Expert: Christine D. DeLoatch, MA CCC-SLP - 11/21/2008

Question
I would really like to have a full examination on my son to rule out other factors before I consider JUST adhd. My son is extremely bright but since preschool I have been told he can not listen. He had extreme separation anxiety as a child and would cry every day in kindergarten and would watch the clock from 900 am to 300 pm, literally. He was very routine ,could only say goodbye a certain way ,etc,  only could eat certain foods, the wind, sun, and noise are extremely bothersome to him.Now , he only uses certain utensils and plates.  He is very impulsive, he will do things on purpose he is told not to do, he fights with his brothers and is physical, will get angry in a second and outburst, can not do simple tasks like remembering to brush his teeth or shampoo his hair..in school doesnt remember to drink all day long, forgets assignments that were given that day, says when a teacher changes subjects, he is still not transitioning to the next subject. Up until this year , had to be on the same floor as me and still does to a certain extent, energy all day long but add tendencies in school , so much energy at home does not want to sleep.He will not even answer a conversation about homework unless pressed to the point that he and I are both frustrated....always seems to get into being bullied.....The neurologist thinks its psychological and his teacher thinks its adhd . It seems like it could be a mixture of all different issues. When he was younger he had sleep apnea and had  what seemed to be a seizure, the doctors arent sure. I dont know where to begin to bring him for help. I tried special education but he didnt score low to give him services. He may have a hidden disability. He is in fifth grade and he hardly writes capitals and forgets to make paragraphs and other mechanical errors. Very slow processing speed. Can not memorize multiplication or line up numbers. Takes forever to complete homework . These are some things just off the top of my head. I spend so much time and have two other young boys. He is physical with my 6 year old ...if my sixth year old does anything to irritate him, there is screaming and fighting. Sometimes, I have to hold on to him to get him to stop or he will really fight him. I really need to start getting help but I am not getting to the bottom of this going to different doctors.What is your opinion?

Answer
Dear Rose,

I apologize if you did not receive this response. So I am writing it a second time.  

You are correct to be concerned.  Please have your child's doctor send him to receive evaluations in the areas of psychology - seeing how smart he is and looking at his behaviors, including emotions and aggression. The psychologist can also do achievement - or academic testing to look for learning disabilities.   He needs an assessment in Occupational therapy to see about his sensory needs and to address the handwriting.  

He may not have qualified for special education before, but he may now.  Sometimes as the child gets older, then the gap gets wider and services can be started.  

You are on the right track.  

The psychologist will need to look at these conditions
ADHD (these kids are too busy and disorganized)
SENSORY PROCESSING DISORDER (these kids can be hyper and have problems with how things feel and smell and can have problems transitioning)
OPPOSITIONAL DEFIANT DISORDER (These kids have a hard time following the rules)
NON-VERBAL LEARNING DISABILITY
LEARNING DISABILITIES
ASPERGER'S SYNDROME (These kids may have problems separating and dislike change.  These kids can also display 'rage-like' outbursts.)

If you have insurance you should be able to get these evaluations done with just a referral from the doctor.  If you do not, you can ask the school to do them, but it could take up to 3 months or longer for you to see the results of testing.  

I would suggest for now that you go an look at a site called do2learn so that you will see some of the basic differences between the conditions.  You may also find some tool to help you son with the taking a bath/shower and not missing any parts.  

You may indeed be correct that there is more than one thing impacting your son's behavior.  

Many Blessings to you.  

Christine
soulspeech@bellsouth.net