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Lack of focus and attention and comprehension, d related or possible add

Discussion in 'Parents of Children with Type 1' started by lohmggcjr, Oct 22, 2015.

  1. lohmggcjr

    lohmggcjr Approved members

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    Dd is in 3rd grade this year, and struggling. Teachers are concerned and I honestly see the same things at home. Quick to interrupt, unable to follow multi step directions, easily distracted with other things. While we do the best to keep numbers in range 80 to 250, (I say 250 because that's most of her food spikes) I'm not sure how much is d related and what may be concern for ADD. Anyone go through something similar? Do you have advice? Should start looking into possible ADD and possible medication? She is 9 and some life skills she should have mastered by now, she hasn't. The school is going to be doing some testing and adjusting her IEP.
     
  2. jenm999

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    I just watched my child do his math homework in purple ink while standing up and rotating in a circle. He is 8 and in third grade and the teacher just asked to reschedule our upcoming conference because the allotted time would not be enough. It started long before diabetes; I think that has just exasperated it because he only has a finite amount of discipline and self-control, and right now it all goes to taking care of himself. I am unfazed; he's doing just fine academically but I know it's a challenge for his teachers. They have not suggested medication or even testing but he is in a small pull-out group for difficult kids (whatever that means) called the "Lunch Bunch" and has lunch with the school social worker and three other kids once a week. His teacher's husband has T1 so I think she's pretty understanding of what he has to go through, and we have a deal that she should just send home any work that he can't finish during the day, whether that's due to attention problems or having to go to the nurse. I guess I'm not offering any solutions, just sympathy!!
     
  3. cdninct

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    Yes, Jacki--we're there, too. I think some things have gotten better in the past year, and other things...well, they might not have gotten any worse, but they don't seem to have progressed as fast as they should. I think K has definitely been labeled a problem child, and I think some staff members have difficulty with him. He has been lucky enough to have understanding teachers two years in a row (last year's teacher had t1d herself!), and they seem to appreciate the great things about him and tolerate and manage the rest. He has been the focus of "team meetings" (whatever those are) a couple of times. No one has suggested ADD testing or medication, so for the life of me, I can't figure out what they really think about him. It is so difficult to sort out what is related to diabetes and what is not. I'm afraid I have no answers, but I just wanted to let you know that you are definitely not alone!
     
  4. StacyMM

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    My son has ADHD. We first realized in 3rd grade just how different his behavior was from his peers and he was in 4th before we finished the testing/evaluation. For him, ADHD came before diabetes so it wasn't a factor. In our case, medication has been a great choice. He felt so much better about himself once he started - he wasn't in trouble all day, he was able to actually sit in a chair instead of perch and hover near one, he was able to finish his work and turn it in, he was able to keep thoughts to himself instead of sharing every single thought that went through his head, etc. He is now in 8th grade and he's still on medicine. We've changed meds a few times, changed dosages multiple times, dealt with various side effects, such as the impact of meds on appetite.

    On the other side, my daughter is about as anti-ADHD as a person can be. Calm, collected, responsible, organized. Last year, though, she suddenly appeared to be a poster child for ADD. I think it began over the summer but we didn't realize how bad it was until school started. She was really struggling and it was as if she was a completely different child. Yearly bloodwork showed a thyroid issue. Turns out that the symptoms of ADD were actually symptoms of Graves' disease. She started meds and every single thing that had me looking into an evaluation for ADD went away. So, if this is something new, keep in mind that there are things that can create behavior that seems like ADD.
    In my son's case, it was just him...it wasn't new or different and he just reached a stage in life where his brain didn't work well with the confines of the educational system.

    And, FWIW, his ADHD has a huge impact on his diabetes management. It takes 'reluctant T1 teen' and makes it even more complicated. If we forget to give him a pill one day, and we get to experience ADHD brain managing T1D, it's really rough. He can feel the difference and recognize the extra struggle it causes and I think it's why he never, ever complains about the doctor visits or the meds. He can tell the difference and appreciate it.
     
