My 8 year old has been diagnosed with adhd: combined subtype.
1. What does combined subtype mean?
2. Does anyone have a child with adhd that also has many sensory issues?
i.e. my child only likes to wear certain clothes, doesn't like sunshine, doesn't like to use a pencil or crayon to write or draw, likes his shoes tied tight, only eats certain foods due to texture, hides under his bed when he is upset, likes heavy stuff on him and likes to swing, rolls around on my exercise ball all the time, all in addition to adhd. The school thinks he sounds like it is autism, but his doctor is slow to diagnose this. He has never been delayed in speech, but very good at verbal communication and sports. He is good at giving me the answers back when I verbally give him a school lesson. If he is in a room with too many children, he looses his composure. He has no personal space. He chews everything and sometimes needs complete quiet. He has ticks.
He wants to know our schedule ahead of time. He has many anxiety attacks if he doesn't know what is going on, if he is asked to write anything and if I ask him to "hurry up".
What do you think? His ritalin only seems to help with the hyperness and focus, not the sensory stuff.
My 7 year-old son has sensory issues and receives Occupational Therapy on a bi-weekly basis. While sensory issues are an issue with autistic children, not all children with these issues have autism. When my son was evaluated for his sensory problems (and ONLY an Occupational Therapist can make a diagnosis of Sensory Integration Dysfuction), they told me he was not autistic, and I agree. He is very social, has lots of friends at school, enjoys being hugged, etc. However, he is very particular about clothes, shoes, needs a structured schedule, has difficulty with self-regulation, and becomes overwhelmed pretty easily. He does a combination of therapies, including weighted vests, listening therapy, and brushing. It really has made a big difference for him.
My son's issues of fidgeting and poor focusing are not related to his sensory problems. I have gone the natural route of giving him Focus, which has helped somewhat. Because my son has no behavior problems at school and is a straight A student, I'm not so sure he actually has ADD as much as he just may be immature.
Please see a Occupational Therapist who has received the proper training for Sensory Integration. It can make all the difference!
My son has ADHD with Sensory Integration Dysfunction as well. He also has FAS and RAD (Fetal Alcohol Effect and Reactive Attachment Disorder). He wil sit and rock as long as we will allow it, and that can become very aggressive, he licks everything, picky eater, loves to be spun in circles, overstimulated by the classroom, picky about his clothes, needs structure 100% of the time, very social, and screams a lot. I could go on.
We begin Occupational Therapy for him this coming Wednesday. I can't wait. They are going to do brushing techniques, and other therapies that worm mentioned as well for our son. We also have a heavy blanket, or you can also use a quilt to roll him up like a 'hotdog' when he gets overstimulated, to calm him down. That really helps our son. It is a game to him and helps him get himself back together without causing any harm to himself or others.
a loving heart is the truest wisdom
I think you will see a big difference in your son as he begins OT. We have gone the OT route three times in the last five years. The first time we went three months, and while it helped, I felt the OT ended therapy too soon. The second time was group Occupational and Speech therapy, which was a waste of time. This time we are doing OT with a very well-qualified OT and she introduced the listening therapy. It has really helped. We have gone on a biweekly basis since April.
You mention your son has RAD and FAS. Please keep in mind that often times the attachment problems can be sensory related. I wondered about an attachment problem with my son before I started OT the first time. The OT explained that children with major sensory issues have attachment issues just because they are so highly sensitive. As my son's sensory issues subsided, the attachment blossomed. He has been 100% attached to us ever since. I wonder if your child was adopted? We adopted my son (and another child too) from Russia, so I really do understand the issues you face.
Both of our sons are adopted from Russia too. It has been a whirlwind experience parenting our sons at times. We are so blessed with them in our lives.
That is good to hear about your experiences with OT. It is nice to hear things are going well, and that everything has worked out wonderfully. Mostly, that your son has bonded so much with you since going through the therapy. That sounds promising for us. We still have some of those issues from time to time with our sons. The RAD is questionable. They do odd things from out of the blue every so often. We never know when the 'things' might occur. Usually, when we think we have made it through the rough waters, the problems re-occur.
