ADHD Parenting Blog

Archives: June 2009

Could It Be Dyslexia?

It’s backward-ness and wrong-order-ness that I’m worried about with Natalie.

My daughter, Natalie, has attention deficit hyperactivity disorder (ADHD), and since her diagnosis several years ago, I’ve learned quite a bit about the condition. Now, I think it’s time to focus my attention on learning more about learning disabilities.

Natalie was quite delayed in both her physical and mental development when we adopted her from Russia six years ago. Her potential for learning was a big unknown. From the beginning, what we saw of her ability to learn was heartening, nearly miraculous. With enough to eat and a little (well, a whole lot of) love and attention, her learning took off like a rocket. Still, we knew it would take several years of school to sort out how much Natalie needed to catch up, before we could assess her ability to keep up.

Six years later, it’s still a bit of a mystery. We know Natalie has ADHD, and while ADHD is not a learning disability, its symptoms, such as lack of focus, can impact her ability to learn. We know she has Sensory Processing Disorder, and the results of Natalie’s SIPT testing gave me a little insight into how this added burden effects specific learning-related abilities, although that complex information hasn’t synthesized in my mind well enough that I can explain it! (Yeah, what she said!)

Nat will turn 9 on Sunday, and she’ll enter 3rd grade in the fall. And, I’m wondering if she’s dyslexic. I wonder if she’s at the right age, and has done enough of the work of catching up over the last six years, to separate this one specific issue out of the mystery-mix that is the one-and-only Natalie.

I read that it’s a myth that seeing letters or numbers in the wrong order, or writing them backwards, are signs of dyslexia. That some of that is normal up until a certain age, and that while some people with dyslexia do transpose numbers or letters, dyslexia involves much more than that--it describes a more general, more all-encompassing difficulty reading. Is that true? I don’t know! But it’s backward-ness and wrong-order-ness that I’m worried about with Natalie.

Here’s a somewhat comical example:

Natalie wrote “BM” in large capital letters on June 28 on our calendar. Why? Is she planning to...no, I won’t go there. It turns out “BM” stands for "My Birthday." Of course. Isn’t that obvious?

So, there’s that. Then a day or two later she and are playing with a magnetic calendar, and she’s putting the days in the squares one at a time. She gets to the number 12, and stops. She shows me both the number 12 and the number 21, and asks, “Mom, which one is 12?” She honestly couldn’t figure it out.

Our pediatrician mentioned sending us to the University of Iowa Hospitals and Clinics for a developmental evaluation. Looks like it’s time to follow through. And it looks like I’ll be looking for some good, easy to read and understand resources about learning disabilities.

ADHD Formula for Trouble

Does (ADHD + delayed gratification) x (impulsivity + hyperfocus) = formula for trouble in your household?

Sometimes kids with ADHD find it hard to delay gratification; to wait for something they want or need. Hey, we all fight that battle, right? Take me, for example. I’m wishing I’d delayed the gratification of buying this new laptop I’m using, and replaced our trampoline instead!

If a person like me, without ADHD, has trouble waiting for what I want, then consider how having ADHD might magnify the problem. Imagine impulsivity and hyperfocus colliding.

My daughter, Natalie, thinks: It’s raining. Hey, it’d be cool to buy a new umbrella! BLIP! That BLIP! is impulsivity -- the idea popping into her mind.

Then, the idea gets stuck in her consciousness. Umbrella? Umbrella. Umbrella! Being stuck is hyperfocus.

Next, combine the two. Now she’s not simply stuck, in a passive way, like a car stuck in the mud that the rain in this example created. She’s stuck, and the car’s alarm is blaring -- BREEEEEP! BREEEEEP! BREEEEP! BREEEP! Loud! Frenzied! Crazy-making! She wants to turn it off -- immediately -- and it’s all she can think about. It’s driving her insane -- now she can’t think! She must push the right buttons--she’s gotta TURN THAT THING OFF!

