Need to Know

This is Dr. Cathy Schiano. She is not only my physician, but also a great friend. One of the things we share in common, is that we both have boys who suffer from ADHD. Her son, an adorable little monster, is younger than Hamza, but was also diagnosed with ADHD. As a mother and a Dr. I felt that she would have the most in depth thought about children and ADHD. The following is a Q & A between Dr. Schiano and myself.

WE: How early can ADHD be diagnosed in a child?
Dr. S: Onset 7 years. 50% meet Dr. criteria by age 4 with a male and female ratio of 5:1.

WE: What are some signs that parents and Dr. look for to recognize systems of ADHD in children?
Dr. S: The most obvious signs are:
*Short attention span
*Low frustration tolerance
*Impulsive
*Distractiblity
*Often hyperactivity
*Poor school performance
*Difficulty in peer relationships
*Parent/child conflict

WE: Once the signs become obvious, what is the next step that parents should take?
Dr. S: The first thing is to visit a family Dr. Parents should also speak to the teachers at school to have the child evaluated by a child study team, Or see a developmental specialist.

WE: Is there special testing to determine if a child has ADHD?
Not really. There is a the hyperactivity - inattentive scale that is used by doctors. For ADD alone one needs 6 out of 9 in the inattention criteria from the DSM-IV-r or 6 out of 9 for the hyperactivity. By the age of 7 a child must be monitored for 6 month and be noted in 2 settings. The first is:

Inattention (6 or >):
* Careless mistakes
* Difficulty sustaining attention
* Doesn't follow through or finish tasks
* Difficulty organizing tasks
* Avoidance of tasks that require sustained mental effort
* Loses things
* Forgetful
* Easily distracted

The second is:
Hyperactivity (6 or >):
* Fidgets
* Difficulty remaining seated
* Runs or climbs excessively
* "Driven as if by a motor"
* Talks excessively
* Blurts out answers
* Difficulty awaiting turn
* interrupts others

WE: In your expert opinion, do you feel that ADHD is over diagnosed? And Why?
Dr. S: No I do not. It is a very prevalent problem. Only 3-5% of school aged kids are diagnosed with ADHD.

WE: What are the best treatments for ADHD?
Dr. S: There really isn't just one type of treatment, sometimes a combination of treatment is required for certain children. There are the medicinal medication of stimulants and non-stimulants. Behavioral therapy, like reinforcing good behavior and stopping bad behavior quickly. Setting goals, sometime using charts can help the child and the parent in setting goals. Anger training is also sometimes necessary. Finally a behavioral tech., IEP in school.


WE: There is so much controversy regarding medicating children who are diagnosed with ADHD. Are you for or against medication when it comes to ADHD?
Dr. S: Medication are not without risk. Stimulants can be addictive, cause appetite and growth problems. There is also the possibility of suicide in a small number of patients. On the other hand, not medicating a child can result in risk of future drug abuse, depression, social isolation, failure in school, parental abuse, and poor self esteem. Some other disorders may develop, like mood disorder oppositional-defiant disorder and conduct disorder.

WE: In your opinion, what is the best drug medication out there now for ADHD?
DR. S: New Non-stimulants like strattera are more recommended. Their extended release works best as medication goes.

WE: Do you believe that ADHD can be genetic?
Dr. S: 50% of children have parental ADHD, Though overall the causes is multi factorial.

WE: As a mother and Dr. what advice would you give to parents with children who have ADHD or showing sign of ADHD?
Dr. S: The best advice parents need is regular support and advice. They also need to establish regular contact with teachers and school staff each year. Joining a support group or looking for blogs like this one can be great help and support for other parents and the children.

I would like to thank Dr. Schiano for this Q & A and also share this video on a medication check list. This is a great video that I believe every parent with a child diagnosed with ADHD should watch. Not only is it for medication but a check list that can monitor any kind of treatments.

What Are They Selling Now?

"Today you'll be amazed to learn of a new treatment,which involves no unwanted medications, that has showed great promise for patients with ADHD" That was the opening statement mentioned by the main speaker.

As a parent with a child who has ADHD, I try to be up to date with all the treatments, whether medicinal of other wise. So, as soon as I saw an advertisement for a lecture to introduce a new treatment, I was very excited.

The event was held at a library. I informed the organizer of the event about this blog, and the assignment that I had to do for class, which involves covering an event related to ADHD. Unfortunately, I was told that I may not use any official names in this post. All the names that will be presented are fictional, but the event is real.

