Binocular Vision Test & ADD

Has anyone taken their child to UC Berkeley's School of Optometry for a Binocular Vision Test recently? Planning to take my 6yr old daughter there. Her school had a doctor from UC Berkeley who did the eye exam and had mentioned about Binocular Vision. I've taken her to my regular eye doctor, who said she was fine. She?s not doing academically well in school, so trying to see if there's any relation in vision. I took her to the doctor and was diagnosed with ADD, just by the questionnaire completed by the parent and her 1st grade teacher. That?s it? Just by a questionnaire? Does anyone know what other tests there to test her? I?m not sure what direction I should start looking into. I've written an email to her principal to see if the school psychologist can give her a test. My daughter now freaks out when you tell her to do homework and hates school. She use to love preschool & most of Kindergarten. Sylvia

The binocular vision testing is very thorough and somewhat exhaustive at UCB, and they have a pleasant manner. The multiple tests look for any problems with visual perception. My son tolerated the tests well, as UCB works well with kids. Good luck

As for ADD... it is not uncommon for children to be diagnosed using no other measures than a survey. Sometimes if it is done by a school psychologist the child is also observed in class. I've spoken to one who recommends brain scans, though I haven't had a chance to persue how one would get that done. We waited about two years to do anything about our son's diagnosis... it seemed arbitrary at the time, borderline at best. The psychologist who presented the results had no credibility since she couldn't even read the graph to us correctly... So we decided to wait and see. This year it became obvious that the other kids aren't ''just like him''. It was impacting him socially and acadmically and really hurting his self esteem, and since we'd tried addressing evey other issue we decided to start medication... it has made a world of difference already and we aren't even through experimenting wiht dosage to see what is best. Still trying to figure it out

With regard to ADD, just a couple of questionnaires seems like an incomplete diagnosis. That would work as a screening test -- saying that your child needed further evaluation, but not as a complete diagnostic tool. It seems like you might want to consult with a developmental pediatrician, developmental psychologist, and/or the school psychology team at your school (you can get an evaluation through your public school by formally requesting it, and I believe it must occur within 60 days of the request). They usually do a very thorough testing of your child, including IQ tests, academic tests, classroom observations, as well as questionnaires.

In terms of your child hating school, some of it may be a mismatch between how she learns and the teacher. You might want to do some talking to other parents who have spent time in the classroom to see if there's been any friction between your child and this teacher. My child had trouble with the teacher in one particular grade, and it was a total nightmare, for him and me. Since then, however, he has done very well, loved school and the teachers, and all has been well. Karen

ADD or just 7-year-old phase?

My 7-year old son has always been ahead on the learning curve, was an early reader, has great fine motor skills, and good focus. Recently, however, he has been having trouble comprehending instructions at school and at home, and can't seem to focus on any school related tasks (he does fine when playing). He is struggling in school and with homework, and seems to be forgetting even the simple things he has known for years. His teacher is concerned that he has ADD. However, he can focus intensely for long periods when doing legos, drawing, or doing other non-academic activities. I get frustrated helping him, because it seems like no matter what I say to help him he doesn’t grasp it (and being frustrated with him clearly doesn't help him). Should I be concerned or is this just a 7 year old phase? confused and concerned

6-year-old shows signs of ADD - how to help him?

I have a wonderful little boy who just turned 6. Since he was in preschool teachers have been quick to mention they think he has ADD. I've been reluctant to jump to this conclusion because of his age. Boys tend to mature slower and be impulsive. I spent some time volunteering in his Kindgergarten class and quickly noticed that my son was not as ''engaged'' during reading time when the teacher was talking or singing, had a hard time staying focused on his work, and was doing very poorly at socializing. I had some talks with his pediatrician over the symptoms and even though they do not generally diagnose them until they are 8 he is showing signs of ADHD. Here is where I am stuck. He is 6. He is a boy. He is above grade level in math and reading. So, there is not a learning disability, but he is really struggling with his actions (he tends to have poor impulse control), his transitions in the class are very difficult for him, he keeps telling me that ''he was in class and his mind made him think of (insert 50 random things here)'' and that he struggles with concentrating. I was amazed that he was able to communicate that with me. Although, it means that it was on his mind too. I'm careful not to mention things in front of him. I don't like labels, and I don't want him to label himself either. I want to know what I can do to help him, but not overhelp him. I'm not sure if he needs a 504 plan. I'm afraid of him getting labeled and having that carry over and the teachers discriminating against him because of it. Or, him being singled out in some way and not feeling like part of the class. I'm really confused because, having not been through this before I have no idea what to expect, what works, or what else to try. This is where I plead for help. Any advice will be consumed and devoured. I want to be my child's advocate. I love him dearly and want him to succeed in life. It just takes one step at a time. eastbaymom