When I imagine that that’s how Natalie feels when she has to delay gratification, it’s easier to understand why delayed gratification is the antecedent to some of her fits.

Natalie’s mega-fit, the one I wrote about in my post, ADHD Rage was, indeed, over her desire for an umbrella.

I’m serious. Just. An. Umbrella.

It had just started to rain as we drove to pick Aaron up from baseball practice, a 15-minute drive from our home. Nat saw some kids walking, carrying umbrellas.

BLIP!

“Mom, can we buy an umbrella?”

Did I say no? NO, I did not say no. I said, “Sure. But right now we need to pick Aaron up from practice. We can buy an umbrella later.”

The alarms went off. Natalie had to have an umbrella NOW. “Later” might as well mean “never”.

After the fit she had, the answer certainly did change to never! The latest gotta-have-it to wreak havoc in our household was a $4.98 chess set that Natalie saw while on a shopping trip to K-Mart. I said, “Yes. That’s a great idea. Let’s go buy it soon. But not right now.”

From Natalie’s reaction, you’d of thought I said “NEVER, oh powerless one! Ha ha ha! (Evil laugh.) I hope you suffer!”

BREEEEEP! BREEEEP! BREEEEEP! BREEEEP!

Natalie flew into a rage. She sent a bowl of grapes skittering across the kitchen table to crash against the wall and shatter. Next came a bowl of pasta.

Let’s just say, a very unpleasant hour followed.

Sometimes, instead of throwing a fit, Natalie whines and begs, and no amount of behavioral intervention seems to help. To throw out another comparison, it’s as if her remote is broken, so she can’t change the channel. Recent cases in point: “I want to turn into a boy so I can play baseball and wear a real uniform!” and “If I had some just had some cardboard and some glue and some duct tape and some aluminum foil to build a rocket ship I’d be happy!” I’m supposed to clap my hands and make these things happen/appear like magic.

Magic--BLIP!--Hey, anybody know where I can get me some of that? I want it NOW!

BREEEEEP! BREEEEP! BREEEEP!

Parents, do you think I described this problem accurately? Is (ADHD + delayed gratification) x (impulsivity + hyperfocus) a formula for trouble in your household?

An Outlet for ADHD Energy

Nat could be jumping on a new trampoline while I relax, but instead, she's looking to me: Entertain me! Stimulate me! Make me happy!

Natalie’s been telling everyone she sees her sad news: "My trampoline is gone!" For a girl with ADHD energy to burn, and for the mom who counted on it to keep her happy and busy, this loss is a biggie.

The trampoline, a gift for Natalie’s fourth birthday, lasted through several broiling Iowa summers and harsh Iowa winters, before caving in just two weeks before her ninth. Actually, the frame, supports, springs, and trampoline mat were still fine, but the safety enclosure, never a very good one to start with, finally caved in under the pressure of two 12-year-olds, Aaron and a friend, playing a made-up ball game while hanging on to it. At our house, no safety net=no jumping allowed.

I made some phone calls and surfed the Web in search of a new enclosure, and found that a new net would cost nearly as much as replacing the whole trampoline. We decided this trampoline had to go, and I hit Craigslist. Soon a dad arrived with his tools and his pick-up truck and hauled the old trampoline away.

Will we buy a new one? I would say yes in a minute, but Don's not so sure. Negotiations are taking place, slowly. Don likes the idea of having more space in the yard and of one less obstacle to mow around. And, of course, he dislikes the idea of spending money.

"Let's wait a couple of weeks, and see how much Natalie misses it before we decide," he says. Sure, I think, a couple of weeks where he's only home one, maybe two of Natalie's waking hours each day. I'm the one who will hear the pleas, deal with the boredom and the lack of motor stimulation.

I picture trying to sit and relax on the patio, hamburgers on the grill. It's that difficult time before supper. Nat could be jumping, I could relax, but instead, Nat's looking to me: Entertain me! Stimulate me! Make me happy!

