Possible Impulse Control Issue or ADHD

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      I was hoping to get some thoughts on my 7 yo son. He has been seeing a counselor since last summer once a week. The counselor was at his school during the school year but he sees her at her private office in the summer. This past week she gave us the forms to fill out for ADHD evaluations and had us drop the forms off to his teachers as well. She believes he has impulse control related ADHD.

      Here is the background:
      He has issues with changes in structure. He strives in a structured situation. But change from school to summer camp (@ school) and incidents happen. When he gets in trouble during the school year it is in recess or art or other unstructured situations/classes. He is well above his grade level. In first grade he was reading on a high 3rd to low forth grade level. Math and other school subjects are easy for him. He had straight As last year, but never made straight A honor roll because he always got Bs in conduct. Basically 2 behavioral issues in a week, talking out of turn, hitting, saying something rude resulted in a B in conduct. Most of the conduct issues I viewed as minor.

      But once about every 4 or 5 months there is a major outburst incident. During the incident he will argue with the teachers or say or do something very very inappropriate, whether its hit someone, say something very mean, etc.

      All my friends, including those with kids on ADHD meds say they see him just being a 7 year old boy.

      In addition to being smart, he is very competitive. That causes some issues with other type A competitive kids. The principal said she thinks they are each trying to assert their position in the pecking order. Whose the fastest, whose the best at baseball, etc. To me all this is normal.

      At times he says mean things to other kids, perhaps he feels some way and calls someone stupid. Or he is trying to be funny (to get people to like him) and says something very inappropriate. This causes him to have issues with friendship. He comments that so and so doesn’t like him. He wants to be everyone’s friend and it truly bothers him when people don’t like him. But what he sees as funny or defensive drives people further away. This isn’t to say he doesn’t have friends. Many people like him because he is great at sports and is an asset. But at the same time, 3 days later, they don’t like him or don’t want to play with him because he did or said something.

      My Concern:
      His behavior is not THAT bad in my opinion. I don’t want to start him on a medication and then find it didn’t help, take him off, and have some neurological change that makes him worse than he was before we started it. With the outburst being limited to a few times a year, I feel that is manageable. But if the medication would help him with friendships, which the counselor claims it should (her youngest son had the exact same issues mine does, and she wishes she had started him earlier than 5th grade on medication). Because of him being smart, a leader, and very competitive, it puts him into social situations, I never had to deal with. I had one or 2 friends my whole life and thats exactly what I wanted. He does Brazilian Jiu Jitsu (year round), Gymnastics (school year), Baseball (spring) and football (fall). He is going to be working with large groups of kids through high school most likely and I would love for those interactions to be easier for him. But I find it hard to justify the risk for just that reason.

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