Anyway, so we took him to see a developmental pediatrician whose advice to us was to hold him back from Kindergarten or have him do it twice, so that he could catch up developmentally to where he is intellectually before he hits 1st grade. We don't want to hold him back or have him repeat K twice, so we're exploring a middle ground - montessori. Montessori schools don't have grade levels per se, and the curriculum is child centered. This means that the teacher will assess my child and provide him with curriula that challenges and interests him. It also means that if he has to do an extra year of school before Kindergarten, it won't be weird for him. He won't be held back while the rest of his friends go off to the next grade.

I wish you well and good job for trying to figure out alternatives to having your child diagnosed with a learning disability - especially since it's possible that he just needs a little more time to catch up socially. anon

By the age of six, you can certainly have him tested. This is really the first and most important step. A professional can sort through the difference between ADHD and just a ''boy.'' In our case, it was very clear cut and almost off the charts. We retested at age 9 with a different person and same results. In our case, medication was and is essential for daily functioning. There is so much to read and so many options. Medication isn't the only option, but it is often a part of an overall solution. My son really didn't know a label until quite recently.

However, we have worked with his teachers very successfully since 1st grade and they have known of the diagnosis. Overall, better for them to know and work with it than not (although I struggle with the same concern of labeling).

If it turns out that he does have it, there is lots of help out there for both of you. They say one out of nine kids may have this. Maybe environmental? In our case, both the dad and grandmother clearly have it, so genetics is at play.

My main advice, get into the subject. Find out what he really has and then you can create your game plan. Good luck! Anonymous

I've been through this with both of my kids -- it's expensive, but well worth it. My son was also 6 when issues arose, we had him evaluated, it was ADHD plus other things. My daughter was also evaluated a couple of years later -- no syndromes, but we got great input from the psychologist on how to parent this particular child.

I would recommend Dr. Carina Grandison (sp?) at Children's Hospital (she evaluated our daughter). anon

After numerous discussions with our pediatrician, we took our son to a developmental pediatrician for evaluation. Honestly, this wasn't terribly helpful and cost a lot. We learned our son has some of the qualities of ADHD and Aspergers kids, but did not receive a firm diagnosis - he's borderline. The pediatrician confirmed our concerns and observations about our son, but didn't add much to our understanding of his behavior or approaches to handling it. Although, she did make us aware that impulsivity is an element of ADHD and can contribute to social difficulties.

We ended up having our son assessed by our public school speech therapist (for language pragmatics/social skills) and occupational therapist. Some of the assessment was observation or in-class and some out of class. The speech therapist worked to minimize the loss of class time. The kids in his class don't seem to view visits with the speech therapist in a negative light. The results of the assessment and IEP were not surprising, but thorough and provided measurable goals. My child was recommended for the gifted and talented program and other services to address his social difficulties. We weren't pressured to accept any services. I am finding that the assessment and IEP are a good place for us to start conversations with my son's teachers. They lend legitimacy to the idea that my child needs support socially and behaviorally. I spoke with a number of teachers about the possibility of stigmatizing my son by putting him into the school evaluation system. They all felt that he would not be harmed or stigmatized by the process and so far, that has been our experience. Overall, I'm happy with the public school process and found our speech therapist to be a good advocate for our child.

We also are planning to have our son attend a private social skills group this year. They do their own assessment of your child. Although we haven't started the weekly classes, I have been thinking that I wish we would have started with this approach. They would have told us if he needs more, less, or different help. And, we would have started working to build social and behavioral skills immediately instead of doing so much evaluation. Good luck. Anonymous

Has anyone heard of inattentive ADD disorder?

I was in my salon the other day and spoke with someone who has a daughter with the same type of problems as my daughter. some were your typical, but some hit right on the mark. She said her daughter was tested and was found to have inattentive ADD disorder. She was givin meds and went from a majority of D's on her report card to A'S. Any input or Recommended physicians who specialize in this hard to detect type of ADD. Ray

Non-medical remedies for 9-year-old's ADD?

