Treatment for ADHD or ADD

Nurses General Nursing

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i would love some feedback concerning add evaluation and treatment. the conner scale is an evaluation tool our pediatricians use to indicate the need for medication in the treatment of add/adhd. after giving these questionaires out to parents and teachers for years, i decided to fill one out on my child. well, he scored high enough to be considered for add treatment. now, mind you, he had no s/s of add, i was just wondering. he makes a's, he is attentive, and he is mature for his age. i questioned the validity of the questionaire and was put off by the doc. i was informed by a teacher and friend of mine, that the teachers all know what to check in the conner scale to raise the score for a child being evaluated, thus suggesting the need for ritalin, or other add medication. i am very concerned about these findings and feel certain that children are placed on these drugs needlessly. on a personal note, my nephew's teacher insisted that my sister get an add evalutaion from the pediatrician because she knew my nephew suffered from add. well, being objective about my babies isn't easy, but i knew that my nephew was not add. to appease the teacher and get her off my sis's back, we took her the conner scale. well, it's no surprise that she scored him high, my sister scored him low. dr. wrote a rx for ritalin. my mother and a very opinionated grandmother, sat on the rx of ritalin and would not let my sister get it filled. heehee it pissed the teacher off, but, by the grace of god, my nephew passed her grade. this year, with a new teacher and new found confidence, he is making all a's and is one of the top students. we all had to work with him to find that confidence. the events with last years teacher really beat his little spirit down to nothing. he was so afraid of her, he couldn't concentrate on his work. now, he is doing great without medicine, but with alot of love, support and understanding from his family.

Specializes in Nephrology, Cardiology, ER, ICU.

Boobaby - what a great and interesting thread you have started. The only thing I have to add is that I too got two independent education evaluations at my own expense, because I didn't think my son would get a fair and unbiased one from the school system.

My son has been in extensive counselling, meds, etc for nine years. He is currently in an out-of-school placement due to behavior issues associated with his mental illness. This has beent he hardest thing I have ever dealt with. The stigma of mental illness is unrelenting.

Specializes in ICU, nutrition.

I'm so glad this thread was started. My son will be starting kindergarten in the fall and I have been walking on pins and needles for the past two years after realizing he will probably be "diagnosed" as ADHD in the first six weeks of school. Ian is very bright, high energy, short attention span (unless it's something he REALLY wants to do), and somewhat impulsive. He is so perceptive and puts things together that I cannot imagine a 5 year old would understand. In the classroom at pre-k, if he knows how to do something, he's not interested in doing it again. I know when he goes to school and he already knows how to write these letters or spell these words, he's not going to want to pay attention. I was the same way when I started first grade except I was so shy that I would never cut up. I just didn't participate and would pay only enough attention that I would know what was going on if I got called on. I still tend to be the same way now, and I really have to force myself to pay attention in a class when I think I know everything that is being said (which usually isn't the case, I've realized with maturity). I'm afraid they teacher will insist that my son has ADHD (which he may, as I have never looked at the dx in the DSM-IV) and that he needs Ritalin. I don't think drugs are necessarily the answer, and research has shown that when they are used along with behavioral therapy, they do much more good and can eventually be discontinued. I am willing to do whatever it takes to help Ian succeed in school, but I think drugs should be the last resort, not the first step. Also, I have heard of schools reporting parents to child protective services for not giving the child the prescribed medication (e.g. Ritalin for ADHD) and the child actually being taken away because of neglect (never mind that the parents were using behavioral interventions with the child and just chose to try it without the drugs. I personally think that is reasonable).

Sorry this is so long, I'm just venting a little. My husband says not to worry about it till it happens, but I can't help it. I get like a grizzly bear when it comes to my baby!!

I wish you all the best of luck with your children. You have every right to go with the type of treatment you think would benefit your child the most. Your doctor should be supportive of your decisions, you know your child better than anyone.

It takes a lot of courage to go through all this, but we'll do anything for our babies! I really don't care if people think I'm a fool, or an idiot. You can run over me and call me crazy, but the can of whoopass gets opened if you mess with my babes. :

Some teachers WILL put the pressure on, sending notes everyday or even phone calls. If I could turn back the clock, I would request to sit in the room and observe the class for a day or two. I know all teachers aren't like the one I encountered. I know too many are looking for an easy answer, though. Doctors don't have enough time to dedicate to these problems. Private counselors are too expensive along with their evaluations. The school system has an evaluation tool, but there is a long waiting list.

So, from one Mom to another, this is the first thing I would tell my patient's to do. Omitting several foods will cause many children to behave better, or slow down a little. You all know the list of foods I'm talking about. Refined sugars, caffeine drinks, any food with red dye will make lots of children hyper. Go to your search engine and look up the Feingold diet. It will explain this much better than I.