  5. StacyMM

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    Not sure if it varies by state or school, but ours cannot suggest ADHD or medication. The teachers will fill out the behavior observation forms when requested but cannot do more. I felt that made it harder, because I do think elementary teachers see hundreds of kids and do have a sense for behavior issues. It's like having someone right there has has seen this behavior, watched kids go through the testing, have learned how to reach kids that learn differently...and not be able to use them!
     
  6. lohmggcjr

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    Thanks for responses. I should mention, no one has suggested Meds. Other than me spinning my wheels about where to go from here. Her attention, distractions and in ability to follow directions is having a huge impact on her school work. She seems to be stagnant in some areas and reversing in others. Needing a lot of one one attention to keep her on track and focused. Things have changed over the last three of dx. For example if I tell her to bring her meter test strips and lancet, she will bring her meter and get mad she forgot to get the rest of her stuff. Three years later, it should be habit? She used to be able to do these things and suddenly can't remember. This is a small example but it translates to a lot of other situations.
     
  7. caretothepeople

    caretothepeople New Member

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    Hi lohmggcjr - If you do decide to get your daughter evaluated by a doctor for some of concerns you have about her attention and development, you may want to check out the information Mayo Clinic has on preparing for a ADHD evaluation. It has some great information about the different tests that could be conducted, as well as specific questions to ask to fully understand treatment options and the dignosis (to make sure you're actually getting the RIGHT diagnosis). Here is the link: http://www.mayoclinic.org/diseases-...s/preparing-for-your-appointment/con-20023647

    Hope this helps,
    MW
     
  8. njswede

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    Hi! My D son has a non-D twin sister in third grade who was recently diagnosed with rather mild ADHD. The symptoms you're describing sound exactly like my daughter. Now, it doesn't necessarily have to be ADHD in your case, but I strongly suggest you go have it checked up. If it is indeed ADHD, she will get an 504 or an amendment to her IEP, which proved very helpful in my daughter's case. Since she has a mild case, it's all about being allowed a little more time during tests, getting privacy when she needs it and small things like that. Our doctor suggested coping techniques and adaptation of her work environment before we even consider medication. So far so good! She's doing much better in school but still drives us a bit crazy at home. But once you understand why, it's easier to cope with it and avoid situations that triggers bad behavior. Good luck! I know how frustrating a combination of D and ADHD-like symptoms can be (although mine are in two separate kids)...
     
  9. quiltinmom

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    I do not judge people who medicate for ADHD. Just want to make that clear. It's not up to me to decide if she has it.

    Some personalities have higher energy than others. Some people are more focused, others are driven, some are fun and bubbly, etc. It could be her nature to be that way. You can approach it as something that has to be changed/fixed, or recognize it is who she is find ways to work around it--and help her work through it and develop strategies to merge who she is with what is expected of her by society. I don't know if this is making any sense, it's hard to explain in a few paragraphs.

    I'm not saying she does or doesn't have ADHD, and it may have Nothing to do with d. I'm also not suggesting that inappropriate behavior should be overlooked.

    I have a Ds (non-d) who has a really bright, bubbly, spontaneous personality. It's how he is made, and I certainly don't want to squash that. But I do understand the challenges it creates in a school setting--where they are expected to sit still and be quiet. :)

    Pm me if you are interested in more explanation. There is a book (and a website) that explains this concept a little better than I am doing. This invitation goes for anyone, not just the OP. :)
     
  10. DavidN

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    Incredibly difficult and complicated issue. Good luck. In our area, 9 times out of 10, if you go in for testing, you come out with an ADHD dx. At least 1/3rd of the boys in my sons grade are medicated.
     