I would like some advice on hermal remedies for a 9 year old diagnosed with add. We have evaluated her, and a very conservative doctor diagnosed her add and wants to medicate her. I have battled with the thought and have finally come to the conclusion we need to do something. We are tutoring and helping at home all the time. I just can't bring myself to do the drugs. When she was little she was harrassed by my husband for not eating well(he's greek) and since we've had her tonsils removed, she eats great now, but is now calling herself stupid. The biggest side-effect to all the add drugs is loss of appetite. Other than the fact that I don't like the idea of my child on a narcotic, even if I could do that, I don't think she or I can deal with her not eating again and the negative effects on the household. Hopefully, being from the Walnut Creek area, all you great Berkeley-ites could recommend some herbal remedies? At my whits end

If she is concerned about being ''stupid'', stimulant medication is much more likely to help her to change this self-perception than any herbal remedies are. And please remember that herbal remedies have psychotropic effects too (which is why they would have any impact at all), but they are generally untested in terms of their effectiveness and side effects. Also, FYI, ADHD is never treated with narcotics. It is typically treated with a stimulant. Stimulants are very short acting and are not addictive. That means within a matter of hours you should see a positive effect on your daughter's behavior and there is little risk to a short-term trial (e.g., a few days). If stimulants aren't effective or if the side effects are intolerable, you'll find out very quickly and can discontinue medication. Good luck! I know you have a difficult decision to make. Liz O.

So I absolutely, positively know where you are coming from and you were totally right to try behavioral modification first (and as well as anything else). BUT... your daughter is coming up on the age when start falling off rapidly in school if the situation is not corrected. I also have an adult friend with ADD who says, ''Even with their side effects, finding a good drug -the right drug- was heaven and made my life so much easier.'' Since you say your doctor is conservative --by which I hope you mean she doesn't prescribe at the drop of a hat-- I really urge you to send your husband to the doctor with your daughter to be educated on the issues... and then try the drugs. They are not forever, they are not all the time, and if they don't help you can stop.

It always bothers me that folks are willing to try herbal remedies that have not been tested and are often not administered by a licensed practitioner. We are, after all, talking about a herb that will affect brain chemistry! Why should it necessarily be better or safer than taking a known quantity in a pill?

As for my own daughter... she's in high school now and found her own solution in a strenuous sport plus the maturity to stay on fixed, regular schedules. But it required a LOT of parental committment and I still think we were awfully, awfully lucky that we were able to keep her on the educational bandwagon until that happened. ADD Mom

''Stupid.'' It is very easy to absorb the messages coming from doctors and schools that there is Something Wrong with you. Your girl seems to have learned some of these lessons already. Then comes that cycle where, the more you tell her she's not stupid, the worse it gets. I don't think there is anything Wrong with your daughter. I feel it is key that you create an atmosphere which lets your daughter be smart, and for that to happen, you and your husband need to believe it first. So she learns differently from other kids. So what? I'm sorry that it's hard for all of you right now, but ADD is not so bad. The real danger is that she hears ''there's something wrong with you'' and ''take this pill, it will all be better". I think that's a very dangerous lesson. Instead, what helped me was: ''of course you're smart and capable. Now let's figure out a way so you can show everyone else.''

I think it is great that you recognize the need to help her, but I would try a lot of other things before the drugs:

* More structure - having blocks of time assigned on a chart for different homework was helpful.

* Move! Get up, jump, chew stuff, walk around the room, whatever; it really helped me focus. My parents fixed it so that I was allowed to do this in class, too - great!

* Rewards for increased independence. My parents helped me a lot, but weaned me by letting me know (gradually) that I was smart enough to work on my own. Then they just became the homework checkers.

Maybe you could try to find some physical outlet for her, like a sensory gym where they allow kids to race around and pillowfight, and such. Those are great.

Best of luck to you, and may you never lose patience with your bright, beautiful girl! Fine Then, Better Now

One dose of appropriately prescribed stimulant medication will do more to eradicate your daughter's sense of being ''stupid'' than almost anything. My daughter's life was changed with the first 15 mg dose of ADD meds... when she was 15. Within an hour she knew her ADD was real, and could be harnessed --- and for the first time she really believed she wasn't stupid... even though we'd been telling her for years that she was smart. She has taken meds continuously since then, but not every day or all the time. As her study skill improve and her impulsivity declines I predict she will not take them anymore...maybe 2 more years.

