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Anonymous says
Adhd moms! I posted a lot in the spring about my 1st grader who was really, really struggling I’m the poster who was having to deal with near nightly meltdowns that were impacting our entire family and she wasn’t sleeping, always fidgeting, etc. We met with her ped who had us do the Vanderbilt forms. Between our parent eval and the teacher eval she clearly qualified as adhd. Our ped told us she could prescribe meds if we wanted. We decided to hold meds until after doing a more detailed eval and see how the summer went.
We booked an appointment with a neuropsychologist after doing a quick phone call with him. There was a huge wait and the appointment is in early November.
You guys. Since we went on vacation at the end of August, we are no longer in what I call crisis mode (ie last spring). Her personality still is more…sensitive? Irritable?…than typical, and she’s definitely the most “IDGAF” of all my kids. She still gets “stuck” (thanks to the poster here for that language!) on things sometimes. But she’s been much better about basically everything; it’s as if we put her on meds.
Reports from her teacher are night and day. We haven’t given her 2nd grade teacher the Vanderbilt forms (yet) but we already know it will be entirely different. Kiddo reports she never uses a fidget; her teacher has reached out and told us how well she’s doing, that she is always on task and focused and a model student. Her learning has been explosive this year and she’s able to read books in ways we never thought possible last year (she couldn’t attend to the book).
So my question is….should we keep our neuropsych appointment? There isn’t really a question of if she has strong adhd components to her personality. We have worked on managing her behavior and parenting her in a way that works for everyone (thank you all for the tips!!). We booked the appt originally to (1) get a gut check before starting meds and (2) get the groundwork in place if/as she needed supports in school. We are no longer considering meds and at this time she’s excelling in school.
Thoughts? We are also thinking about calling the office to get their thoughts as well. If we can slide the appointment out until like December that would be ideal but I’m not sure that’s an option.
Anonymous says
Oh- and I should add, this is a $3500 out of pocket appointment. The cost isn’t an issue, but I don’t want to do it only to be told to come back when symptoms are worse and pay it twice!
Anonymous says
I would call the office, explain that there is a variation of reports between last year’s teacher and this year’s and you are seeing differences at home as well and so you would like to reschedule to January so you can get a fuller picture of where things are and come in with update to date info for the doctor.
anon says
+1. Or even push it to February, so you can get teacher input after the holidays. We also have mid year academic testing in January, so it would be good to see how that goes too.
Anon says
What behavior management and parenting strategies are working for you? Asking as a parent of a ADHD 1st grader who’s been struggling a lot in the past couple months.
Anonymous says
OP here. I could write a novel but the key elements are good sleep, absolutely no screens after 5pm on nights she needs good sleep, unstructured exercise every single day, heaps of positive reinforcement, trying to meet her where she is some days, and tons of parental flexibility/leeway.
Some examples: when dinner is a fight or she can’t sit still for it, we let her eat outside on the porch swing. If she’s hangry beyond help and refusing to eat and we see Bad Things Coming, I let her have a big snack or meal while watching tv or YouTube. She refocuses on the show vs fighting about eating and devours whatever is in front of her.
I also know she takes forever and a day to finish things (queen of “just one more thing.”). So I back up the clock 5x what I would for my other kids knowing she will take forever. She hates rushing so she wakes up 20 minutes earlier than my other kids with a goal of getting to the bus stop early enough to climb the tree there.
For sleep, she decided earlier this year that she would like to be able to have a sleepover by next year. She made a list of things she needs to do between now and then and has put a lot of effort into it (tuck myself in, sleep in a bed that’s not mine, sleep in a room with noise, put myself back to bed if I wake up).
We had a chat with her teacher when school started as a heads up. I think her teacher has been doing a lot of positive reinforcement in school that really helps. It seems like she’s gotten “stuck” on liking school vs last year when she was stuck on hating it.
anonM says
Thank you for this! We do this with my Ker, who I suspect may have ADHD/ADHD tendencies like multiple family members. Sometimes I feel judged for being lenient when I know he’s too dis-regulated and just needs to eat/sleep, and this is reassuring.
What type of unstructured exercise do you mean, and how do you facilitate that? (We’ve been biking to/from school, and I’m trying to get something else in place when we can’t do that safely due to winter/other concerns).
Anonymous says
Unstructured exercise- not sports teams. We do that too, but it doesn’t quite check the box.
Time at the playground, bike riding around the neighborhood, rollerblading (neighborhood or in our garage), obstacle courses in the basement, climbing walls, trampolines, that sort of thing.
