So I'm in a really weird place where I deeply believe that my 7yo daughter does not have ADHD (she has some behaviors consistent with it, but I 100% believe they stem from other sources), but other forces in her life are pushing for an ADHD diagnosis for her (they just want to throw meds at her to make her easier to handle, which I think is the wrong reason in the first place even if it were a legitimate diagnosis.)
Anyone else ever run into this situation before? Are there any advocacy groups designed to help avoid misdiagnoses?
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Concernedmamma
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Hi, what other sources do you think are causing ADHD-like behaviors? Just curious. I can't speak for your daughter, but my three sons showed signs of ADHD around 5-7 years of age, and since they were at a private school, they received accommodation without me realizing it. Then when they switched to public school, it was immediately brought to my attention that my kids needed help. They were talking out of place, tapping, noises, wiggling, and having trouble keeping up with the schoolwork. We tried changing their diet, consistent exercise, supplements, and yoga/meditation but nothing was working and they were getting in trouble in school often. We finally gave in to the diagnosis around 6th/7th grade and went on our medication journey. That too can be stressful as you have to test to see what works but I can say the medications have helped. I know I didn't answer your question but wanted to share my experience. Good luck, go with your gut and all you can do is your best. Take care. You are a great mom!
Well, she's really a lot like I am, in almost every way. I recognize almost all of her behavior from my own life and I am most definitely not ADHD. I have had this confirmed by multiple therapists. However, I am ASD ( I've recently learned that new research suggests that ASD can run in families). My partner used to have a step child who was solely ODD (Obstinate Defiance Disorder) and he says that some of her behavior looks similar to that, though much less severe. ASD, ADHD, and ODD all have overlapping behavioral symptoms. In my opinion, I think her behavior looks like I would have looked if I'd had the same early childhood trauma that she's had. First of the many reasons that I think that she has it is because her behavior is inconsistent between environments. She's spent as much as a week at a time with other family members and she doesn't have any of the same behavioral problems that she shows when at home or at school. She also just started martial arts and her coach has seen zero indication of any behavioral abnormalities. That's not really something that you see when someone has a neurochemical imbalance, which is what causes ADHD. When it's your brain chemistry out of whack, you don't get to choose to leave the behavior behind just because you change environments (you bring yourself and all of your idiosyncrasies with you wherever you go). That's something that happens when it's a learned behavior or coping mechanism.
I actually wrote out all of my thoughts, observations, and opinions on the subject in a letter that I'm going to be giving to her assessor. I can send it to you, if you'd like.
Masking their symptoms is very common for a certain amount of time, no matter the condition. It’s very possible those people haven’t seen the behaviors because they are holding it in so much that they let it out afterwards. I know I did. We know right from wrong but use all of our efforts to not “look” adhd then when in a safe place, let it go. This can be dangerous for adhd or even autism, depending on the person.
As someone who's spent a lifetime learning to mask effectively, I can confidently say that my 7yo, who has spent almost 3 years of her life in lockdowns and has all of the social delays associated with that, does not have the maturity or experience to effectively mask to the point of fooling multiple adults in her life (with related experience) who are carefully observing her. If she was older, I'd say that was a valid consideration, but as it stands, it doesn't fit.
Well, as a parent, you have your daughter's best interests at heart.
If you think that there are other factors that are causing her ADHD-like behavior, then my recommendation is to talk to an expert (family practice doctor, pediatrician, child psychologist, or other specialist).
You should certainly want to get her a correct assessment, whether her behavior is due to family dynamics, social factors, biological factors, due to ADHD or other neurodivergent condition.
Yes, other things can exhibit similarly to ADHD. But ADHD is often a comorbidity with other neurodivergent conditions. (A partial list includes
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My eldest daughter was extremely active and very spontaneous as a child. That's how I phrased it from the time that she was seven (the year I married her mom and became her stepdad). If you look at those phrases, "extremely active" and "very spontaneous", they mean essentially the same thing as "hyperactive" and "impulsive".
