Shouting ADHD

[PooPooOnMars]

I read a thread on here recently that mentioned that children with ADHD tend to shout.

I have been concerned about my ds(3.10) and his ability to pay attention. He often just can't sit still, like on a bus or at the dinner table and doesn't seem to hear me quite a lot although his hearing does actually appear to be fine. At least if I go up behind him and say chocolate he hears me fine! It's more his attention is elsewhere. I also lose his attention very easily, for eg, if I am talking to him I can see his eyes go to the side as his attention drifts (my dad does that, sigh) and he then can't tell me what I have said.

Due to the family history I have been on the lookout for this sort of thing so perhaps are quite aware.

My question is about the shouting. I remind him that he is shouting and doesn't need to, and to pay attention to how close he is to someone before being so loud etc, but will this actually work? My sibling is a massively constant shouter but no one ever told him not to. It was like I was the only one in the family that is really bothered and it bothered me hugely! There was no guidance from my parents for any of their issues including their violence.

Am I wasting my breath trying to explain to my ds about shouting? Does is work? Anyone else dealt with this or have any other ideas?

(He is only young so not diagnosed or anything.)

Thanks

Yes, he can learn about controlling his noise level but it will probably take some time to get it. I'd persevere - he certainly won't learn self-control if it's not pointed out to him, and he will pick it up in time.

My son (now 13) was the same. I talked to him as you do to your son about appropriate noise level, personals pace etc and it did come eventually. I also made a card and dice game about tones of voice and noise levels, where we had to take turns to say a statement in different ways. It helped him to understand the different levels and adjust his tone appropriately, but it did take years.

DS2 is 6yo and really has no volume control unless you are right there reminding him constantly. We are working on it slowly, but when he gets overexcited (frequently) or upset, it all just goes out the window.

As I'm sitting here typing, he is next to me on the sofa bouncing while he eats, waving his arms, chattering, wiggling, and looking all over the room (or alternately looking at the television from all angles with his eyes glued to it while his head moves all over).

Thanks for the replies. :)

My ds 7 has ASD & ADHD.

Its a great idea to explain to your ds about shouting, my ds isnt even aware he shouts!

Hes getting better as hes getting older but i have to remind many times, every day.

Good luck.

my son has ADHD and yes he was really loud when he was younger but had no idea he was doing it. To them they are not shouting but they have no idea how loud they are when they are talking

I think (and hate to admit this) he only started talking at a more 'normal' volume when he was put on medication (age 7), although I do often still have to remind him about his 'volume' and he then (most of the time) will stop being so loud.

My DS is 6 and one of the biggest problems at school was that he was loud and would make nouses to himself. He was diagnosed with autism aged 3.5 so it was put down to that. However, I always felt he also had ADHD and eventually 3 months ago he was diagnosed with severe ADHD and put in Ritalin. The difference in terms of shouting when he is on Ritalin is very obvious. They had tried numerous behavioural strategies at school to stop him shouting but when he had the Ritalin it just stopped. So I would say that yes shouting can very definitely be down to ADHD. The Ritalin has finally let our son start to progress at school. I would say though that backing up with behavioural therapy is key. You can make a chart with scale of loudness on eg 1 is quiet, 2 is normal, 3 is loud and teach what voice volume is appropriate to specific situations. we were however told that behavioural therapy could only work once our son was on Ritalin as without it he wouldn't be able to concentrate and therefore listen to the behavioural therapy

How do those of you with children on ritalin feel about it? Was it an easy decision to make?

My son is on Concerta XL rather than Ritalin although I wouldnt be surprised if it was a form of it. Concerta is a slow release medication and I found ive only had to have it increased just the once.

I agree that its not just the medication that is needed but support from home and school in helping them understand the 'right' choices over the 'wrong' choices, including volume of speech. I have found using the term 'right' choices and 'wrong' choices are alot more effective than saying 'naughty' or other similar terms. Using the words I use I have found my son very much on board with what we use for discipline and having open communication, explaing all the time what is happening, what is going to happen or discussing why something has happened as also been of great benefit.

DS2 is not on meds at this point (he's 6yo). I honestly am a bit torn on it, and we've discussed it and agreed to wait a bit. He has a lot of physical and verbal tics as well as some health problems, and we're not keen on putting him on meds that may increase the tics or affect his health in any way. Not to mention that the thought of trying to get a tablet into him on a regular basis makes me feel like I'm going grey(er). It's a hellish struggle just getting LIQUID meds into him!

The idea of it really freaks me out but i suppose that's natural.

At the moment i can't imagine making that decision but he's still really young. If it was affecting his life at school, with friends, learning etc then i would have to see.

At the moment because he's young he's not hugely different to other boys his age. I think its a case of seeing if he grows out of it alongside his friends. Not being an expert i don't really know.

We spent years trying to get results on behaviour management techniques alone but there was very limited improvement, if any. If anything it proved more frustrating for ds because he was trying so hard to get it right and just couldn't. As someone upthread said, the child needs to have a certain degree of functional ability to process what you're trying to teach them and until that's there you're largely wasting your time. The medication makes that possible for them.

