Getting a Diagnosis for ADHD in Middle School

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• ADHD inattentive type - 13 year old
• 12 year old son super spacey - Advice Please!!!
• 8th grade daughter just diagnosed with ADD
• 12-year-old has many symptoms of ADD
• 10-year-old diagnosed with both ADD and Tourette Syndrome
• Diagnosis for 6th grade daughter who may have ADD
• How do I know for sure that 12-year-old has ADD?
• Middle schooler with ADD - poor note taking in class
• My 12 year old son thinks he has ADD
• 10-year-old may have ADD

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ADHD inattentive type - 13 year old

Nov 2012

Our very bright 13 year old is struggling in school. She does her homework but frequently forgets to turn it in. Has trouble completing tasks unless supervised. Doesn't plan ahead. She is otherwise a happy child with loads of friends and enjoys school very much. We suspect she may have ADHD- the inattentive type. We are torn. We were hoping it was just a ''maturity'' issue and would sort itself out. Unfortunately, she is getting ready for high school and still remains absent minded and this is taking a toll on her grades . I am very concerned about medicating her. I would love to hear from parents who have dealt with this issue. I would also love to get some recommendations of doctors, therapist etc who are experts in this field . Worried mom

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At the age of 40 I was diagnosed as ADHD Inattentive Type. I always scored in the top 1 % percent of standardized tests but my performance at school and in life was always unpredictable. I am not sure how much I would have been helped by a stimulant at your daughter's age, because of maturity problems and problems at home. But by the time I was in college I would have definitely benefitted from medication. It took me eight years to get my bachelor's degree. My life has changed so much for the better since starting Ritalin. Before Ritalin I could not follow a conversation or news report or teacher's lecture or even read a few paragraphs without my mind drifting. I don't feel like an outsider in social situations any longer because I don't have to work so hard to make sense when I'm listening and talking over background noise. I am motivated to start projects and able to complete them. Completing projects was always a huge challenge for me before medication.

I know my post probably does not help with your decision about medicating your child, but if your home life is stable and she does not have emotional problems, my advice is to consider getting a prescription for her on a trial basis. If you then decide to discontinue the medication, stay open to medication as a possible future solution. Good luck to you and your family. Benefitting from Ritalin

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Hi, We had concerns related to attention/focus/motivation etc. for years, but it was not an academic or behavioral problem in elementary school. Once he got into middle school, the expectations increased and he had more difficulty managing. We hadn't sought an official diagnosis for him until that point, although we had done some work with an OT around sensory integration issues and done neurofeedback, because we saw that the issues were there. We really wanted to avoid medication if possible. Finally we got to the point that we didn't feel there were other options and that we owed it to him (and ourselves/our relationship). It's been a godsend and I'm so glad we got to that point. Doesn't make the issues go away, and we have dealt with trying to maintain his weight, but it makes it workable. Also improves his mood hugely, I don't know if that is an issue for you or not.

I do believe that neurofeedback can do amazing things for many kids (but make sure you get a good provider who is familiar with ADD issues). It just was not helpful to him. You might want to try that route before medication, though (or at some point even if you opt for medication now). Good luck. I think it's not unusual that issues get more intense at this stage. anon

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My daughter has similar issues and at 13 she was diagnosed with ADHD. We tried various drugs and they worked for attention issues but she did not like the effects - she felt they turned her into a boring, unimaginative person. (But trying them seemed right, and the results motivated her like nothing else could have). So we read Sanford Newmark's book ''ADHD Without Drugs'' and tried 1) organizational training, 2) general health, and 3) cutting back on computer/tv screen time. This has been working very well for 2 years. Though she still has her spacey moments, she is happier, has an a- average in school, and is doing well in extracurriculars too. For organizing, I basically had to do it for her for a year and gradually start turning it over to her: checking her planner every day, reminding her to check it, making a separate shelf for each school subject or project where she sorts all materials each day, buying extra used textbooks online (and the school provided some) so she could keep one set at school and another set at home. Now she is pretty good at it bur still needs some reminders (and praise). Seems like a lot of trouble at first but it's what she needs. For health, getting enough sleep (9+ hours!), taking vitamins & minerals, and eating well including real breakfast with protein made a huge difference. For screen time, which I don't think is good for the ADHD brain, our rule is no more than 1 hr/day, 2hrs/day on weekends, and none within an hour of bedtime because it keeps her awake for a while. All these have been hard to achieve sometimes but the effect is apparent every single day they happen. But the most important thing is that she understands better how her brain works and realizes she is not bad or lazy as some teachers have implied. Everyone is different but I urge you to try these kinds of measures in any case. Wishing you well

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I was diagnosed with ADHD at 36. I wish that there had been more diagnoses and information about ADHD when I was a kid. My teenage years would have been so much easier.

There are many ways to manage ADHD without meds if that feels like a better fit for your family. I manage pretty well with a good diet, lots (I mean LOTS) of exercise, and keeping a pretty strict calendar.

The first step is a diagnoses and I urge you to do that. Once you know what's going on, then you can figure out what the next steps are for her to be successful.

I would also recommend two books: Driven to Distraction and Delivered from Distraction, both by Dr. Ned Hallowell.

Well managed ADHD can be a gift. We're a super productive and creative group when given the right resources. Good luck! ADHD and loving it.

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Our daughter too had ADHD Inattentive type. For 3 years my husband and I disagreed about medication so held off. Once started (roughly 5th or 6th grade), we found that a tiny dose of Ritalin made a very marked and positive difference. Immediately she was then able to focus and get school work done, the quality of her work went way up, and (directly related) her sense of self esteem soared with her other successes.

I highly recommend Dr. Lester Isenstadt, Psychiatrist (Berkeley). Don't wait though. Already in middle school and still dealing with these issues could leave her without adequate tools, coping skills, and sense of self to thrive in high school. Wishing you well

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I hear you! My daughter is the same kind (although younger). However, I have talked to her teachers every year about the possibility of her having ADD. I would also like to avoid medication if at all possible. One day, my sister-in-law sent me an article about Executive Function (or dysfunction) in kids, and that was totally describing the problem. Read about it online, and find useful advice on how to help your child get organized: http://learningdisabilities.about.com/od/eh/a/executive_fun ct.htm.