Has your son with ADHD adjusted to his new teacher this year? Mine did better than we expected. We were quite concerned. He doesn't handle change very well. It usually upsets his core. It took him 4 weeks to adjust to summer this year. We had to readjust his meds because he was so out of sorts with school ending, and then put him into daycare for a very strict routine. It was a nightmare. Next year- summer camps. They will be more productive for the boys because they got bored at daycare though it was structured; camp will keep them very busy.
I'm glad I checked out this sight. Usually no one posts about their children and parenting. It is good to talk to another parent about this.
a loving heart is the truest wisdom
Thanks for responding. My son has been diagnosed with Sensory Integration Disorder by an OT and was treated until he was 5 then they cut them off from the Child Development Center and you are on your own (British Columbia, Canada). We did do brushing techniques which he loved and he sleeps with a heavy blanket. I am just about finished making his "heavy vest" I let him pick out the material (camo) and have sewn glass beads into it. It is really heavy, but he loves it. I am really grateful your your responses. Sometimes I think his sensory issues make him hyper. He still is not writing though and in grade 3. I am waiting for a teaching assistant as I homeschool him.
My five year old may be attachment disorder and she was not adopted, may be just genetic. Doesn't come to us when she is hurt or upset, instead retreats to her room or bathtub. Doesn't like to be cuddled except on her terms and she hoards everything. She even wanted to clean one of our chicken bones from dinner to keep in her room. Does this sound familiar to you? I just cleaned her room and came up with a garbage bag full of paper and broken toys, rocks, and stuff that I had already thrown into recycling before she hauled it back out. She will find containers and then fill them and store them in her room.
Children with sensory issues thrive on structure. You can't tell them to "go outside and play" unless you have some specific suggestions on what they can do. Everything needs to be spelled out. I think camp would be a great thing for your boys in the summer. I'm a SAHM but do have a schedule of activities for my boys when they are home. It makes life easier. My son did not have trouble adjusting to his new teacher this year, as he knew both second grade teachers and like them. They attend a small Catholic school, which is a perfect match for my older son because he really needs the rigid structure. He loves it there. My other son who we adopted is in first grade and he has never had any issues whatsoever. I have a third son who is 2.5 years old. He was my "surprise, you really can get pregnant" baby!
Worm, attachment disorders are not genetic. There can be a whole host of other reasons as to why she behaves the way she does. Perhaps you can take her for an evaluation somewhere? Also, I can't help but wonder if the hyperactivity in our children is somehow related to sensory issues, too.
My son sits at the front of the room, near the teacher, who will tell him quietly to pay attention. That's the extent of any provisions he gets. The weird part of my son's behavior is that while he fidgets, sits at the edge of his seat, and daydreams, he is a straight-A student! He is in the advanced reading and science class (yes they do that in second grade, which is silly). So that is why I'm not even considering medication for him. As long as he does well academically and socially, I feel that I can just deal with the fidgeting stuff. He actually does great behaviorally in school as well. What I mean is that he does not have tantrums, gets along with the teachers and classmates, etc. His problem is just sitting still and paying attention. He does have tantrums at home, mostly when he is tired or when there is a change in routine. I really feel this is more sensory than hyperactivity.
I started giving my son Focus last week and just started Bright Spark yesterday. I do feel like it is helping, though it is hard to judge because he has been sick. There has been a decrease in his tantrums after school, and he is more willing to do his homework. He still has morning and evening tantrums, presumably from being tired, although he sleeps 11 hours.
My son has an IEP and when he disrupts the classroom is sent down to the Special Needs Room for a time out where the teacher has him do worksheets or sits in a rocking chair (he likes to rock) and listens to soft music.
His most difficult time is on the playground where there is absolutely no structure at all and too much stimulation. There are no boundaries. Last year the teachers and us set up a boundary system and rules for him on the playground which worked. It was a booklet, with pictures of him implemented using balls, pretending to play with classmates on the playground in action on the playground in certain areas of the playground, etc. He also had a recess buddy. Every recess he would sit down and look at the book before going out to recess with the buddy to remember what was expected of him at recess. It really helped, and so did his buddy- reminding him of the rights' and wrongs' of the rules.
When he was in preschool, he had an aide the first year full time just for him. The next 2 years there were 2 aides for the entire room, as he and his brother were both in a Special Needs Preschool program.
I'm also a SAHM. My boys are both 6 and 7. After school and before school they know what is expected of them every day with routine. If not, things are very chaotic. Whenever we have something new that pops up- an appointment, etc. that is when the tantrums break out. So, I try to do my best to forewarn him of the appointments- a day, early morning, etc. It doesn't always work.