As I step into the library, I saw familiar faces. Not of people that I knew, but mothers and parents who came looking for hope, like me. Smiling and over exuberant faces emerged all around. There was a nice refreshment table so that everyone can converse until the main speaker was ready to begin.

As I circled the room, I talked to other parents. It is invigorating to talk to others who can relate, to the struggles and anguish.

The speaker is Dr. Jane (This is a fictional name, I will not reveal the real name) She talked for a half hour strait, about the hope, and the ultimate solution to all our problems, yet she never mentioned once what she was offering. Restless, I became sceptical. It is always my opinion that If someone truly believed in something, they would come out and say it. This Dr. was circling.

Finally, after an hour of talk she reveals their break through method to treating ADHD. Meditation! Yes, their break through is meditation. I'm a firm believer in meditations and what it can do to the mind, but either this Dr. never saw a child with ADHD or she is mad.

I would love to see how she expects to have my son sit still for more than 2min. Looking around the room I realized that I wasn't the only person with doubt. Someone came around and gave us some pamphlets, to better explain the presses. The first thought that came to my mind was a Monk Sanctuary form the pictures on the pamphlet. Hands were raised immediately with questions. I stayed quiet trying to determine if it was just me being sceptical or not. Apparently not.

Some started walking out after the Dr. started giving vague answers on how they plan to get the children to sit still long enough. Others walked out after hearing the price. I was one of those people. About $5000 for the first 6 weeks. Those 6 weeks are only the beginning of a year long process.

After a room full with about 30 parents, by the time I left there was only about 5. I guess five is better than nothing. Who knows maybe there is some truth to meditation as a form of treatment, but It's not for my son; for one thing we can't afford it.

This is was on PBS on Meditation

No More School

Through out the semester, I have been leaving classes early, jumping in and out of class to answer the phone. What no one knows is that I have to be on alert, at all times, just in case something goes wrong with Hamza at school. He goes to a private school in New Jersey, while we pay crazy amounts of money for the kids to attend private schools; the school has no idea how to handle a child like Hamza.

While the teachers employed at the school, are the best of the best, they have no training in special education. Hamza is the "problem child" at the school as they say. Yasser (my husband and Hamza's father) and I decided last year that we would transfer Hamza into a special education school program, but we were assured at his current private school, that they will provide him with a trained teacher in special education.

True to there word, the school provided the 4th grade class with a teacher that had some training in special education. When a teacher knows how to deal with Hamza, they fall in love with him. He's a sweet boy, who is misunderstood. He's smart and talented, but unfortunately, he has other teachers through out the day.



Once he goes to gym or has lunch, the problems start. He fights with other children during those periods of the day. He is constantly getting hurt or hurting someone else. For discipline, other teachers, aside from his homeroom teacher, become involved. These teachers have no idea how to handle Hamza's discipline. They don't understand that a child like Hamza can't just let go, and move on.

One of the symptoms of ADHD is persistence. Therefore, once a thought is embedded into Hamza's mind, nothing can over ride it. He becomes preoccupied by the events of the day. Meaning, he loses focus, and can think of nothing except his punishment, especially if he feels that he was wrongly punished.

On Thursday, after Hamza was involved in a altercation with another child; the school decided to suspend him. This would be fair if they also disciplined the other child, who was also misbehaving, but they didn't. They only suspended Hamza and assured the other child's parents that this will never happen again.



So I had enough! I decided it was time to take Hamza out of the school and look into putting him in another program tailored around his needs. I must give the public school system some credit. By next week I will be meeting with the child study team for the Sayreville school system. Public schools have so many alternatives and incentives in helping children with special needs. I'm very optimistic that this is a step in the right direction.

The month of May

A month full of promise, and summertime sunshine, but for me it's starting out as trouble. On May 2nd, for some unknown reason, I decided to have a party for both my daughters. Ultimately, it was meant to be an all girls party, with no Hamza. Unfortunately, circumstances changed and not only was Hamza at the party, but I had to invite other boys to accompany him.

Never, never, again! Wow! with fifty girls at the party, they were all unnoticed. Ten boys on the other hand, including Hamza became a nightmare. I had to be in ten places at one, with eyes in the back of my head.

Currently Hamza is not on any kind of meds for his ADHD. His father is so against any concept of medicating a child, that he will not succumb to using meds. as a source of treatment for ADHD. For me, on the other hand, I'm starting to reconsider the concept of meds. for Hamza again.

