Parenting a 7-year old with anxiety, ADHD, and a learning disability
September 7, 2021 7:33 AM   Subscribe

Our 7-year old has been diagnosed with anxiety, ADHD, an a math-related learning disability, and some related issues by a private psychologist. We have some external resources lined up, but I could really use some help parenting.

Kiddo has been in therapy with a LICSW for a while, who recommended the Psych assessment. We have been working with our school district for a while on some informal accommodations given kiddo's struggles (even prior to the psych diagnosis) and are in discussions with them to get some formal accommodations and a special learning plan. We are also getting a consult with a developmental pediatrician for potential pharmacological treatments either for the anxiety or the ADHD (psychologist recommended probably starting by trying to control the anxiety, rather than trying to address the ADHD).

Kiddo has been in some amount of turmoil since kindergarten, so the official diagnosis should not have been a shock, but, man, it was a shock.

SO and I have been trying to address and support kiddo's needs since forever, of course, but it some ways it always seemed like our family responsibility--finding what works for our goofy, rambunctious kid. Now with (multiple!) clinical diagnoses that require (multiple!) professional interventions, I'm a loss. I have no idea whether the approaches we've been using just to get through our days actually help kiddo's long-term growth and development.

We will continue to get advice from the psychologist, the LICSW, the school, the developmental pediatrician. But it will take time, whether weeks or months, I think, to get all the input and feedback that will inform what I think we "should" be doing to support kiddo's needs.

You've been here and found your way. How did you do it? Looking both for the usual AskMe fare on being a parent to a kid with these issues (books, websites, podcasts, whatever), as well as the perspective shift from what feels like "family unit parenting" to "it takes a village parenting."

Hope me!
posted by myaskme to Health & Fitness (13 answers total) 5 users marked this as a favorite
 
Flexible routines. Some kids love very structured routines. Mine likes a fairly flexible routinem and is fine if things are a little late or early as long as they repeat. We limit new experiences to once or twice a week max.

Lots of outdoor nature really helps! Days we go for long walks or have outdoor exercise are much better.

We explicitly model and talk about friendships and working with peers. We practiced what to do with bullying, with a regular fight with a friend, sleepovers, asking a teacher for help, etc.

I write short lists of what they need to do each day that includes things like brush teeth, shower, do homework X, do homework Z, play games for 30min and then they can work through the list instead of wandering about in a daze. This did not work when they were younger, I had to literally remind them of each step throughout the day, but working up to a written list has been great.

Expect things to get misplaced and lost. My friend with regular kids will give a consequence for losing a water bottle while I will just shrug, remind my kid again to keep track, and pull out another cheap water bottle replacement. My kid now keeps track of her ID pretty well, but two years ago, no way I would've given them that responsibility. Adjust your expectations to be several years younger (you wouldn't be surprised if a 5 year old lost a water bottle!) and that they will lag behind their peers for some things like neatness and organisation.
posted by dorothyisunderwood at 8:06 AM on September 7, 2021 [8 favorites]


At first I just assumed that “goofy and rambunctious” was the natural state of children, but after we ran headlong into some school difficulties during first grade, we realized some more intensive management at home would be required. Which I guess is to say that I think you might be ahead of the game, already knowing your kid has some different needs before winding up “in the system.” You’re not starting from scratch here, and that’s great.

The first thing I tried, on the strength of someone else’s AskMe actually, was the Superflex curriculum, which takes common childhood self-management struggles and makes them into villains that can be defeated by Superflex the superhero. It was designed for one set of neurodivergent kids but I think has actually gotten much wider application. There are books, games, and a lesson plan. It took months to get Little e into therapy, but when we got there we learned that her SLP used this too and so effectively we’d given her a couple months’ head start. She had great fun with this stuff, and I recommend it.

Mr. eirias has been the king of the daily routine. For Little e, organized silliness is a huge motivator, so we built on that strength. Mr. eirias wrote a silly song for her that he would sing at drop-off to remind her of all the stuff she had to do when she got to her locker. At the tail end of the ride to school he would also go through a simple checklist explaining things you would think would be obvious to most people (“Listen to your teacher. Participate in class.” Etc) but that Little e benefited from having spelled out. Your kid’s list may vary. For several years we practiced nighttime routines — the same little list of three, then four, now seven different jobs that need to be done before bed. Little e is a pro now but I think it took longer than most kids to get there. A year of virtual school helped immensely, I think — like dorothyisunderwood, we found the ability to write daily checklists so helpful — although (one hopes) that is not an intervention that is likely to be available again en masse. (It’s worth noting too though that seven means your kid had barely any school experience before the pandemic probably made things weird… so keep that in mind, and try not to panic.)

