I have a 10 year old who was diagnosed with "disorder of vigilance" to be specific. Meaning when he does try and focus it mentally exhausts him. He is very active and the doctor says this is his defense in keeping his mind alert or "awake". He worked with an occupational therapist for Sensory Integration. He loved it because of all the physical activity. His OT said he never had trouble focusing with her, because he was allowed to move. His doctor said this is a relatively new term and some doctors just say it is another form of ADD, which it probably is, but he does not have a lot of the other classis symtoms. His main ADD sympton is his inability to focus and concentrate. Ritalin works wonders for him in the mornings - different child as far as school work - great attitude and can do his work. I can't give him any more, because then he can't sleep and is very irritable when it is wearing off. The afternoons at school he is kinda floundering at school, but he goes to a school just for learning differences, so they understand and work with him.
Here is my problem. Almost everyday around 4:00 he is a different child and progressively gets worse in the evening. Very active, forgetful, silly and/or irritable. Sounds classic ADHD, but he is not that way during the day, or at least to a much lesser degree even w/out medicine. I know no one is at their best when they are tired, but he literally can't seem to function when he is tired and he needs 12 hours of sleep (which is part of the "disorder of vigilance") to be his best. Anyone else heard of this disorder or have any nightime suggestions. I have read everything I can find, so if I hear something new I will be so excited. Thanks!

You are describing the type of ADD and ADHD my family has. Trying to focus exhausts our brains. We need to move to keep focusing. I had to stomp around the house and wave my arms to learn in high school. I would wander around campus chanting softly to the rythm of my footsteps to learn information in college. Jumping up and down works great too.

The more tired my daughter and I get, the more restless, talkative and irritable we get. The more tired we become, the harder it is to relax.

I need at least 10 hours, preferable 11 to get enough sleep. My daughter easily sleeps 11 or 12.

Ritalin works wonders for us too. But we build a tolerance to it rapidly so we can only take it occasionally.

I have never heard it described as anything other than ADHD.

"Primary disorder of vigilance is a term for a syndrome that includes poor attention and concentration as well as difficulties staying awake. People with vigilance disorder tend to fidget, yawn and stretch, and appear to be hyperactive in order to remain alert; they typically have kind and affectionate temperaments."

Rainonwindow - Could it be that you and your daughter are truely suffering from disorder of vigilance rather than true ADD? Stimulant medication IS helpful in the treatment of disorder of vigilance so having success with ritalin doesn't push the diagnosis one way or another. Disorder of vigilance is also genetic. Without treatment disorder of vigilance may get worse with age. The term isn't recognized by the American Psychiatric Association so many doctors don't even know about it much less use the term as an official diagnosis.

cindyk -
Is there any way your son could take a short nap in the late afternoon/early evening when he gets home from school?

ADHD and disorder of vigilance are not the same thing. As most of ya know lots of things cause ADHD symptoms. Disorder of vigilance and ADHD have many symptoms in common but there are differences.

An ADHD child always shows symptoms, whether or not they are tired. Of course EVERYONE gets more irritable and less focused if they are tired. Extreme sleepiness and sudden ADHD like symptoms are indicators of disorder of vigilance. While some ADHD children need a normal amount of sleep or a little bit extra, many ADHDers can get by with less sleep than the average person.

Here is a bit of info I found interesting:
http://www.findarticles.com/cf_0/m2250/n6_v37/20836824/print.jhtml

Have you had his blood sugar tested in the afternoon's?

Have you had his blood sugar tested in the afternoon's?
Thank you everyone for your replies:

Rainonwindow - Funny you talk about the chanting to yourself. When my son is forced to concentrate he starts singing to himself while doing his work. I was wondering if you are sensitive to caffeine? It will keep him up for hours if he has even a small amount of caffenie. If you do a search for "primary disorder of vigilance" you can find some on it. See what you think of it as compared to a typical ADD/ADHD. How old is your daughter and how does she do in school?

BornFree - Thanks for the link. I have read all that. It is very interesting. Wish we could find more on it. The thing that scares me is the possibility of it getting worse with age. As far as the nap....being a very active 10 year old, I think he would rather put his hand in fire than take a nap! Seriously I have tried, but it is funny if he sleeps during the day he won't go to sleep until later which causes him to be sleepy in the morning. Catch 22!! You can't beat it! If he could do a quick 15 minute power nap it would probably work, but it would turn in to probably an hour of struggling, convincing to get him to do it.

Cynmomtx - I have thought of the blood sugar thing. He does not eat much at all in the morning and at lunch. Because of the ritalin he is not very hungry until later in the day. I'm sure not eating much of anything is affecting his behaivor. His teacher said he could bring a healthy snack for the afternoon, so we started doing that. Maybe his next appt. I will make it in the afternoon and they can check it.

Thanks everyone for your input.

Cindy -
If he can't nap during the day can he do something else relaxing, so he can rest and get back focus.. what about self hypnosis (for those of you who dont know this..in reality this is nothing like what you see on tv!!!) it is a guided deep state of relaxation much like meditation except hypnosis guides and helps a person to stay more focused on relaxing than does meditation. You can download free samples of things like 10minute vacation, which is just a 10min. recording made to help guide a person into a relaxed state. This is not dangerous, there is no mind control involved, its just nice and relaxing. If he can't manage that, there is also yoga. Another suggestion, have him listen to classical instrumental music. It's calming, accelerates learning, and improves mood.