Anonymous says
It’s so individual, though. My ADHD kid thrives with the structure and instant feedback of sports team practice. He plays an intense, fast-paced sport, though. I don’t think baseball would cut it.
Anonymous says
Yes omg yes keep it. It took you months to get! Go in. Have the discussion
Anonymous says
It’s not just a discussion, it’s many hours of formal testing.
anon says
I vote keep the appointment. Anecdotally, one of my kids was doing totally fine in school until all of a sudden she wasn’t, and that was when I was really glad to have to formal diagnosis from the neuropsych because it let us rapidly get the 504 supports in school that we needed.
Anonymous says
We were in almost this exact position and ended up cancelling the appointment. I’m glad your daughter is doing so much better!
FWIW, my son had strong, strong ADHD behaviors in first grade, but the world shut down and it was hard to tell what was ADHD and what was just life being nuts. A lot of factors changed, and 2nd grade was great. He back-slid in 3rd grade, which is when we started down the evaluation path, but no neuropsych appts were available until Sept/Oct, and by then he was having a great start to 4th grade in a new school, so we deferred to wait for a good read from his new teacher. Last year was great, so we just never went back. This year is going well so far, too. Obviously we keep an eye out, but I’m reluctant to make A Thing out of what seems now to be a dormant problem.
Anon says
I’m the “stuck” mom! Who also sat on a $4000 appointment for a year – I just kept rescheduling! I’d keep the appointment, really. My son had an amazing first grade year, rocky start to second, which then leveled off (and I sat on the appointment that year too), and now, we are seeing some behavior re-emerge that I am thankful we have a psychiatrist on call to help quickly triage. He still goes up and down, and I’m honestly just glad to know when we go through a rough spot that it will even out.
Anon says
I was going to say definitely, until I got to the price! As a mom just starting to wade into this (I posted a couple weeks back about my son’s bad behavior reports from school this year, I think you maybe replied?) is there a…free option? Maybe the waiting list is much longer going through the public channels, but sounds like you could get on the list and wait it out?
If you can afford it, I’d keep the appt because it’d be good to get a formal diagnosis/gut check to keep in your back pocket if you need it. But it would be a hard choice for me if I wasn’t propelled by a current crisis.
Anon says
One of the obnoxious things about health care in the US is that there are very limited “free” options for neuropsych. We did get our kids evaluated through a hospital system that took our insurance (and with only a shockingly short 10 month waiting period), but 90% of the options around here (DC area) don’t take insurance, so it’s a lot of money out of pocket.
Anonymous says
To be clear this is a full neuropsychology evaluation. it’s 4 hours of testing, plus two or three consultations beforehand. I think there are some options that insurance would cover, but (1) the wait list was truly insane, like 2 years and (2) she may not longer qualify for coverage. At the time we booked she for sure qualified as it was life-disrupting and a clear cut case, we just didn’t have anyone that could see her. In many cases, you can get an ADHD diagnosis through the schools. Even in our peak crisis our kid was hitting grade benchmarks so she wasn’t flagged. We wanted to have her tested because we absolutely know “hitting benchmarks” for a very bright kid is easy when you are 6 and gets rapidly harder with ADHD as you get older no matter how naturally smart you are.
Adding to all this is the neuropsych is very highly regarded and happens to be the brother of a dear friend. Part of what we wanted to understand in booking the appointment is if she’s really “just” an immature kid with mild ADHD and an attitude or if she has other issues in the mix we should be looking out for and parenting to. She struggled to read last year but we couldn’t tell if it was attention. So many of her numbers and letters were flipped and it was to the point she built in compensation- “I know I do it wrong so I always check around the room first before writing them down.” She would read above grade level but the *way* she read was not right. her teachers didn’t notice until I pointed it out because she was hitting benchmarks.
If you are looking for help with a diagnosis of ADHD, our pedi did it pretty quickly. But all she could offer was meds, which we were on the fence about. A psychologist would also be able to diagnose and offer some behavioral help.
Anon says
This is super helpful. It feels like such a quagmire! And yes my son is hitting all academic benchmarks right now, too (gifted program, etc). I’m not against meds but I wouldn’t want to use them without a sense of the bigger picture, so I totally understand wanting to pursue that.
Boston Legal Eagle says
OP, are you in greater Boston? I think you are based on posts, so would you mind sharing the name of the psychiatrist/clinic if so? My older kid can probably fit in that category of maybe there’s something more but maybe he just needs time. K was difficult, 1st grade was great and 2nd grade is great so far, it’s mostly at home (where he’s also gotten better!) but I am unsure what even is in the range of normal.
