I am reading
Driven to Distraction, a book about recognizing ADD in children and adults. My educational consultant/former teacher/remediator of reading difficulties/ASD guru friend gave it to me after I went and observed Megan in her classroom and took detailed notes. My friend read my notes. She observed Megan at her office. You know what Megan's primary problem is? It's not anxiety. That's right, my friends. My little girl is not an anxious child. But get her into the classroom, what you'll see is ADD masquerading as anxiety.
Anxiety is a secondary issue to the primary problem, which is ADD.
I am so certain of this that I have contacted the educational psychologist for another consultation and review of my classroom observation. I may consult with a neurologist next, since ADD is a neurobiological issue, a genetic one that runs in families. Yes, that's right...guess who else has ADD? My dear dad does, and he sees it in Megan. Guess who else probably does? Probably me too (but more on that later). Guess who else has a neurobiological issue? Anna does. Yes, we seem to be all sorts of neurobiologically challenged over here.
My mother (who does not have ASD or ADD, bless her), sees the ADD in Megan too. I told her that I've honed in on the problem and she let loose one of her favorite nicknames for me - Terrier. I have grabbed the issue and will worry it until I get the truth and the results I need.
I feel like recent family history is repeating itself. I was worried about autism for Anna as early as when she was 2 years old. I was told to wait and see...she's to young to assess for autism...she's too smart to have autism...wait and see. I waited and Anna (and our family) was the worse for it. I, the mom, knew it was autism, but listened to everybody telling me it wasn't. You know what? It's happening again with my second child. I've suspected ADD for a full year. Everybody keeps saying...she's too young...she's too smart...wait and see...But I am not doing it again. The longer we wait, the worse it will get, and Megan and our family will be the worse for it.
My educational consultant friend tells me to seek solutions, not truth. I have to respectfully disagree with her. I will seek both. My mom does not call me Terrier for nothing.
And so I am reading Driven to Distraction. It sounds like Megan across the board in all areas of her life - at home and at school. Things at home related to the anxiety have improved but the things related to the ADD have not improved. I strongly believe Megan has
ADD with secondary anxiety, where the anxiety is a direct result of the ADD. I am arming myself with evidence, like I did with Anna. I will take notes, write updates, and generally be a pain in everyone's patooty until Megan gets what she needs - namely, an ADD diagnosis and accommodations in the classroom to help her cope. My friends, I have faced down autism. I am not afraid of this.
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Interesting excerpts from Driven to Distraction (Hallowell and Ratey, authors)Preface
"(ADD is) an inherited neurological syndrome. (It is) an imperfect label...the syndrome is not one of attention deficit but of attention inconsistency...hyperactivity may or may not be present; some children with ADD are quite dreamy and quiet. ADD...almost never occurs in a pure form - that is, without some accompanying problem, such as a learning disability or low self-esteem."
page 9
"...within the domain of properly diagnosed ADD there is also much variability...there is another kind of ADD that shows no hyperactivity whatsoever. Indeed, these people can be underactive. This is the child, often a girl, who sits at the back of the classroom daydreaming..."
page 13
"Four major traits (of ADD): (1) deficits in attention and effort, (2) impulsivity, (3) problems in regulating one's level of arousal and (4) the need for immediate reinforcement."
page 16
"...secondary psychological problems...typically develop in the wake of the primary neurological problem of ADD."
pp 41 - 42
"One must look carefully at the child's individual history. The (ADD) diagnosis rests primarily upon the history. There are also psychological tests that
can (my emphasis) provide additional evidence in making a diagnosis. Certain subtests of the WISC..
.may suggest (my emphasis) ADD.
There are other tests that attempt to assess attention and impulsivity, but it should be stressed that there is no one definitive "test" for ADD (my emphasis)
. The most reliable diagnostic tool is the individual's history as elicited from the child, from parents, and from teacher reports...One must make a judgment based on a comparison of the individual child to his or her peer group. If he or she stands out as markedly more distractible, impulsive, and restless...then the diagnosis of ADD can be entertained."
Page 42
"While psychological testing can be very helpful, it is
not definitive (author's emphasis). Children who have ADD can appear not to have it when psychologically tested. This is because the structure, novelty, and motivation associated with the testing procedure can effectively, for the moment, "treat" the child's ADD. The child may be focused by the one-on-one structure of the testing, focused by the novelty of the situation, and be so motivated to "do well" that the motivation overrides the ADD. For these reasons, the clinical data - the teachers' reports, the parents' reports, the evidence of human eyes and ears over time - must take precedence over the data garnered through psychological testing."
Page 43
"For those children who do have ADD, it is of great importance that the diagnosis be made as early as possible so as to minimize the damage to self-esteem that usually occurs when these children are misunderstood and labeled lazy or defiant or odd or bad. The life of a child, and his or her family, with undiagnosed ADD is a life full of unnecessary struggle, accusation, guilt, recrimination, underachievement, and sadness. The sooner the diagnosis can be made, the sooner this unnecessary pain can cease. While diagnosis and treatment do not put an end to the difficulties ADD creates in the child's life, at least they allow for those difficulties to be known for what they are."
"...a good example of a person with ADD: impatient, impulsive, distractible, energetic, emotionally needy, creative, innovative, irreverent, and a maverick. Structure is one of the hallmarks of the treatment of ADD...(it can beautifully capture) the dart-here, dart-there genius of the ADD mind."
page 52
"...the crucial difference between the primary and secondary symptoms of ADD...Primary symptoms are...distractibility, impulsivity, restlessness, and so forth. The secondary symptoms, and the ones that are the most difficult to treat, are the symptoms that develop in the wake of the primary syndrome not being recognized: low self-esteem, depression, boredom and frustration with school...The longer the diagnosis of ADD is delayed, the greater the secondary problems may become."
"...ADD occurs within a developmental framework. That is to say, it evolves over time, just as a child's personality and cognitive ability evolve over time. It is not a stagnant phenomenon but a dynamic one, and it's influence changes over time. The tasks of each stage of development may be unnecessarily difficult as long as the ADD remains undiagnosed."
page 65
"...as early as kindergarten (children with ADD can get) distracted easily and distract others..."
My further reading:
http://www.estronaut.com/a/attention_deficit_disorder_girls.htm
http://www.helpforadd.com/add-in-girls/
http://www.ncgiadd.org/pdf/GirlswithADHD.pdf
http://www.additudemag.com/adhd/article/1626.html
http://www.helpguide.org/mental/adhd_add_diagnosis.htm
http://www.helpforadd.com/criteria-for-add/
http://www.borntoexplore.org/DSM.htm
http://www.cdc.gov/ncbddd/adhd/diagnosis.html
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Postscript: I cannot believe I was thrown into such a tailspin by an anxiety diagnosis. Most of it was because I didn't see the extreme anxiety. Neither could my family or close friends. So I've waited all this time, spinning my wheels and thinking, waiting to start treatment because I didn't think it was simply anxiety. I mean, anxiety was present, I could see it, but I knew it was hiding something else. While it felt like her school issued a blow by not allowing my professional representative into Megan's classroom for an observation, it turned out to be a blessing in disguise. I went and observed myself, armed with what to look for from someone who knows. And I saw it in the classroom, the same thing I see at home, the same thing I see elsewhere in Megan's life...the inability to stay focused. With resulting anxiety. I feel so much better now, it is centering to know... I can now operate from a place of strength to pursue solutions. The educational psychologist said in her report that we should not rule out the possibility of ADD in the future. The future is now. The anxiety related to the ADD will not get better until the ADD is addressed.