• My eldest did not really had any attention issues as a child, so her mom and I thought that there was no way that our daughter could have ADHD. By the time she was a teen, she became oppositional and defiant. At first, we thought it was due to a trauma that she had gone through; then we thought it was "just a phase" due to her adolescence; then we thought it was due to her questionable choices in friends.
I've spent the last few years learning about ADHD, due to my own ADHD diagnosis, and the more I learned, the more I realized that I dismissed it as a cause of my daughter's behavior, without trying to understand what ADHD is.
My wife and I used to gripe about how many people were medicating their kids, instead of working on their parenting skills.
Boy were we off-base! We have since had friends with kids who have severe ADHD, and have seen the kids on and off the meds...and there was a very clear difference!
But ADHD doesn't look the same in all people who have it. My daughter seems very much Hyperactive-Impulsive (she's still undiagnosed at 30 years old, but her doctor has suggested that she get an ADHD assessment...she is accident prone, which i think is due to her impulsivity). As for me, I've always been mild-mannered, but a real space cadet, due to my mind wandering, distractibility, and difficulty maintaining focus.
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Now that I've experienced being medicated for Inattentive ADHD, I wish that I'd had this to help me when I was in junior high and beyond. (I think that I was mild enough in elementary school that I wouldn't have needed medication, but definitely would have benefited for coaching and skill development.) - Note: I don't just have ADHD, I also have anxiety, and they can make each other worse when I am not taking proper care of myself.
In light of my experience with my friends' kids with ADHD and my own experience with ADHD medication, I regret my previous assumptions about both ADHD and ADHD medication.
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I would encourage you to keep an open mind about whether your daughter has ADHD, but keep to your convictions about understanding the whole picture. People are not so simple that we can each be put in one box to define us. Your daughter is a unique, multifaceted individual... even if she is diagnosed with something, it does not define or limit who she is.
At 7 years old, she's only just getting started at developing into the person that she will grow into someday. While she is young, you can have a tremendous effect on her development. Over time, she will take the reins more and more. Foster a healthy self-image in her, and encourage her to speak up for herself, to self-advocate.
Quick answer (everyone in house waking up here!) but you can dm me for more or comment back, if you like. There's informal assessment, Vanderbilt scales to be filled out by you, partner, and teacher, and then there's a full formal assessment which includes controls for your kinds of concerns. A child psychiatrist usually refers you out to a psychologist who specializes in these for the latter, and it is a 3-hour or so detailed, multiple testing process. It helped me agree re our oldest having ADHD because I felt similarly to you about her. Just throwing that out there. Hang in there! (2/3 kiddos + spouse with ADHD over here)
She's going to be assessed with the comprehensive version, I believe. Now, I'm not trying to throw anyone under the bus, but the person pushing for this particular diagnosis (even though my daughter's therapist is not convinced of adhd) told me last week that when they took her to meet the assessment guy and do preliminary paperwork, he said he was 90% convinced of ADHD even without giving the assessment. That kind of rang alarm bells in my head because that's not the way these assessments are supposed to work as far as I understand. I'm in the medical field and I know that it is an outright and blatant breach of medical ethics to decide on a diagnosis prior to testing or looking at any empirical data.
As a doctor, you can't tell a homosexual that they have AIDS before you've done the blood work. You can't even tell them that they probably have AIDS before you've done the blood work. That's the kind of behavior which gets someone sued for malpractice.
That said, it's also entirely possible that the person who relayed this to me either misunderstood or was purposefully trying to mislead me. Either are equally likely given previous experience.
Anyway, I do have a fully written statement giving my thoughts, observations, and opinions about her and her behavior, If you'd like to read it over. I can send it to you.