Anonymous says
Yes- I can email a list of options if you want to list a burner.
Boston Legal Eagle says
Late in the day but bostonlegaleagle0234 at the gmail. Thanks!
Anon says
happy for your family! but please please please share all the tips
Anon says
Not OP but it might just be the passage of time more than anything they did.
anonamommy says
I would try to reschedule until December or even January if possible.
Also, anecdotally – I am almost in the exact same boat. 2nd half of first grade was a real challenge, I was extremely worried. Second grade has been a completely different experience, entirely for the better, and I have no idea why — better teacher? More maturity? More challenge? Different seating arrangement?
We just got off the waitlist for a neurospsych consult I called about in March. We are keeping it, but our only out of pocket cost is a co-pay. If I were looking at your price, I would absolutely push it until later.
Anonymous says
We had a similar thing happen, cancelled the appointment because dad really resisted “labeling” his child and thought she had gotten herself together, and then ended up in a crisis situation later on and had to wait another year for the correct diagnosis. I would keep the appointment.
Anon1 says
I would keep it. You’ll likely have ups and downs over the years based on where she is developmentally, emotionally, and academically. She could also have environmental factors at school that may make it more difficult to manage, like a difficult class or teacher with a style that doesn’t jive with her needs. You want this in your back pocket for when things aren’t going well.
SC says
I am so happy for you and your child for being out of crisis mode! I would keep the appointment, though there’s nothing wrong with rescheduling if you can. First, from the many people I know with ADHD, there is rarely a linear path. So many factors affect behavior and learning that it’s common to cycle between rough years and easy ones. Having an evaluation already in place can help get the help you need quickly when you need it, rather than waiting up to a year. And the help she gets in school doesn’t have to be meds–it may be something like a different seating arrangement or extra time on tests.
Also, based on my husband’s experience with an evaluation, understanding your strengths and weaknesses can be really helpful in understanding yourself, identifying coping skills that work for you, and asking for help or informal support. His evaluation is from when he was in high school, and he still uses the information to understand and explain and advocate for himself. I believe his evaluation was almost $2000, 25 years ago, but it has definitely been worth it. I think he would have benefited from being evaluated in elementary school and grown up with this understanding.
Anon says
My K-er has started recognizing words in the wild! I think they’re mostly sight words they’ve memorized but it’s still cool.
GCA says
Aww! We call them ‘words in the wild’ too! Some kids are very into this (kid 2), others less so (kid 1, reluctant reader till mid 1st grade, now I have to enforce lights out or he reads all night); a good phonics foundation helps.
Anon says
Oh, mine has been reluctant too, and any prompting from us to sound out simple words met resistance, so we pretty much gave up on doing it. I think that’s why I find this so exciting. She’s very headstrong so I think she just had to come to it on her own timeline.
Anon says
Love it! I learned my kindergartner could read when he told me that ‘a world of wine awaits me’ because he saw it on one of the postcard mailers that was delivered to our house. This kid’s first word was also ‘waffle’. I am a great mother.
Anonymous says
That is amazing!
Cb says
Haha, my first word was waffle as well! A totally functional adult, although very fond of a waffle.
Anonymous says
My daughter’s preschool teachers didn’t believe she could read until she read the joke off a yogurt pouch.
Anon says
Hahaha I love that story! I’m OP and this same kid said to a random woman at dinner last night (as she was pouring wine) “don’t pour too much, you don’t want to get silly!” I swear I’ve never been even remotely tipsy in front of her, I don’t know how she knows these things!
Cb says
Amazing! I had some concern about my 1st grader’s reading over the summer and then all of a sudden it clicked. He’s skipped 3 reading band levels in the last 2 weeks, with plans for him to be in the chapter book group by Christmas. He’s also much more excited about reading now his fluency is increasing and the books get a bit more interesting.
Anonymous says
I just saw a therapist for the first time ever, mostly to have someone to vent to about mom stress and strategize getting services for my autistic child. She was really nice, but a lot younger than me, and a lot of her contribution was just affirming me and saying “you got this mama!” type stuff. Should I look around for someone that I click with better? Or is this just what I should expect for coming to therapy with no specific “problems”, just looking to vent and strategize about parenting and family issues?
Anon says
find someone else…someone might not be able to help you with actual advice, but htey can provide more concrete strategies for managing stress and emotions. Look for someone who does CBT or DBT.
