Almost 10 year old just diagnosed with ADD. Now what?

December 29, 2019 9:08 AM

After testing with a child psychologist, she confirmed what I had suspected which is that our almost 10-year old son has ADD (but NOT ADHD). He has pretty significant deficits in working memory (nothing in the lower average range, but definitely way below normal).

Medication: the doctor indicated that medication might be helpful for him, but was not a necessity. Neither husband nor I are opposed to medication at all but I will reach out to his pediatrician who knows our kid well and is super awesome for his specific recommendations. For this type of ADD, what medications are usually prescribed? Does anyone have a kid who is using ADD medication at this age and what has been your experience? Are the rumors of stunted growth with ADD meds true?

Tutor: he has a tutor already who has a kid herself with ADD but he sees her once a week for an hour so I don't know how much progress she is going to be able to make with him in figuring out hacks for his working memory problem. That being said, she has already made some amazing progress from where we started.

Vision: thanks to the Hive mind suggestions to have his vision checked, he has been diagnosed as being farsighted and has glasses now with a good prescription. He is also on a waiting list for vision therapy as he has some significant tracking issues.

School: this is where things get murky. His teachers do not see that he has a problem. I understand this as he is not outright failing (anymore) and does not have the hyperactivity problem that would make it more apparent to them. That being said, they are happy to work with us. Do I need to consider a 504 plan? He has handwriting issues too that may require occupational therapy. Should we try to get that through the school or just go the private route?

Is there anything else that I should be considering, evaluating, or seeking?

posted by tafetta, darling! to Education (4 answers total)

I have ADD (not ADHD). While it causes problems for me, I have really come to believe that the different way I process the world is a gift and not a problem in and of itself. It did make school tricky because school tries to be one-size-fits-all, and ADD doesn’t quite fit.

Two big tasks for him will be learning patience and learning to assume he’s missed something on the first pass through any work. I remember your last question, and thinking it described me at his age. My mind was like a fast-twitch muscle—I would sprint through a test and finish early, getting the hardest questions right but making a number of boneheaded mistakes that I could have avoided had I checked my work. He will learn he needs to use the extra time he has from finishing early to go back over and over and over his work and check for “sloppy” errors (they might be sloppy but they are so tough to spot!). He will have to learn how to tolerate that flare of impatience and dislike of not doing something right this second. I bet meditation would help, or any other practices that help kids learn patience and sitting with mental discomfort, because there’s a lot of that with ADD. Even some more traditional practices like etiquette, that give him good reason to practice holding back from cutting people off mid-sentence if they aren’t getting to the point.

Most of all, he will lean that it’s ok that his mind works differently. Things that he needs to use that others don’t (like alarms or sticky note reminders) don’t mean he is deficient, just different. If these are presented as “life hacks” rather than crutches, they might be more appealing. I spent unnecessary time as a kid resisting the fact that I would just not be good at some of the things treated as simple in school, like memorizing dates in history class, or even understanding directions. I could tell you exactly what the page of the textbook looked like that described the Battle of Bunker Hill, but never the date or the names of the people involved. That’s ok. On the other hand, any writing class worked great for me: the emphasis on writing multiple drafts, the creativity, the lack of rules.

School (before college) was also tough because of the strict schedule. The same classes every day at the same time. Homework every day at the same time. (The drowsiness that can come with ADD feels insurmountable when you have your most boring class first thing in the morning or right after lunch. Ugh!!) Make sure he gets good physical activity and fresh air as much as possible. Let him play around with listening to music while doing homework, or having little things to fiddle with on his desk. For me, it was like my mind was two parts—having music or something to do with my hands occupied the part of my brain that would have distracted me otherwise, so the other part of my mind could focus on my textbook.

That’s not to say that medication isn’t helpful—I was medicated by the end of high school and in college. But being diagnosed late meant I came up with tricks on my own to get me through, and it’s those that have been most useful to me in life as an adult. (I still need to work on my patience...) As an adult, I love the mind I have and the interesting way it works.
posted by sallybrown at 10:07 AM on December 29, 2019 [13 favorites]

Yes, I would pursue an IEP/502 plan. It can be the gateway not just to getting him services but also to getting him exemptions and/or access to assistive technologies like being able to type his homework; being able to type his tests and exams; being able to use noise canceling headphones in school; and extra time on exams including his SATs and ACTs. It also gives you much more leverage when dealing with a school failing to independently acknowledge there is an issue.
posted by DarlingBri at 10:15 AM on December 29, 2019 [8 favorites]

I was diagnosed with ADD as an adult after having severe problems in basically every school task that wasn't a standardized test up through grad school (which is where I finally got tested). Just in my own experience, the meds would have helped dramatically more than the assistive technology stuff—the meds are amazing, even though they don't bring me up to the executive function of a person with a more adapted-for-2019 brain.

What I was told when I first looked into them was that people with ADD (or inattentive ADHD) often need higher doses than people with ADHD, and that treatment doesn't always work as well. Stimulants are probably what you'll be prescribed—the other medications (Intuniv, Kapvay, etc.) seem more targeted at people with hyperactive symptoms and mostly just made me sleepy. (In fact if your kid has trouble sleeping on a stimulant they might prescribe one of those to take at night.)

Strattera is a non-scheduled drug, which makes it easier to get and perhaps makes non-psychiatrists more comfortable prescribing it. But it was originally targeted as an antidepressant and works the same way (you take it until it builds up in your system, no immediate results, taper off if it doesn't work) which to me was a much scarier prospect than just taking a stimulant that works in 20 minutes and is going to be out of my system in six hours if I hate it.

I took Ritalin (immediate release methylphenidate) for years and found recently that Adderall (immediate release amphetamine) was way better for me, but I would recommend giving both a couple of months as a trial so that you know how they affect him after the dosage is dialed in. The extended-release versions of both drugs might be a better fit for your kid, but as an adult I much prefer being able to control when I'm on it and off it, since there were days when an extended-release drug just wouldn't "pop" in my system for whatever reason, or would stay there too long.
posted by Polycarp at 12:55 PM on December 29, 2019 [3 favorites]

Additude Has lots of information, including podcasts.
posted by oenzemain at 4:24 AM on April 30, 2020