Specializes in CV-ICU.

Okay, I just wanted to clarify that we went through EXTENSIVE family counselling, support groups for ADHD boys and girls (separate for each sex); parent support groups; the county came in and evaluated us and made us have respite weekends from my son (this was after my dtr. took after him with a butcher knife and broke it and the door to his bedroom because HE would NOT give her HIS piece of cake--this all occurred in a 25 minute period of time between when I went to work and Hubby came home!-- it was the daughter we needed respite from, Not the son!). We did behavior modification; had teachers that worked VERY closely with us (small parochial school with 16 kids in a class) and they even tutored our daughter when she had problems for 2 1/2 yrs (she refused to learn to read- just didn't want to).

DIET????? My son was lactose intolerant and the only problems we had with his diet was from the lactose intolerance-- colic, bloat and cramps, and diarrhea. However, my daughter was extremely sensitive to red food dye and was so hyperactive from it that even her young friends in 2nd and 3rd grades refused to give her red food dye. (She was about 15 months old when we picked up on that one -amoxicillin for an ear infection!). And caffiene DID calm them down AND STILL DOES! Benedryl was given to my daughter once and we never did it again-- she was SO nasty and hyper that we couldn't tolerate her at all!

Hogan, YOUR experience is not the same as OUR experience has been. I get so angry when people infer that we "DRUGGED" our kids instead of dealing with their problems; dammit; I did EVERYTHING possible trying to deal with my kids and we needed the meds with all of the other interventions. I don't believe that meds are the first line of treatment; and I didn't like beating my kids either. I was raised by the rod, and when I found that I was hitting my son uncontrollably because "I" was mad, I called First Call For Help. I am so frustrated by people who THINK they know it all and they have NEVER been in my shoes and have no idea what we went through.

I seriously believe that Ritalin and other drugs used to treat ADD and ADHD works differently in kids who truely are ADD/ADHD. My kids (both of whom are very articulate young adults now) have been able to describe in detail what they are like both on and off Dexadrine. I had hoped they would be in the 50% group that would outgrow their ADHD at puberty; but they weren't. They are unique, neat individuals who just happen to have a disability with a title. There are lots of unique, neat individuals in this world who have disabilities which don't have names; are they considered more normal than my kids? I doubt it.

Sorry, something on this thread just got my Mommy defences up and in action.

Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Read, read, read, research!! We had temperament counseling by an RN who is now a MFCC; also had child in one of her socialization classes (series to reinforce acceptable socialization skills - age-specific, of course).

Thom Hartmann has written a number of books about ADD (adults and children) -- with a very POSITIVE slant!

Dr. Daniel Amen (http://www.amenclinic.com) has also written a number of books, backed by his experience with SPECT scanning of patients (also adults and children). His work is controversial among the medical community but it is fascinating to explore. He contends that ADD can be diagnosed and measured with the scans (as well as a thorough consultation, not JUST the scans) - has defined six different types of ADD, each with different treatments (some w/diet, some w/diet and meds, -- some meds should not be used w/certain types of ADD, he maintains). Check it out.

I believe Hartmann posits that it was ADD pioneers (restless, impulsive . . .) who came across the Atlantic to the New World . . . and their descendants continued West . . . which puts a lot of ADD in California!!! I think I also read in one of his books (it's been awhile since I've read them) that a dean of a major university said the kids who give the school the most trouble, are the ones who become the entrepreneurs, and who come back to endow the school!!

Also from my reading (sorry, don't remember from where) is that ADD people come from a hx of drug or ETOH abuse: the family member is an undiagnosed ADD who is self-medicating. That hit home, as I come from three generations (at least) of alcoholics (not one myself!), with some sibling drug use in hx too . . .

Also something to consider is possible SI (sensory integration) dysfunction. Evaluation and therapy done by certified SI Occ. Therapist. Therapy is time-consuming and $$$ (ins. doesn't pay, of course!!), and benefits not generally acknowledged by mainstream medical community, but some have greatly benefitted from therapy and swear by it. In simple terms, can help w/tolerance of light/noise.

Read, pray, check out all options, get 2nd opinion(s), and above all DO WHAT IS BEST FOR THE CHILD. Courage, and God bless. --- Diana

Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Here's a post from the non-nurse husband of DianaH. Aside from all Diana's study, we literally tried everything. Anyone who doesn't have an ADHD child and condems the use of Ritalin really cannot understand. To know what it is like to watch your child's self-concept and self-esteme go down the tubes because he or she cannot stay in line with the rest of the world. Even the best schools do not deal well with these kids -- the fact is that even the very best environment of love and disipline just doesn't work by itself. We fought the thought of using Ritalin for years, until our son started showing the signs of hopelessness, and then we knew that our son needed something we could not provide. Fortunately the pediatrician's perscription helps tremendously in this ongoing process. -- DH

Specializes in Pediatric Rehabilitation.