If we'd known about the ADD when she was 9, we would have done the same thing then, instead of 6 years later...

For me meds for ADD are like eyeglasses for myopia -- I would be cautious about getting the safest glasses I could and the ones with just the right prescription -- but wouldn't deprive my child of glasses because they might have unwanted side effects.

I understand your concern, but weight loss or loss of appetite aren't always side effects, and there are ways of dealing with either one if it happens. ADD mom of a (smart!) ADD daughter

7-year-old's ADD diagnosis and what to do about it

My 7 yr old first grader has been given a definite diagnosis of ADD Inattentive. My son is a highly compassionate, fun loving, creative ''space-cadet'' type, who gets along with all his peers. All the adults he interacts with think he is a delightful child, including his teachers. I would not call him hyperactive, although in a classroom setting he fidgets and seems unable to stay focused on classwork. The only challenges we have encountered with him are in the classroom, where he seems unable to stay on task.

The doctor who evaluated him did not observe any learning disabilities, and seemed very convinced that a 5mg dose of Ritalin would greatly help him during those morning hours in school. His learning would improve and we were not likely to experience any negative side effects. We obviously want the best for our child, and it seems to us that if this is the case, if medication will give our child an immediate benefit, that we should start treatment now.

I should note that the teachers and administrators at my child's school have been very helpful and supportive, and they have already taken (and will continue taking) all kinds of remedial measures to help our child in the classroom. However, there is only so much that they can do, and they have expressed concern that in later grades, when the learning is more challenging, and the workload is greater, our child will become frustrated and his self-esteem is likely to suffer.

My question is to parents who have a child with similar characteristics diagnosed with ADD: Did you try medication? Did it help? What were the negatives? I am especially interested in hearing from parents who decided to wait a couple of years: Do you see the benefits of having waited?

I know there are a lot of horror stories circulating about Ritalin, and I am not interested in hearing about this, unless you have had direct experience with your child. Also, please understand that we are not parents at the end of the rope who are desperate to fix some behavior problems, this is not the case. We have been told that the most effective treatment bar none for our child's problems is medication, and we are wondering if there are any reasons why we should delay it.

Thank you! Anon

At your son's age organizational or occupational therapy might be great -- but I would not hesitate to give a 7 year-old the ability to be ''like everyone else,'' and that's what Ritalin has done for us.

I tell people that stimulant meds for ADD are like glasses for myopia... some folks do fine without them...if they're only slightly out-of-focus to begin, and can develop coping skills to deal with their challenges. No questions here!

Although his teachers have consistently remarked on his attention issues, I resisted having him tested for ADD, in part because I was/am dubious about pathologizing what seems to be a common and benign characteristic -- i.e. dreaminess. Because S was basically mastering all of the skills he needed to until this year, I hoped that he'd learn to pay attention better as he grew up.

Fourth grade was a tough transition. As he is in public school, his class went from 19 students to 27. Assignments, both in class and homework, became more demanding, requiring more sustained effort. For the first time, S became conscious and bothered that he was not performing on some assignments as well as his friends. His self-esteem was plummeting during the first semester, especially as his teacher was big on timed arithmetic tests, which he found excruciating. He broke down on several occasions, telling me that he was going to flunk 4th grade.

So, we had him tested and diagnosed in November. His teacher made a bunch of accommodations, which have helped, but she says that he's shown marked improvements on math and writing since we began the Ritalin in February (confirmed by my own ''blind'' test - a series of math quizzes on and off the meds).

