Any advice re adhd?

[howmanybrokenbones]

Regular but name changed. I put this in AIBU to get comments because I really want to know what is 'normal' for a 13 year old boy. Have been directed here for help...

OK, middle lad just turned 13 and today we were in casualty (for the 7th time in a year). Today's exploit was an exact replica of one in October 2009, broken right hand after hitting a door in temper. Other incidents have included broken collar bone (being daft - normal daft! - on bicycle) and a very badly broken arm from jumping out of a first floor window when dared to by a friend.

History - has always been impulsive and struggles at school. he is a lad who cannot sit still. He is bright; his mental maths is exceptional but he is unable to focus long enough to get stuff on to paper unless he has one to one help.

Schools over the years have mooted the idea of ADHD and he might well be mildly dyslexic. He has been to excellent schools and they have offered a lot of help and support without the label attached. I have been reluctant to affix a label, I genuinely do not know where the difference lies between a 'normal' active boy and a child struggling with ADHD.

The A and E said I should take him to the GP and get him some anger management help this morning. I just don't know what to do. He is the kind of lad who if given a 'label' especailly at school, wil use it as an excuse to not conform. But...I am begining to feel as though I can't keep him safe. He is getting bigger and more independent and making more and more mistakes that result in him being hurt.

We have done the fish oils etc (perhaps some improvement but little) and have tried very hard to get him to think before acting. He is permanently in trouble for being vile (he is aligning himself with a thuggish group at school now) and has terrible relationships with is siblings (eldest has a diagnosis of Asperger's). Even meal times cause a row as he is incapable of remembering even the most basic of table manners.

He is very very sensitive and gets very upset by any change at all. He hates being in trouble and being shouted at with a vengeance. He has had a tough couple of years with starting secondary school coinciding with his father leaving home for a while. His dad is back and things are reasonably stable.

Oh I am really not sure what is reasonable or not. There is more to tell I think but this is sufficient (if you have read this far!) to give people some idea of what he is like and to perhaps compare with their own experience of 'active' lads.

I am at my wit's end; quite literally.

This is my next comment in answer to some advice to seek help....

Ok I know this really. I work in this sort of area. I also know enough to be sceptical about the diagnosis in some cases although I have seen kids where diagnosis and treatment has changed lives for the better. I have a deep mistrust of local child services; that is a major issue! I am just no longer able to be even slightly objective in thinking about my own child.

I just hoped that there would be parents coming on here saying my son is exactly like that...we tried x and this helped!

howmany, to be honest, in reply to your sentence "I have been reluctant to affix a label, I genuinely do not know where the difference lies between a 'normal' active boy and a child struggling with ADHD.", I would say "It isn't your job to know. It is your job to take your DS to someone who does know."

Whether your DS has ADHD or a temper that needs controlling, he obviously needs some sort of help because he needs 1:1 to sit still long enough to concentrate, and he keeps breaking bones!

I am glad that he gets help at school. But one day he will leave school, and be expected to behave in an adult world. He needs help now to give him skills that he will rely on in the future.

Take him to the GP, tell him the history, and get a referral to either a developmental paediatrician or CAMHS.

I'm not a diagnostician, so I can't comment on whether it is ADHD you're seeing or whether he is reacting to the changes in his life (doubly hard at that age, anyhow).

In your shoes, I'd be asking for a referral to CAMHS. Label or not, he sounds like he's not in a good place mental health wise and could do with some positive support. While you're concerned about him being labelled has having ADHD, or whatever, I'd be more concerned about him ending up labelled as a trouble maker like the other boys he hangs out with. That would have far more negative connotations for him in the long term, specially given the fact that he's so sensitive to criticism and being in trouble.

You are both right. I feel very guilty for trying to manage, unsuccessfully, for so long.

Don't feel guilty. It's easy to hope that you're not really seeing anything serious because you don't want these things to be happening to your child, after all.

I probably sounded harsh in my original reply to you, but the fact that you've recognised that something is amiss and posted here about it tells me that you are worried about it and that you want it to be dealt with. Good luck!

I have no idea whether your ds has ADHD or not.

However would just like to add, the fact that he is angry and hurts himself, can be a 'symptom' of other things and disorders beside ADHD.

You don't need to feel guilty - believe me, if you get a diagnosis, and find that your DS does have ADHD, you'll spend the next few years feeling guilty that you haven't done enough to make life better for him. It's human nature

Concentrate now on being his champion - He is not just a clumsy 13 year old who is careless. He is your darling son who has been in A&E 7 times too many this year. He has a history of self-injurious behaviours, whether through lack of care and attention to dangers or impulsivity. He also needs 1:1 support to access the curriculum.

Book an appointment with your GP, and tell them what you want - a referral to a developmental paediatrician and/or CAMHS. This is a crucial time for your DS. He needs real, active help before he hits year 10.

You can do this

Thanks

Going to GP after school tonight. Taking son with me. Any advice? He drove me up the wall last night as I had to repeat myself over various tings so many times. Not sure I feel very objective today.

Added to which he accused eldest son of stealing money - I suspect he is trying to get eldest into trouble but just don't know.

Whatever is going on he wants more attention than he is getting but we just can't generate more time for him without taking away form the other two. Feeling a bit low...

Tell the GP what you told us: that there's things going on with him that are a real cause for concern and that you appreciate that 13 is an awful age, but 13 year olds aren't generally so nihilistic and careless with their own safety. Add that there has been a lot of upheaval for him over the past few years, add that ADHD has been suggested several times in the past, but not followed through on and ask for a referral to a child mental health specialist (which will probably be CAMHS). Hand the GP a list as you walk in if you don't think you'll hold it all together.

And good luck.

Ok

Son now very angry with me - he says he does not need help and feels got at.

GP says to get help via school and ed psych. Son does not want to do this. Without cooperation everything is going to be useless.

I feel like I have made things far worse and achieved nothing.

Tell the GP to refer your son to CAMHs nevermind refer to EP and school! If he won't ask him for his reasons why not in writing. Then right your reasons why in writing and request a 2nd opinion.

Don't take your son next time you goto the GP either, the GP should have asked your son to wait outside whilst you were speaking about your son to him.

The school would only most likely tell you that they can't get the EP involved without a medical referral. Agree that you need to go back, without your son and ask for the referral to CAMHS.

OK GP very good. Local CAMHS is crap, I think he honestly thought the EP service would be better. However, am sure GP will do as asked.

Hi, wow what a time you have all had! Guilt though is not productive. I may well be that he does have ADHD. It's relatively easy to diagnose and involves the use of an assessment known as a Conners Rating Scale. School complete one section and you complete the other. The scores have to agree with one-another because if you have ADHD in the playground you should also have it at home. Strange as it may seem the first line of treatment involves a drug like Ritalin (to you and I amphetamines) and the effect can be dramatic. However, sometimes the type and dose has to be adjusted to suit the child. Finally the most important aspect to consider is running a behavioural programme in conjuction with medication as he will have learned inappropriate behaviours while coping with his ADHD. Children tend to get more control over their impulsive behaviour as they get older. Hope this helps. Sorry for long text. Best wishes.