I do get your concern. Many doctors do see a lot of kids with adhd but may have less experience with other conditions. Be glad your therapist is keeping an open mind and doing the objective testing before being subjective. I would just think of the docs unofficial diagnosis as a hypothesis. Remember, it’s ok to have a hypothesis but we have to back it up with evidence. I would ask the doc what evidence they have that it’s adhd and not asd or ODD. If your kid is doing the neurological evaluation that takes hours, the therapist will have part of it a discussion about experiences that would give more indication of these conditions. It’s not always obvious one way or another though, because there is so much in common, and because of chances of comorbidities.
I get it, totally. I suppose it depends on the person doing the assessment. It's weird, too--my daughter's assessment showed her much more intensely ADHD than my son (middle child), but his manifests far more radically. Supposedly, that is gender, but who knows? I think they rely a lot on the packet the teacher fills out, too. (I felt bad for my daughter's teacher.) There were a lot of other things I was worried about, but the assessing doctor was clear that the assessment showed we didn't have to worry about.
I'm assuming you had pages and pages to fill out for the assessment, too?
The ahead-of-time comment is weird and would freak me out, too. That seems unprofessional!
So far I think they've only gotten the responses from the teachers. They don't even have her therapist's paperwork yet because I haven't been in yet to sign the release. I haven't filled anything out yet and I don't think the other parents involved have either. I'm going to try to get her martial arts coach included in the teachers category, but I know he hasn't yet either. Basically, at most they have a couple of questionnaires from her school and that's it for their data so far.
When we did the questionaires, the doctor had me and dad do one each, Sydd did one, her main teacher did one, her favorite specials teacher and her least favorite specials teachers did as well. 6 total. I don’t think we had any space for words, but it was a lot of information covered.
Because she lives in a split home environment, she has four parental figures, five grandparents, quite a few teachers, past daycare providers, and a martial arts coach. I believe most if not all will contribute to her assessment.
Same as below for us. My wife, me, teacher. Pretty extensive forms ahead of time. Then 2 or 3 hours of testing with n extremely detailed report & meeting after. Here, the testing folk didn't have anything to do with treatment options.
My stepsons school tried to diagnose him as autistic because of his outbursts. I was working in aba therapy at that time and could tell it was not the same as the patients I had. It prompted my partner and I to get a neuro evaluation and the doc kept labeling why the child was not autistic. We got the doc to be straight forward in that the child was adhd with dmdd tendencies. The child was later diagnosed with anxiety as well. It took 3 years to get autism off the child’s IEP after so much discussion and proof that they weren’t.
When I was diagnosed adhd, my neurological evaluator said they were on the fence for autism. Either way, you need to get a second opinion and get re evaluation.
I'm in medical and I've definitely seen people in my field favor pet theories. Diagnosis is outside of my scope practice, but knowing that it's a tendency for many people, I definitely will pursue a second opinion if this diagnosis goes through. Though, if you end up with two of the same sort of people looking at it from the same perspective, you can get a double misdiagnosis, which just kind of puts the nail in the coffin. If it's hard to come back from one, it's harder to come back from a corroborating second opinion. So on that front, it adds some slight hesitancy.
Go with your gut. Ppl like to medicate for everything these days. My son is adhd, with several other labels as well. We are non-medicated. We, meaning he and i put in the hard work and hes been doing great...for years (hes 11). We are in a private school and he gets accomodations. He also doesn't know he has ADHD or the other labels. Again, this world wants everything labeled.
Do make sure that he knows his diagnoses by the time he reaches adulthood. I have interacted with multiple people on this forum and other ADHD forums who were diagnosed as children, but never told, only to struggle for many years, and get diagnosed again. Some of them were heartbroken or resentful that their parents didn't share their diagnosis with them, and lamented that they might have done better on college or after moving out on their own, had they known.