One of the symptoms to ADHD, is to act before thinking. There is no thought process behind some of Hamza's actions. Therefore, on the party day, I had to make sure that he would not chase a cat across the street, or run after an ice cream truck. He also has very little control over his emotions. Any little thing will make his cry, and his anger can be set off just as easily. When he's angry, he acts without thought. Meaning, I had to make sure that he doesn't become violent with other children. At one point, I just reached him right before he jumped into the lack. He told me he wanted to catch a fish.

It becomes very hard for him to interact with other children. They don't understand him, and he doesn't understand them. They make fun of him because he cries; and they know how to trick him into doing things he's not suppose to do. The only way to keep him still is to put a video game into his hand, but what kind of option is that? He's very smart, so I don't want to wast his brain on video games. Most kids with ADHD are extremely smart, with high IQ. Academically, he's brilliant, but the problem is, to have him to sit still long enough in a classroom.

At the party, I compared him to the other boys, and I came to the conclusion that he needs help. He's ten now, and he still has trouble interacting, and doing what other boys his age do. The other kids at the party his age, were able to go off on their own, but Hamza couldn't. He has no control over his actions, and anything could happen.

So what are my options? Should I consider putting him back on meds? I'm starting to lean in that direction these days. Some say meds are the easy way out, but what else can be done? He needs to be able to go out and play, ride his bike, and have friends like any other ten year old child. He's a sweet boy, fun and loving, who needs to enjoy his childhood.

Help

Some hope. After losing all hope on understanding what is needed for my son, St. Peters found me. Strange? As I was sitting at St. Peter's University hospital for a doctors appointment for a family member, I drove the entire office crazy, or I should say my son, Hamza, drove everyone crazy.

He was six at the time, and I found that people have very little tolerance for non-behaving children. Doesn't anyone know that there is no perfect child? If I yell or try to discipline my son, then people will whisper that I'm a horrible mother, maybe even abusive. When they see my son out of control, people whisper that I'm a horrible mother, that has no control over her child. Either way I'm a horrible mother in the eye of the world.

It was Nancy, the only brave person to approach me in that doctors office and offer me some help. She was a nurse, who told me about a great program that St. Peter's has for children like my son. It's called forKEEPS. For info go to:

http://www.saintpetershcs.com/Services/OtherServices/CommunityOutreach/ForKEEPS.aspx


This program is located in New Brunswick, New jersey. Not only do they help the child, but they also help the parents, by guiding them throughout issues that will arise everyday with a child with ADHD. My husband and I meet with the therapist once a week. We were told of different activities to do with our son at home. At this time we only had Hamza and Aaisha, his older sister. The therapist also helped us to consider feeling with all the attention that Hamza was getting.

The program was very school oriented. Hamza went everyday from 8am to 3pm, Monday through Friday. He had his own teacher and therapist.

Unfortunately, everything in life has to have its flaws.

As a parent still struggling to understand my options with treatments for ADHD, forKEEPs concentrated on medicating my son. They tried several types and different doses, but the results were on different scales. On medications he was definitely less active, and had the ability to concentrate on the task at hand, but he also became very emotional. Always crying for every little thing. While he was already anti-social, on meds, he became even more withdrawn. It was like he was crawling into a hole within him self all the time.

After three month we took him out of the program, but now that he is ten I wonder if we did the right thing. As a parent one must ask are meds the best option for treatment? Some say yes and some say no. For me I still have no idea. My husband is dead set against using meds as a solution, for me, I'm not so sure. If I could go back maybe I would have kept Hamza in forKEEPs. I actually recommend it to all struggling parents out there in NJ.

Really Funny:

This is South Park's idea of a cure for children with ADHD

Overwhelmed

Full time Student, mother of three, and a wife. I think that sums it up. Is my plate full? It's full and over flowing. So I'm behind on everything, really behind! Now I'm playing the catch up game. Wow, what was this blog even about? Oh ya! ADHD.

Last I talked about signs to look for, one of those signs was speech problems, or delayed speech. Not all children with delayed speech or speech problem necessarily have ADHD, but it is common.

Recently as I researched sources online, I stumbled upon a study by: Zvia Breznitz. This study compares the speech and vocalization patterns of boys with ADHD against boys with Dyslexia and boys without learning disabilities. Since this was a very long study, that consisted of about 30 pages, I'm not going to bore you with all the detail. Here is the sum up.

Speech and ADHD. Can Speech be used as a diagnosis for ADHD in children?

