View Full Version : Diagnosis of ADHD at age 4


Dizfriz
10-17-11, 07:26 AM
New age guidelines from the American Academy of Pediatrics,

http://www.medicalnewstoday.com/articles/236069.php

Dizfriz

bree
11-02-11, 01:40 PM
Hmm a family history of ADHD and elimination of SFD in one so young do you think would assist improper diagnisis; IT IS SUPER YOUNG

Dizfriz
11-02-11, 01:49 PM
Hmm a family history of ADHD and elimination of SFD in one so young do you think would assist improper diagnisis; IT IS SUPER YOUNG

Just to clarify, what do you mean by SFD?

Dizfriz

Old School MBD
11-02-11, 01:59 PM
I was dx at age 4 with minimal brain disfunction....now known as adhd

anticipate
11-02-11, 02:27 PM
I can't say I'm surprised. Kids with extreme ADHD are like full-on F1 cars from the get-go. We began to suspect he was ADHD when he was only 2, and were certain of it by age 4. That's not to say I'm a big fan of medication at that age....

johndt
11-14-11, 05:56 PM
I agree. I suppose you can see the symptoms but medicating at this age is not a good idea in my book either.

happytexas
11-14-11, 09:57 PM
I suppose you can see the symptoms but medicating at this age is not a good idea in my book either.

If you were in the position of even considering medication for a 4yo, you wouldn't have to "suppose" the symptoms were there. Medication for children this young seems to have been reserved for those with aggression and/or are a safety risk to themselves or others, and who haven't responded to other behavior modification techniques--this recommendation doesn't change that.

If this had come out a few years ago maybe we wouldn't have had to live the misery that were years 4 and 5 of ds' life:mad:. 4 years old may be SUPER YOUNG, but ADHD symptoms at that age can really be THAT BAD.

bree
11-15-11, 12:32 AM
Just to clarify, what do you mean by SFD?

Dizfriz

Defriz sorry i must remember to subscribe to threads (I did once) I meant SPD or sensory processing disorder.

For those who dont know (My understanding is limited to so please correct any unintentional errors) it is often comorbid with autism but not always.


But it may be a stand alone diagnosis, children with SPD will be sensory seeking or overwhelmed by stimulation. I have only dealt with a child who is sensory seeking once and it can be so difficult and distracting, (this is my experience anyway) .

SPD mimics autism or ADHD or both but children grow out of it eventually to a large extent (as far as I know) and is currently helped with therapy from OTs by OTs. It may be in the next DSM or it may not but was considered for inclusion. SPD is more pronounced earlier in life and as I said could easily be mistaken for extreme ADHD early in life

ADHDTigger
11-15-11, 04:39 AM
I was both diagnosed and medicated at age four. I began kindergarden at age four.

My mother knew there was something that required follow-up before I was 12 months old. She was right.

In 1967, Sensory Processing Disorder wasn't broken out as an individual diagnosis. It as an element of ADHD- or Minimal Brain Dysfunction as it was known then.

Medication for children this young seems to have been reserved for those with aggression and/or are a safety risk to themselves or others, and who haven't responded to other behavior modification techniques--this recommendation doesn't change that.

I was never medicated as a result of aggression of self safety. Behavior techniques in 1967 were not beneficial even if known. In my own opinion, societal lack of education/understanding is the major source of impairment on the subject of ADHD.

It would be lovely if the actual EXPERIENCES of ADHD people were taken into consideration along with the stream of "knowledge". Believe it or not, those of us who have had this disorder for 50 years might actually KNOW stuff, scientific or not.

bree
11-15-11, 05:40 AM
Im sorry Add tiger I hope that was not something I said that upset you, I really need to consider what I say. The reason I did go on a bit was because I really think it needs more people at the root level to understand this. (parents ccc workers and teachers) because the lack of knowledge by us is at times staggering. But I may be more interested because of my ADD.

