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Attention Deficit Hyperactivity Disorder

Getting A Diagnosis of ADD

05/15/2006

Question:

my 7 yr old stepson has recently been put on adderall because his mother says he doesnt listen in school or at home, but when he is with us on the weekends we have no problems out of him, he wasnt given an evaluation by a pshycolgist to determine if he even has ADD. He has been on the medication for a week now and he is on the lowest dose and he is always dizzy and says that he can`t concentrate like he did before he took the meds, but he also tells us that his stepdad treats him mean and pulls him by the ears and thumps him in the head when he does something wrong and has a camera in his room to watch him to make sure that he doesnt do anything bad. He said he dreads going home after school because his mom is at work until 11pm, could this child just simply be asking for help and being depressed instead of having ADD? Because like I said when he is here with us he is a good kid and does everything he is asked to do, and with the experience I have with kids if they have ADD or ADHD they will act out no matter where they are. what should i do?

Answer:

It sounds like you and your husband, or perhaps just your husband (depends on the relationships) should speak with your stepson's mom and step-dad. Whatever is going on---wherever the "truth" lies, it is usually best to bring things up and discuss them. However, a few points below...

Just because he does well at your home does not mean he does not have ADHD. Children often have more problems with their ADHD in the home where they spend the most time...where they get disciplined the most. In addition, most of us do better in environments where we are comfortable and many children with ADHD do better when routines are followed. Perhaps your home represents both?

When you speak with his mom and step-dad, keep in mind what a difficult job parenting likely is for them. If parenting in your step-son's home does involve painful ear pulling and cameras in his room, it might suggest the adults there feel incapable of controlling his behavior in more appropriate ways. While sympathizing with the difficulties of parenting you might encourage them to see their family doctor or his primary care doctor and discuss both different, more productive and appropriate forms of discipline and what your step-son has shared with you.

If your husband has the legal right to do so, encourage him to meet with his son's doctor about the diagnosis, medication and discipline his son describes.

Sometimes a diagnosis of ADHD is straightforward and can easily be done by a primary care physician. Once in a while it's actually wrong, as you fear. It could instead be things like depression, anxiety or even just inappropriate expectations.

Medicines can sometimes take a while to get used to. He might look much better the next time you see him or his doctor may quickly pick up on a medicine problem and change his medicine this coming week.

On the other hand, if your husband has no legal control over his son's healthcare (through a divorce settlement) and you feel your step-son is responding to medication very poorly and inappropriately, that it is not changed in a reasonable period of time, and that his mother seems unconcerned or unable to take action, it may be time for your husband to call his son's doctor anyway. Their can be a fine line between being a "busy-body" and a good samaritan but, where children are concerned, ere on the side of the latter.

For more information:

Go to the Attention Deficit Hyperactivity Disorder health topic, where you can:

Response by:

Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati