Question:

I have a 5-year-old son who is extremely bright however has some behavior issues at home as well as at school. He is a fast learner but has a short memory. For example, if I ask him to go wash his hands he will go into the bathroom and then immediately come out and say "What did you tell me to do?" At school, he just won't settle down when it is time to sit and follow the teachers instructions. He's very figity. However, I know he's learning because he is already reading and has a photgraphic memory. For example, the first time he saw the word “family” he spelled it once and then when I covered it up he spelled it correctly.

I keep getting calls at work about his behavior. What can I do? Does this sound like AD/HD?

Laura

Answer:

Dear Laura,

The symptoms you describe very well could represent AD/HD yet they could also be characteristics of many other conditions. If I were your son’s parent, I would request a full evaluation to look at any number of conditions that could be causing his difficulties, including, but not limited to learning disability, giftedness, depression, anxiety, and AD/HD.

This assessment can be completed by your school district. In California, parents may request an assessment and the district has an obligation to create an assessment plan within fifteen days of the request. I stress the words in writing. A simple verbal request will not do the trick.

The conditions mentioned above can be diagnosed by a school psychologist. After the assessment is completed, parents also have the right to request an independent assessment if they disagree with the assessment results. Neurologists, pediatricians, psychiatrists, and clinical psychologists are able to provide differential diagnosis for AD/HD. Of these, child psychiatrists have the most in depth background in other mental health conditions that sometimes mimic AD/HD.

Because your son is so young, a specific diagnosis may not be apparent at this time. Cognitive test scores do not stabilize until about age eight and children mature at different rates socially and emotionally. You may have to wait but you should document incidents that occur in case additional assessment needs to take place in the future.

If your son is found to have exceptional needs, even if these are not severe enough to qualify him for special education, he may be eligible for a behavior support plan that would specify interventions to take place for behavior problems. Having the school intervene to support appropriate behavior would provide relief from the potentially stressful experience of receiving calls about your son at work.

With the advent of IDEA 2004, California schools are in the process of transition. IDEA 2004 gave school districts to right to implement a new service delivery model designed to prevent serious academic and behavioral problems. As part of your assessment process, you should check to see if your son’s school is implementing the Response to Intervention (RTI) model. Steps for support will differ under this model than under the conventional approach. Your son may or may not be eligible for “Tier 2” interventions. These are interventions such as “social skills group” that take place in small groups rather than with an entire class. Eligibility is driven by documentation of past history including multiple office referrals, teacher request for assistance, and parent referral.

Additional information about assessment for AD/HD is available at:

• National Resource Center on AD/HD.
  http://www.help4adhd.org/en/treatment
  
• California Department of Education. Ask A Specialist: AD/HD, “previous questions.” http://www.askaspecialist.ca.gov/

Additional information about behavioral support is available at:

• Positive Environment Network of Trainers (PENT). http://www.pent.ca.gov/home.htm
  
• National Technical Assistance Center on Positive Behavioral Interventions and Support (PBIS) http://www.pbis.org/main.htm