Children with inattentive ADHD aren’t the hyperactive, obnoxious kids that we typically hear of being associated with an ADHD diagnosis.
Iused to congratulate myself on what a good job I was doing as a parent. Both of my girls got As and Bs and had sweet dispositions. So what if they were a little rambunctious or required excessive micromanagement to get homework or chores done? It is par for the course, isn’t it?
In elementary school, both my daughters were enrolled in GATE (Gifted & Talented Education) and received a somewhat more specialized education than regular classrooms provide, here in the Clark County School District, in Southern Nevada. For example, my younger daughter, Natalie, is excelling in math, so her teacher has her working in a more advanced section of their workbook then most of the rest of the class. This allows her to do work that is challenging to her, at her level. My older daughter, Emilia, two years ahead of my younger, got mostly As and Bs through fifth grade. My older daughter complained often that her homework took her much longer than her younger sister. My fifth grader often had to work on homework until bedtime, whereas my younger daughter, in third grade, was usually done within an hour or two, including reading for half an hour. Emilia developed a weird habit of picking at her finger until the skin was red and inflamed, almost bleeding. It seemed to come and go, so I assumed it was just a weird behavior related to being fidgety or bored, so I never mentioned it to the family physician.
I mentioned some of the challenges I was dealing with, with Emilia, to a co-worker at an event near the end of the fifth grade. She mentioned similar troubles she had with one of her sons before he was diagnosed for and treated with Attention-Deficit/Hyperactivity Disorder (ADHD), but I discounted it because she gave the example of her son’s sports performance, and how much it had improved after he went on medication. I broached the subject with my parents and current husband (not my children’s biological father, as I am remarried).
The response I received was faces of concern, shock, and distaste, “No, no, she’s not ADHD, they told me. It’s just the school — it’s too challenging for her. You don’t want to medicate your daughter!”
Facing this peer pressure at the mere mention of the subject, I dropped it and forgot about the conversation entirely over a summer blessedly free of homework.
Then Emilia started sixth grade. Almost immediately, her grades showed Cs, Ds, and Fs. Our daily schedule became a nightmare of staying up until between 9 pm and midnight trying to complete homework assignments, while still receiving abysmal grades. Emilia had a plethora of missing and late assignments. I kept trying to follow up with her and felt like I was getting nowhere. The increase in writing assignments was agony, with a one-page paper taking Emilia half of a Saturday to write, on simple topics such as “What I did this summer.” Emilia told me she thought it was just adjusting to having multiple classes, classrooms, and teachers. I tried to give her time to adjust, but by the end of the first semester, when she barely pulled Cs in most of her classes, I knew there had to be a bigger problem. Something had to be wrong, this couldn’t be normal, could it?
Again, I complained to my parents and husband. They blamed the magnet school program Emilia was in, and told me that maybe it was just too hard for her. I couldn’t believe this was the reason she was struggling. In fourth grade, Emilia had been tested into a sixth grade math curriculum, because of how well she was doing in math. In fifth grade, she was doing well in that sixth grade math class, where a teacher from the middle school came and taught to the fifth graders in her special advanced math program. I continued my search for answers.
Talking to a friend who lives in California and has children with special needs, a friend told me that her special needs counselor had recently diagnosed her daughter with ADHD inattentive. She explained to me that children with inattentive ADHD aren’t the hyperactive, obnoxious kids that we typically hear of being associated with an ADHD diagnosis and that having ADHD and not being able to cope with things can cause anxiety, which can lead to behaviors like the picking at her finger like Emilia demonstrated. Could this be the problem underlying Emilia’s difficulties?
I began doing my own research on ADHD. As I read about the symptoms of inattentive ADHD, I became convinced that this was likely what Emilia was struggling with. Emilia’s biological father and uncle had ADHD. When I told my brother that I thought Emilia had ADHD, he told me he had been diagnosed with it but hadn’t told our mom, and stopped taking the meds pretty quickly because he didn’t like the side effects. Reading about the symptoms of ADHD, it was possible that my father and myself even have undiagnosed ADHD. There was family history, there were symptoms, and there were significant areas of her life that were being negatively impacted. All the clues were there.
Let me tell you a little more about Emilia. Emilia wants to be a chemical engineer who creates new chemical compounds! She thinks of herself as being smart and good at math and science. While children often change their career goals over time, I knew that if Emilia wanted to do any work that would require a college degree, such as engineering, she had to be able to do well in school, without my micromanagement.
My family was so adamant that it was not ADHD that I was hesitant to even take Emilia to a doctor to discuss a diagnosis of ADHD. I considered my options. If I listened to my parents and husband, Emilia would continue to do poorly in school, likely burn out, and have to go into a lower-level program the following year. I was worried that her self-esteem would suffer a significant blow if she had to downgrade her schooling. If Emilia couldn’t cut it in middle school, it seemed highly unlikely she would be able to cut it in college, so I’d be essentially kissing her dreams of a science career goodbye.
I wasn’t willing to do that. If, instead, I went against their wishes, and took Emilia to a doctor to get evaluated for ADHD, what would happen? First, perhaps the doctor would decide she didn’t have ADHD. Perhaps she had something else. If the doctor did diagnose Emilia with ADHD, it wasn’t an irrevocable commitment to try medication. If it didn’t work for her, we could quit. Was there really any harm? Didn’t I owe it to Emilia to try every avenue that would help her attempt to reach her career potential?
What would be the big deal about having to take an ADHD pill every day? My brother and father both have diabetes and take a pill every day in addition to having to watch their diets. I have Hashimoto’s Thyroiditis, an autoimmune thyroid disorder and have to take pills every day, watch what I eat, and watch my stress levels. Would it have been better if none of us had been properly diagnosed and started taking medication? I wrestled with and came to terms with the fact that, for me, needing medication to be “normal” was not a big deal. As a mental health advocate for mental illnesses like depression, another hypothyroid symptom that I suffer from, I had already been advocating for equality in perception and treatment open-mindedness for mental health issues compared to physical health issues.