When things were especially rough at school, we asked for daily (brief!) feedback from Little eirias’s teacher. This had two positive effects. One, it gave us the ability to reinforce at home, especially the behaviors we wanted to see more of. We found that punishment is best used as a spice — too much of it wrecks the whole meal — but teachers are busy and left to their own devices they will only tell you about the problems. Two, it built up our relationship with the teacher, which was key to everything, on all sides. It sounds like you are probably starting in a better place than we were, if they’ve been willing to accommodate your kid’s needs without a diagnosis. I think that bodes well.

I would suggest you not get too tied to the specifics of your kid’s compendium of diagnoses. Little e has a different set of labels but the classroom solutions are often highly overlapping. The same week we met with the neuropsychologist, I was at a conference where I saw multiple posters on the topic of how difficult it is to tell some of these apart and how one of the major factors in which one you get is less about the specific difficulties than about their intensity. I think framing conversations about IEP/504 plans (or whatever structure your school and your country allows for) in terms of your kid’s specific known needs will be important, rather than just sticking to a menu defined by the diagnoses themselves.

Finally: in the midst of our difficulties I was told by a person wiser than me that Little eirias would grow and change. She has. The other night she said to me, “I want to slice all the bad memories of school out of my brain because it’s so fun now!” It still pains me that she has those memories, but what I most wish is that I could give Past Me a glimpse of Present Little e, full of all the confidence she had in abundance before her early school years took it away. Absent a time machine, I’ll share that with you instead.
posted by eirias at 9:25 AM on September 7, 2021 [12 favorites]


ADHD can have a lot of variability, so your mileage may vary. Having 3 kids with ADHD , each had different issues, two needed 504's (the NJ designation to get official school recognition/help). One had medication early on, after a few years of trying non-medical solutions/paths, and then he came off medication in middle school. Though, now 23-ish, he says that we should have kept him on, and is looking to work with a doctor to get prescribed again. He was able to compensate, and was an 'A' student, but struggles with attention, executive dysfunction, and organization.

The other two also have similar struggles, though. Two of them go to therapy and that helps, as well. They get strategies for handling different issues, and can talk through problems.

Positivity and flexibility, as noted are important. And they can be successful - though socially there were many struggles. And working with the teachers was important, though we had to fight fairly hard to get the 504's approved and followed.

Having a schedule helps alot- which can be an adjustment if you're a spontaneous type. knowing what to expect and when helps them plan and organize better. Lists, whiteboards, and even timers are good. Though you need to look at if things are becoming overwhelming and adjust. Trying to fit too much into a schedule can be worse.

Also, I know that excess sound and noise affects one of them a lot, so especially when out, or at a birthday party where there can be excessive sounds, etc... good to pay attention on if that is a trigger for them.

Also, don't feel like you're locked into the first therapist, psychologist, neurologist and whatever you see. There is a lot of variability in their approaches, and some are better with different ages, and even different types of ADHD issues.. so if someone isn't working out anymore, or you don't feel they're attuned to your little one, do find someone else for a 2nd or 3rd opinion.

Easing into changes also.
posted by rich at 9:52 AM on September 7, 2021 [2 favorites]


Don’t be afraid to push your school on getting an IEP if you believe it is appropriate. All public schools in the US are required to provide both IEPs and 504s, although there are some significant distinctions between the two. It is all well and good not to be adversarial, but do not hesitate to hire an educational advocate or attorney familiar with your jurisdiction and district. Do not assume competency on the part of your school district. Based on the number of dropped balls over the years, I regret every time I thought “well, they must be doing it right; this is their job.” When doing it right is expensive and resources are slim, there are incentives to cut corners, and that can be the difference between a shitty school experience and a good one.
posted by chesty_a_arthur at 12:24 PM on September 7, 2021 [3 favorites]


To be clear I’m not addressing that to anyone in particular; it’s advice I want to give myself 10 years ago, countless tears, and one out-of-court settlement ago.
posted by chesty_a_arthur at 12:26 PM on September 7, 2021 [1 favorite]