In short, she needs to help herself get organized. She will need to learn to use calendars, written notes to herself, and other organizational material to get on task. She could also find a positive reinforcement for doing the right thing, and creating a plan for herself, with your help. You can get there, and so does she! Not organized but spontaneous!

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My son was diagnosed at age 6 as having ADD, but we resisted medication for years. In middle school, he had all the problems you describe -- inability to focus and complete schoolwork, a backpack where completed homework went to die, no organizational or planning skills. His poor grades and negative feedback from teachers and peers really started to affect his confidence, and the management we had to exercise with a resistant teenager really strained our relationship.

Finally, after a horrible year in 6th grade, we had to act. We had him reevaluated and medicated (Focalin XR). It was like magic -- instant executive function. He was on top of things, we didn't have to nag, and he was able to be the student he was meant to be. Rather than hating school, he began to love it. The main side effect of the meds is appetite suppression. He needs a substantial, high calorie/protein breakfast before he takes the meds, and he brings to school every day a high-protein smoothie so that even if he doesn't eat, he gets some good calories.

Now, a HS senior, my son understands the meds, and plans around/manages them. He eats a lot and well (this is relative, of course; he's a teenager) before taking meds and after they wear off. He modulates his dose based on what he has to do (no meds on weekends/vacations unless he has a lot of schoolwork, time-release meds for full days, short-acting meds when there are limited school tasks, etc.). He is thriving: a confident, happy, successful teenager.

Our only regret is that we didn't go the medication route sooner. It changed his life.

We see Brad Berman in Walnut Creek. He knows his stuff. Only downside: It takes months for new patients to get an appointment. Grateful for Meds

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You have nothing to lose by giving the ADD meds a try. If they are going to help your child, you will be able to tell immediately. Really, like within an hour. Ritalin is not addictive, and it leaves the body completely within a few hours, so if you don't like how your child is after an hour, in 3 more hours you are done with the trial. It's not like anti-depressants where you wait for months to see a difference. Ritalin has been used for ADD since the 1940's, so it's also not like a medical experiment with risky unknown results. Try it for a day or a week and then stop if you don't like it.

This is the argument that convinced my husband after our son was diagnosed in 3rd grade with Inattentive ADD, that we should at least try the meds for a short trial. We saw immediate benefits. All of a sudden, we could have a conversation with our son at the dinner table, something we'd never been able to do before. We didn't have to constantly shout his name to get his attention. He could read to the end of a sentence. He could follow a Little League game and understand when it was his turn at bat. We realized how disconnected he had been from the world, having Inattentive ADD, and for him, Ritalin was a great gift.

There is definitely a stigma attached to Ritalin, though. It was very hard for my husband to move past his aversion to giving our son meds, and I've found that most people, even teachers and close relatives, have a similar negative reaction. If I happen to mention my child's ADD to another parent whose child isn't ADD, I often get a look of disapproval, or a sermon about ''medicating children'' and ''over-diagnosis of ADD.'' People who don't have an Inattentive ADD kid don't get it. It's an organic brain condition that doesn't go away by signing your kid up for tutoring or seating him on the front row of class or turning off the TV or eliminating gluten from his diet.

So my advice is: do your child a favor and at least do a short trial of meds. You are no worse off by trying it, and you stand to gain a lot. a mom

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Our child (age 7) was diagnosed with ADHD-inattentive this summer, and we started meds this fall. Her capacity to pay attention is much better, and so is her schoolwork. Her doctor comments that most kids are grateful to be on the meds because they function better socially as well as academically. Our kid no longer has poopy accidents (before meds, she didn't notice her own body) and no longer gets yelled at by teachers (before meds, she didn't notice they were talking to her). She no longer gets trapped by distractions -- and she felt trapped.

Among kids with ADHD, the ones who on meds are much safer drivers, considerably less likely to get mixed up with recreational drugs, and less apt to get pregnant or contract STDs, because they have more impulse control. Of course, they seem a little different on the meds than off. Does this mean the medication makes the child ''not herself,'' or is it that the UNmedicated child is the one that is ''not herself?'' I had a diabetic housemate that sometimes failed to regulate his blood sugar well; he would become suspicious and irrational, which meant we couldn't tell him to check his sugar. And my bipolar brother felt he wasn't ''himself'' on lithium - he died as a result. What happened with my housemate and my brother is not uncommon, and results from imagining we should be able to manage naturally on our own. Soemtimes we can, sometimes we can't. Sometimes medication is a means of managing a crippling, potentially deadly biochemical disability.

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12 year old son super spacey - Advice Please!!!

Sept 2012

My 12 year old son is earnest, bright, and super spaced out about certain things. He has no sense of time and is always late - and always feels terrible about it. He writes down his homework assignments, then doesn't do them - he says he forgot - and feels terrible about it. He scores off the charts academically, and is super fast to learn things in the classroom, and loves his classes and school. He seems happy, walks around the house singing and loves to write and read, is social, and genuinely seems to want to do the right things, but just can't execute - and then he apologizes and agonizes excessively about forgetting or being late. He has always been like this, so it isn't a new teen thing. I don't want be responsible for repeatedly reminding him to do things, to hurry up, or to check the lists that we have made for him, especially since this hasn't been successful in getting him to be independent (and I am tired of doing it). So, should we have him tested for executive functioning? Or is he just lazy and wants to rely on my helicoptering? How do I know the difference? Should I keep helicoptering - and if so, when can I stop! What is going on here? He seems to authentically want to do things well, but I am out of patience! What should I do? HELP!! Thanks for your advice! Wants To Land The Helicopter!