Then again, I'm the one who quit my job, causing us to need to think twice, or three times, before making a major purchase. So I can't argue too much.

Don recognizes the various needs the trampoline fulfills given Nat's ADHD and sensory issues. He even wondered aloud if we could make a case for it being medically necessary and therefore--What? Tax deductible? I don't know where he was going with that line of thinking. But it proved Don does understand Natalie's needs, and is considering them.

Time will tell whether Don--and his checkbook--will adjust to the idea of a new trampoline, or whether Natalie will have to expend her ADHD energy without it.

Pausing to Be Thankful

It's good to be reminded that not everyone achieves the side-effect-free, positive results from ADHD meds that Natalie enjoys these days.

My post, “No ADHD Med Vacation for Us”, about whether or not to give children with attention deficit disorder a summer medication vacation garnered a few comments. Parents, thanks for reminding me that not everyone achieves the side-effect-free, positive results from ADHD meds that my daughter Natalie enjoys these days. It’s good to be reminded to be thankful!

Some commenters said that taking medication flattens their child’s personality. I’ve read about adults with ADHD who have the same complaint. My first thought when I hear this is: Well, they just haven’t found the right medication. If only it was that simple, huh? There’s a certain degree of unwarranted disrespect in that way of thinking. It assumes a lack of communication with the doctor, a lack of trying. I realize that taking medication, or giving it to our children isn’t something we take lightly. And, I know that for some individuals, the “right” medication just doesn’t exist.

Luckily, the medication that Natalie takes absolutely, positively does not flatten her gregarious, hilarious, unmatched personality. It allows it to shine. It slows her down enough to feel comfortable in her body. It slows her brain down so that it runs at a tolerable pace. It brings out her loveable, true self.

There’s another medication non-problem that I’m reminded to be thankful for; the fact that Natalie never resists taking her medication. She takes it willing, with no fuss or bother, time after time after time. She even sometimes reminds us when it’s med time. I can only imagine how stressed out I would be if I had to battle her four times a day, every day, to get her to take her meds.

When we first brought Natalie home from Russia she had an intestinal parasite. She had to take a horrible tasting liquid medicine four times a day for two weeks. I tried everything to get her to take it--mixing it with Hershey’s Syrup worked the best--but nothing really masked the taste. Believe me, it was a looooong two weeks!

Yes, I am truly, utterly thankful for medication that works wonders to treat Natalie’s ADHD, and for the fact that Natalie is happy to take it!

Does your child resist taking ADHD medication? If so, what’s your spoonful of sugar that helps the medicine go down?

A Red Flag for the IEP

A school schedule change sounded like a nightmare for kids with attention deficit disorder--until I did my homework on it.

A group of Ames, Iowa elementary school principals, charged with finding a way to address the district’s flattening scores on standardized tests, proposed abolishing recess.

No, that’s an exaggeration. But judging from my initial reaction, and that of many community members in our oh-so-involved-in-school-politics city, you’d have thought that was the case: evil administrators who care about nothing but test scores want to creates a two-hour “uninterrupted” block of time for literacy instruction, and they plan to reduce time in PE and art, and eliminate the morning recess in order to do so. And, to make matters worse, they didn’t consult a single teacher as they hatched their plan! Scores on standardized tests are all they care about--red flag! A two-hour “uninterrupted” block of time--red flag! Cutting recess and PE when our kids are already becoming fat and lazy--red flag!

When I read about this proposed new schedule in the local paper, my mind did, absolutely, scream, “Red flag! Red flag!” An uninterrupted two-hour block of time sounds like torture for any elementary school student. For kids with ADHD, it would be absolutely out of the question.

I knew immediately that I’d have to add accommodations to Natalie’s IEP before the new school year starts in the fall, to force the school to give her regular breaks and opportunities for movement. So, once again, I started making phone calls.

