Expert: Christine D. DeLoatch, MA CCC-SLP - 12/14/2007

Question
i adopted a baby that was in foster care with us we briught him home from the hospital, his mom was a meth addict and baby was born testing positive to meth.  the first 2 years seemed very normal no problems.  he will be 3 in march and we are really seeing changes.  extremely hyper! never still for long , used to sleep thru the night , never does now, used to nap great has a hard time now.  is into something all the time.  have locked kitchen cupboards, moved kitchen chairs out of kitchen  , it is just something all the time.  he doesn;t stay with ine activity for long. how do you deal with a 2 yr old with adhd i tried being consistent with time out  but ended up spanking because he just wont listen he goes right back and does the same thing again.  we have benn potty training since june . he has been going potty for most of that time if you take him but will wet if you dont take him . he has had 2 bowel movements in that time one when we first started and second time in nov. 4 mon later we made a big deal about it bought him a new truck and trailer but hasnt done it since.  refuses!! i sit him there before nap time for 20 min.  and he goes to his bed and goes right away in pull up.   any ideas much appreciated thank you

Answer
Dear Nancy,

Thanks for asking me your question.  

Unfortunately, children exposed in the womb to stimulants, like cocaine and meth often receive a diagnosis of hyperactivity as children.  The good news is that they don't often have mental retardation or problems learning.  They do have problems regulating their own behavior.  

I would suggest that you ask your doctor about a referral to an OT.  An occupational therapist can look at ways to get your son to calm down.  

You may also look into a program called 123, magic that may or may not work for behavior.  

You may have to become very regimented with your son in terms of keeping to a very strict schedule.  That way he may be able to be more focused on what is coming next and get into fewer things.  I would really recommend almost no-free time.  He can have choices -Like to watch a movie or to play with cars.  You may also want to get a small carpet square or bath mat so that when he is watching TV he has to be sitting on the mat.  You also will need to reward him more frequently for any on-task behavior, like sitting on the carpet square.  

You may have to think of it as training. There is a good site called do2learn.com that is wonderful and has several things that you can print out to get started.  Read the information about Autism as well as ADHD, because the types of training methods I am speaking of are commonly used with Autism, but I have found they work well with ADHD also.  

Using pictures seems to help kids who are often visual.  Kids with ADHD are often visual learners or rely on their vision when trying to remember things.  

Notice, that I did not recommend speaking to the doctor about medication.  If the Occupational therapy does not help, and getting him to sleep through the night is a big issue, then maybe some medication for that may be in order.  In terms of the generally ADHD-type symptoms you are seeing, doctors find that medication only works about 50% of the time in kids under 5 and most doctors won't prescribe medication for kids under 4 anyway.

The professionals that need to be on you support team should be 1) His primary doctor 2) an OT  - If further testing is needed move to a neuro-psychologist and behavioral therapist.  You want your son available for learning.  When he is moving so quickly he misses out and does not understand the rules for safety and establishing friends.

Many blessings to you.  Please let me know if you need any further information.  

Christine