Yes, yes, yes!! chesty_a_arthur. There is an inordinate amount of push-back from school districts who have to have a lot of professionals involved in testing and then accommodating kids with learning disabilities, or actually any kind of disability. Parents need to school themselves deeply on the subject, including the law. An appointment with a local educational disability attorney to outline what is required of the district and what accommodations are mandated would be very, very helpful, as well as a local parents group, which can identify problems in your school district. All this testing and accommodating is resisted by school districts. It's very expensive and requires lots of professional meetings and kiddo might need to be pulled out of class regularly to receive his mandated therapies, like OT or speech therapy. Schools must then find quiet spaces for the child and professional to meet, which can be a challenge, since the professionals usually travel from school to school without offices in each building. You will not want to hear that your child's 30 minute session was terminated at 15 minutes because the meeting room was double-booked. It is not your job to find a suitable room; it is their job, and you must then insist on another session.
You must, in other words, be the fulcrum of all the interactions with schools and therapists. It can become a full-time job to monitor and stay on top of everything.

Two of my daughter's 3 kids have IEPs for ADHD and a couple of other speech issues, and even with them in place there is constant juggling around school holidays. In PA kids get re-evaluated every 3 years. But for her youngest, who was evaluated in May before kindergarten (as a preschooler he was evaluated and received services, but starting regular school is a completely blank slate. The Eval must be done all over again by the district's special ed professionals). The school district has a whopping 90 days to complete all its evaluations and make a report, but the summer doesn't count! So since there were 5 weeks that school was in session since the eval in May as part of kindergarten readiness, the report is not due for another 2 months after school begins. So the child will miss whatever accommodations he deserves until after the report is completed sometime in November. My daughter is very well known as an advocate for her kids, and although very civil she is a thorn in the side of the principal. But she knows her rights and what the kids need and deserve, and I think the professional special ed teachers, and the kids' classroom teachers, are thankful for her persistence and advocacy in pushing back against the principal, who is more of an apparatchik and less of an inspirational figure.

It's a whole new world for you, but remember that you are the expert on your child. Don't let an administrator talk you out of what you feel is important. You are your child's most essential advocate.
posted by citygirl at 1:11 PM on September 7, 2021 [1 favorite]


As a counterpoint, I think whether the “thorn in their side” approach is likely to have the best payoff is really situationally dependent. It sounds to me like you’re starting in a good place in terms of your relationship with the school and their desire to help. In your shoes, I think I might see how far grace and good will can take you before taking a hard line, because those things can be hard to get back once they’re gone. But I appreciate citygirl’s point that sometimes, maybe a lot of the time, the hard line is the only way.

I come from a different set of experiences — I infer from your question that your kid is in a public school, and so the hard line is a live option for you in a way it wasn’t for us in a private school. If not for grace, I wouldn’t have much in the way of hopeful stories to share here, I think, so there’s a bit of survivorship bias in my perspective. And there’s really nothing you can do about whether or not the team you have is one you can work with collaboratively. I expected an apparatchik — that I didn’t get one is an enduring mystery to me. If you did, I think you’ll know.
posted by eirias at 3:13 PM on September 7, 2021 [1 favorite]


I spent years trying to treat my anxiety first. Turns out life got so much easier and less anxiety provoking once the ADHD was pharmacologically treated.

Also, skills training. Not coping skills/therapy but actual work on organization / metacognition / organization skills. The kind of info that reminds me to think around the tendencies my brain has .
posted by bindr at 4:06 PM on September 7, 2021 [1 favorite]


I second looking into an IEP or a 504 plan. Special Education services these days can be really awesome and it's not (rarely not) the disorganized bullshit that was around (or not around) when we were growing up. You have legal rights and the school system should help guide you through the support process.

Also, something positive: I teach middle school currently and I taught high school before. Many of the middle schoolers were diagnosed at about the same age as your son -- ADHD, anxiety and/or learning disabilities -- and genuinely seem to be doing great as 7th and 8th graders. They have different interventions and strategies, some take medication and some don't, but all seem to be successful socially and academically too. Your kid is still the same awesome kid he's always been but now you have even more tools to understand and help him be his best!
posted by smorgasbord at 4:36 PM on September 7, 2021 [1 favorite]


Keep listening to your daughter, and involve her as appropriate.

Consider getting an outside tutor who can assist with building skills in areas of weakness, and help diffuse the parent vs. child vs. homework battle.

