How Do You Measure Whether a Child's ADHD Has Improved?

I didn’t realize how worried I was until the wait was over.

We got the news: Our family will continue to receive help dealing with my daughter Natalie’s attention deficit hyperactivity disorder (ADD/ADHD) and other mental health issues through Iowa's Children’s Mental Health Waiver. Phew!

Through this waiver our family receives respite services -- blocks of time where a trusted someone cares for Natalie so that my husband, Don, and I can take a break, spend time alone as a couple, and spend time with our "neurotypical" son, Aaron. Natalie gets to ditch her (sometimes crabby) mother's company for some it’s-all-about-Natalie one-on-one attention from another adult. I’m telling you, this service has been a lifesaver; it’s been the key to preserving my own questionable mental health!

Thank God, I think to myself when I hear the news.

Our case manager, Tammy, gave me a heads-up early on in the process that re-approval wasn’t a given. A psychological evaluation completed a year ago confirmed Natalie’s ADD/ADHD diagnosis, along with a couple of others that fall under the category of mental health -- a requirement for qualifying for the waiver. But it also verified that Nat, who is adopted, has fetal alcohol spectrum disorder -- a developmental disability (DD), which falls under Iowa's Mental Retardation and Developmental Disabilities Waiver. There is a chance, Tammy said, the diagnosis would disqualify Nat from receiving funding. A DD waiver might not be nearly as good for our needs -- if we even qualified for it, she added. If we were denied a mental health waiver, we would have to start an entire new process to apply for a DD waiver -- and the state has a certain number of waivers for each program, so it could mean going on a waiting list until one became available.

Tammy also reminded me how much progress Natalie has made in the last year. It’s true, she’s doing so much better than before. She’s made huge strides in terms of therapy goals, identifying her feelings, and using words to express them. She’s positively a star! And her outbursts of aggressive behavior occur less often than they did a couple of years ago.

But when Tammy started going through the reevaluation forms and I answered questions related to the last year’s events, it became clear, at least to me, that Nat still has plenty of problems. I could only hope that the powers that be would see it that way. Yes, my girl is doing great, considering. But she has a long way to go. Will I ever learn how to communicate that effectively?

For the last few months, the possibility of losing respite services has weighed on my mind. Each time we had a few hours of respite (we get this less often than we'd like), I’d think, What will I do without this? Many times when I desperately wanted a break but none of our providers were available, I’d think, Oh God, this is what it’s going to be like.

So, when I read Tammy’s e-mail saying that Nat was reapproved, I was ecstatic. I wanted to call everyone I know! I wanted to send out a mass e-mail! My relief was palpable. Jeez, I’m glad that’s over -- for one year, anyway.