I'm not sure if one can still comment on the DSM site (it was open to the public too comment on but took an awful coincience and research for those of us not in the medical community to find out about it) OTs and other teachers and parents of . SPD (suffers??) did not know about it. SO I ran around like a silly sausage making people comment on it.

mcnay1
11-15-11, 09:19 AM
My son was diagnosed and medicated at 4 YO. Am I happy about it? No, but I was happy that he was then able to focus in school, have enough concentration to sit and learn to write and read like the others in his class and start to "catch up" and even surpass his peers academically. He has always struggled socially, but the medicine and therapy has helped in all aspects of his life. He is/was never hyper, but he did/does have a lot of wheels turning in that little head of his that he has to learn to either slow down or sort efficiently to live a good life. We struggled with the decision to medicate, as most parents do, nor did we take it lightly, and it was not the first thing we tried, but it has been one of the best things that we have done to advocate for our son. As much I regret that our son has to deal with this disorder for the rest of his life, I do not regret his diagnosis at 4 YO. It has made coping with his issues and teaching him to cope with his issues a lot more effective.

happytexas
11-15-11, 10:58 AM
In 1967, Sensory Processing Disorder wasn't broken out as an individual diagnosis. It as an element of ADHD- or Minimal Brain Dysfunction as it was known then.

SPD still isn't considered a stand alone disorder. The DSM-5 committee wants more studies done, saying that SPD doesn't meet the criteria as a separate disorder.

However, sensory issues are frequently the first sign that "something" is "off" with a child whatever the ultimate diagnosis, though often in hindsight. I think it is something that deserves more attention from general peds since they are more likely to have contact with an affected child than an OT or developmental-behavioral ped.

I was never medicated as a result of aggression of self safety. Behavior techniques in 1967 were not beneficial even if known. In my own opinion, societal lack of education/understanding is the major source of impairment on the subject of ADHD.

I guess I responded based on how it appears today. It can be very difficult to get anyone to even acknowledge the possibility of ADHD in a child under 6 or 7 years old, unless they are aggressive/violent or a safety risk--if a parent is "lucky." Though this may be a "corrective" response to how diagnosis was handled in the past.

It would be lovely if the actual EXPERIENCES of ADHD people were taken into consideration along with the stream of "knowledge". Believe it or not, those of us who have had this disorder for 50 years might actually KNOW stuff, scientific or not.

Agreed:)

happytexas
11-15-11, 11:43 AM
SPD mimics autism or ADHD or both but children grow out of it eventually to a large extent (as far as I know) and is currently helped with therapy from OTs by OTs. It may be in the next DSM or it may not but was considered for inclusion. SPD is more pronounced earlier in life and as I said could easily be mistaken for extreme ADHD early in life

I think that some improvement in SPD is due to physical maturity, though the ability of adults to better to manage/deal with it may also be a factor.

Time did an article a few years ago on the status of SPD (below), though the tone is a bit :rolleyes:. In the mainstream there seems to be a lack of understanding that though everyone may sometimes experience X or be bothered by Y (as exemplified by the "everyone is ADHD sometimes" comments), for others it is chronic and disruptive to daily living.

There is a lot of overlap in symptoms between SPD, ADHD, and spectrum disorders which is another argument for general peds recognizing their limits and referring out, particularly with preschoolers. Though this is an issue with psychologists and psychiatrists too.

To receive recognition, advocates must provide persuasive evidence that "this is not just part of autism or ADHD, that it's a better definition of what these kids are experiencing," says Dr. Darrel Regier, director of research for the American Psychiatric Association and vice chair of the DSM V task force. What's needed, says Regier, is a body of peer-reviewed studies that defines "a core set of symptoms, a typical clinical course" and, if possible, good treatment data.

Read more: http://www.time.com/time/magazine/article/0,9171,1689216,00.html#ixzz1dmryXkXQ (http://www.time.com/time/magazine/article/0,9171,1689216,00.html#ixzz1dmryXkXQ)

Information Processing Disorders (http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CGEQFjAC&url=http%3A%2F%2Fwww.ncld.org%2Fld-basics%2Frelated-issues%2Finformation-processing%2Finformation-processing-disorders&ei=fIDCTqnzK83isQKK2KHmAw&usg=AFQjCNE5Bs7dtWvnqpSNqXD2p3HQMYgRCw&sig2=73779ly2nXqDGspSRrDYRA)

Sensory Processing Disorder Explained | SPD Foundation (http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CFwQFjAA&url=http%3A%2F%2Fwww.sinetwork.org%2Fabout-sensory-processing-disorder.html&ei=NYPCTvrZMZGGsAKyh-2cBA&usg=AFQjCNHTeCi4ZBZs10zXGywHAHe4Uph9fw&sig2=bRqAESwvWyNy5r7Xr3aDqA)

ADHDTigger
11-15-11, 12:40 PM
Good info, HappyTexas! I keep hearing SPD individually identified and assumed that it had been defined as a separate disorder.