Attachment problems are stemmed by many variables. More than one thing can cause an attachment problem, and it does not have to be just an adoptive child. Contact your pediatrician if you suspect problems. They can refer you to someone for help.
Got to go to bed....
a loving heart is the truest wisdom
The book idea before going out to play is a great idea, I am going to do that. I do find that I review behaviour with him but he is so impulsive that he gets lost in his hyper world. Yesterday I had to drop him off at a friends house so I could go to an appointment and when I picked him up he was so hyper he was "out of it", his arms were flailing and he was talking nonsense like not even real words and he couldn't even focus on me. It was all I could do to get him in the van and get him home to a quiet area with no stimulation. When he was an infant we couldn't even turn on the lights to change his diaper. Does any of this sound familiar. Does your child get that hyper that he cannot even focus on your face?
Yes. Our son won't look at us. It drives us batty. He will not focus- period. We tell him to look at us between our eyes when we talk or he has a time-out for a minute. Then he straightens up, and if not, has another time-out until he looks at us while we talk. We try to talk to him in very short sentences and make the talks extremely short and to the point. That is about all he can handle. That is what both the therapists and psychologists mentioned; short words and sentences when talking with an ADHD child. They don't comprehend all of the in-between words very well or process them. Their minds just work too rapidly.
At the preschool where our son went to when he was 4,5 they did booklets and picture formats of things he was to do; i.e.- bathroom with word bathroom, and story time (when it was and how soon it would be and where it would be with a picture of him in the rocking chair sitting quietly), playtime (him playing with toys), etc. If they went on a field trip they did a booklet of pictures of getting on school bus, snack time, lunchtime, etc. It really helped. The teachers were excellent at both schools. We were so lucky.
The current teacher isn't aware of all of his problems now. He hasn't shown a lot of his problems and is doing considerably better (yeah) but still has problems in the a.m. at home. That makes us aware that he can still have outbursts at school, and has had one since school started. He punched another child and was sent to the principals office. The teacher flipped out- and then I explained to her 'that is typical of him'- and what made him flip out and though it was not appropriate, the reason what triggered him to do it. She was appauled.
Hang in there. Things will get better if you are consistent and have a routine. Nancy Thomas, an author, writes about attachment issues. I have her book about attachment disorder and it is fabulous. It might help answer some questions about attachment issues.
Both of you: Do you ever feel like other parents stare at you sometimes when your child is getting really wild and crazy in public or at school? I do, and it is utterly upsetting. I don't get embarrassed, just upset because they don't understand, and I wish 'they' could walk our shoes for once. Then they would comprehend how daily life can be so interesting and enduring.
Anyway, I hope you gals have a good night.
a loving heart is the truest wisdom
Last edited by moderator2; 09-21-2006 at 03:45 PM.
Reason: The book title and author name is permitted - do not promote websites
Try going to a small fundamental baptist church where the first verse they learn is eph: 6:1 "children obey your parents". Most of the people I socialize with are from this church and so I do find it hard, mostly because I want him to be like the other children and I can't help but think he would do better with a more consistent parent. Yesterday when he freaked out it was in front of one of these ladies and I truly do not know what she thought, but Sam was really acting scarey out of it and all I kept thinking was lets get out of here. Having an invisible disability is the worst because people just think they are bad and I frequently worry about what he will be like in his teen years The group of mothers at the church just say I am extremely patient with all the kids, but my children have definitely taught me that. As for being out in public, I try to do it only when I think he is going to do well. One therapist told me to try only to put him to situations where he would be successful. Are your children on any medications? and do they help with sensory disorder?
I just finished Sam's weighted vest and he loves it.
My son does not behave violently, and he rarely misbehaves in public. He just gets a "deer in the headlights" look when overwhelmed, and if he really is overstimulated, he will just run around without any sense of direction or purpose. He does not hit, kick, or act violently towards anyone (except his brother, but it is typical sibling stuff).