Anon says
I think you’re gut instinct is right, to look into finding someone else. I’ve used some “free” therapy session through work where I didn’t have a lot of time to pick someone for similar stressors. Even those therapists have helped me walk away with actionable ideas and exercises to work on to help with enjoying day to day life in the first meeting.
anon says
Keep looking. I know two therapists with social work backgrounds who also have kids with special needs. I’d try to find someone like that. For both, their social work background included helping families navigate schools and other resources. If you have a burner email I could send you my friends’ professional page.
Anonymous says
I agree you should keep looking. If it doesn’t feel right, she’s not the right person for you. Sometimes you just don’t click with people; it’s not even necessarily about age or personal experience or training. What I thought I needed from therapy and what has actually been incredibly helpful was very different, but even so, my relationship with my current therapist felt really productive and insightful right away. She’s younger than me and I doubt she has kids, but she has helped me a lot with navigating parenthood and dealing with aging parents.
Anonymous says
A lot of therapists are not action-oriented and will just take your money to chitchat. It works best if you can articulate specific goals up front and have the therapist describe her plan to help you achieve them. For managing stress I would look for CBT or something else that is relatively structured and evidence-based. For coordinating services for your child you may want someone separate like an educational consultant or social worker.
Emma says
I would shop around. I wasted a lot of money on a therapist who I really didn’t click with because I thought therapy was the right thing to do. I switched now and I’m much happier. I explicitly looked for an older woman with kids and still took a while to find a right fit but it’s made a huge difference in the value of therapy for me.
Vicky Austin says
All of a sudden kiddo is refusing to nap at daycare and daycare’s only solution is for me to pick him up. They have checked him for fever and he’s good; he’s probably stealth teething but has been since well before this all started yesterday. Help me use my words?
Anon says
Blithely “oh, I’m sure it’s fine. He sometimes struggles with naps at home too. Feel free to give him some ibuprofen if he seems to be in pain from teething and call me if he has a fever or vomiting! Otherwise, we’ll be there for pick up at 5.”
Also, what in the world? My daughter notoriously didn’t nap in the infant room. They’d always just warn us at pick up and we’d get her down fir bedtime asap.
Vicky Austin says
Thank you, that’s perfect. It’s an in-home center and it’s very newly opened, so I’m sure they’re just figuring this all out.
Anonymous says
I would be kind but firm. “Does he have fever? No? Then I won’t be able to pick him up: I’m working today. It’s not ideal if he doesn’t nap but we’ll get through it.” You could offer to drop by and administer ibuprofen if you feel comfortable and day care doesn’t want to/isn’t allowed to do that for him. I find it a tinge funny they are freaking out as you’re the one who will be dealing with the fallout of a missed nap. And also, it will be fine. You might give ibuprofen at bedtime tonight if he seems fussy. Happy teething!
Anonymous says
If it’s an in-home day care, she’s probably counting on all the kids’ napping at the same time to give her a chance to clean up, prep snack, take a break, etc. That’s probably why she wants you to pick him up if he’s not napping. Are you on wait lists for regular centers?
Anonymous says
Wait, what? They are demanding you pick him up if he won’t sleep? That is out of bounds. In the infant room at our day care they let the babies sleep or not sleep according to their needs and mood. They didn’t start enforcing schedules until age 1. I suppose they would probably have tried to put my baby on a nap schedule if I’d asked them to, but she was a free spirit who preferred to do things on her own schedule so I didn’t ask.
Anonymous says
Wait what?? I’d say “As experienced childcare providers, I would expect you to have some strategies for children who struggle with naptime. I am at work and paying for childcare unless my child is actually ill, which they aren’t”.
TheElms says
What on earth? I’m sorry you’re dealing with this. How old is kiddo again? If kiddo is over 18 months I think kiddo just doesn’t nap those days and yes they will be cranky but kiddo will survive and so will daycare. If they are over 2pm kiddo might just be dropping napping early. Can they do quiet time on their cot with a stuffy?
If they are under a year, I would ask if daycare can make sure they are in a crib in the darkest quietest part of the room. Can you bring in a sound machine or do anything else that is still within regulations to make it more like home?
If they are a year to 18 months and recently transitioned to napping on a cot maybe its the transition?
Vicky Austin says
Thank you! He’s only six months. They already have a sleep sack and a Hatch just like at home, so I’m not sure what the heck is going on. Appreciate the advice.
TheElms says
I suspect he’s just becoming more interested in his surroundings and has FOMO since he can likely see other kids now and is more curious. Hopefully its just a phase and passes soon!
Anon says
Maybe he’s ready to move from 3 to 2 naps? Or lengthen the wake window?
Anonymous says
“I’m not picking him up because he isn’t napping.”