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Your son sounds a lot like mine, who is ADHD (inattentive type). We struggled for a couple of years then got him tested when he was eight. For a year after that, we tried everything *but* medication-- nothing really worked. Now he's on medication, which isn't a magic bullet-- you still need to work on behaviors, check in when it's homework time, etc.-- but wow, what a difference it has made in his life. You will hear a lot of negativity, in person and on the web, about medication, but it's mostly from people who have no clue. No clue whatsoever. So get your son tested. Good luck! Been there

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Hi, Helicopter Mom, YES. Get your son tested. I was in the GATE program, my IQ score was at the genius level, and when I was 5, I memorized the phone numbers for all kindergarteners (without meaning to). In 7th grade (age 12), my frazzled mind started to get worse. My thoughts were disorganized, I was forgetting everything, I felt horribly guilty about not living up to my potential, and I started to lose self esteem. This worsened through high school. I wrote down my homework but forgot to do it, or I avoided it because I didn't know where to start. I survived with good grades by learning how to cram for tests immediately before that class started (I realized this was the only way I could get info into my head and actually retrieve it). It felt awful - I always felt something was wrong with me because my brain was obviously different than my peers'. I dropped out of college - twice. Last summer, at the age of 33, I decided to finally go see if there is help out there. After 5-6 months of trying meds and combos of meds, I was given a new life. For almost a year, I've been a rock star at work, started my senior year of college and am receiving A's in all classes while working full time and parenting 6 year old twins. A strange side effect was the fact that I am a lot more patient with my children. Please, please get your son tested. Your son is smart, and he might just need a little help to focus. My 6 year old daughter is exhibiting the same signs I did as a child, I had her tested, put her on a very low dose of medication, and she has blossomed. I had her in Sylvan tutoring for a year and my father was trying to teach her phonics (he was a teacher), but nothing stuck. She wasn't hyperactive - she just couldn't concentrate. With medication, she learns and retains info, is able to retrieve information easily, and she is more social with her classmates. It's like night and day. On the first day of her medication (she didn't know what it was for), she grabbed a book and went to the couch to read. She had never done that in her life, and I was floored. So - explore everything, don't give up, and don't delay. I wish you and your family all the best! CC

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This pretty much describes how my brain works and i have ADHD, the attention deficit type. Particularly pronounced for me are problems with time management and scheduling - even getting out of the shower in the morning in time to organise my daughter for preschool is beyond me. No one likes to give kids medication but the drug Strattera was a miracle for me, suddenly i knew what it was like to have executive functioning and i finally understood what planet everyone else was on. Even when i havent taken my medication (it clashed with some thyroid meds i was on for a while), it was still invaluable for me to have that experience with better functioning because it allowed me to manage my life better knowing where my brain was letting me down. I wish i could describe what it feels like to have no sense of time, but its as if to have a shower and then get my daughter dressed and then for me to dress are all isolated incidents with no connection, my brain wont allow me to group all those task together and apply a time pressure, logically i know there is a timeframe but i dont FEEL it. Its great you are onto it so quick, I wish i had been diagnosed as a child rather than an adult. Erica N

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I don't know how helpful this is, but I WAS a spacey 7th grader - what you said about your son pretty much described me at that age. I always got good grades, but was always losing points for forgetting to hand things in, being late, losing notes, etc.

My mom was very ''helicoptery,'' and in the long-run, I think it just delayed me learning how to function on my own. Having said that, I may have benefited from a tutor/mentor to help me with chronic disorganization, study habits and time management - sort of like a life coach for kids, if such a thing exists (someone who cares about you but isn't your mom).

Another thing to think about is the cause of the spaciness - for me, it was intense anxiety. I was very social, but I was preoccupied with certain things and unable to concentrate in the present moment. I don't know if that's an issue with your son. Good luck. Now as a mom myself, I can imagine how stressful it is. Former spacey 7th grader

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You might want to look into the book, Smart, but Scattered. Has straightforward advice about helping kids of all ages who are struggling with different types of executive functions. I read it 1/2 for work and 1/2 for my own child and thought it was very good. Don't get the Kindle version, though- too hard to reference different sections! Mom of a space cadet, and pediatrician

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Sounds just like my ''airy fairy'' who finally got diagnosed wtih ADD Inattentive type. She is doing great now with some behavioral treatment and some stimulant meds. Been There

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8th grade daughter just diagnosed with ADD

Mar 2012

Our daughter in 8th grade was just diagnosed with ADD, inattentive type. The doctors are not recommending medicine, but we do want to talk with a specialist to understand how best to help her. I have a few books I'm now reading, but they aren't based on her situation. I'd really like our family to learn some tips/tricks on how to help her, especially with her study skills/homework. Ideally an expert in ADD could spend time with her and help her figure out what would be best for her. All the information from the BPN website is from years ago. Do you know any such tips/tricks and who might help us uncover them for my daughter? Thank you. -Concerned Parent

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I am curious why the doctors have not suggested medication for your daughter. My daughter -- who has the same diagnosis -- has been on medication since 5th grade (now in 8th) and it has made a world of difference for her. I'm not a doctor, nor a pill-pusher, just a mom who has seen her daughter's life become significantly easier as a result. That being said, there are tutors/coaches who can assist with ''executive function'' issues and teach skills for organization and focus. I don't have any suggestions because we haven't used one. However, if your daughter attends a public school, she may be eligible for such support paid for by the school district; I have a friend whose daughter receives those services. Been there

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Linda Lawton has helped my daughter immensely, both with things like time management, study skills, focus, and prioritizing, and also with the feelings of confusion and shame that are so often a big part of the A.D.H.D. experience. She works with both teens and adults with A.D.H.D. in her office near El Cerrito Plaza. Linda is gifted at assessing what each individual client needs, and then tailoring sessions to suit those needs. Honestly, I don't know what we would have done without her. Her website is www.centerofattentionandlearning.org. anonymous

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12-year-old has many symptoms of ADD

May 2009

For several years I have been concerned for my 12 year old, and think he has many symptoms of ADD, lack of concentration, tantrums, inability to complete homework, low pain threshold, highly irritable, lack of organizational skills, just to name a few.

I've brought it up with several teachers over several years, but they all tell me it's a lack of motivation, or he's choosing to be social rather than do his work. I think this is because he doesn't show symptoms of hyperactivity, and they tend to lump the two together. He just can't seem to keep up, this last progress report he had a 22% in math and in science, subjects he enjoys. Then an A in English, and he tests in the 90th percentile when he's been assessed. He's so smart, but nothing we do helps him stay on track with his school work.

I have a referral to a psychiatrist that helped my friends daughter, she had similar symptoms and she now takes Ritalin, which they think is fabulous. I have also spoken with the Attention and Achievment Center in Walnut Creek, that uses cognitive skills training instead of medicating, which is very appealing to me.