I'm not crazy about my kid being on a stimulant, and I am comfortable that we waited until the attention issue became a self-esteem issue for him. If we could afford to send him to an arts-oriented school with very small classes geared towards dealing w/ kids w/ ADD, I'd probably do it. Reality being what it is, I've accept him being on the meds because his attitude about school has improved dramatically, and he is now keeping up or excelling in each subject. (BTW, he started on 10 mg, which did nothing. He is now taking 15, which works fine.) Another mom of a space cadet

Just remember it is called a drug TRIAL. You TRY the dosage and drug on your child to OBSERVE if it makes a difference. You get your child's teachers to fill out an ADHD questionnaire (like the SNAP) before medication has begun and then at the end of the 1-2 week drug trial so you have an objective measure (although it may be obvious that it helps or does not help). Your son sounds pretty insightful so you can also ask him how it makes him feel. Ritalin is a short acting drug that will leave your child's body FOREVER after about 8 hours. Giving your child a few pills is NOT like deciding to do some type of irreversible surgery. If you do not like the drugs, you will have the power to STOP or try a different dosage/type. If you decide to stay on the medication then every year or so you will see what happens if you stop the drugs and in order to decide if your child still needs them.

I am sorry if I seem impatient, but I have seen this question so many times and I really do not understand why people are so hesitant to just TRY something. I do not see what the costs are in terms of trying this drug--it is completely reversible. I think that there is so much angst about medication for mental conditions and some hidden fears of addiction that people do not realize this is NOT really a big decision. You are not getting married to Ritalin, you are meeting briefly for coffee!!! Then if things work out you will date a bit while constantly re- evaluating your relationship!

My one caveat is that you do need a doctor who knows what they're doing and is going to be systematic, knowledgeable and objective about what is really a PROCESS. The MD shouldn't just throw the prescription at you and run. They've got to check in with you and follow up and keep tabs on your kid's growth. best wishes

1. Local resources: local CHADD chapters, support groups etc etc can be found at http://www.chaddnorcal.org. It's a great starting point and you will be welcomed at our meetings!

2. Information: there's a lot of misleading information and scare stories out there. I'm an engineer and like to understand how things really work under the hood. The best book I have read which has real, hard research-based information is by Paul Wender ADHD: Attention-Deficit Hyperactivity Disorder in Children and Adults. Oxford University Press, 2002. It goes into the neuro-chemistry, clinical case-studies etc.

3. Meds.

* I take meds every day and they're helpful.

* Delaying meds will not *harm* your son.

* Ritalin may or may not be the *right* medication - it did not work *for me*. If it makes a positive difference, great. I had BAD sides effects with Strattera which, anecdotally, are experienced by many males although denied by the pharma company. The only times I ever got driving tickets was when I was prescribed amphetamines.

* Meds ''the most effective treatment bar none''? This underestimates the significance of complementing with non-medical support. In my and my friends' experience, meds alone are NOT enough, and you may need to experiment with various organizing strategies and techniques. If you can get him into various habitual daily rituals (making lists and checking them) it will make a huge difference, especially when you and supportive adults are not around.

4. In my experience, many non-specialist educators and medical staff talk very knowledgeably about ADHD although (a) their knowledge comes from third-hand sources and (b) is several years out of date, typically gained through CE credit courses.

5. ADHD is a gift as well as a frustration. Find ways to exploit, develop and enjoy the positive and creative and fun sides of ADHD as well as 'fixing' the disadvantageous side-effects. This will help your son It is important to understand that your child does not have a problem, but a condition. Steve

Two kids with ADD/ ADHD - need meds?

Both of my kids, now 7 and 8 (20 months apart) have been little handfuls since birth- very active, very verbal, very intense, very creative and very bright. In fact, they were great babies, and we gave ourselves all the credit for raising them ''right''. Both of us parents were similar as kids and it was not thought to be more than a strong personality. We used to joke about ADD, but imposed as much structure as possible and learned to enjoy the chaos...then they started school. Both have problems there, primarily impulsiveness and emotional reactivity. One is gifted based on testing and off-the-charts active, the other distracted, dramatic and dreamy. After one too many discussions with schools, we started family therapy directed at behavioral modification (1-2-3 Magic, etc.) and have instituted every nonpharmacologic approach to ADD on the books. I am a researcher, but I have even done things that have no proven benefits based on research, such as limiting sugar.

Nothing is working for school and whenever we go out to public events (BD parties, etc get them overexcited) although their behavior is markedly better at home. I have tried to think of their ADD as a personality type that can be adaptive in many ways. I work with alot of successful adults who were hyper kids. I cannot seem them as ''diseased'' or having a brain disorder.