* Researchers have found that children with ADHD often have difficulty self-monitoring their speech.
* Children with ADHD have a language behavior disability.
* They have less targeted speech and larger sections of disruptive speech.

Research

* 105 boys split into three groups
* 35 with ADHD
* 35 with dyslexia
* 35 control group with no learning disability

Results

* Boys with ADHD had a higher degree of behavioral disorders than did the boys in the other groups.
* The boys with ADHD were observed as exhibiting hyperactive behavior.
* The participants with ADHD did not experience and reading problems but were less proficient on a mathematical sequence completion task, which required attention and concentration.
* The vocalization duration average was longer, the pause duration shorter, the pause frequency greater, the turn change frequency lower, and the length of response time during turn change longer compared with the boys in the other group.
* They also spoke with a higher pitch.
* Since children with ADHD lack attention the gabs created in the speech flow had two possible sources, either they were distracted or they were concentrating on how to reenter the conversation.
* Some of the boys with ADHD rambled, connected associations to certain words and ideas, and had trouble with verbal flow and stopped their verbal flow to allow their conversation partner a turn and then returned to the flow without any permission.
* Boys with ADHD were louder than the other boys.
* The production of sound activity requires delicate coordination of different speech organs (i.e. vocal chords, tongue, and so forth), and boys with ADHD found that difficult to control.
* The research also shows evidence that the neurological maturity (leading to functional ability) of boys with ADHD is different from that of the control groups.
* Boys with ADHD lacked the ability to evaluate and regulate the muscles power, which caused the voice pitch they produced to be less varied than that of the control group. This can stem from late neurological maturity.
* They had difficulty adapting to the environment’s demands and therefore they tended to shout more.

Conclution of the study

* Speech and temporal voice measure may be used as the groundwork for locating physical, objective, and easy-to- measure factors that distinguish between boys with ADHD and those without.
* The present study constituted a step in contributing to the theory dealing with the cognitive patterns of boys with ADHD.
* Speech and vocalization measures may be used as an objective measure for finding the difference between the cognitive processing if boys with ADHD and those of other children.

There are many other studies out that deal with children with ADHD, but believe it or not, there is still a struggle with trying to determine what is the best treatment. At least knowing what to look for is a step in the right direction. The only problem, as a parent, I need more than just a step, I need clear answers, no more confusion. I need someone to tell me strait out how to deal and treat my son.

Knowing What to look For

Children will do what children do best, play and have fun. To know if your child has ADHD or not, you must be able to recognize the signs. Not every child who is showing a little hyperactivity, should be classified as having ADHD. For one thing as a mother, try to understand what is ADHD. Once you have a better understanding of the disorder, it easier to see the signs. So what is ADHD and what are the signs? I have underlined a few easy and simple point to help guide other parents in knowing whether a child is showing signs of ADHD or not.
What is ADHD?
* ADHD stands for Attention Deficit Hyperactivity Disorder.
* It is a neurobehavioral developmental disorder.
* It is a commonly diagnosed psychiatric disorder in children.
* It effects 3 to 5% of children globally.
* More common in boys than girls.

When are the signs?

(0-12month) Infancy

* More fidgety or squirmy
* Less able or less interested in cuddling
* Impatient, easily frustrated
* Require more attention than average baby
* May sleep less or take short catnaps

Toddler (1 to 3 years)

* Inability to sustain attention for even a few minutes
* Constantly distracted by sights and sounds around them
* Difficulty sustaining eye contact
* Able to pay attention to certain high interest things such as a favorite video game or playing outside when high energy levels are required
* Excessively hyperactive
* Always in motion
* Lack of interest in cuddling or quiet activities
* Difficulty calming down after becoming excited
* Highly impulsive: will jump off of decks, slides or out of windows, will run into the street more often
* Accident-prone
* Difficulty sleeping, may have a hard time falling asleep and may be up at 5:00 AM each morning

Preschool

* Inability to sit still
* Lack of interest in quiet activities or in listening to stories
* Changes activities every few minutes
* Inconsistency in attention skills, may be able to hold attention when an activity is interesting, but not able to keep attention for other activities
* Always in motion, sometimes running without looking, may run into street or fall often
* Poor social skills
* Behavioral problems, not listening, disobeying or consistent unsafe behaviors
* Can be clumsy or have underdeveloped coordination
* May grab toys from classmates, siblings or friends
* Difficulty waiting for their turn
* May be aggressive, causing fights or hitting other children
* Can be talkative with signs of speech impairment