Liz Jurgensen, the district’s Director of Special Education, encouraged me to take a wait-and-see approach. First of all, she pointed out, we don’t know if the new schedule will be approved and implemented or not. Additionally, she suggested that before making any changes, we should give the new schedule a chance. See if Natalie has any problems with it before jumping in and making changes.

I told Liz I would rather be proactive. Natalie doesn’t have behavior problems at school. She holds it together there, while internalizing a lot of anxiety. The anxiety eventually comes out. Sometimes she lets loose when she gets home, other times it comes out through strange, seemingly unrelated behaviors, like stealing other people’s stuff. By the time we figured out whether or not Natalie could tolerate the new schedule, I concluded, it would be too late. Some damage would already be done.

I believe it is often the case that boys with ADHD are more likely than girls to have behavior problems, and that girls are more likely to internalize their feelings. Do you agree with this, parents? I think Natalie’s special needs are at risk of going unmet because she doesn’t act out at school. She may be struggling, but she’s struggling quietly--losing focus, feeling anxious, suppressing the urge to move her body. This new schedule sounds like a set-up: how much would she suffer, how much of the school year would be lost before it inevitably led her to fail--and for someone to take notice?

That’s why I really, really want to be proactive. Yes, I’ll wait and see, but only for the decision about whether or not the schedule will be implemented. If it will, I concluded, I’ll call an IEP meeting.

Next I talked to Pam Stangeland, principal of one of Ames’ five K-5 elementary schools, and a member of the committee that proposed the schedule. I was told she was sensitive to the needs of students in special ed, so could address my specific concerns about how the schedule will impact kids with special needs.

Pam confirmed that special ed is her passion; that every decision she makes as an educator takes into account the needs of kids in special education. She has a child of her own with special needs; a child in Level 3 special ed, who has autism.

Pam said that another parent had e-mailed her who had come to the same conclusion as me--that the new schedule will necessitate adding accommodations to our children’s IEPs. But, she disagreed. Pam said that a two-hour “uninterrupted” block of time didn’t mean two hours of straight instruction, or that kids wouldn’t move around for two hours. In fact, if teachers use the time as intended, it will allow for more interactive, creative, multi-sensory learning. It should actually allow for more movement and stimulation than with the current schedule.

For special ed kids, it offers another benefit. Right now, kids are pulled out of the regular classroom for their time in the special ed room. They miss core instruction. Their peers are aware that they are pulled out. The new schedule includes a block of time for individualized instruction for all students. Some kids would be challenged with enrichment activities. Some kids would benefit from re-teaching. The special ed kids would receive their “pull-out” time during this time, so would not miss whole-class experiences, and would not be seen as different from their peers.

“So,” I asked Pam, “parents of kids in special ed should actually be happy about this change?”

“Parents of all kids should be happy about this change,” Pam said. "But parents of kids in special ed should be celebrating.”

I’m glad I did my homework. I may still add some language to Natalie’s IEP to pique the teachers’ awareness of Natalie’s needs, but Pam pretty much sold me. Here’s hoping Ames’ teachers embrace the spirit and intent of the new schedule, and that happy kids engaged in learning fill our classrooms, if not our playgrounds, this fall.

ADHD at Summer School

Now that school’s out for the summer, I can relax about all-things-IEP and other ADHD-at-school worries, right? Wrong!

In the envelope with her end-of-the-year report card, Natalie brought home an official notice that she’s enrolled in the district’s Accelerated Learning Program (ALP)/At Risk summer school session.

Long-time readers of this blog may remember that I was less than thrilled with (nearly psychotic about) Natalie’s summer school experience last summer.

“This isn’t special ed! She can’t be here!”

I’m angry all over again just thinking about it.

So, instead of relaxing into summer, I’ve been fulfilling my role as Natalie’s advocate. I’ve been working the phones.

