Well, it's official. Carter has ADHD, too. To be honest I would have been more surprised if they told us he didn't have it, so it's not like it really changes anything at the moment. The therapist was probably shocked when we didn't do more than nod and shrug, but between having been through it with Jacob and being nearly positive that Carter's behavior was a textbook case, it was sort of a "been there, done that" moment.
So now what? Well, we start therapy. I'm honestly not sold on this therapist yet. He's pretty new, sort of a low talker, and so far hasn't shown signs of really relating to Carter. I felt like the evaluation was really by the book--like literally, he was reading us descriptions and explanations right out of the paperwork. We filled out a few evaluations, his teacher did a set of scales and the school psychologist provided some insights from observations, and beyond that he basically observed Carter in passing while he was reviewing paperwork with us for two sessions. How you can diagnose someone without talking to them at length, I'm not entirely sure. I don't think the numbers are wrong, mind you, but it struck me as different than what happened with Jacob. Jury's out, but we'll see.
Next up, the therapist checks in with the school and we maybe consider a 504 plan to ensure he gets whatever help he needs, which would probably still be on a pretty low level. Maybe a different seating arrangement, maybe a little more time or an extra break. He might try out some social skills classes at the therapist's office. And yes, we're trying to start the process toward medication. Maybe that seems quick, but we've been dealing with symptoms for long enough that it's clear behavior modification is hard, and at the very least will take awhile. It's not like we haven't been trying already. We saw medicine make such a huge difference for Jacob at school. He went from hating school and disliking his teacher to liking school and loving his teacher. While Carter may not have the same immediate change (they are SO different, after all), even the thought of taking some of that school burden off him sounds so huge. He has struggled for so long, and the idea of being able to even the playing field a bit, to calm all that's rushing through his brain, and to give his body a break could make a huge difference for him. I want all of this to be easier for him, and I really think we need to take the edge off before anything else can start to work.
The problem is that we don't have a timeline on the medication. Apparently we get put in a queue. I don't know if that will be short or long. If it goes more than a couple weeks, I will likely see if I can check in with our pediatrician to get him started. Unless someone has a very specific plan, I feel like we'd start with the one Jacob took since he didn't have any negative reactions to it (and genetically that seems safest, no?), so I feel like it doesn't have to be a big to-do if that's set up to be our starting point. Just find the right dose and let's get it started. My urgency is that I'd like to get him started while school is still in session, since his teacher will definitely have feedback if she sees a difference. We'll see him at home, too, particularly on Wednesday, but school is a whole different animal in many ways, so I know her feedback is essential. On top of that, it would give me serious peace of mind to know before the end of school if it's working so we can either make changes over the summer or simply be comfortable we can start third grade on the best possible note. I don't want him getting a rough start, getting that negative reputation, and then having to try to make a comeback in the midst of much harder school work. Third grade is what broke Jacob, essentially, as he had never struggled academically until then. That was our sign that he needed more help. Carter has never been at that same level academically, so the more we can do to help him, the better.
Interestingly, he did not score on the anxiety scale we filled out, but did come out "above average" for the sensory one. He's shown a little anxiety here and there (like when 4-day school was restarting), and he obviously has some concern over self-esteem and how he presents himself, but his was nowhere near what we have seen with Jacob, and even he never had an anxiety diagnosis. But the sensory thing is interesting. If you look at some of the symptoms of Sensory Processing Disorder, he definitely fits the bill in many ways. He has had minor issues with foods and clothes--he still can't eat mashed potatoes, or really any non-fried potatoes without gagging--and he has complained many times about music or other background noise bothering him. He complained a couple weeks ago about his new, full classroom of kids being distracting, too. His motor skills are hit or miss--he can run like the wind but his balance is iffy, and while screens and games have always come naturally to him, writing and drawing have always been a struggle. I think in many cases, it's hard for him to take what's in his brain and translate it to paper. Anyway, the therapist seemed to indicate we could dig into that later.
In the meantime we'll focus on reducing impulsivity, hyperactivity, and lack of focus. We'll work on the sibling rivalry and the disrespectful talk. We have plenty to think about, that's for sure. But of course, since we pretty much knew this was coming, it doesn't change much other than to be another vivid reminder to be mindful of what he can and can't control. It's hard to realize both our kids were dealt different versions of the same crappy hand, but Jacob is proof that functionality is possible. We definitely have our challenges with him, too, but we are SO much more functional as far as he's concerned than we were years ago. Now we have teenage stuff to deal with, which is a whole different ballgame anyway. I've always feared both together, and while we have our moments, so far we're okay. We sort of always knew he was going to be a challenge (from 18 months on, anyway), but Carter was more of a surprise since he seemed pretty typical right up through around four. Something seemingly went off the rails at that point, but it's hard to know what. Was the beginning of reading and writing too much? Were his daycare teachers inadequate at managing him or were the kids bad influences? Did all of the bullying from his big brother hurt his self-esteem and ultimately encourage him to hide in his room with a non-judgmental device? Was the pandemic a major player, or just the straw that finally broke the camel's back? His brain definitely works in a very specific, quite rigid way right now, and it's a far cry from the laid back, sweet kid he once was. That part hurts more than anything. But we'll fight to find that kid again, as I think he's just buried in there somewhere under the rapid-fire brain and body. I hope so, anyway....for all of our sakes.
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