I can tell you unquestionably though that the sensory issues for me DID improve in my late teens until peri-menopause in my early 30s. Over the last 15 years, it has gotten progressively worse. I can only assume a hormonal interaction that is driving this.

The science tells us that ADHD is, in general, life long. I will always believe that the decision to medicate is an individual thing, but also see a value in early diagnosis. Behavioral intervention won't hurt a child and may help both the parent AND the child by setting in place habits and routines that are beneficial even if ADHD diagnosis isn't valid. While not proven- or even really assessed- it's possible that early intervention through behavioral modification might even help the ADHD child with the self esteem issues that are going to be as life long as the disorder.

I know the h*ll my mother went through to get me help in 1967. I need to believe that we are learning to NOT put parents through that now.

Lunacie
11-15-11, 01:41 PM
Defriz sorry i must remember to subscribe to threads (I did once) I meant SPD or sensory processing disorder.

For those who dont know (My understanding is limited to so please correct any unintentional errors) it is often comorbid with autism but not always.


But it may be a stand alone diagnosis, children with SPD will be sensory seeking or overwhelmed by stimulation. I have only dealt with a child who is sensory seeking once and it can be so difficult and distracting, (this is my experience anyway) .

SPD mimics autism or ADHD or both but children grow out of it eventually to a large extent (as far as I know) and is currently helped with therapy from OTs by OTs. It may be in the next DSM or it may not but was considered for inclusion. SPD is more pronounced earlier in life and as I said could easily be mistaken for extreme ADHD early in life

I don't know whether you mean that not all Autists have SPD, or if you
mean that other people besides Autists can have SPD?

I have SPD myself and it's gotten better and worse and better and worse
again over my lifespan. I'm nearly 61 so I doubt I'll ever grow out of it.

I'm hyper-sensitive, have ADHD, Anxiety and Depression. My 10 year old
granddaughter has Atypical Autism and is hypo-sensitive. We have to be
detectives and figure out what's making her irritable because she can't
identify aches and pains for us.

Dizfriz
11-15-11, 01:52 PM
One of the major problems with the Sensory Processing Disorders is that there is is little available for screening guidelines or clinical awareness of the possibility of it being present. As it has been mentioned, many are diagnosed as ADHD because the behaviors fit that diagnosis.

How does the average clinician, doctor or school counselor look for SPD? I have seen little even discussing this until a year or so ago. I do not remember seeing any professional workshops on this. That does not mean that there were none but I suspect there were few.

I am more aware of Central Auditory Processing Disorder because a neruopsych friend was interested in it. Otherwise I would have known almost nothing about it and would have no way of screening for the disorder and referring. I did catch a couple with this diagnosis as a possibility and was able to refer them out for an assessment.

This a problem especially until it is recognized as a legitimate disorder with reasonably clear diagnostic markers so clinicians can look for it.

There are a lot of these orphan disorders out there that clinician do not screen for. One very good reason is that there is not a lot of evidence that many of these even exist and the discussions often consists of vague generalities with few specifics. Clinicians need good screening guidelines to catch these things.

On the issue of treating for ADHD in 4 year olds: The evidence is pretty clear that ADHD can be a major issue with children this age. Many parents cannot find day care or preschool for these children.

I have never talked to or read of any professional liking to medicate kids for ADHD especially this young but one has to look at the consequences of medicating and those of not medicating. It seems that the Pediatricians have weighed in on medicating.

I tend to agree having seen some very severe four year old ADHD kids.

Just some thoughts,

Dizfriz

ADHDTigger
11-15-11, 02:27 PM
Diz, I know that the issues I have with sensory processing were considered to be part and parcel of ADHD when I was diagnosed. The two "signatures" that I recall are hyper-flexion of the hands- I am not capable of extending a flat hand, palm down. My fingers flex upward. The other was toe walking. I still do both of these as an adult.

I have an innate clumsiness that improved with dance lessons. It has returned with a vengeance post menopause. I frequently have the sensation that I am slipping as if on ice while walking on any surface. Stairs are NOT my friend and I cannot use an escalator at all.