In reading your posts, it sounds to me that your children's issues are FAR more sensory-related than anything else. Please know that my son used to behave in many of the ways you describe, but no longer does. OT is what got us through the bad behavior. It worked wonderfully. The first time he was in it, he went weekly for four months. Many of his issues subsided, but I worried about his inability to socialize. He went to group OT for an entire summer (at age 3.5 years). That September, he started preschool for two mornings per week and made friends. He was not a social butterfly, but he did fine. The playground was not good for him because there was no structure.
Once we sent him to Kindergarten, he blossomed. He was in a rigid, structured setting, and he thrived. No playgrounds! Recess has several organized activities from which to choose, or you can bring a toy and share with others. It's ideal for him. Still, last year I noticed he was still easily distracted, not focusing, and fidgeting. He still toe-walks all the time, and has very bad temper tantrums (never at school). So we went back to OT and started the listening therapy program. It has helped tremendously with his handwriting, he doesn't touch everything in sight, and his modulation has improved. We still have a ways to go, but he is getting better.
I'm not 100% sure he has ADHD. I really believe his issues are more related to sensory problems, and his OT and teachers agree. MEDICATION DOES NOT HELP SENSORY ISSUES!! If medication is not working, than there is a good chance that ADHD is not the problem.
Remember that sensory integration dysfunction is related to autism. Children who have SID are not always autistic, but Autistic children always have SID. So the autistic-like behaviors we see in our children can be odd to us. I was very nervous that my son had Autism, but because he loves to be held, makes excellent eye contact, and is now a social butterfly (who would have guessed), he is absolutely not. But it doesn't change the fact that he has SID.
My advice to both of you is to investigate, get another evaluation/opinion, and work hard at OT. We have been at it for six years, but it has been worth it. You will see huge changes with a correct diagnosis, and ultimately, appropriate treatment. OT has saved our son and made our family life more enjoyable. We are not there yet, and there are days where we have setbacks, but all and all, things have improved.
Please check out the books "The Out-of-Sync Child" if you haven't already. It is an excellent resource for senory issues.
Thanks for the input. True, the medication only helps to keep him calm, but he still has many sensory issues while on it. I rarely use it because of this. I am going to push for an OT. Thanks for the boost.
Oh my gosh!!!! I have never heard of another parent mentioning toe-walking!!! My son toe walks as well! We freaked when we first saw him do it. He does it a lot, and it just makes one cringe at the sight. You'd think it would hurt them?
We are still awaiting for approvial with our insurance for the OT. Each week the OT office gives us a call the night before our alledged appointment and then we wait. It is annoying. So we never know if we will have an appointment or not. Frustrating. He really needs it because he can sometimes be aggressive with other kids like his cousins or his brother, not intentionally; just out of impulsiveness. It is sensory reaction. The pdoc told us it is Sensory/ADHD combination. Mostly, it is when he is in action and is stimulated. We also have a neice who has Sensory problems who is 4 years old. I can't remember the types; she is one extreme where our son is the opposite.
I have read 'The Out of Sync Child' and have the book, while I read it often, because I am not able to contain a lot of information due to the meds I take. I have Bipolar Disorder and my meds cause short term memory loss, so I have to re-read a lot of stuff constantly. LOL I can relate to some of the things my son goes through. I too, get over stimulated as well in various situations.
My son is taking meds. He had to due to the schools request and becuase of his destructive and violent behaviors. He was harming other children and was on the next way out of the door of being kicked out of school. He takes Ritalin LA, Ritalin, and Clonidine. He has taken Adderall and Risperderal as well. They caused him problems- appetite loss, lethargy, and some aggression. Each child reacts to medication differently. All children are treated differently in each situation. Meds verses no meds. We have another child with An aggressive disorder that I completely forgot the name of- go figure, and he is not on meds. He is doing really well. Both of our boys do have RAD though. They both have been in therapy for the RAD, and it has been really successful.
I sure hope we are able to get the OT approved. If not, I feel that my son will be cheated out of a great experience and therapy that will help him get better. That is very obvious after reading your post amm.
The weight vest sounds really nice worm. Wish I could sew. The sewing machine and I are not friends. We don't work well together. LOL Somehow I always manage to break the sewing needle. Don't know how I do that.