My first call was to Valerie Terando, the district’s public relations officer. “Did she by any chance have a negative experience last year?” Val asked.

Liz Jurgensen, Director of Special Education, the recipient of my second call. The summer school program Nat’s attending isn’t Liz’s domain--Natalie’s one of only a few Level 1 Special Ed kids invited to participate in the ALP/At Risk program’s session. But since Liz was the victim of my hysterical, blubbering, mini-breakdown last summer, I’m keeping her in the loop.

Liz referred me to Teresa McCune, the ALP/At Risk program director, who stepped into the position right about this time last year. “One of my first acts in this role was to go with Liz to the school for a meeting with that teacher,” Teresa said.

Teresa is completely revamping the program this summer. No field trips. Writing activities will replace most worksheets. There’ll be “interactive” learning experiences and “unique and interesting” activities. (Mmmm, savor that language!)

Karen Green, the teacher Natalie is assigned to, is a certified special ed teacher, who pursued the opportunity to teach this summer with enthusiasm. And Iowa State University education students will be on hand to work with students in small groups under the teachers’ supervision.

Teachers will attend an orientation before the session starts. They’ll know what the game plan is--the program goals, the expectations. They’ll receive background information about incoming students. They’ll be given copies of IEPs for students who have them.

No more: “This isn’t special ed! She can’t be here!”

No: “If you want the teacher to know Natalie has an IEP, give her a copy yourself.”

Although only time will tell how this plan will play out in reality, I trust Teresa’s intentions. Natalie will know I’m sincere when I reassure her about school; calm her anxiety, address her fears. I can relax into summer, after all.

Hey, Teresa McCune! I just caught you being good!

No ADHD Med Vacation for Us

For some kids with ADHD, summer vacation brings a break from ADHD medications. Not at our house!

Today is the last day of school for my children. They gain their freedom this afternoon, and I lose mine! Sigh. No, it’s okay. I’m really looking forward to this summer--my first ever, as an adult and as a mom, that I won’t be working outside the home. I want to lavish attention on my kids, spend endless hours at the pool, be a cool mom during the hot days of summer.

For some kids with ADHD, summer vacation brings a break from ADHD medications. Not at our house! It’s clear that Natalie needs medication year-round. After all, taking medication helps Natalie with much more than just concentrating in school. My guess is that only a tiny minority of kids with ADHD--probably the “H”-less ones--can really thrive while taking a medication vacation.

I’ll never forget a conversation I had with our pediatrician when we first talked about starting Natalie on Ritalin. She said that when considering whether or not to treat a child’s ADHD with medication, parents should assess how the ADHD symptoms affect the child not just at school, but in all areas of life. Take social interactions, for example.

During the tough months of med adjustments we went through last fall and winter, Natalie’s classmates noticed that her behavior was different. She was up and out of her seat a lot. She impulsively grabbed their stuff. After things settled back down for Natalie, med-wise, her teacher commented that her relationships with peers improved also. Those relationships are huge to Natalie. She’s so sensitive to kids being “mean” and seeing her as “different”.

If you’re planning a summer getaway with your family, you’ll compare hotels for cost and amentities, won’t you? Or weigh staying in a hotel vs. camping; gas prices against the cost of flying.

In the same way, compare the cost and the benefits when considering whether or not to give your child with ADHD a summer medication vacation.

Respite from ADHD Parenting

Everyone in our family benefits from time away from the demands of parenting a child with special needs, to rest and recharge.

As parents of kids with ADHD, we try to reinforce positive behavior by catching our children being good; making good choices, behaving in a positive manner. Since I’m sometimes quick to criticize the individuals or institutions that work with Natalie, I thought it was time I caught them being good too! So, in that spirit, I’d like to commend the developers of Iowa's Children’s Mental Health Waiver for allowing recipient families the option to choose their own respite providers.

Through the Waiver, our family is allotted a certain number of hours per month of respite; time away from the demands of parenting a child with special needs, to rest and recharge, and in our case, to devote some time and attention to our non-ADHD son, Aaron.

