Saturday, 13 November 2010

How to get ADHD

I always suspected Bambam might have ADHD, or at least, that there was something about his development that  was atypical. Several parents and teachers have praised me on my persistence and success in pursuing a diagnosis and treatment for him. Perhaps I should share some of my experiences here.

When Bambam was a baby, he seemed to find it exceptionally difficult to calm down. He also did not play 'appropriately'. He had toys that stimulate different senses and are meant to elicit different responses, but he would only throw and bang. Since then, I have noticed that other babies can also, for example, investigate and concentrate quietly. Obviously this is normal for any baby and certainly, at this point, there would have been no reason to suspect a problem.

As he grew up to be a toddler and an older child, his speech seemed delayed to me and he continued to find it difficult to play with toys appropriately. Throwing balls and banging hammers is fine. But most children will build with blocks, fit puzzles, draw with pencils, roll marbles down the track. Bambam was, well, like Bambam, or Godzilla. Constantly on a rampage. At home, I soon organised toys and furniture to be safe to drop, throw, and bang into. When out, I developed an iron grip to hold his hand and it still felt like walking a cat.

He couldn't focus on anything, even if he liked doing it (with the notable exception of screen-activities, common in ADHD) I learned to break down instructions to him into very short, very small steps. Not: "get dressed", not even: "put your trousers on", but "pick up your trousers" - pause for execution - "now turn them over with the button to the front" - pause for execution - "now put your one foot into the leg"... etc. If left to himself with this for even a moment, trousers and all other clothes would be flung around the room and hanging from the light fixtures.

I must stress, he did none of this from malice. He was, and is, genuinely incapable of controlling these impulses and focusing on the task at hand. He was often surprised and even saddened by the havoc he caused, like he wasn't really there when it happened.

By this time, I felt we needed a professional opinion. What really got my goat was the difficulty at reaching the right specialists. I mentioned a problem to the health visitor, who told me to go to the GP, who referred me with no result for more than 6 months. When I inquired, it turned out we had missed an appointment with the specialist centre, because they had gotten our address wrong. So the GP had to refer us again. When we were finally seen, we were assessed by a temporary registrar paediatrician, who tried to claim that speech delay was normal in bilingual kids even when I asserted it had been a problem before our household ever became bilingual. They tried to blame his behaviour on the fact that I'd separated from my partner and had re-married and the stresses that entailed. They wrote a little report mentioning impulsiveness and hyperactivity and left it for six months.

Six months later, at the follow-up visit, the entire medical staff at the centre seemed to have been replaced. Lather, rinse, repeat.
They did suggest I attend a parenting class. I know it is part of the support that ADHD children need, but at that point it just felt I was being branded a 'bad' parent. I have trained both as a primary teacher and a childminder and volunteered as a play leader for six years, so it felt very inappropriate. I couldn't even attend the class because I couldn't get childcare for the other kids! I did look up which system they were using, and got myself the book instead, which has proved invaluable: The incredible years

After three entirely unproductive visits, we made an official complaint that 2 years of follow-up had yielded absolutely nothing. I pointed out that he had been described as impulsive and hyperactive in each and every report, regardless of other circumstances, and that his behaviour was the same both at home and at school. Within weeks, we actually saw the consultant paediatrician and a child psychologist and soon we also got referred to a psychiatrist who was able to confirm the diagnosis of ADHD. Then we just had a few months to wait for Bambam's sixth birthday to start ADHD medication called Concerta.

The trick to getting this far was to use the internet to interpret symptoms, being careful to discriminate between hysterical misinformation and actually medically relevant data. Then figure out exactly what you want to achieve, check the NICE guidelines and quote them at your medical professionals until they listen. Do not give in. They try to avoid getting patients 'on their books' because they are understaffed and overworked. Although they are doctors, it's perversely not in their interest to diagnose. But it was in my interest and in Bambam's interest that we found out about his ADHD, because it is perfectly treatable with specialized behaviour management and medication. The earlier it is recognized, the better.

In future posts, I'll go into some parenting tricks I've learned over the years, the benefits of treating with medication, and how to deal with ADHD in school.

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