I'd like some advice on how to go about getting my son assessed, whether the school district should be involved, should I go through a psychiatrist, or my ped? Or do I go with this alternate treatment, has anyone tried this center? Do I want an ''official diagnosis' or does that stigmatize kids in their schools? We are in Walnut Creek. Thankful for any advice

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You have opened an explosive area and am sure you will get very strong opinions for both sides. My son got diagnosed with ADD at the start of 3rd grade. We too were told all the things your school is telling you. We are in Lafayette. We were fortunate to already be a patient of Dr. Brad Berman from 4 years earlier for something totally unrelated. Because of that we could get into see him quickly and get him evaluated and diagnosed. Berman's number is 925-279-3480. BTW, I can't say enough good things about him.

Anyway, we decided to go the meds route because of his young age. You could tell from the first day how much it helped. School was better and his self-esteem started to improve. We liken the meds to eyeglasses a tool to fix a defect. We did not go the behavioral route because we didn't want him to lose anymore time in school. He had ''checked out'' in February of his second grade and lost almost half a year. Also when the dose needed to be changed because he had grown, it was obvious from the day we changed it how much it helped.

The school would do nothing for us until we asked in writing for an evaluation. I'm not sure they would have done any special resources or would have changed their opinion of him if we didn't have Dr. Berman on our side. They quickly gave him an evaluation and gave him the resources and provisions he needed. Now that he's on the meds, we are starting behavior modification as well.

So I would run as fast as I can and get an evaluation. Unfortunately there is a huge wait to get into Dr. Berman. I would get on the waitng list, but find another behavioral pediatrician to help you now. Your psychiatrist may be sufficient, I don't know. At the same time I would ask for a school evaluation.

I also have an 8th grader whose friend is getting the exact treatment as you are. They have a doctor and an advocate and are sill battling the school, but started at the school when he was 13. He has been on meds for years. Their hope is to get him accommodations in time for high school. The work only gets harder as they go through middle school and high school and every minute is precious.

Good luck with your choice. People will question you no matter what you do, so go with your gut.
Mom and Wife of ADDs

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We're going thru something similar with our son. We're both very wary about medicating kids (ours is only 5!) But we have a therapist we respect, who recommended we see a child psychiatrist for an assessment; I also spoke with an adult psychiatrist that I know and respect; they both advised me that 1) the research (which is plentiful and on-going) suggests that not only does medication really help the child focus, put them in a position where they can succeed, and thus begin to build their self esteem back up (which is usually destroyed after years of not succeeding the face of their teachers, family, friends and classmates), but that the brain may actually get ''healthier'' on meds - it shows signs of atrophy after years of untreated ADD/ADHD (not to mention the anxiety/depression that can develop with untreated ADD). They also both said that once on medication, cog. behavioral therapy has a better chance of working (for obvious reasons). I'm no doc so I'm not the best person to try to explain... but I would highly recommend you see a child psychiatrist for an opinion - and not just any child psychiatrist, but a really experienced one who is respected in the field, who will look at the whole picture, not just assume it's ADHD and prescribe ritalin, like less experienced ped's might, unless they are quite sure that that is what you are really dealing with. These mental issues are complex - there could be more than one thing going on. One such person is Herbert Schreier, who's been the head of child psychiatry at Oakland Children's forever. :-) And for the record, I was talking to our babysitter last night about my son, and she told me that she WISHES she had been medicated as a child for her ADHD! That her childhood was awful as a result - classmates constantly teased her in the meanest possible ways, she didn't have a single friend, teachers ''wrote her off,'' and she was constantly aware that she was ''different'' but couldn't manage to help herself. Her mom thougt she'd grow out of it. As a young woman now in her mid- 20's, she is doing cognitive behavior therapy to try to undo some of the life-long (bad)work and social habits, low self- esteem, and coping mechanisms she developed. Her story made me much more open to the idea of meds, and less ''judgmental'' about it. You just need to learn what you can, find doctors you trust, and do what feels right for YOUR son. Good luck. anon

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Try taking your son off of all gluten products (wheat, barley, oats, spelt, rhy. Maybe Dairy, but try gluten first. Does he take Omega 3- fish oil? My son has been gluten free for 2 years(he's 14) and it was a stunning change. Also the Omega 3 helped him focus (fyi, Omega 3 was prescribed by a psychiatrist after a brain scan of my son). he takes 4 caps of Omega-3 per day. It helps to minimize sugar intake too. Personally, I find eliminating gluten easier then sugar. You have to read labels and ask questions....gluten is in a lot of things. It's hard at first, but definately doable. We've never used meds and dont' need to. Try these first. Much safer and healthier. mom of ADD plus other issues

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There is a strong anti-meds bias in this community, which can make it hard to know what is right for your child. I shared it, and resisted any medication for my son when a sees-ADD-everywhere doctor said he had ADD in first grade. We managed until 6th grade, when everything fell apart: homework was an all-evening nag-fest, he couldn't keep track of assignments, and this brilliant kid was getting Cs and feeling like a failure. Enter the meds (and Brad Berman, whom we had seen for other issues and also adore). The change was immediate, and fabulous. Overnight, he had executive function. He was able to focus in class, keep track of assignments, get homework done in study hall. He was also more socially cued in, and doing better there as well. He goes off the meds on weekends unless he has homework or a school function (his choice -- he knows he does better with them). Now, finishing eighth grade, he is confident and has no concerns about his ability to handle the work in a demanding high school. So don't be afraid of meds. You wouldn't deny your kid insulin if he/she were diabetic. Some brains need meds to function well. There is little risk to trying them, and if they work, they really, really work. Grateful for Meds

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The bottom line is that the best approach is not either/or but both. Medication maybe needed, and cognitive skills must be taught to make a change in behavior permanent (Pills do not teach skills). Like a previous responder, we resisted meds for years and then found that they worked wonders for our son. Our pediatrician also suggested that our son may have a condition that might benefit from meds when our son was in first grade (although she didn't name it ADHD as the time). In spite of considerable difficulty at school, I did not want a label and did not want to medicate him because of the anti-medication sentiment so prevalent in our society(and despite the fact that both my husband and I are physicians). After 7th grade, it became clear that there was a misfit between our perception of a very bright, creative person and his school performance. Our son went underwent a thorough assessment and has been managed by Dr Brad Berman with medication. What a relief! He has not been reduced to a zombie nor lost his personality. Instead, he is able to focus, is neater, gets better grades, and is a much more pleasant person on medication. We've also tried other alternative methods, such as fish oil (which Dr Berman supports) and PS/DH--can't comment on whether the latter has been effective. We also use cognitive methods such as educational therapy and behavioral modification techniques that we've learned through CHADD, Children and Adults with Attention-Deficit/Hyperactivity Disorder, http://www.chadd.org/ Try both.

