August 30, 2014

Attention, Please



“H, sweetie. H? Look at me. Over here. I need you to put this book in your room and then get shoes on. OK?”

She looks at me and vaguely nods. I ask, “What did I just ask you to do?”

The vague look briefly intensifies and then turns to a look of anger/annoyance. I get something between a whine and a grunt.

“What did I ask you to do, please?” I repeat.

After one or two more exchanges of that sort, I finally get her to answer me in words. “I don’t remember,” she tells me, not looking at me.

And then we start again. It either ends in the book put away and the shoes on or it ends in a tantrum and some time out.

It was moments like that, plus a lot of other things that finally led us to take H to a developmental pediatrician right around her birthday this year. We’d begun to suspect that she had Inattentive ADHD, and it turns out that she does. I know those of you who know H are thinking, “No! She’s not hyperactive. She’s so sweet and quiet.” You’re right. She’s not hyperactive. It turns out there are two sub-types to ADHD: Hyperactive and Inattentive. She has the inattentive type.

Suddenly we had an explanation for her behavior. We knew why, at five, I still had to stand in her room and remind her of every item of clothing that needed to be put on—sometimes multiple times. We knew why she seemed to forget immediately the things we’d talk about. We knew why she was sometimes so rigid in her preference for routine—asking her to brush her teeth at the wrong time of the morning could spell disaster.

The news also brought me such mixed emotions. There was relief that we weren’t crazy; that something actually was going on. Relief too that I wasn’t just a bad parent who couldn’t teach her kid to be independent. But then there was the realization that this is a lifelong condition. There was the fear of the hurdles she’d have to overcome to be the independent, successful adult we want her to be. There was concern for how she’d manage in school, and whether this meant a lifetime of meds to improve her concentration.

It’s been a few months, and I still feel all of that. You can also add in the frustration I feel when I realize that her behavior is motivated by the ADHD, not her desire to drive me insane, yet there’s NOTHING I can do to change it. I suspect that this is kind of a new normal, which I hope will improve as she gets older and her understanding of her world and herself improves.

I recently read my awesome friend, S’s, blog. She’s a homeschooling mama and was talking about her struggle to reduce interruptions from her three boys as she tries to provide each one-on-one instruction during their school day. She talked to her oldest two about the issue, they brainstormed ideas, put them into action, and she saw progress immediately. The kids are doing great with it, and everyone is happier.

It was sort of like reading fiction for me. That would never happen in our house. I would take the same route to try and talk rationally, on her level, about the problem. She would tune out two minutes later and interrupt me to ask a complete non sequitor. I would try to redirect. The conversation would end with me realizing the entire content was completely lost on her. We’d try again later. I’d try to implement some simple strategies. If I managed to stay sane and incredibly consistent then we might see progress in two to four months.

I’m not kidding. I’m not exaggerating. She’s a smart kid. She’s a loving child. She just can’t concentrate long enough to listen and remember things most of the time.

What makes the entire situation more perverse is the fact that Josh and I are both extremely logical people. We are cause and effect people. We are problem solvers. We are practical. When H begins to sob uncontrollably in the middle of a project because she can’t open the lid to a jar, we are both baffled and bewildered. To us, this is no big deal. Try again. Ask a grown up. Problem solved. To her, it seems as though a dragon has appeared and inserted itself between her and all the happiness in the world. Getting her to “see reason” is so difficult. Even after we resolve the problem, you get the sense that she may not have learned the lesson you were hoping to teach.

The list goes on. Her ADHD touches all aspects of her life—intellectually, socially, and emotionally.

I’m hopefully not whining here or even really venting. My purpose today is just to be real and express my concerns. I’m also curious if anyone else has gone through this with a child. The further we travel this rabbit hole, the more likely it appears that we will at least need to try concentration meds. This is not something I am enthusiastic about. So far, removing gluten from her diet has improved her appetite (a huge win) and lessened her mood swings (also a huge win), but it has not addressed her main problem of inattention. We could try more extreme elimination diets, but I fear that we will start to see push back if we start taking away things she loves, like dairy. She’s five, and it’s really hard for her to understand the abstract interaction of food and behavior. On an everyday basis, we coach her as best we can on coping methods when she runs into a speed bump, but it can be hard to find the right language and approach that makes sense to her. It’s almost like she speaks a different language. We just don’t think the way she does, and I feel like that’s starting to show more and more.

At times, I feel so distressed and helpless. I keep hoping that as she gets older, she’ll understand more and things will just click. But I fear the reality is that as she gets older and life gets more complicated, the problem will only get worse as her meager coping skills become stretched to their limit. How do we help our kids when we don’t know what’s best for them? Meds can be a dangerous path. Side effects can be worse than the symptoms they alleviate. She may have to be on them for years, and we don’t really know the effect on a growing brain. But not giving drugs could carry a heavy price in terms of self-esteem and self-confidence with “untreated” ADHD. Does she really need them? Or is it just that I want an easy solution? And nowhere did anyone issue me that instruction manual kids were meant to come with.

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