Are your boys picky eaters? My boy is very picky. He is also picky about what he wears too. He sometimes will only wear the same sweat pants 3 times a week, and if he could wear them more than that. It is really annoying. And to get him to eat protien, well, I am thinking of buying some pediasure because he won't eat much meat. He is really skinny.
a loving heart is the truest wisdom
It's funny but that is my daughter's nickname! I am a pre-school teacher and I also have a daughter who is 11 with sensory problems. She was diagnosed with adhd, but I don't believe that she has that. I think her lack of focus and problems with attention are a direct result of the sensory issues. I do not, nor have never had her on medication. I don't judge those that go that route, but I have had some bad experience medicating my children and have chosen not to do it again. She has adjusted pretty well up until now, but joy, joy we're in middle school and that's a whole nother issue in itself. She also has to have the right kind of socks, no tags in the shirt, the shoes have to almost fall completely off her foot, as well as, various other little curiosities. Sensory intergration problems can either be from being too sensitive like my daughter, or not being stimulated enough. The things you mentioned are classic sensory behaviors and once he starts OT and you get educated you will see it's easier to deal with than you might think. Just look at it like this, your son is a unique individual that has his own likes and dislikes. He may be a bit more demanding in certian areas than your other children, but he can and will learn to adapt to his own personality. Trained professionals will be a big help in determining how well you guys do with this. It is not as bad as it seems. I see children just like your son EVERY year in my classroom. He is not as different as you might think. In fact I have one in my room this year that sounds alot like him. These children need a little more patience, acceptance of who they are, and lots of love and most do very well. They and you learn to adapt and rise above. Have hope for his future and don't get overwhelmed by the labels people will try to put on him. He's yours and you know him best. You don't have to accept every doctor's oponion as the Gospel. Get educated on this and you will feel better.
Good luck and God bless.
Great post, Cyndi! Sensory issues are so overlooked because, in my opinion, not many professionals even know about it. Many children are misdiagnosed because of the lack of awareness of SID.
Buying socks and shoes for my son is a chore. Socks have to be thin, but not too thin, cotton, and fit snuggly. The only socks that we have found are at Gymboree, but he will soon outgrow that brand and I don't know what we will do! Buying sneakers takes forever. We found a brand of school shoes that fit him perfectly, so that is ALL WE BUY FOR HIM. They have to be slip-ons (although he can tie shoes). No zippers or velcro. Who knows why. Tags on clothes are a problem, although I have noticed that more and more companies are going tagless.
Food has to be the proper texture. He is very willing to try new foods, but he primarily eats fruits and vegetables. He likes chicken and pasta, but is not wild on red meat. Food is not allowed to touch. No condiments on hot dogs or hamburgers, certainly no cheese on a burger, and we NEVER do milk in cereal. I'm very used to this and don't think twice about it now, but it was a challenge at first.
Hang in there, ladies! We will all get through this. It is SO NICE to be able to chat with others who have similar experiences. Sometimes I feel like I'm the only one, and it really is hard for others to understand.
Check out kohl's for socks. I know they sell girl's white sock that have no seam across the toe. I haven't checked for boys, but if they are white who will know the difference? Yes, you are right we will get through this. It's all good. Besides we don't remember how quirky we were as youngsters now do we? I'm sure our parents didn't know what to do with us either!!!
Do you ever feel like other parents stare at you sometimes when your child is getting really wild and crazy in public or at school? I do, and it is utterly upsetting. I don't get embarrassed, just upset because they don't understand, and I wish 'they' could walk our shoes for once. Then they would comprehend how daily life can be so interesting and enduring.
I feel this all the time with my son who has asperger's. He touches people, gets in their faces, hugs people, just cant keep his hands to himself, along with just being annoying! He is fine in structured situations but get him with anything outside of that watch out!!!
I wish I could wear a sign saying "I'm really not a B of a mom, I just need to structure him"
People that I hear whispering that he should be disciplined really need to walk in my shoes for just a halfday! I want to see how they would deal with it.
We too have out son, who is 7, in OT for sensory issues. He searches out sensory things. Once he drank a container of boiling water and it took a while for it to sink into his brain that it was hot. Only after he blistered did he notice it. This was when he was 4. i took him to the dr and explained what he does and asked if he could have sensory problems. The dr at that time said no. Now almost 3 years later he was diagnosed with sensory disfunction, oppositional defiance disorder and aspergers. I agree with the sensory disfunction, but after working with the OT I think the other things are related to the sd instead. He has improved greatly even after 3 OT apts.
Last edited by momof4boys; 09-23-2006 at 08:46 PM.