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Although whether or not any given treatment is effective varies from one child to the next, existing research on treatments for children with ADD/ADHD suggests that generally, treatments including stimulant medication are most effective in improving attention and related symptoms; next best are behavioral treatments (working with parents and teachers to structure the environment in a way that teaches the child skills and improves his/her functioning). There currently is not a lot of evidence that individual cognitive training with the child is effective (although it may be more effective if parents and teachers go out of their way to reinforce skills taught in therapy when the child is out in the real world). I am a clinical psychologist who does behavioral parent training and teacher consultation out of my San Francisco-based private practice-- I specialize in working with families of children with ADHD or other behavior problems (as well as with parents of children with significant anxiety or worry). NK

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10-year-old diagnosed with both ADD and Tourette Syndrome

August 2008

My son is 10 years old and he has been diagnosed with Tourette Sindrome and ADD. His doctor talked about start him on some medicine to help wit ADD before the school starts.We will discuss with her about it and I need some advice from parents who may have the same or similar case to help us find the best solution for our son. thank you.

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My experience with children who have comorbid diagnosis is that it takes a skilled psychiatrist - as opposed to pediatrician - to prescribe meds. The comorbidity in the meds can cause side effects and a downward spiral if both diagnosis are not thoughtfully considered. If you haven't already seen someone, I have had clients work with Dr. Ellen Krantz in Marin and also try Dr. Lisa Hardy in Walnut Creek area. HOPE THIS HELPS, ML

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Diagnosis for 6th grade daughter who may have ADD

Nov 2007

We're looking for a local child psychologist/psychiatrist with experience in diagnosing ADD. Our 6th grade daughter has seen 4 therapists in other cities for a variety of ''symptoms'' but no one has suggested ADD. After doing my own research I think it highly likely she has ADD. Now in 6th grade her self esteem is suffering from her forgetfulness, distractedness, day-dreaming and mental confusion. It's been so many years of watching her symptoms with no relief from talk therapy- one therapist said ''oh no it could not be ADD and anyway that's too hard to accurately diagnose with most kids unless the teacher makes enough negative comments. But your daughter behaves well in class so it could not be ADD.'' Help! We just want to discuss her symptoms with someone who really knows ADD in girls. thanks, concerned mom

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Wow, I am surprised to hear this. Girls can have a subtype of ADD called ''ADHD-inattentive type'' - and it is exactly what you are describing - the daydreaming - but since they are generally cooperative and not hyperactive they don't fit the mold. If I were in your shoes, I would go the Dr. Ned Hallowell's clinic in San Diego. They are the best, the kindest people. Read Hallowell's books. The important thing is that he looks upon ADD as a gift, and wants the kids and parents to consider their job to 'unwrap' the gift. Much better than pathologizing the child and listing all the ways they don't fit it. You can also listen to some excellent short podcasts of his at http://www.additudemag.com/adhd/article/2711.html So I would follow Hallowell's whole approach if I were in your shoes. The other thing you need to research and consider: your daughter might also have ''executive functioning'' impairment of some sort - the ability to plan, prioritize, problems with the passage of time, messy, does homework but doesn't turn it in, etc. Start attending lectures and doing some internet reading. They need help in their metacognition (thinking about thinking) and often need explicit instruction in social cues. Try speech and language therapist Kris Neugebauer in Alameda. The main thing for you to know is that this is NOT willful behavior on her part and she can't just ''TRY'' harder. Try to change the way she is perceived - like she is the problem. No matter how tempting don't buy into that. Be her champion. Be open to medication (it is very low risk and you can just do a trial to see if it helps) and other therapies which are looking good - eg neurofeedback. Good luck and be positive! Anon

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Dr. Steven Sturges MD is an expert on ADD, besides specializing in the prescription of drugs for ADD as a psycho pharmacologist, he is also a caring and sensitive therapist with an in depth knowledge of the field. He is particularly experienced with adolescent patients and would be well suited for this type of diagnosis. He practices in Berkeley. Anonymous

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Clearwater, in Oakland, specializes in psychological assessment for children, and our rates are very competitive. ADD assessments can include a school observation as well. We also have an educational therapist on staff. Call 596-8137 or visit our website: www.clearwaterclinic.com for more information. Sally Francis, Ph.D.

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How do I know for sure that 12-year-old has ADD?

Nov 2007

My 12 yr old son was just diagnosed with ADD (inattentive) by Dr Gary Landman. The reason we went to see him in the first place was due to my son saying he was having trouble focusing in class. (a few of his teachers had mentioned that he seemed pretty distracted at times in class.) My son went on line and researched his issues and told me ''I think I have ADD'' I had never, ever considered the idea that my son had ADD. He is a very smart kid but does not wow with great grades (B's and an occasional C) My friends who know him say that he is simply bored and under-stimulated. How do I know for sure if he really has ADD or if he simply needs a different type of academic setting? AND if he does need a different academic setting, where do I send him? confused mom

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As you now know, the diagnostic process for ADD is pretty simple and straightforward: does the child's behavior meet a certain number of tests or not? I have heard that one bottom line question is whether or not the child's attention issues are responsive to medication. At this point, there's no way of knowing ''for sure;'' you will have to decide if the situation warrants treatment, and if so, what you and your son are willing to try.