I have a great difficulty with crowds and can become extremely disoriented in them to the point of shutting down. I have a similar intolerance for sound. Some sounds are painful to me at any level.

I am extremely sensitive to touch and have experienced times when someone just touching me is as painful as a slap. I can't tolerate certain fabrics and clothing tags are not a good thing. What makes this one tough is that I might be able to tolerate something on one day but not the next. I don't wear socks much because I don't like how they feel. Tights work better for me.

I also have synesthesia- but I'm told that it isn't related to the other sensory issues. I don't know if that is an opinion or supported by any research. In 1967, this was all considered to be part of ADHD.

As an older adult, I find that many of these sensory issues are more and more disabling. I also find that medication helps significantly.

Dizfriz
11-16-11, 03:38 PM
ADHDTigger

I very much think sensory processing disorders are real but with our present level of knowledge, they are very difficult to screen for especially with children.

Dizfriz

ADHDTigger
11-16-11, 06:03 PM
I completely agree, Diz.

I guess I question if sensory processing issues are separate from ADHD or if they are a part of it.

From the list I posted, another person might share all, some, or none of THOSE issues while having their own unique set. I know that I have seen toe walking associated with other disorders as well as ADHD for example, but is it merely a characteristic that is shared across multiple disorders or is it indicative of something else?

Maybe that is where my thinking was going- that along with the symptoms that define ADHD from a diagnostic perspective, there is a list of common characteristics that *may* be present with ADHD, and sensory dysregulation might be one of them.

bree
11-17-11, 03:55 AM
ADHDTigger

I very much think sensory processing disorders are real but with our present level of knowledge, they are very difficult to screen for especially with children.

Dizfriz

I totally agree with you about the lack of knowledge, it needs to be in the DSM because that appear to be the bible for many. Even though it should never have been and still should not be but we are all so busy and need something.

Why are we all so busy anyway? If we work in this area we should make the time or all phycoligists and phycitrists (spelling but you know what I mean) should specialise in a few disorders...no that would not work. Id love to know the answers.

Black_Rose1809
11-17-11, 06:28 PM
I think its a good thing that they are diagnosing children at a early age. It took until I was 9 years old to undestand I had ADD and it took until now, 20 years old, to diagnose me with the dylexia version of math. It can help them when they start school. At least the teachers will understand what's going on and what they should do.

happytexas
11-18-11, 10:52 AM
I think its a good thing that they are diagnosing children at a early age. It took until I was 9 years old to undestand I had ADD and it took until now, 20 years old, to diagnose me with the dylexia version of math. It can help them when they start school. At least the teachers will understand what's going on and what they should do.

:eek: I had not heard of dyscalculia before this; though after reading on it a bit I'm not sure if it applies to ds, I want to have him evaluated for it sometime this year, jic. We have an OHI meeting next week and a reeval at the Children's hospital in February where we could address this, and I'll ask his teacher to keep an eye on his progress in math with this in mind.

We try to be ontop of his education considering his issues and the trouble dh and I had in school at this age, particularly with math--ds has started struggling a bit with math but is actually doing pretty well learning his "math facts" for addition. Also, Dh and I both went for a long time with undiagnosed nearsightedness that affected us academically, and a recent a check-up found that ds needed glasses--ds didn't realize what he couldn't see until he had the glasses.

ADHDTigger
11-18-11, 02:21 PM
Happy Texas, the three most common LDs with ADHD are dyslexia, dyscalculia, and dysgraphia. Any one or any combination can be in play.

For me, its dyscalculia and to a lesser degree, dysgraphia. I can do math that relates to something else- how much fabric to buy to make a pair of pants, for instance- but am totally lost on the formula that would provide the same answer. I can make change easily but have more difficulty if the equation is presented in a written format.

I learned to write through the good offices of a teacher who encouraged me to "draw" letters.

Reading has never been an issue.

The question comes up in the General section from time to time. Many adults report having problems with reading but not math or trouble with math, not reading. I don't recall anyone saying that both were problematic, but I have a memory like a steel sieve, too.

This is what I was thinking on the subject of sensory dysregulation. I think that there is a value to knowing what characteristics are common with ADHD. Possibly as important as knowing the diagnostic symptoms.

So much to learn...