Q:
Am I in denial, or this behavior is not an ADHD?
I hesitate to take our son to a doctor specializing
in ADHD for fear that he may fit the mold and be diagnosed
with something he may not have. He is fidgety at home, and
we do have to remind him to do something we've asked him
to do...but we have to do that with our other children also.
He is not at all defiant; he is a very loving, sweet, considerate
little boy. At school they say he won't stay seated and
that he has difficulty staying on task. We don't see that
at home. He sits through 3 hours of church on Sunday without
a problem. We have observed that all three children get
overly hyper around new people and that they all tend to
see what they can get away with when they are babysat, etc.
His reading teacher at school says he climbs all over the
chair and is constantly in a hurry. When we sit down to
read to him, we see nothing like this. He loves to read
and is very excited when he is able to read a difficult
word and often grabs me and hugs me and kisses me on the
cheek when he gets one right, but other than that we have
no climbing or off-task behavior. Again, we don't deny he
has some traits...but we feel they developed from his earlier
childhood. And he is still emotionally younger than his
age, as well as the fact that he had no discipline or structure
up until we adopted him a month shy of his 6th birthday.
The school is pressing for us to have him professionally
evaluated and put on medication. We are leery about the
medication part of it. He has progressed in his behavior
to being sent to the vice-principal. I'm told that with
the next occurrence, he will be suspended for 1 day. Now,
this is not defiant behavior, bullying, stealing, hitting
or hurting someone at school. His behavior issues are strictly
that he gets out of his seat and talks out of turn. I'm
going to sit in on class this week and see what really happens.
Although this would be annoying behavior...I can't imagine
suspending a child for a day because of it. I know the school
thinks we're in denial but they have had no experience with
IA children and I just could not seem to make them understand
there may be other issues involved.
A:You are concerned about school's personnel
jumping to the conclusion that your son has ADHD and will be put
on medication unnecessarily. It is certainly a valid concern.
Your son's behavioral problems in school may be caused by a variety
of factors that might or might not include an attention deficit
or hyperactivity. I think that it is important to have an evaluation
done by a developmental psychologist or pediatrician. They will
provide questionnaires both for the parents and the teacher, which
will be part of the input for the evaluation. Before the diagnosis
of ADHD can be properly made, there needs to be evidence that
some of the behaviors occur in at least two different environments
(e.g., school and home). There are also computer-assisted tests
that can help compare the child's attention span and impulsivity
against established norms. If your son's issues in school stem
from some other source, such as learning disabilities or difficulties
with social adjustment, they also need to be identified as soon
as possible.
My experience is that many of the hyperactive and disorganized
behaviors that we see in post-orphanage children have been developing
differently than they do in general population. One thing that
most internationally adopted children have in common is a total
lack of experience with emotions regulation. In normal development,
caregivers respond to infants' distress and assist them in the
management of negative emotions. Language also plays critical
role in development of self-regulation, because it allows children
to gain control over their feelings and helps them inhibit impulsive
responding and behave in a more organized way. I would recommend
including a social-emotional learning component and language treatment
into the remedial plan for your child.