In any case, now that you've obtained a diagnosis, you're going to have to learn to steel yourself against your friends' well-meaning assessments. Your son may well need a more stimulating or otherwise more appropriate educational environment (a topic for another post; there are many differing opinions on this subject), but please don't decline to treat an underlying problem (if you conclude that there may be one) because of the misconceptions of others. Good luck! ADD mom

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ADHD, especially inattentive type, is best assessed in the context of the school setting. I would suggest that you have the doctor you are working with have one or more of your son's teachers fill out the Connors Teacher Scale. This is a standard assessment tool for evaluating ADHD. You might be asked to fill out the parent version of the scale too. Having the professional you are working with consult with the teacher and/or observe the child in school can be helpful as well. Don't be quick to change schools as yet? How well is your child doing in school? Has his performance been suffering? And if so, for how long. How is he doing in relation to his measured IQ? What have standardized achievement tests shown? Answers to these questions will help determine the extent of the problem and whether the current placement is working. Most children with ADHD can be adequately educated in mainstream classrooms of public schools, although some accommodations may be necessary (i.e., sitting in the front of the room, having oral & blackboard assignments be copied for the student, interventions for improving the student's organization skills, etc). Teacher awareness and acceptance of the child's problem and teacher cooperation with interventions/accommodations also is important. Once a reliable assessment of the problem is completed, a plan for intervention (academic, medical, psychological, and/or parenting) can be established. Most of all, don't panic. This is a very manageable problem. DB

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My advice is to get a second opinion. I worked as a local school counselor for many years and had an opportunity to review many of Dr. Landman's reports on a variety of kids over a significant span of time. He made a diagnosis of ADHD for every child. You can interpret this as you wish. In his defense, I never consulted with him directly. I strongly recommend Dr. Debra Sedberry in Walnut Creek, Dr. Brad Berman in Berkeley or the Ability Resource Center: http://www.abilityrc.com/home.php. Most of the boys that I have worked with with this diagnosis generally have a long standing history of mild/moderate behavioral problems in school or poor grades in general. Finally, I recommend you consider having your child evaluated by a psychotherapist. Perhaps there are larger anxieties that prompted him to self-diagnosis himself in the first place. A parent and psychotherapist

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Hi Confused about ADD, I'm a Learning Specialist and know Dr. Landman. He is great when you know for sure your child has ADD because he prescribes meds without doing thorough testing, however if you're unsure I don't think he's the right person to go to as he'll prescribe when something else might really be going on. An MD who does thorough (though expensive) testing is Dr. Brad Buhrman or Berman (sp? I just had a baby and can't remember how to spell). You could also take him to the Ann Martin Center in Oakland and Piedmont. They are a non-profit organization and they do thorough testing. You also might want to read The Mislabeled Child by the Eide's. He tells all about attention issues and other issues that mimic ADD. Susan

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Hello. I am an adult who was recently diagnosed with ADD and I can tell you now, that a diagnosis as a child would have saved me years of trouble. From what I understand, you can have testing done on your son (very expensive), but you can also go to an ADD specialist and have him evaluated. There is also some great books out there, esp. anything by Edward Hallowell. He has written several. There is also a woman who works out of Albany and is an educational therapist. She can work with your son in terms of school and behavior modification. Her name is Linda Lawton (Linda Lawton 510-499-0994 cell; 524-0350 office; easy4you AT sbcglobal.net email ) I believe she has been reviewed on this site before. I've gone to her and she is fabulous. Even better is that she is a former teacher and a parent of an ADD child. You can tell her that Kate recommended her. Kate

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My son told me the same thing and at a younger age. Frankly there is one really fast way to determine whether the diagnosis is correct - have him take the meds and if he feels he can focus better and he can TELL the difference, then he has ADD. My son can tell when he's taken his meds - it makes a difference in his ability to concentrate and do his homework or stay focused in class.

And don't dispair. Some people respond to ADD like it's leprosy. Ignore them. See today's (Tu, Nov. 13) NYT's article about two new studies on kids with behavioral issues. Of the kids with ADHD they say: ''The other (study) found that children with attention deficit disorders suffer primarily from a delay in brain development, not from a deficit or flaw.''

In other words they grow out of it. According to the study, they grow out of it by early adulthood. mom of adhd kid

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Dear Confused Mom, I have a 9 year old with ADHD and I have been learning a lot about it. Your son may have ADD, but this diagnosis requires more than one visit to Dr. Landman. My son has had many extensive evaluations, but the most comprehensive, and the most useful has been the neuropsychology assessment by Dr. Kristin Gross (510-530-1676). Dr. Gross tests for many things- she can tease out what are real learning difficulties, what are attention difficulties, and where the two intersect. If there are attention difficulties, she can tell you more specifically what type. She is located in Peidmont, and charges $3500 for an evaluation. The evaluation consists of 4 sessions on 4 consecutive weeks: First with just parents, second and third with kid, fourth the results with the parents, and probably the child in your case. Each session is about 2 hours. Best money I have ever spent. Since your child is concerned enough to explore this on his own, I would suggest getting an extensive evaluation to take the guess work out of this. If money is a real issue, you can have a psycoeducational testing done at your local school district. There are support groups and information about AD/HD through CHADD, ADDA and good info at Swab Learning.org. I would be happy to talk to you about more specifics. I am just a struggling parent, but I have had so much trouble finding the right place for my son that I want to help others. email me and we can set up a call if you want. Good luck. Lisa

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I suggest that you visit the websites of www.chadd.org and www.schwablearning.org and begin to read up on this disorder, if you haven't already done so. The media have done a poor job of presenting the facts around treatment and diagnosis of this condition, and it's easy to be dangerously misinformed. There is a lot of accurate information available, and these two websites provide well-researched science, and lots of other helpful stuff. LL

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Middle schooler with ADD - poor note taking in class

Oct 2007

My son has just been diagnosed ADHD. He has never been very hyperactive in the usual sense, but he has had a focus problem. We had him eval. because of a marked problem at middle school. He is seemingly incapable of copying notes from the overhead or whiteboard. He is very intelligent, scores in the advanced range on the STAR tests, and gets Bs and As on his tests and most long-term projects in GATE classes at school. However, the middle school that he's in heavily weights class notes that he periodically must pass in and be graded on, as well as Daily Planner checks, that are also periodically graded for accuracy. He started taking a low dose for his height/weight of Concerta, and it seems to be helping with his focusing problem, but the note-taking is still pretty poor. Thanks for your help. E.

