Expert: Norm Bishop - 10/6/2009

Question
Hello
I hope you are well.  And can maybe offer some advice?
Firstly thank y ou for your time.

My son is 6 and has been diagnosed with ADD.  We finally took him for an evaluation because his teacher and the school have requested several times due to his behaviour.

He is a lovely, caring, loving, happy, very talkative little boy.  He is not the normal 6 year old -rough and tough type, but a soft boy who loves others, wants to help, and loves spending time with people. He has amazing manners - always please, thank you, excuse me etc - my kids are known for this - but he has problems with concentration.  He can not concentrate for long periods at a time - apparently not long enough for a 6 year old.  It seems that due to this he is falling behind in his work.  He is very slow at school but usually gets his work done - and it's very neat.  He says he is bored at school.  His teacher says he doesn't like to hang around and wait for things to happen  eg if in line he starts to mess around with other boys etc and wont stand in his place.  

So it seems it mainly his concentration.  Not focussing for long periods, distracted by other things - it seems as if he gets ideas while he's busy with something then just HAS to tell you - he loves talking like mom.  

So now we're faced with the dreaded ritalin/concerta/strattera etc.  I am not convinced.  I admit at home it has been difficult and we are not always fully structured - I run my own small business and my husband is not used to doing housework/kid work etc so I kind of just do what I can do here and there and sometimes for example the kids play late while I am working.  Oh I know what I SHOULD be doing but it feels like this load does not get lighter!

I feel that his problems may be due to our (husband and my# relationship as it is not great and the communication is bad, and to possibly not enough structure in the home!

Is this possible or as the doctors say NO - he's born with it and that's that. #I had a stressful pregnancy as I fell pregnant 4 months after the death of our first son who died at 6hrs due to asphyxia at birth as the doctors cut his cord before he was delivered and he didn't come out then! - could it have been this?)

So another point of view would really help - not the usual - put him on medicine and the teacher will see a change almost immediately.  I think WHY!? what's so wrong with him besides not paying attention as long as others!?

Distressed.  Please help.  Thank you.


Leial
South Africa


Answer
First...At age 6 years old it is difficult to diagnose Attention Deficit Disorder, especially when a child at that age has not had a very extensive school or out of home history.

Second...The stimulant medications for ADD students work well enough to observe a difference in roughly 1/2 the kids who take it.  Therefore, the other half have no noticable changes.

Third...There are side effects to stimulant medications, such as difficulty sleeping, lowered appetite, etc.

Let me clearly state that I am not a Physician.  I am an educator with educational experience.  

What I say is what I have seen over 34 years in the education business.  

The problem with him not being able to pay attention as long as others is that he will not develop skills at a level the same as his peers.  The longer it goes on, the further behind he will become.  

That places you at the proverbial "rock and a hard place."  What I would recommend that you do is to begin to structure the child's life both at home and at school and see what difference that makes.  You would create a system where he is rewarded for doing what he is supposed to, as he is told and when he doesn't then he loses privileges.  A similar system would be in place in school.  If that changes his behavior, then you can possibly avoid medication.  

By the way, there is no research that indicates that ADD is caused by pre-birth trama, we simply do not know what the causes are...if your son was without oxygen for more than 3 minutes at birth then there could be some damage to his neurological system, however, if that were the case it would be more severe than ADD.  

I would recommend that you ask for a behavior specialist at school to create a system behavior management, incorporate a similar one at home and give that a six week trial...you would observe to see any changes over time.  If there is no change, then see a physician with some specific training or experience in ADD, see if he/she says the same thing as the first doctor.

I wish you luck...Norm