One of the doctors that I work for has a daughter who has been diagnosed with Inattentive ADHD (ADHD-PI). This physician does not have Inattentive ADHD but she reports that her husband, who is a Mechanical Engineer, probably does. Their daughter is in private school and is now in 5th grade but ever since 2nd grade the child, who I will call Jenny (not her real name) has been falling behind is her school work. She did not catch on to reading right away. She would come home from school upset because she said that she was always the last kid in the class to complete her math work. She would frequently not have a clue what her assignments were and her teachers reported that for most of the day she was off in her own world.
Jenny was the eldest of three girls but her sisters seem to be much more mature and 'with it'. Jenny had few friends while her sisters had oodles of play dates on the calendar. Jenny was happy to play in her room for hours with her American Girl dolls, her sisters preferred to play with other girls in their school. Jenny loved helping her mom bake or garden but her mom reported that she became distracted after about 5-10 minutes of any activity.
This family tried many things to get Jennie more focused. She had tutors and Learning Specialist who worked with her at school but she made little progress. On her annual trip to the pediatrician in the third grade, Jennie was diagnosed with ADHD. The pediatrician gave the family a prescription for Ritalin LA 10mg. Jennie's parents were reluctant to fill the Ritalin prescription and instead had Jenny seen by a Child Psychiatrist.
The family saw a respected Child Psychiatrist who thought that Jennie had ADHD-PI and recommended that she be started on 18mg of Concerta. The psychiatrist explained to the family that the best course of treatment was probably a stimulant in combination with Cognitive Behavioral Therapy (CBT) and gave them the name of a therapist in our area.
The family was reluctant to fill the prescription and decided to try CBT prior to trying the stimulant therapy. The CBT treatment seem to help Jennie understand the nature of her problem and Jennie, now in fourth grade, though still struggling at school, seemed to be trying out strategies to stay attentive.
One day Jenny came home and said that her class was doing a play and that she had been given a speaking part in the play. Her mother was ecstatic. Maybe she was outgrowing her ADHD, her mother thought. Jenny tried to practice her lines. No matter how hard she tried, she could not seem to remember the few sentences that she had to say in the play. Jenny's mother spoke to me about her daughter right about this time.
I told her about my blog, about my son and about myself. I explained to her that coffee helped my son and I and that she could give that a try. Jenny's mom responded that her daughter was terribly picky about food and that it was all but impossible to get her to eat or drink anything other than a few favorite foods. I told her that my youngest son, the Hyperactive Impulsive ADHD son, was exactly like that and that I could relate to how difficult it was to try get him to eat anything other than the 'acceptable' food on his very limited food list.
The premier day of the play came. Jennie could not remember any of her lines and she stood on stage looking down on the ground as if frozen. The teacher came on stage and said the lines and the performance continued but Jenny was devastated. She cried after the play for over an hour. Her sisters stayed away from her which only made her feel worse and Jenny said that she was too 'sick' to go to school the next day. She kept saying that she was the stupidest girl in the 4th grade.
Her mother decided that day that she needed to do more for her daughter. She went to Walgreen’s and she filled the prescription for Concerta that the Psychiatrist had written. She explained to Jenny that she had Inattentive ADHD and that the medicine would help her with her attention and with her memory. She told Jenny that she did not have to go to school that day but that she was going to stay at home and try the new medicine and practice the lines that she had to recite for the play. The second and final performance of the play was to be on Saturday night, three days from the premiere.
The Concerta was a miracle drug for Jennie. Within hours of taking the medicine, Jennie had learned her lines and was reciting them, by memory, easily and happily. Jennie's teacher called and spoke with Jennie and her mom. She assured Jennie that kids forgot their lines all the time and that no one would tease her when she came back to school. Jenny 'nailed' the second performance and has done beautifully ever since. She is now getting straight 'A's in school. She has a friend at school that has come over many times and Jenny's mom reports that Jenny's sisters have begun 'sharing' their play dates with Jenny as well.
I share this story because I believe that the stimulants are often necessary and a 'life saver' for kids with Inattentive ADHD. I see much more of Jennie in me than I see my son in me. My son was an early talker, an early reader, and could do multiplication as a four year old. I was NOT that child AT ALL. I could not read well until I was in 8th grade. I hated and did poorly in math, my writing was illegible and mostly unintelligible and I felt like I was the dumbest child in the entire school. To make matters worse, I had no school friends, only neighborhood friends, and my siblings were embarrassed to have to admit they were related to me. I believe that, at Jennie's age, I probably would have greatly benefited from some Concerta or other stimulant therapy.
I think that it is possible to come through a rough school age life and be successful but I also believe that kids like Jenny will be more likely to succeed if they are given medication. This is especially true when a parent has exhausted all other avenues and nothing else has worked.
This is so interesting (all of your posts are). My 8yo daughter has a prelim diagnosis of ADHD-PI. She is begging for the neuropsych appointment as soon as possible because she is starting to feel like she can't focus or concentrate (and saw herself in some of the stories you've written here, as well as in a book her teacher reads to the class with a boy with ADHD). We don't know what will be recommended for her, though we, too, are hesitant about medication. (I'd take it for myself! But, it's harder with a child.) She is very social, always has been (makes friends at the beach and playground, has great friends at school and camp), but I wonder as time goes on, if things would change.
ReplyDeleteBeth
kids with Inattentive ADHD are often very intuitive and self aware. I just heard, in a private email, of a reader whose seven year old grand daughter has asked to be given help to help her focus. The girls parent were hesitant to ask the school for help and were hesitant to medicate her (in her case the caffeine did not help). They are now going to get her the help she needs because the girl has told her parents that she wants it.
ReplyDeleteChildren often take the lead in their own care and with this happens I think we are obliged to listen.
Thanks for your comments! Tess
My daughter has not been diagnosed yet but everything in your blog describes my daughter. My daughter has trouble in school with all subjects. In school she was tested for dyslexia in second grade because she had trouble reading. The said she did not have dyslexia because her problems are on all subjects all around. Comprehension seems to be her problem she will read something but does not understand what she is reading sometimes. She also has trouble remembering things. More tests have been scheduled in Feb. to see what is going on. I just started giving her Nordic Naturals Omega 3-6-9 vitemins that are said to boost concentration and memory because I'm also hesistant about medication. Thanks for sharing your story it was very helpful.
ReplyDeleteYou may want to try a little coffee of coca-cola with caffeine to see if this might help a bit. Make sure she is getting enough sleep and that she is getting enough protein. Also a multivitamin with at least 12.5mg of zinc is helpful.
ReplyDeleteLet me know how it goes and thanks for your comments!
This brought tears to my eyes. My son has been diagnosed with ADHD-PI by a licensed psychologist. We took him to a psychiatrist with the report from the psychologist, hoping that at long last we could find help for my son, who is sweet and kind and smart but who is falling further and further behind in school, much to his dismay. The psychiatrist told us he MIGHT consider prescribing Ritalin but only if my son became disruptive in school. My son has never been in trouble in his life. We don't even have a discipline system at home because he is a good kid. Our insurance company will not allow us another visit with a different doctor. I'm going to try caffeine and also the vitamin supplements you recommend. I'll do anything to help my son. I just wish I knew how to convince him that he is smart and can do anything in class that his peers can do.
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