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My mother was a 6th grade teacher for years, and she had a couple of kids who had a very specific learning disability -- they were incapable of copying from a vertical plane to a horizontal plane. If she laid things beside them on the desk, they could copy them just fine. Could your son have a disability like this? Karen

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Hi. If you haven't already, it would be a great idea to have your son checked by a developmental optomotrist. This is different than a typical eye exam, and might uncover some issues, such as visual processing or accomodation issues that make copying from the board more challenging. Many children with visual issues look like they have ADHD. You can have 20/20 vision and still have problems with vision. David Grisham in San Rafael (Rising Star Optometry) is fabulous for this. Sara

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You are fortunate that your son is doing so well in school, and the fact that he has difficulty taking notes should not hold him back! Have you attempted to speak to your son's teacher(s) about ways to make accommodations in his classes? Have you inquired at your son's school about a possible student study team or 504 plan? This can enable him to get accommodations in his classes. Students with diagnosis such as ADHD are sometimes entitled to certain accommodations in the class, such as being given copies of notes, rather than having to take them himself, or an alternative way of getting the notes he needs (maybe he takes only a portion of the notes and gets copies of the rest, or he may need a guided notes outline to help him get his notes down; another possibility is for him to borrow another student's notes or the teacher's notes and copy them at home at his own pace). I am speaking as a Special Education teacher who has taught many teenagers with ADD/ADHD and learning disabilities, and who have great difficulty taking notes. I am not suggesting that your son needs special education services, but rather some help and understanding from the school that might enable him and you to have more flexibility. Carmen

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With an ADHD diagnosis your son would qualify for accommodations. Make the request in writing. Possible accommodations: using an organized student's notes, getting the teacher to provide a written copy of the material being presented on the overhead or board so your son can take his ''notes'' (underline, add to what is presented, etc.) on that paper, different grading policy for notes for him. Anon

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Has he been evaluated for dysgraphia? I am a teacher and I had a student who had problems taking notes because of dysgraphia. In any case, if his ADHD results in his disability to take notes, that should be an accomodation in his IEP. The teacher can just hand him the overhead later or make a copy of it for him, and/or accept that he may be able to learn just as well or better by just listening, or recording lectures to listen to or take notes on later. anon

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Hi - I wish I could send every parent my experience with the Handle program. I did recommend it here about 6 months ago for someone who did not want to medicate for ADHD. We just finished our set of exercises, and although according to the reassessment my daughter still is not quite up to speed with inner ear/auditory issues and right brain functioning, the change in her ability to do all the things required in her 6th grade class is remarkable. She never got evaluated by the public school system, since she goes to a private school, but it was clear that she wasn't able to keep up in lots of ways over the last year or two. I might have termed her issues as dyslexia, but in the assessment done by Handle, she had a lot of inefficiencies in many neurological systems. Her strong point was kinesthesia, which masked a lot of her issues with muscle tone, proprioception, binocular vision, and vestibular system. It sounds like your son has a neurodevelopment issue that is pretty specific, and he could greatly benefit from the Handle program. It's troubling to me that given all his strengths, he's now on a drug for ADHD. I hope you explore the permanent benefit your son could get from doing the Handle program. The local practitioner is Sindy Wilkinson. Google Handle Institute for the website, and go to the list of practitioners to find Sindy's website and contact information. She is located very close to the 24 freeway at the border of Lafayette and Walnut Creek, so not too far away from East Bay cities. Good luck - I cannot recommend her and the program more highly. Susan

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Consider getting a 504 plan, and ask for a modification around notetaking. This seems appropriate given that his work/grades are ok otherwise. anon

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You may want to get his eyes checked. I am a grad student and last year was having trouble copying notes and was missing a lot of material. Even though the board, projections, and teacher weren't bleary per se, trying to focus without glasses made it just hard enough that I couldn't write everything down. Hope this helps! T

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My 12 year old son thinks he has ADD

Sept 2007

My 12 year old son has had a very hard time focusing on schoolwork recently. This has not been an issue before now. He thinks he has ADD and even went on line and took a questionnaire about it. We just moved back to Albany after being away for one year, so I have not re-established a relationship with our Dr (We saw Ben King at Berkeley Pediatrics) I do not really think he has ADD but he is certain he does and wants to get checked out. Do you know where I should start with this? albany mom

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I suggest that you start at the website for chadd.org (Children and Adults with Attention Deficit Disorder) and go the the information bank they operate jointly with the CDC (federal office, Center for Disease Control). This is science-based information about AD/HD that is not hysterical or faddish. If you are interested, there is a public event this Saturday at the Berkeley Public Library, from 12:30-3, sponsored by CHADD of Northern California. It will be a panel discussion in observance of AD/HD Awareness Day that will provide information from a variety of perspectives and take questions from the audience. If your child is having trouble paying attention, or thinks s/he is, there is probably something at the root of it, whether it is AD/HD or some other learning challenge. Good luck. LL

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It's really good that you are respecting your son's beliefs. First of all, ADD can show up around adolescense so he may be right. Your doctor should refer you to a specialist. My son also told me that he thought he had ADD -- he was a little younger. He turned out to be right. Since he had ''discovered'' it, he was more willing and interested in the things that could help him. Don't worry. ADD just isn't so very bad. Some people act like you have leprosy but they are just ignorant. ADD kids seem to be an especially smart bunch and can be amazing at adapting. Good luck to you both. mom of a really nice, smart boy with add

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Find a behavioral pediatrician, a clinical psychologist, a therapist, or an Educational Therapist, EXPERIENCED in evaluating attentional issues. You could start with the Ann Martin Center in Oakland (non-profit, sliding scale), Langley Porter in S.F., the Ability Resource Center in Walnut Creek, or check the directory of professionals on the East Bay Learning Disabilities Association website. Your pediatrician also might have this background, but ask first. Good luck! writeck

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I would get him tested. My father had a learning disorder (not ADD) and as a child, a friend of his mother who was a specialist assured her that he ''couldn't possibly have any learning disorders.'' It took a real toll on him throughout his middle school, high school, and college life, and he certainly could have had a much easier time if someone had acknowledged that there was actually a problem and he wasn't just lazy. It's worth it. Anna