I agree. And the other thing I would say is that, if you hear Russell Barkley discussing ADHD research, there is a higher risk of developing ODD and defiant behaviors in kids not treated with medication for ADHD. He has lectured about this. I am not saying every child with ADHD not treated with medications will develop ODD or defiance. But Barkley has good data that, in some kids, continued parenting responses to ADHD behaviors (which are so common) can unfortunately foster development of defiance and ODD. Breaking that cycle by quickly terminating or improving the ADHD symptoms with medication can potentially decrease that child’s risk of ODD. Also, speaking as a high functioning adult who has had academic and professional success with undiagnosed ADHD, they came at a tremendous price of impostor syndrome and low self esteem. I would give almost anything to have been diagnosed, treated with medication, and had the same success with the self knowledge, self compassion, and vastly decreased effort that I would have lived with. At 50 it’s a very difficult thing to accept. My 2 cents and certainly not an expert opinion—-just a perspective. In the Adult ADHD support group, many people express a similar lament.
My advice is to take a deep breath, try to remain open minded to the information, and see what the evaluation (s) show. It’s possible that her data forms from teachers, parents, etc will be below the threshold for concern and the professional evaluating her will say she doesn’t have anything.
As a parent whose children have both been diagnosed with autism and ADHD, I have experienced the heartache of watching my kids struggle to manage themselves in a classroom, after school activities, and at home. It feels very unfair that other families don’t have to watch their beloved children struggle while we do.
Children of a parent with autism have a much higher chance of having ADHD or autism or both. I realize this feels unfair and difficult to hear. This isn’t your fault or something you have done wrong. It’s just what we know medically from large studies. This doesn’t mean your daughter has ADHD, autism, or any other condition. However, it’s possible she is being referred for an evaluation because someone has observed behaviors that are interfering with her performance in certain settings . Maybe you can speak directly with whoever described symptoms and started the referral process? That way you can understand the concerns. Our son behaves very differently at school compared to at home. At school he looks fine, like he has no problem organizing his work or managing his time. At home he is crying, stressed out, tantruming, etc. So the demands on her at school could be causing school staff to see different behaviors than what you see after school & on weekends at home. Or if she lives between different households, they may have different schedules, rules, expectations, etc, and she may demonstrate different behaviors at different households.
Funny story: my mom and stepdad (ages 80 & 93) asked us 2 years ago if we would change our wills so they could be our kids’ guardians in case we died. (My mom is dreaming if she thinks this is happening). My stepdad has moderate dementia & I would never have elderly parents as my kids’ guardians. My kids were so well behaved visiting them because everything is different, they get special food treats & all sorts of special activities etc because it’s “granny and grandpa’s house.” My kids looked like angels there. At home we are putting out behavioral fires all day 😂😂😂😂 Best wishes to you as you seek an understanding of what’s going on.
Oh, I'm very well aware of who started the process and why they started it. It has been verbally expressed to me that the purpose of pushing for this is hoping for a diagnosis with the intention to medicate for behavioral modification. That's part of what got my hackles up in the first place. I think working to understand a child in your care is always admirable, but that's not what this is. This is a callus disregard for the underlying cause of misbehavior for no other reason than convenience. Add to that narcissism and attention for manipulation coupled with the fact that after they spoke with the Assessor, the Assessor is quoted to have said that they are already 90% sure of their diagnosis without any data or testing at all except for the questionnaires sent back from the school (nothing from parents, coaches, other care providers, extended family, etc). My mommy alarm bells are ringing all over the place on this.
Sounds like a very tough situation. Maybe asking the school staff if they have concerns about behavior would be useful. In general they interact with many families, are very experienced managing complex situations such as caregivers who disagree about behaviors they’re seeing at home. Maybe having them fill out data collection forms for the assessment would be useful. And who knows what the assessor said? If that information was relayed to you by someone eager to get a specific diagnosis for your child, I would remember that a skilled professional sets aside the family dynamics or parents’ wishes and evaluates the child. Ultimately, the assessor’s responsibility is to your child—-to use their best professional skills to evaluate her and make a diagnosis if one exists. Even when hearing a diagnosis will crush, anger, or frustrate a parent, the professional must do what is right and correct for the child they are evaluating. They shouldn’t avoid giving an accurate assessment because hearing that information will be too upsetting to a parent.