But we now are beginning to understand why people medicate their children like ours- the reaction of teachers and other kids and their parents to them causes us and the kids alot of anguish. People are quick to assign blame. It's assumed we do not discipline our kids (and yes, we don't hit them but there are very clear consequences when they misbehave, but impulsive kids still lose control of themselves at times) or spend enough time with them (both parents work), etc. I am tired of yelling at them and dampening their exhuberence, which I have been advised I must do to get them to be able to behave at school and in public. They never were allowed to run around screaming, but you have to shout to keep them in line and impose consequences daily. I am NOT setting expectations too high- as if!- I'm sure half the parents we come in contact with assume I'm too lax. But they also think it's unseemly that when one of the kids get revved up, I have to speak firmly to them in public.

They have friends because they are creative and funny, but if a kid wants to be mean, they choose one of mine. When my kids get upset, they often cry or ''take a swing'' back- very rewarding to tease with low risk of retribution. They both do well in school, but are felt to be underperforming by teachers- one's messy handwriting is said to be a sign of insufficient pride in work product, the gifted one can't sit still for reading aloud. It's one month into the school year and I have been to 2 ''conferences'' about my problem children. I am in tears and stressed out daily- trying to hold the line on their behavior and bear up under criticism, snide remarks and ''advice''.

Here's the dilemma- do we give them medication? We promised ourselves we'd give the other path a full year to work and if anything, things are worse as one year later. I just can't yell anymore at kids who really are trying their best. I know they will gain self-esteem if their schoolwork begins to show their potential (I myself am less concerned about ''grades'' at this age but they both are very invested in school despite daily negativity there). Our medical advice is that it's time to give it a try. One kids is getting too dispirited from all the criticism and the bouncier one is starting to lose his temper from the same. I know I will likely be judged negatively for medicating the kids too, but I am concerned that they used to be hyper and happy, and now they are hyper and anxious.

I am asking for support in general from parents of kids like mine. If you gave your kids medication, what tipped you over into that decision? Did the ''shame and blame'' from outside the family play a role? Did it just wear you down to deal with their behaviors constantly? Did the meds make them into zombies? Some days, I really just want a quick fix, but my real concern is their happiness and future well-being- and it's starting to seem one or both might be happier on meds. not quite super-mom

Use your skills as a researcher and do a lit. search--look at what works, look at what people do in other countries, look at the risks and side effects of ritalin.

Honestly from your letter I couldn't figure out a reason why you wouln't want to try medication. Because people are going to judge you?

Keep in mind if your kids are zombies from the meds. then it isn't that they shouldn't be on them, it may be that they're taking too much.

Get a good doctor who knows about this and then go for it. What do you have to lose?

Also, your kids sound almost old enough and together enough to have an opinion about it themselves. Ask them whether they like it. Sometimes kids like it and feel so much better on medication and ask for their medicine when it is stopped. extremely thankful my child is on medication

If you have not yet seen this site, visit: http://millermom.proboards23.com/

It is a huge source of support on all these issues and includes a large section on complementary & alternative treatments, which work well fro some kids. There is also a large section on conventional medication.

We did a trial of medication when our daughter was your kids' age and the side effects were just too tough to deal with, due to her metabolism, I guess. A few years later we tried again, and it has been really, really good. The side effects have been tolerable, and most importantly, she feels like it is really helpful. It helps her with attention and also with impulsivity in her social interactions. I'm fairly certain that without the meds, her life would be much more stressful and home life would be much more bitter. She's not zombie-ish at all. It seems the key is a willingness to work through the trial-and-error period to find the right medication and dosage-- and that can be trying.

Best of luck on this journey, Sympathetic Parent

Medication is not a miracle although we saw a difference in our child within the first few weeks of starting. What it has done for our child is help him focus and control his behavior just enough that he can engage and learn in his school environment and start experiencing some of the success that is rightfully due to him because he is smart and bright and can be a pleasant guy. We use the lowest dosage that we are comfortable with and that appears to make a difference. We use his more balanced personality as teaching opportunities to empower him to take responsibility for himself. Now, I'm convinced we did the right thing and could kick myself that we waited 10 years before getting help for our child. Because he has had some real success, I hope that as he grows older and his maturity and physiological system catches up OR he learns about better behavior and can more control his actions he may be able to eventually be med free. But I would also support him staying on the med as long as he benefitted from it. We'll just have to see what the future holds. Happy to have a happy kid

I wanted to write to tell you that trying meds was the best thing we could have done. My kid is still his same wonderful smart weird energetic (and occasionally very trying) self, but it is just much easier for him to focus and control his impulsivity. He handled what could have been a very difficult transition to middle school this fall beautifully. He likes school and is doing very well there, both academically and in terms of behavior. He would tell you himself that it helps him to take the medication. One initial issue was getting the right drug. He started on Concerta, which kept him up all night, but after switching to Ritalin, that was much better. The other, ongoing, issue is that he doesn't have much appetite in the middle of the day - we've had to be pretty vigilant about making sure he eats.