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Hi, In an effort to educate myself about boys (I have a 5-year old) I just picked up ''The Minds of Boys: Saving Our Sons from Falling Behind in School and Life'' by Michael Gurian. It is a REALLY valuable book, and I recommend it to anyone who has a son in school. The statistics and stories about how boys are faring in this society are scary, but the book offers practical advice on what to do about it. Gurian maintains that most ADD is misdiagnosed and is actually attributable to normal young male behavior, based on boys'developmental patterns and brain development. He describes how to correctly diagnose ADD (it does exist, just not as much as everyone thinks), the social and environmental factors that exacerbate it, and what to do about it. Your son probably *doesn't* have ADD (you'd probably have known about it before now)but reading this book will probably answer your questions and give you some strategies to help him do better in school. Good luck! Mom of a young boy

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My husband has ADD and his 15 year old son does as well (and after many fights with the mom he's now off the drugs). We both agree that we will never test any of our children for ADD because we feel like it just gave him a crutch for not doing the things that he needed to do. He's still hyper and has a REALLY hard time focusing on schoolwork and chores but now that he's not taking medication and knows he's expected to perform to a certain level despite those problems, he's actually improved a great deal and makes his way through as well as most other 15 year olds. We found that the real key was to focus on the issue that he does have a hard time concentrating but that means that he needs to come up with a system that will help him do better. We've worked to identify things that make him distracted and unable to accomplish tasks (for example, no talking on the phone while doing dishes)and he goes to bed earlier on school nights so he's not overtired. Most kids at that age have a really hard time concentrating at school - classes are generally pretty boring. I feel as though identifying a challenge that arises because of a particular type of personality damages a child's development by letting them see themselves as unable to overcome it - or as it necessarily being bad. We all have challenges in everyday life because of who we are and how we relate to other people. It's part of what makes us special. It's also part of how we learn to control and discipline ourselves to function in society by keeping jobs and building relationships. I can't tell you how many times I've heard ''you know I have a hard time remembering things'' to reprimands for not doing something he was told to do several times. Or using ADD as an excuse for being disruptive and rude to classmates and teachers. His behavior improved dramatically when we stopped accepting it. He's not perfect, but also not allowed to use excuses like ''I'm just not good at that''. There are lots of things each of us is just not good at and we find ways to figure out how to do better. I think that's a more valuable life lesson than diagnosing such problems as in escapable disorder. Even if your son does have ADD he will still need to learn how to function in society just like everyone else and the long-term use of personality altering drugs to control it is an option that you will probably both end up regretting... especially if you love your son for who he is now. You can also talk to the teachers and tell them he is having a hard time concentrating and ask if there is anything they can do to help him stay on track. anon

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I'll try not to belabor this point: Whether ADD is over-diagnosed or not, those of us who have it -- and are attempting to parent kids who also have it, resent the perky insights of those who would assure you that its just ''horse-puckey'', and that ADD meds are ''bogus'' and completely useless without behavioral counseling.

Chances are your boy doesn't have ADD, but if he does, the appropriate medication would work in roughly the same way that glasses work for myopia. Not a cure all, but a tool to help with focus. That tool either would or wouldn't be enough to balance the years of thinking he's stupid or inadequate, when in fact he just has the neurological equivalent of ''can't see the board'', and years of people telling him to just try harder.

There is an on-line test you can give him, at www.amenclinic.com (or Google the Amen Clinic, Dr. D. Amen) that might reassure you, either way and point you in a good direction. My kids'had extensive evaluations with a psychiatrist who was also an ADD/ADHD expert, and were based on testing and interview - not teacher recommendations. They were also highly accurate and useful. Good luck. Heather

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10-year-old may have ADD

Nov 1998

My 10 year old son will be going through testing at school to see if he has any learning disabilities. They have suggested that he be tested for ADD by a pediatrician because ADD is a medical diagnosis. Our entire family sees a General Physician and my boys don't have a pediatrician. I will be asking for a referral to a pediatrician through PacifiCare and am wondering if anyone has any recommendations for a pediatrician who may have experience with ADD diagnosis and is located in Martinez, Pleasant Hill, etc. area (Hill Physicians Medical Group).

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Kaiser offers a small group screening for ADHD every six weeks which is pretty thorough. The cost is minimal.
Galen

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I have LOTS of info about ADHD. There's a lot of misinformation out there about ADHD and treatments. This disorder hasn't been termed hyperactivity for years and years. I would be very suspicious of an evaluator who called it that and then gave you the information that since she attends to what interests her, she is not hyperactive. This is THE classic definition of ADHD. Have your daughter evaluated professionally by someone who knows what they are doing. NO teacher or parent can help your child develop normally if her brain synapses aren't firing correctly. Believe me I know what I'm talking about.

There's a ton of information about this very real disability on the Net. Also, your daughter may not have ADHD. There are many other conditions that cause children to appear hyper and unfocused, from emotional trauma and life changes (a divorce for instance) all the way to brain tumors. She needs a complete battery of tests before you decide on an intervention. The results of a looong study on children are just coming out. You may have read about it. The gist of it is that therapy, behavior mod, counseling, beneficial classroom environment, parental training, etc. are all good and important, but NONE are very effective without medicine. And fortunately or unfortunately, depending on how you look at it, EVEN MEDS ALONE ARE MORE EFFECTIVE THAN ANY OF THE OTHER INTERVENTIONS COMBINED. It's a hard decision to put your child on medicine, but I see it much the way I would feel if she needed glasses to see with.

I am not pro-meds, by the way. Nor do I think every hyper kid needs treatment, far from it. Kids exist along a spectrum from very quiet to very wild and it can all be within the range of normal. My 8-yr-old daughter's behavior wasn't within that range, and I knew WAY before she was officially diagnosed at the end of second grade. She was not a behavior problem, just very spirited. But it would take her 3 hours of intense struggle, watching her every moment, to do 15 minutes of 2nd grade homework and she couldn't learn to read at all, no matter how hard she tried. Now in third grade, she reads all the time and is doing very well in school, almost caught up and in some cases, ahead of her class.

Parents, run screaming from anyone who presumes to know your child is ADHD without a professional evaluation. This is a serious condition. People with untreated ADHD have much lower social and economic success in later life. They are frequently ostracised and many have few if any friends. They often end up self-medicating with illegal drugs. They take impulsive risks. ADHD is potentially life-threatening. It is a diagnosis, not a term to thrown at any kid who is spirited.