima2NYM_LTR




 
 
    
 

Post Tue, Feb 08 2011, 9:26 am
Health is a Virture wrote:

.....But, wow, the amazing thing is that you have a school that is willing to work with you!! That is amazing. so many schools will say "either meds or you're out!" I guess he doesn't have a behaviorial issue Tongue Out, otherwise maybe their response would be different.

Anyway, I think you should find a good developmental doctor and/or school psychologist that can help you. You should find out if your child has any form of a learning disability because learning disabilities can also contribute to attention issues. Don't lose total respect for your DS's doc---he's just doing his job--disseminating meds


The local school district did the testing and then presented it to me and the sec. studies teacher (on behalf of the school). he does have some behavioral problems, which is why we had him tested to begin with. He is improving in behavior, and one teacher has more issues then the other. The biggest thing is getting him to sit still and focus on the job at hand. Our school is also an OOT school, and they dont 'kick kids out' unless there are major problems which cannot be resolved.

The ped said that its not that he likes writing prescriptions, but if it will help, why not? And everything has side effects, but they are minimal, and we can always switch to a different drug, but he sees families lives improve SOOO much with the medication.

We will see how he does with continuing to improve, and I will ask to be referred to a specialist before giving any meds


edit to add: He doesnt have any learning disabilities at all- that was the official 'test' the school district gave him, with the ADHD aspect as observation and info from parents/teachers. He tests at grade level in all skills and is very bright, and gets good 'grades' (if you can call it that in 1st grade)
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imasinger




 
 
    
 

Post Tue, Feb 08 2011, 9:39 am
Wait, was he tested for ADHD or not?

The Connor rating scale is a reasonable instrument. I would not put a kid on meds who "showed tendencies." I would put a kid on meds who was diagnosed with ADHD.

That is the discussion I'd be having with the doctor. Maybe he read the report differently?

Having tried lots and lots of different approaches for my DS with ADHD, I think that if yours does get the diagnosis, you might want to consider "both and." Behavior mod is very helpful. So is medication. Together, you can get some really great results.
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Ima2NYM_LTR




 
 
    
 

Post Tue, Feb 08 2011, 9:57 am
officially the district cant test for ADHD, but they can look for signs in the process of an educational eval and pass it on to the parent/teacher/ped.

I want to see what happens with continued reinforcement. His teacher has seen a lot of good changes over the past few months, and if we put a system in play, he may continue to improve. If there are still too many issues, we would want a specialist to diagnose him/ work with him before starting any meds.
The ped didnt even officially call it ADHD. when I asked him outright, he said it is all a spectrum, and the question is just where we all fall on the spectrum. Thats all. if cant even give it some sort of name like (example) "mild ADHD" then what exactly are we medicating?
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mamommommy




 
 
    
 

Post Tue, Feb 08 2011, 10:27 am
A pediatrician can make a diagnosis of ADHD, and yes, most doctors will recommend to medicate. That is what they do. I don't either much like the comparison to wearing glasses, but I don't think that your doctor is recommending something that most other doctors wouldn't do, and regardless of whether or not your ds actually has ADHD or just tendencies, you should still address the issues.

I definitely believe in behavior modification for ADHD, but many people find it difficult to control ADHD exclusively in that way without medication, not to mention that it can take a long time for those therapies to work, and depending on your child and the severity of his issues, a lot of damage can be done in the interim.

I would definitely suggest taking your child to a developmental pediatrician, psychologist, psychiatrist (a more specialized professional than a regular pediatrican). A diagnosis is helpful, but not mandatory to treat your son. The board of education does not diagnose ADHD, nor does does having the diagnosis automatically qualify your child for special education services (but it will qualify him for something called accommodations - under the students with disabilities act - so it's wise to get a diagnosis for that reason alone).

While your doctors attitude may not be what you wanted, it's not unusual. I wouldn't lose faith in your doctor just for this alone.
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Chana Miriam S




 
 
    
 

Post Tue, Feb 08 2011, 11:01 am
I am of two minds with medication. My son is almost 15 and has PDD-NOS. Most of it manifests itself in Attention Deficit issues. For many years, we did not medicate him and did a lot of behavioural intervention. Since he was three. Occasional meds that never really seemed to work. Until grade 8 when we realized he needed more. So we put him on meds and they did not seem to help much.