How could I do less for my daughter? Still, I quailed internally at the idea of going against every adult in my life that I respected in making a decision for my daughter’s health.
Then, I recalled the conversation I had with my other co-worker the year prior, about her son and ADHD. I remembered that she had told me that her family had not wanted her to put her son on medication, but she had gone against her family’s advice and had him try it, anyway. When she saw how much it helped him, she knew she had made the right decision. Remembering her story gave me the encouragement I needed to go against my family’s opinions and take my daughter to a doctor.
Once I made the commitment, things moved quickly. At the time I am writing this, Emilia has been on medication for only a month. She was diagnosed with low-level, inattentive ADHD. Since she has been on the medication, she has noticed personally that she is less forgetful, and that she can perform math and writing assignments faster in school and at home. She has had minimal side effects of stomach pains and sweating. I have made the entire choice of whether to take medication hers. If at any point she doesn’t want to take it or thinks the side effects are worse than any benefits she receives, she can stop or try a different medication.
As my daughter’s advocate, I have connected her with a good doctor who made the diagnosis and left how she wants to treat it, up to her. Another friend told me about 504 plans, which are educational accommodation plans for students with disabilities mild enough that they can still function in a normal classroom. I am working with my daughter’s school on putting a 504 plan in place. Even if Emilia ultimately decided not to take the medication, having the 504 plan in place and getting accommodations through it such as extra time and a quiet room to complete her tests so she can focus better, are worthwhile outcomes of going through the process of obtaining a diagnosis. Her grades are already starting to improve, and I am getting her after-school tutoring from her teachers in the classes she is struggling in.
We’re going to bed on time most days, now. She still has some struggles to work through. Will Emilia become a chemical engineer one day? I do not know. By pursuing the ADHD diagnosis, I have helped my daughter to better understand her physiological makeup, and how to overcome weak areas through medication and moral support. In addition, I support and encourage her in areas where she feels successful, such as science and math. I am supporting her in becoming who she wants to be, rather than letting a treatable mental health condition, shut the door on a future she wants for herself. I can’t control her future, but I can give her every opportunity to succeed that I can. The way I see it, getting the diagnosis and 504 plans are more tools in her toolbox, and the minimum I can do for her.
Looking back, I wish that I had gotten Emilia evaluated by a doctor sooner. I see how she still struggles with some concepts, and I realize that these are concepts that she didn’t fully pick up in prior years. It is likely that her ADHD was already causing her not to focus as well as she needed to, and she is paying for it, now, in how she struggles with these concepts from past years. When I told my daughter’s psychiatrist that Emilia had been in GATE at her elementary school, she told me that it is common for intelligent children with undiagnosed ADHD to skate by without experiencing significant problems in school.
Another friend told me about how she was not diagnosed with dyslexia until she was an adult Throughout school, she had just thought she was stupid and as a result, never pursued a college education. Hearing my friend’s story, I wonder how an earlier diagnosis might have changed her perception of herself, and how her life path might have been different. My hope with sharing this story with you is to encourage you to explore every avenue you can to help your child be the best they can be, and the sooner, the better.
Don’t overlook early warning signs
If your child is struggling in school, don’t automatically dismiss it. It could be symptoms of a learning disability or mental illness. If so, the sooner you get your child help, the better off they will be and the sooner they can get back on track.
Getting a diagnosis is worth it for a 504 plan even if you don’t want to medicate
Getting a diagnosis doesn’t mean you’re agreeing to medicate your child. Even if you choose not to medicate, 504 plans can help your child do better in school.
Empower your child
If you decide to try medication, explain to your child why you think trying medication is a good idea, but let it be their choice. Empower your child to be part of the solution in helping themselves benefit from medication.
Understand there is no one-size-fits-all medication
My psychiatrist has told me that many people try medication once, then stop and assume “it’s not for them.” Due to differences in our physiology, some people will do poorly on one medication, and well on another. There are also differences in dosages. If you want to try medication, make sure you give it a true trial before you write it off.
Look into medication alternatives
While my daughter’s psychiatrist says that medication helps a lot more than many other behavioral alternatives, there is no reason to limit yourself. There are many behavioral, diet, and organizational tools that can be used to support your child.
Be willing to go against the grain
It’s hard admitting that your child might need special help. It is often difficult for other family members to consider that something is wrong and that your child might need help, when it’s an invisible illness like ADHD, versus a physical handicap, such as a broken leg. Find a doctor that you can trust, and get their opinion. Do all the research you can. Then, share your findings with your family and ask for their support, even if they disagree with your choice.
Find a good doctor who will help you identify and solve root causes, not symptoms
I found a local facility that specializes in clinical trials for ADHD, so I know that the doctor will take time to ensure that the diagnosis is accurate, rather than just trying to rush me in and out of the door. Mental health diagnoses are tricky because many conditions have similar symptoms so it’s not a clear-cut yes/no. For example, if you complain to your doctor that your child has anxiety and depression, they may get treated for that.
However, perhaps your child is anxious and depressed because they have ADHD and are not doing well in school, causing them to feel overwhelmed and worried about their grades and feeling like a failure, causing them to feel anxious and depressed. If your doctor doesn’t ask enough background questions to identify potential underlying causes such as ADHD or another underlying mental illness or learning disability, you may not receive the right type of treatment to really solve the root cause of your problem. If you are not totally comfortable with your first doctor, look for another, or for a doctor that specializes in clinical trials for that condition in your area.