Wonderful thread! Just want to remind how easy it is to be judgemental until you've been in the exact situation. For years, before motherhood, I enjoyed the attitude that Ritalin and ADHD were ridiculous...that these kids were discipline problems..that the parents were to blame...yeah, well :(

Right now, I'm in the process of having my two year old evaluated. I'm terribly confused by the definition of ADHD; it seems to be so broad spectrum. My son is very late talking; at 26 months, his vocabulary probably consists of 35-50 words. He will watch tv programs in their entirity, has for as long as I can remember. If he's concentrating on something (tv, toy, etc), you can literally scream his name and he will not move a muscle, no response. He will not follow simple commands, but he WILL react as if he's going to do what you asked..then moves to do something else (he DOES respond to "no", "want to eat?, "give me/daddy/etc. a kiss", ", "want to go outside/bye-bye", just not "hand me that toy/cup, etc). It's almost like this IS a behavior thing, like he responds to what he desires. I also have a three year old who has a vocabulary larger than mine and rarely slows down with her desire to use it. I wonder if his lack of speech is due to her over-use of speech (her "talking" for him). It's almost like he can say anything he WANTS to say, but limits his use of words. He says something new everyday..and then he may not use that word again for months. If he's hungry, he goes to the cabinet and gets a box or can of food and brings it to me. If he's thirsty, he hands me an empty cup. If he want to watch a certain video, he goes to the shelf and brings me the tape. I've tried frustrating him to get him to verbalize his wants/needs to no avail. My husband is "a man of few words", I (obviously ;)) am very verbal. My son is very easy going and laid back(again, like his father). He's not easily frustrated and rarely throws temper-tantrums. He's a very affectionate-loving kid. My kid's pediatrician is very proactive, so when I voiced my concerns at his 2yr check-up, she suggested referrals. She went on to suggest this could just be his personality. She suggested speech/hearing consults, I questioned autism. She gave me referrals for all three. Speaking with coworkers and parents of other ADHD children, several have told me this is some of the same behavior they witnessed early on in their kids. I have a very hard time understanding how a two year old who can sit through a whole video tape, or can ignore his surroundings because he's focused on something is ADHD. He passed his hearing screen with flying colors (could hear the "beeps" better than me..lol). His speech appt is this week and he has a neurology appt next week, so I hope some direction is near. I KNOW this kids is very smart, but he just doesn't know how or has no desire to show his knowledge. Hubby says he's just downloading and processing the info and when he's ready, he'll share it with the world. I sure hope he's right. Anyhow, I'll be hard pressed to medicate my baby; I'll have to be convinced nothing else will work, but I'll never say "never".

As we researched the net, hubby and I were amused that we both fit the ADHD definition..although we are complete opposites.

very confusing :(

Great thread! Thanks for listening to my concerns.

tracy

doesn't anyone care that most parents aren't educated like you all? they will put their kid on this stuff at the slightest suggestion...

my problem is w/ the ease that this stuff is prescribed, and the lack of information shared w/ the parents.

Shouldn't giving a pure amphetamine to a 7 year old be at least further/better studied? I think it's not so crazy to study whether or not this kid will be more likely to use drugs later in life. There aren't any longitudinal studies w/ credible long-term data to prove the safety of Adderal and Dexedrine on kids. What, you say that there is no such long-term data for Albuterol or Singulair? You are probably right, but those two meds aren't pure amphetamines either. BIG difference in my book.

All I'm saying is tell parents that this is an amphetamine, that it can cause cardiomegaly, etc. We (as nurses) always harp on informed consent.

Let's face it, the general public is NOT informed about this stuff. We are educated, and likely get more attention from the specialists, because of our profession.

as with one who is without children..........

i only humbly wish you with children within your charge.........

godspeed and much love, life and health..........

and micro isn't being facetious here in anyway shape or form...............

Specializes in CV-ICU.

I still say that unless you have walked in MY SHOES, you will NOT tell me that the drugs we gave our kids were wrong.

Hogan, MOST meds have not had long term studies done on them even for women! Most meds have only been tested on young men! Pharmaceutical companies never tested meds on women for fear of pregnancies; and most meds have never been tested on geriatrics, youths, etc. What is your point here?

I realise that you probably feel the need to tell others about the dangers of drugging kids; but do YOU personally have an ADHD kid who has not responded to other methods of treatment? Yes, I am sure that ADHD is often used to "diagnose" a high energy child; and I do feel that that is wrong too. But Ritalin has been used for many years for narcolepsy and ADD/ADHD (which used to be called "minimal brain damage" in the 40's, 50's and early 60's, BTW) and for exogenous obesity (until it was found to be more habit forming for many of the obese pts).

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