For Natalie, it’s a chance to escape from her crab-apple mom, and to receive positive, one-on-one attention from other adults.

Natalie has some problems with separation anxiety, so time away could easily be a negative rather than a positive, in her mind. In an effort to make respite as pleasurable for Natalie as it is for me, I hand-pick the adults who care for her. Right now, we’re blessed to have four fantastic people registered with The Respite Connection, to work with Natalie: Natalie’s Aunt Ann (my older sister), Natalie’s cousin Hannah (my 20 year old niece), Natalie’s former daycare teacher Allie, and Nat’s former occupational therapist, Summer.

Summer joined the crew most recently. After cutting back the number of days she works in order to spend more time with her toddler son, and after Natalie’s discharge from services negated issues with professional boundaries, Summer said she’d be open to providing some occasional childcare. Her son would enjoy having a playmate, she said, and she could earn some extra money without taking time away from him. How about providing respite, I suggested. She talked it over with her husband, researched what it would take as far as training and time commitment, and finally applied. Natalie spent the afternoon with Summer and her family on Sunday, for the first time, and had a fantastic time.

“Did you like playing with Emmett?” I asked. “I LOVE Emmett!” Natalie replied.

Two members of our family, a much-loved young teacher, a skilled, caring professional--we couldn’t be luckier. I couldn’t possibly feel any better about how Natalie spends her time, or with whom she spends it, while our family takes time for respite.

So, many thanks to the folks at the Iowa Department of Human Services for allowing me to choose people who Natalie already knows and loves to provide our family’s respite. You’ve been caught being good!

Omega 3s and More

The triggers, and therefore the treatments, for ADHD acting out are probably as diverse as the children who experience them.

I appreciate the comments, both posted and private, to my post, Reacting to ADHD Rage. Rob recommended articles by a behavior therapist. A friend recounted privately via e-mail that for her child, Risperdal did the trick. And did you read Jaydra’s comment? She’s a child behavior expert, but when her own son flipped out she wasn’t able to reach him. Jaydra says that low blood sugar and low serotonin levels turned out to be her son’s curse; addressing those issues his cure.

The triggers, and therefore the treatments, for ADHD acting out are probably as diverse as the children who experience them. I know some of Natalie’s triggers; hunger and anxiety. Hmmm, that sounds a lot like what Jaydra said. Low blood sugar? Check. Low serotonin levels? Well, SSRI (Selective Serotonin Reuptake Inhibitor) antidepressants are sometimes used to treat anxiety, and they’re all about serotonin, aren’t they? Maybe Jaydra’s on to something.

So, the question is, how do you raise serotonin levels? Heck, I didn’t know! So I googled “serotonin deficiency”, and guess what came up? Fish oil; omega 3’s. Hmmm. Rings a bell!

I have given Natalie omega 3 supplements before, but lately, had forgotten to do so. So, to the cupboard I went, and there they were waiting. I’m back to giving Natalie her supplement each day. I buy L’ilCritters brand Omega-3 Gummy Fish: Smart Gummies For Smart Kids. Each two-gummy dose contains 120 mg of omega 3 fatty acids; ALA, DHA, and EPA.

At this point, I’m finding all the articles and advice about supplement types and recommended dosages mind-boggling! Fish oil capsules, or omega 3 supplements; ratios of DHA to whatever.

So, until someone can tell what the ideal product is, and the ideal dose, I’m calling the gummy fishies good enough. After all, Natalie likes them. And I bought fish oil capsules for myself, toward my goal of curing my ADHD by Proxy! I’m back to taking my vitamin and mineral supplements, too.

Between protein buffering to level out Natalie’s blood sugar, fishies for her serotonin, and working on her self-talk to manage her fears and anxiety, I hope that this summer, in this family, instead of ADHD acting out, peace will be all the rage.