Is it time for a second opinion?

[MamaPajama]

Hi All-

My husband and I are struggling with my son's current treatment plan and we're hoping to hear some thoughts on how we should proceed.

Backstory: our son was diagnosed with undifferentiated ADHD in Feb 2018, when he was five years old. He also has anxiety and sensory processing issues. He has a 504 and receives accommodations at school. His kindergarten teacher and the rest of the school staff are phenomenal - very understanding and supportive. Along with classroom accommodations that are in place, he sees the school social worker as needed, and has weekly appointments with the school psychologist.

Outside of school, he receives PT twice per month and he sees a counselor weekly.

Currently: He is 6 years old and is in his final few months of Kindergarten. Despite all of the school accommodations and services he receives (along with our very supportive parenting style), he continues to struggle with impulse control and physical boundaries. It seems to me that he is caught up in a never ending ADHD/anxiety cycle and he is spinning out of control. His school behavior has improved to some degree, but only after months and months of consistency and support. He still struggles with social interactions. He is the oldest in his peer group but is the least mature. It's apparent that the few friends he has are beginning to become annoyed with the meltdowns, incessant talking, boundary violations, etc. There are fewer requests for playdates lately. He has resorted to being the "funny kid" to try and get attention.

It is so difficult to witness my son struggle in spite of all the services and accommodations that he receives.

We have taken him back to the developmental pediatrician twice to talk about these ongoing issues. She basically shrugs her shoulders,says that this is all consistent with the ADHD, anxiety, and sensory issues. She says that we need to bring him back for a re-evaluation in six months. That's it.

During our most recent appointment last week, I made a serious request to consider medication and she refused to discuss it. I left the appointment feeling hopeless, like it was a complete waste of time.

I'm not one to push medication. We've spent 14 months exploring all other possibilities and have yet to see any of meaningful/positive result. We aren't expecting perfection, but we are exhausted. There are two other children in our family, and we find that their needs have been pushed aside so that we can fit in all the support services that my oldest son requires.

We're stretched to our limit and worried for our son. My fear is that we are losing precious time with a doctor who doesn't seem to be concerned enough for our son's emotional health and social development.

Are we expecting too much, or is it time for us to seek out a second opinion? As his parents, are we missing anything as far as support services? We are open to feedback and suggestions. Thanks.

[Onthemove1971]

MamaPajama-

You guys sound like amazing parents! All of your hard work is going to pay off. I would find another doctor, as harsh as it may sound... in my opinion your child needs medication. Many studies state that children with ADHD can truly thrive with all you set up, but really suffer without medication. Even if you have to drive, find a child psychiatrist, guarentee they will support you.

It is my opinion your child'd needs are more complex that your current doctor understands.

It sounds like she has helped you to get this far and I know with proper ( please don't be scared if it takes more than 1 type of medication) medication things will be so much easier on him and you guys.

We started with our pediatrician and really took the wrong medications. At that time our so had so many behavior issues in school. Now with the right medication, 504 plan and the thearpy he is doing so much better.

I hope this makes sense.

Let me know if you have any questions send me a message so I can help you.

Big hugs!

[SylvieS]

Even with all of the best support in place, the reality is that it can take a long time and years of maturity for the tools you are giving him to “sink in”. That being said, our neuropsychologist gently advocated for medication pretty early, saying that it would give him a little help taking that “pause” in thinking before doing. If I remember correctly, the current research recommends all of the therapies and behavioral supports until age 6 and then a combined approach with medication after that. I think it is perfectly reasonable to get a second opinion. It sounds like you are doing an amazing job getting resources for your son.

[jam1959]

It concerns me the pediatrician just blames everything on ADHD, sensory issues and anxiety without trying all avenues available including medication. I think it is time to find a new pediatrician and see about a referral to a specialist. Do not fear medication. It can take a while to get the right one and right amount but in the long run it can help so much. If it does not help you do not have to keep giving it. However be patient initially. My daughter complained of stomach pain but that went away. She could not function in school without it and she recognizes how it helps. Good luck.

[123boys]

Your situation sounds very similar to mine. Young son (7) with adhd and anxiety and major impulse control/meltdowns plus two other children.

It sounds like you have a great plan and support from school. I would definitely seek a 2nd opinion.

We started ADHD meds in 1st grade and they did not seem to help. They actually seemed to make some things worse.

After trying the 2 classes of adhd meds with little change, the psychiatrist said you often have to treat co-morbid or underlying issues 1st.

We started sertraline for anxiety and saw positive changes in behavior. Again, it isn’t a magic pill and he still can have meltdowns but much less frequent.

Best of luck!

[Cjkchamp]

I hate hearing when doctors won’t listen to parents! You need a new dr. My son is 7. Diagnosed at 4. On medications since 5. He has had a lot of the services you mentioned and then some. What has worked for him now is broad spectrum micronutrients. I’m going to keep beating the drum until all parents start investigating them. Hardy Nutritionals and True Hope. Research. Find a new dr; one who practices integrative medicine and looks at your whole child would be awesome. Someone who listens to you! Keep up the fight!!

[Janice_H]

It is time to find a new pediatrician. Your son will greatly benefit from medication. A psychologist or psychiatrist specializing in ADHD can help find the right medications. You will see great improvements in school, social settings and at home.

[Lisamarie123]

Hi! Sounds like you are doing an amazing job!! Have you tried cranio sacral therapy from a PT? It is supposed to help with anxiety & ADHD. Also, the book finally focused is wonderful and has natural treatment plan options & supplements that most kids with ADHD are lacking. I do think that a 6 year old is way too young to be on medications. We don’t know the long term effects on developing brains with these medications. Acupuncture also helps too. Good luck!!

[4lizzylou]

I have done medication for both my boys and i would not do it any different. My older one is 21 and has been on medication since he was in first grade. He would have never made iit in school with out it. same for my 12 yer old who has been on medicaion for about three or four years. I hope this helps

[anirush]

Not all pediatricians are trained in treating ADHD. My grandson's Pediatrician recommended a psychiatrist when the medication got beyond what he was familiar with.

Don't necessarily need to change your pediatrician but you need to find a pediatric psychiatrist who can help you get your child on the right path.