The doc (a developmental paediatrician) kept upping the dose but we did not realize that really, it made almost no difference for him to be on that drug (he was on 72 mg Concerta daily.)

When he started highschool and went from a class of 8 to classes of 30+ in our local public high school, let me tell you how the feces flew. After all that intervention, and years of working with him it all went right out the window. He took half a Gr. 9 course load and had modifications. He was taking academic and then the school suggested that basic was more his speed. Everything was falling apart, we were stressed and HE was stressed and the teachers were stressed and everyone was upset. I have no doubt it was having a serious impact on his self esteem.

We finally got into a Doc (paediatric psychiatrist) who specializes in biochemicals. He immediately discontinued the Concerta and put our son on Vyvanse. The effects were immediate and profound. During our first appointment he said ' the behavioural is only going to take him so far' and we knew it had because despite his attentional issues, he is an awesome kid. In our situation, I wonder if we had found drugs that worked for him earlier (vyvanse was not widely available in Canada until now) whether he would have succeeded faster and had the behavioural interventions work better and quicker than they did.

Sort of like a heroine addict. Methadone allows the addict to avoid the physical discomfort of withdrawal, while not having a mind altering effect. If an addict takes methadone first, they MAY be able, with a compatible behavioural programme, be able to kick the heroine more easily than if they went cold Turkey.

The wrong meds will not be helpful. The right meds might be very helpful and save you years of frustration and hurting on both yours and your child's part. This means, you need to work with the Doctor regularly and the teachers regularly and make sure they are taking the time to really assess changes. You need to do it at home too.

For example, when my son started on Vyvanse, redirections were down 90% in resource class. He stopped getting up and wandering as well as spending hours in the bathroom. At home, his hygiene improved and he started following through on what he was supposed to do. we could visually see the concentration improvement when he was working on homework or a project.

finally, between the half semester (50% in Academic English and 58% in Academic Science) and the end of the semester, his grades improved so much that no longer were we talking about him failing. His final grades were both 70%. He got 90.7 on his english exam. these are respectable marks but when you look at how the first half of the semester went, they are miraculous. When he said 'but I only got 70%, I would have rathered 80- I said that I could not be more proud of his 70 if he had gotten 100 without trying. he worked for it and he deserved every single mark.

Now we are working on improving his organization. He is up to three courses this semester and so far no phone calls home. We will see how it goes. In the mean time, I agree that drugs without intervention are a bad idea, but drugs with interventions gave my kid the life I always knew he was capable of having. The school went from suggesting basic classes to figuring out how he will be best served in Academic classes (looking at a hybrid of class time and independent study.) Last week, the Resource teacher, who two months ago must have thought I was nuts to think my kid was ever going to university, told me not to worry that when it came time, we would look for a university with appropriate supports. My kid feels like a million bucks. Our house is peaceful and quiet. We trust him more. Thankful does not begin to describe it.
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Aribenj




 
 
    
 

Post Tue, Feb 08 2011, 6:06 pm
Yeah your pediatrician sounds like a typical doctor trying to fix the issue with medication.

For my son's issues, I notify my pediatrician, (who happens to agree with what we're doing) but he has a behavioral psychologist who I go to with questions. Her job is to figure out what he needs, and what we need to do to. But otherwise, the pediatrician mostly stays out of it.
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Mama Bear




 
 
    
 

Post Tue, Feb 08 2011, 8:10 pm
occupational therapy does wonders for focusing. My 1st grade son was also just evaluated for difficulty focusing. My meeting is tomorrow and I hope he gets approved for OT....
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Mama Bear




 
 
    
 

Post Tue, Feb 08 2011, 8:20 pm
btw - OP - your ped's reaction is appropriate if a child has SERIOUS ADHD, and the mother refuses to medicate. not mild/maybe/ahem ADHD.
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Ronit




 
 
    
 

Post Tue, Feb 08 2011, 10:29 pm
I'm with you on this. You don't medicate without a diagnosis.

Why don't you take him to a pediatric nuerologist?
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