  11. Caldercup

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    My son was a straight A student all through elementary school and well into middle school. Then things went quickly south. While teachers never said anything about his behavior or activity level (he's NOT hyperactive), they mentioned him being "dreamy" and having trouble staying on-task. His grades plummeted as he headed into high school. Then a severe depression set in -- he said he felt stupid, even though everyone kept telling him he was incredibly smart. Being the concerned parents we are, we took him to a child psychologist who spent a great deal of time speaking to him and evaluating him. Then they asked me to come in to do an evaluation of my son. I checked off box after box in a long survey. The psychologist said, "Well, that confirms it. It's clearly ADD." I was shocked because I always thought hyperactivity went with the attention-deficit. I told the guy, "But what C does is totally normal. We all do it." Um... no. He asked if anyone else in my family had a dx of ADD. I thought about it -- my brother and one of his twin sons. My cousin. My sister's son. "Yep," said the psychologist. "It runs in families. If you think the answers you gave are 'normal,' is that because you do the same things?" I nodded my head. "Well, you probably have ADD, too. Because these are classic symptoms of attention-deficit disorder."

    Turns out, I do have ADD. So does my sister. And, thinking back, so did my late mother.

    My son decided to see if the meds would help him. Boy, did they ever. He was able to pull his grades up and finish at a high-ranking high school while also holding down a part-time job. He still has trouble focusing at times, but he is doing so much better. (And the depression was a result of his feeling as if his brain wasn't working. With the meds, the depression cleared completely.)

    The meds had zero impact on his blood sugars.

    Now, I decided against going on meds myself because, at 45 years aold, I had built a system of coping mechanisms to deal with my focusing issues. I still struggle at times, but I can handle it. My son at 17 could not.
     
    Last edited: Oct 29, 2015
  12. jenm999

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    We had my son's teacher conference today and she pretty much suggested ADHD without coming out and saying it (I don't think they are allowed to). I'm a bit deflated, because I feel he's such a good doobie with his diabetes care and maybe is just all out of discipline. Something's gotta give - the psychological burden of this disease is practically doing me in, I can't imagine how hard it is for him! In earlier grades he was a problem kid because of impulsivity and rowdiness, but now they say he's zoning out and "not available for learning." Anyone else have this experience?

    We are in the care of a wonderful psychiatrist who not only specializes in kids with chronic illnesses and learning issues, but is T1 herself AND lives in our town, so understands the high-achieving culture here. I think there's nothing to be lost by having him evaluated, and if it's not ADD/ADHD and is just his way of coping at the moment, they are more likely to hear it coming from her than from me.
     
  13. DavidN

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    I have to admit I was very anti-medication a few years ago but after going through what we're going through now with my son, I'm a bit more open to it. My biggest concerns are (1) addiction (Google adderall [or another of the meds] gateway or adderall abuse), and (2) your quote above. You learned to function without meds. If I put my son on meds, how will he learn the "coping mechanisms"?. I am 99% sure if I went in for an evaluation, they'd label me ADD. But I hear you. It's tough. Is it a mis-firing of the brain? Or not uncommon adolescent boy behavior. I think about this every day.
     
  14. jenm999

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    Bumping this thread as things have continued to develop on our end. My son was formally evaluated in January. Turns out he is highly gifted (particularly in visual/spatial) but also has below-average processing speed. And they do believe he has ADHD but of course cannot diagnose. I resisted the ADHD diagnosis until yesterday when I was the chaperone on a five-hour field trip. My son is an outlier among outliers. I had not observed him among his peers in school since 1st grade when he was much younger; now many of the boys have matured but he has not. So, slowly opening my mind to an ADHD diagnosis and learning about treatments, both medical and alternative. I am really worried about how this could impact his diabetes, with which he is very compliant and in a pretty good head space. Waiting for a call back from the psychologist we know who specializes in ADHD and chronic medical conditions.

    For the time being we have amended his 504 to give him accommodations for the neuro-psychological deficits revealed in the evaluation - more time, less busy work, more movement, preferential seating, etc. His teacher is willing to do whatever it takes to help him but after five hours of shadowing him yesterday I am feeling that he might need more.
     