I would encourage you to get a second medical opinion if that would help, and then just to give it a trial of a month or two. You can always take them off medication if you feel the harm outweighs the benefits. I still cannot necessarily say I'm thrilled at the idea of medication, and I just have to tune out those who want to be judgmental about it, but our experience has been very positive. Good luck with your choice. Been there, doing that

It is all a very painful process -- for both your children and for you. It never ceases to amaze me how other people make such negative assumptions about your parenting skills when your children ''act out.'' In our case, we had to battle not only other parents, but the school, where the principal was very unsupportive and, despite a public pronouncement of ''community,'' took a hands-off approach to creating a community for our son. We, like you, have clear rules and clear consequences and discipline at home, but suffer others' assumptions and implicit criticism when our child acts in a way that is contrary to their expectations.

Good luck in your decision. anonymous

Do you know that your kids have ADD/ADHD? Have they been diagnosed? If they havent, you need to do that. If they have you need a really supportive doctor. I use Brad Berman who is WONDERFUL. He really likes my kid! He really cares. Hes told my son to call him anytime. They have one-to-one talks. Brad tells my son how terrific he is and is frank about the issues hes dealing with. My son too is gifted, cares about school, has friends. But the ability to control himself is not all there yet. We decided to put him on meds when he expressed his concern about how things were at school. He is very clear that having meds helps him focus on school and on his homework. It has helped with his cooperation as well. He was already a very self aware person not that he sat down and talked a lot about it, but at times he certainly does. It has made life much easier for everyone and school is much better. We also decided in middle school to put him in a private school with whole-child approach - that is they care about his mental and emotional state as well as his academic performance.

By the way, I got the recommendation for Dr. Berman a few years ago from this list. His office is in Walnut Creek and his phone number is 925-279-3480. There was a waiting list for new patients when we signed up. But I left a very frank message about how hard things were and they got me in earlier.

Good luck! Don't be afraid of meds.
a mom who has been there

I am also a volunteer facilitator for an adult support group and a certified parent trainer for CHADD. I hear a lot there from people who have experienced AD/HD from both sides, medicated and non-medicated. chadd.org has a national clearinghouse and it is a place to get information about medication and support groups for parents. Schwab Foundation has a parent message board.

In my private educational therapy practice I see people who have had both good and poor results with medication. It's not for everyone and it's a very personal choice. Medication works best with education - of kids, teachers, parents, family, friends.

The practical considerations you mention are the reality of life with ADHD in this time and place. It's not easy, but it doesn't have to be awful! Good luck to you. linda lawton

ADHD and IEP?

Is an IEP appropriate for a 7 year old child just diagnoised with AD/HD? Should I request an IEP from the school? We have not yet tried drugs, but I want to get more information before we try them. I wonder if the school/teacher would give him more attention if he has an IEP in place, or if this would lable him. ANy help is really appreciated. Thanks. Mom

He is, however, eligible for services under section 504 of the Rehabilitation Act (which is a Civil Rights act that deals with access). Called a 504 Plan, this plan is a program of instructional services to assists students with special needs (who donÂ’t qualify for special education) in the regular education classroom. The plan should detail strategies for helping you child be more successful in his classroom setting. It may include things like: quiet room for testing, seating close to the teacher or away from distractions, assignment modification, etc. Since anyone can begin the referral process for a 504 Plan, I suggest you make a request in writing to the school district/school asking for a 504 Plan referral. In your request, mention the ADHD diagnosis and include a written record from the physician, neurologist, psychologist or other expert who made the diagnosis. Hopefully, the school will comply and ask you to be a part of the process. At the 504 Plan meting, you would offer your suggestions for what would help your child be more successful. HereÂ’s a link with some more information about 504 Plans. http://www.schwablearning.org/articles.asp?r=777

Medication should ALWAYS be a last resort – something you try when you’ve tried everything else and your child is still not meeting with success. Many teachers and administrators will suggest medication because it’s easier than trying to implement behavior plans and educational plans and doesn’t cost the school district anything. As a special educator, I know how important and therapeutic meds are for some kids. But it’s important to explore all other options.