Find out what math/reading/etc, curriculum the school uses, and research legitimate criticisms about them. Something to keep in mind is that even if a curriculum "works for most children" it's not necessarily the case that it will work for your child. Make a plan to address the relevant weaknesses (e.g. lack of fluency in math facts -> start listening to those addition/ times tables songs now.)

You should be aware that just because the school hasn't mentioned to you about an area/skill of weakness... doesn't mean that there isn't a problem. Your daughter may be able to compensate to a point, or perhaps the school hasn't specifically looked for it. In short, do not assume that a passing grade means that your daughter has mastered the material.

Try to help your daughter have a life (e.g. people, activities) outside of school. If your daughter is interested, martial arts can be helpful.
posted by oceano at 4:45 PM on September 7, 2021 [2 favorites]


Oh and as a family, I think you will want to have a healthy and realistic view of grades (and make sure your dauther knows this). You presumably want your daughter to always do her best, but you also understand that sometimes grades measure other things as well (e.g. test anxiety).
posted by oceano at 4:53 PM on September 7, 2021


Your experience though unique certainly rings a bell from when my kid was 7 and I was overwhelmed by new diagnoses, constant 'issues' at school, and exhaustion and overwhelm from parenting an intense, misunderstood and wonderful kid.

Here's my reflections now that kid is 19:

- Sure, try all the stuff - it's worth trying - but no method or book or strategy will 'solve' things or make things significantly easier or answer all the questions. There are whole industries and ideologies telling you that yo have to do x,y,z but the reality is there is no perfect way to do this. You're going to muddle through, be imperfect, and have a different kind of family life than you imagined or than what the world will pressure you to have. It's a process, but work toward accepting imperfection and a lack of answers.

- Avoid being strongly goal oriented with the kid. Let them be themselves in the ways that are possible.

- Get support from parents who also have intense kids. Especially if their kids are a few years older, so they have been through some of this stuff already.

- Do not solicit or accept feedback from people with "easy", neurotypical kids, or anyone who conveys their belief that if only you parented the way they think you should, your kid would act differently.

- Take care of your own mental health. This is essential to being able to be patient and present for your kid who will need more support than many peers do. Take turns having days to yourself. Find a way to have a recurring date night. Get massages or therapy or things that help you rejuvenate yourself.

- Make a point to notice and aknowledge and reinforce the stuff you're doing great at! For example, it's clear that finding appropriate support and help for your kid is a priority for you. That's wonderful. Keep it up!

- What are the times when things feel great between you and your kid? Find ways to do that more. For me it's when I'm not multi-tasking and we can leave our normal environment and do something together. Find those things for you and your family and amplify them. You know how wonderful your kid is, in ways that others aren't always going to see. It's a beautiful thing that no one can take from you and that you can put at the center of everything else.

You show such love and commitment to your child in this question. You're doing a good job. feel free to direct message me any time.
posted by latkes at 4:58 PM on September 7, 2021 [7 favorites]


I have a good impression of the Superflex curriculum as well.

Understood.org provides free info and resources on learning disabilities and differences. It's run by a consortium of education non-profits and isn't trying to sell anything to parents (as far as I knew from when I used it a lot in 2019; I think they've always sold training packages for teachers). It looks a little more "appy" now then I'm used to but I think there's still some good stuff.

If you are in the US, there is a federally-funded non-profit for your state or region whose role is to help parents understand the educational options described above (504, IEP, evaluation timeline, etc). How those options function can vary quite a bit from state to state, and it can REALLY pay off big to talk to a local expert early in the process. They can also often refer you to other local resources. You can find the one that covers your area on this list of non-profits.

I would also be explicit with all the pros that your goal is "help kiddo's long-term growth and development" and that you are willing to read, take classes, try or buy things, etc (whichever of those or other things apply). Some families' goals are "just get through the day" and so the advice and suggestions may vary. If you have the bandwidth to do more, let them know, basically.

Now with (multiple!) clinical diagnoses that require (multiple!) professional interventions, I'm a loss.

I just want to reassure you that your kiddo is still the same "rambunctious, goofy kiddo" they were the day before you got the diagnosis, and you are still the same thoughtful, dedicated parents you were that day, too. Your kiddo didn't get worse or bad or damaged somehow; you didn't become bad or overmatched parents. The only difference is that now you have more information about some of the aspects that make them the unique kiddo they are, and a good start on how to help them. That's ultimately a good place to be, and it sounds like you are doing a great job already.
posted by Snarl Furillo at 6:43 PM on September 7, 2021 [3 favorites]


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