Sorry, I responded without reading the whole thread. Trust your experience and your child's experience. It sounds like help might be needed for any early trauma. They would need different approaches. ADHD doesn't respond well to therapy, whereas trauma does.
PS If your child had early childhood trauma, and could have neurodiversity, she would probably benefit from an evaluation for trauma symptoms at some point if she’s never had one. Maybe she already has, and it’s not an issue. People with neurodiversity are unfortunately more prone to developing PTSD after a traumatic event than neurotypical people. I don’t think it’s known exactly why. I know that post traumatic stress symptoms can look like ADHD sometimes (inattention, difficulty concentrating) so worth mentioning if someone is suggesting ADHD as a possibility.
That's really good to know and definitely something I will be bringing up. She definitely had some very major early childhood emotional trauma and I have worried about the lasting effects of long-term buried PTSD since it happened.Do you happen to know, does an evaluation for trauma symptoms happen before, at the same time as, or after testing for neurodiversity?
That bit about making sure to ask that they also assess for autism is really helpful. I don't think it would have occurred to me. Now I definitely will. She has had some pretty major early childhood emotional trauma, which, honestly I really believe is at the core of a lot of her behavioral problems. I wonder if I can get them to assess for PTSD as well? Not that it would necessarily show considering how deeply buried the trauma is. At 7 years old, she really doesn't remember most of what happened, but that doesn't mean that she hasn't built on it over time. It's been one of the main things that I've been concerned about since then, how would what happened affect her as she grew up. Hell, I still have PTSD about it and I'm a fully functioning mature adult with good reasoning and logic.
As far as the martial arts thing is concerned, I've spoken with her coach about it. He says that he's seen many children with various disorders, including adhd, in his classes over the years and they are always fairly obvious in the beginning. He said it's not just the love of it that helps diminish the problematic behavior, it's the habits formed over time in the class. He also said point blank that she never showed any signs of it as far as he could see from the very beginning and that he would never have listed her as likely to be in that group. He said she's one of the best students he's ever had, the opposite of someone coming in with problems that need to be worked on, and he's seen a lot of those kids.
I always knew my son was quirky and was an out-of-the-box thinker. Once he started school, he just didn't do the work. He didn't have any hyperactivity or oppositional behavior, and ADHD didn't even cross my mind. A few years later, after tons of testing and diagnostics, it turns out that he has ADHD inattentive. As I educated myself about this, I realized that almost every box was checked, and that I very likely had this type of ADHD as did my mom. We are learning skills, getting him an IEP, working with teachers to build his executive functioning, and hopefully can put off meds for a bit with this. What I wanted to add is that ADHD doesn't necessarily look like the stereotype. It can look like dreaminess and spacy-ness, procrastination, forgetfulness, and not being able to follow basic self-care routines. We have benefitted from the knowledge that we've gained about this disorder and have been able to have a more harmonious household.
So she's very much like me. She doesn't like doing things that she's not already good at but if something is too easy, she gets bored really quickly. She also thrives on one-on-one attention and praise. I feel like when she's with me and I'm teaching her I can leverage these into keeping her very easily, it just doesn't really fit with the teaching style of school. I've tried to get them to give her work that challenges her so she doesn't get bored, but their schools response was that they can't do that until she demonstrates proficiency at the level that they give her first, it's a catch 22 because when it's too easy, she gets bored and goofs off instead of doing the work which then doesn't show them that she's proficient and ready for stuff that would actually challenge her. She's in second grade and right now they are learning about number placement, I.E ones, tens, hundreds, thousands, etc. I taught her that over a year ago, so spending two weeks on it in class at this point is super boring for her. She can already multiply and divide so identifying digits is definitely not challenging for her. It would be like taking a kid who can read and making them sit down with really repetitive ABC's work instead of giving them chapter books. I want to homeschool her so badly, but that's just not on the table.
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Advice for finding a therapist for ADHD daughter?
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