Finally, I understand your concern about labels. Our culture is very quick to identify someone with a label. Some labels are good, though. Your reaction to your child’s ADHD will have the most impact on how it is perceived. It is important to get your child the help he needs so that he can be a success – that’s the label you want for him. Be honest, open and loving about his ADHD and help him understand how it makes him unique. Begin to teach him now how to advocate for himself. And by all means, don’t let a thing like a label prevent you from getting him what he needs. You’re his voice until he’s able to have one himself. Good luck! shari

''Schools often try to insist on an IEP to put your child in Special Educ. classes, which he probably doesn't need, and where, unless he is extremely slow, he won't learn much. The reason they do this is because they get much additional funding for everyone they put into Special Educ.''

It is true that districts receive money for each special education student, however, the grants for special education donÂ’t begin to approach the costs; districts and general ed parents complain that special education ''encroaches'' (the word makes me cringe) on the general fund.

The Individuals with Disabilities Education Act [IDEA] requires that students be educated in the ''least restrictive environment,'' which is the general ed classroom for the large majority. The school is not likely to place a student in a ''special day class'' unless he or she really belongs there. A kid of average intelligence with ADHD, with or without learning disabilities, would not be placed in SDC without some severe behavioral problems, for example.

''Only students with one (or more) of the 13 disabilities recognized by the Individuals with Disabilities Education Act may receive special education services. So, unless your child has another disability (such as a learning disability, which often occurs concomitantly with ADHD), an IEP is out of the question.''

ADHD is expressly considered a qualifying condition, usually as Other Health Impaired without other problems. It was added to IDEA in 1999 because a lot of IEP teams didn't realize that it could fit the definition of OHI without being named. A couple of people noted that ADHD has to adversely affect the studentÂ’s educational performance (which is more than grades) to be a qualifying condition for special education, and that is exactly true. All the other eligibility categories require the same criterion, that to benefit from school, the condition has to adversely affect the childÂ’s performance *and* the child needs special education to address the problem. OHI students do not have to demonstrate a discrepancy, though students with learning disabilities must, but California does not require a student be two years behind, as someone suggested. Absent needing special education remediation and support, 504 accommodations may cover what the student needs, and either family or school may request evaluation for special ed or 504.

Regarding medication, one person wrote that “Medication should ALWAYS be a last resort - something you try when you've tried everything else and your child is still not meeting with success.”

That’s one opinion. I have seen many, many families grapple with the difficult issue of medication. Another view might say that parents may not want their child to have met failure in everything they’ve tried before trying medication, which after all, is not an irrevocable decision. That’s between the doctor and the family. The school can never demand that a child be medicated, though in my opinion it’s not out of line for a caring teacher to say something like, “Have you thought of consulting your doctor about medication? Other people might say that a teacher should never mention medication because they aren't professionally qualified to diagnose and treat, and that they’d be seen to be doing it for their own ends, in order to have a compliant student.

Sorry this was so long, and I hope it made some things clearer. Dana Lear, DrPH Negotiating the Maze Special Education Advocacy, Research, Support www.negotiatingthemaze.org

7 yo with ADHD & learning disbilities

My son is far behind others in reading, spelling and comprehension as he enters second grade (good oakland public school). We have had various tests done, and while he is quite bright, he displays some processing disabilities and mild adhd behaviors. We are wading through all issues, including IEP, behavior counseling, Ann Martin tutoring, Lindamood Bell, further more specific tests on learning. Can anyone offer advice based on their experience? I am looking for experienced professionals who can help us with behavior training (us and him!) and tutoring at our home. We feel by starting early we can get a handle on this, but we would really benefit from some expert advice. Concerned mom

ADHD and T.V.?

Have any of you ever heard the idea that too much T.V. can be linked to development of AD/HD? I'm particularly wondering if any of you have read anything by T. Berry Brazelton or Matthew Dumont that supports this idea. Also, does anyone know, have any independent, verifiable, double-blind (i.e. scientific method) studies shown any link between AD/HD and T.V.? Colleen