I was confident that I'd done all I could myself to teach him appropriate behaviours but although he understood what I said at the time, he lacked the capacity to think clearly and quickly enough in the moment to respond appropriately so he was constantly in trouble. He was given no support whatsoever at school, which included failure to support an NHS assessment into ADHD so we had to go privately for his diagnosis and trial of medication. The effects were immediate but in no way did they resolve his problems completely - it's still an ongoing challenge but it's far more achievable to make progress now than it's ever been. The drugs aren't magic and they aren't very effective on their own, but strategies and medication together can work wonders.

What's a sensory seeker?

Streaky. That's awful that the school didn't support you!

I would agree with streakybacon.

The best intervention for adhd is meant to be medication combined with Behavioural therapy. For us, our son has severe combined type ADHD and autism and behavioural therapy had a limited affect without Ritalin to back it up. The psychiatrist told us that ABA was very useful but would have minimal effect unless DS was in medication as he couldn't 'attend' without it. Once he was on Ritalin the noise at school dramatically reduced overnight having had 2 years of trying to tackle it behaviourally at school. School thought the noise was down to his autism but I am certain it is due to ADHD as he is not noisy when on medication but he always is when the meds are wearing off.

For us the Ritalin has ultimately made the difference between if he can attend mainstream or special school. Without meds his noisy behaviour was a real problem in mainstream but with meds he is manageable. he does have cognitive ability and I felt he would be held back in special school as in some ways his ability (eg in reading was in line with his NT peers) and also I feel he needs to learn how to interact by learning from NT children.

However the ADHD is still there even with the meds and we notice it takes about 20 minutes to work, it then works for about 3 hours but after 4 hours it wears off. I always know when it is wearing off as the whistling and silly noises and loud voice start again. One thing I would say is that our Ds is on short acting Ritalin as concerta (long acting) didn't work with him and he is on quite a high dose (35mg a day). We also notice that when the meds wear off eg in evening at bed time, the behaviour comes back worse than normal - almost a sort of rebound effect.

I am not entirely comfortable with my son taking medication but he has no Pre existing medical problems and I was advised it is safe unless child has certain Pre existing health issues (eg heart problems). Stunted growth can be an issue but children at monitored for it.

I look at Ritalin in terms of overall benefits - the way I see it is that the small risks of the medication are outweighed by the overall benefit to my son's quality of life - he also has autism and at least if he can concentrate and be less hyperactive we stand a better chance of him learning and being receptive to behavioural therapy.

ETA- it ultimately comes down to what is right for your child.

Meds aren't a magic solution but i think they have made a difference for us. But our son's needs are still severe and he Wil need full time 1:1 for the foreseeable future.

Would those with a diagnosed adhd child be able to tell me how severe it was at the age my child is? (3.10) Im not sure how you would rate that though

hmm hard one to rate,

at 3yrs 10 months everyone seemed to agree that my DS had ADHD as he was impossible to contain at playgroup and nursery. He was put on a IEP at nursery which has gone with him all through school.

I avoided taking him shopping or places where if he became hyper or difficult it would be hard to remove him. The outdoors was great, parks, fields, anywhere without danger of traffic etc was a good way to release some of his energy.

I know he couldnt sit for story time at playgroup or nursery because of disrupting all the other kids and would be sat with a assistant doing an activity.

there was a huge difference between my DS and the other children his age so it was easier to see what was going on. Look at his other behaviour and see what it is like in regards to the other kids his age.

PooPoo You don't know the half of it! Bearing in mind he already had a dx of ASD, he should at least have had some support for that, but the ADHD was always denied, even at the same time that he was causing major disruptions in class and at breaks. It's why we home educate now - four years and I haven't regretted a minute of it.

As for rating him at pre-school age ... well,I ALWAYS felt he had ADHD from very early on, but in time we were led down the autism path initially (dxd at 7 years). I still felt there were elements of his presentation that were more consistent with ADHD but nobody would listen. In fact, up till the dx came the general approach from CAMHS, school and everywhere else was "Wait and see, give it another few months" during which time he was getting progressively worse.

At 3.10 or so ds was very loud, hyper and forceful, couldn't sit still for seconds or focus on activities or games. We called him Forrest Gump - get him out into an open space and he would run and run and run. He was constantly seeking input, needed to be stimulated all the time. And extremely oppositional - he'd willingly go without treats (if that was the sanction we imposed) to prove himself right and get away with stuff. He was highly manipulative even at that young age. He had tons of problems at nursery but none of the staff flagged it up - I had no idea of ADHD or ASD so didn't equate my concerns to those conditions.

If you're concerned about whether or not your son might have ADHD and whether you'd need to consider medication to treat it if he does, it's worth bearing in mind that in some cases a drugs trial is used as a deciding factor in cases where the usual assessments have proved inconclusive. Essentially, if you have ADHD then you will be more likely to respond positively to methylphenidate and if you don't it will have the opposite effect. Lots of consultant psychiatrists will use the drug trial in this way if they aren't certain about the final dx.