  15. quiltinmom

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    He wasn't just "performing" because you were there, was he? Does his teacher say if he acts like that always? Obviously there's more going on than you stated here, but as a mom of boys....I can't help but wonder how much of his behavior was normal for him, how much he was acting differently because a parent was there and/or it was an out of the ordinary activity. (Although ADHD kids like their routines, I hear.)

    Anyway...adhd is complex. No question about that. Good luck finding answers. :)
     
  16. forHisglory

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    1/3rd is just too high! I believe in the diagnosis. I have a child that acts in these ways but I've never pursued testing yet as he's only in K. We homeschool, but I have him in a T-K preschool program 3 days/week. Do you know that at preschool all the behaviors stop? He is the best behaved student in the class, filling his entire incentive chart each week for a treasure box surprise? Whose child is this? We have a fairly structured routine (not schedule), but ALL of my children, boy or girl focus better when they can expend their energy outside during lesson breaks. The cut recess out at our local elementary school after 2nd grade (they get PE instead). Not good. Some of my greatest joys schooling at home is watching them explore the yard, woods, creek.....some really learn better when they can move around a bit! This stat just made me cringe so I wanted to comment.
     
  17. jenm999

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    No, I don't think he was putting on a show for me. And the behavior was consistent with what we see at home. What was eye-opening was seeing him in comparison to his peers.

    Definitely not leaping to medication, especially given the T1. Hoping to hear back from that specialist today for a consult. We are playing the long game - mental and physical health comes before grades. But at some point this behavior may impact his self-care and self-esteem. So important to tackle this now while he's pretty happy-go-lucky.
     
  18. mwstock

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    In January my ten year old son with type 1 was diagnosed with epilepsy. The type 1 diagnosis is hard enough. Just when you seem to feel comfortable managing the one, the second diagnosis hits you sideways. I know my wife was very hesitant to put my son on medication for the epilepsy. His last seizure was severe, so the doctor persuaded us based on the risk and history. obviously it was clear when my son had the major seizures, but we did not notice he was having absence seizures. After he went on the seizure medication my wife noticed a dramatic improvement in his attention span. He was not staring into space or day dreaming while doing home school at our dinner table. The human body is complex, so it could be a multitude of things or at least can be a process to diagnose issues. I just thought of our journey when you mentioned, lack of focus.
     
  19. jenm999

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    Thanks for that perspective.

    Well, we met with the child psychologist last week (the one who specializes in kids with ADHD and chronic health issues, and has T1 herself) and she says he's unequivocally ADHD, both based on his observed behaviors and according to his neuropsych profile. We are exploring a medication trial, especially as I read more about ADHD and understand that it's not about willpower. Decreasing screen time and processed food will help but won't change how his brain is structured. I'm also learning more about how ADHD medications actually work (they don't dull the impulses; the stimulate the control). I'm a little sad that he has to deal with another thing on top of the diabetes but also glad to have an explanation for his behavior.

    Interestingly his testing showed he was in the 95th+ percentile for all cognitive areas but in the 16th for processing speed. SIXTEENTH! That sure explains why he was bombing on all assessments, which are all timed.

    She also talked about how kids with ADHD seek activities that fit in a narrow window - interesting enough and challenging enough to hold their attention but not so difficult or overwhelming that they get frustrated. Right now for us that's Lego. But he's also super compliant with his d-care. I had viewed this as evidence that maybe he did not have ADHD; she feels that self-care is falling into that narrow window right now because he has a good grasp of the disease and it plays to many of his strengths. She says this is GREAT and we are doing a good job (not medically, but in terms of his acceptance and involvement). So that felt really nice to hear.

    Anyway, thanks for the feedback.
     
  20. quiltinmom

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    I'm curious, did she observe him, or did she go off of behaviors you described? Pure curiosity, nothing else.

    My kids love Legos too. :)

    It's good you know what's going on...while it is another diagnosis, at least you know, so you can do something about it.

    Good luck!
     

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