For those of you who ADD/ADHD children....

[Elisabeth in IL]

Did you see a Neuologist or Psychiatrist when thinking about medicating? Is there a difference? Which is recommended and why? Thanks from this nervous mama. :001_unsure:

[Soph the vet]

Usually I am only dealing with the neuroses or the psychoses of animals, however I did have a thought about your post. I believe I have one ADD or borderline "hyperactive" child so I am somewhat interested in the subject. A neurologist will approach your child from a biomedical starting point. He or she is going to rule-out or in any medical reason for your child's behavior and may run tests to help determine that. A psychiatrist will approach your child from a psychological, emotional, environmental, etc. starting point and may or may not recognize true medical reasons for your child's behavior. I would vote for the neurologist first. I would also consult with a nutritionist and see if there are other things that can be tried prior to meds. Meds certainly help some children, but they can be an evil unto themselves in difficulty to titrate the correct dose, frequency, and resultant untoward side effects. My two cents for what it is worth.

[Michelle T]

who specializes in ADHD. There are also neurologists who specialize in ADHD, so I guess it could be either.

In our case, our ped felt DS was way too complicated a case for him to handle, so he referred us to a very highly regarded psych.
Michelle T:hat:
I liked this smilie. What's it mean?

[Tracey in TX]

We only used our family physician. I gave him tests scored by teachers, coaches, and DH & me. (I sought their help. It was not a recommendation by school.) On a 1-20 scale, DS was a 4 (20=comatose and 1=hanging from the rafters. 11 is the "norm".)

A year later we did the same test on DD.


Some states have stronger requirements than others. We didn't even *require* paperwork or testing. This might be a doctor's preference.

Good luck,

[RebeccaC]

We have dealt with this with our sons and with nieces and nephews. It has been our experience with in our family that you want a doc and maybe a team of professionals who will look for underlying causes and treat those so that meds for ADD or ADHD may not be needed. I have a niece whose ADD was cause by a subtle seizure disorder and only a neuro would pick that up. I have a niece whose ADHD was cause by food allergies and environmental allergies and that was pick up on by neither of the docs you listed but by an allergist. The niece with the seizure disorder needed meds to treat the seizures and meds to treat the ADD. The niece with allergies whose ADHD was more severe than the other niece needed only to have her diet changed in major ways and her environment changed to clear up her ADHD.

Our sons problems were cause an autoimmune disorder, that caused sleep disorders, that caused the brain to scramble all auditory input and environmental allergies exacerbated the autoimmune disorder. They were dxed and treated by a neurologist, audiologist, a Neurodevelopmental psychologist, and an allergist. For my sons we never gave them meds to treat ADD or ADHD but treated the underlying causes of the ADD and ADHD. For my sons that meant not just meds but also an auditory therapy called FastForWord and treatment for their allergies and changes in our environment.

My brother has adopted a couple of boys whose mothers were addicted and one from Ethiopia who had nearly starved to death as a baby. Those boys needed a combination of classical ADD drugs and SI (sensory integration) therapy to help with their attending problems.

So the long and short of this post is see a good pediatric neuro and see and allergist and have both docs do a thorough work up. You will get a lot further treating any underlying cause than you will just treating what may be a symptom. Hope that made sense :001_unsure:

Good Luck!

[Whisperlily]

I was in denial for years and years. ;) My pediatrician was wonderful, and when I finally came to him with questions, he already knew my child well.

We'd discussed his activity level as it related to different aspects of his healthcare... allergies, eczema, etc can cause a "crawling out of your skin" feeling which leads to frustration when they're not really sure why. His large adenoids caused sleep apnea, and lack of sleep causes them to run "on empty" during the day. After the adenoidectomy he did sleep much better (and his snorting and frustration due to a constantly stuffy nose went away)! Due to food allergies in our family, we were already eating mainly foods from scratch, and watching typically "trigger" foods.

We'd already covered the other possible avenues, without even thinking about ADHD. The Ped started the meds and now we're seeing a psychiatrist. We would have stayed with our pediatrician, except that we moved and we were referred to a psychiatrist here. My old ped. was wonderful, and got us "to the point" where the psychiatrist could take over.

After the psych's eval. we learned so much MORE, and I thought I'd researched ADHD to death by this point. She was able to see things I never noticed, and I'm pretty aware of how my DS functions.

We've never seen a Neuro. Now I'm wondering if, like the psych., I'd learn a different aspect and see an even bigger/fuller picture of how this all works, and what the best multidimensional approach would be for DS.

Yeesh, was that helpful, or clear as mud. :tongue_smilie:

[Ottakee]

My answer---it depends.

A neurologist looks more at the nervous system and function while the psychiatist looks more at behavior and mental health issues. Both are MDs and can run tests, prescribe meds, etc.

For us, we see both and need both. My girls actually have 2 neurologists and a psychiatrist.

I would check with others in your area and see who is really good with ADD/ADHD. It would also depend on what other things you might be seeing as there are many things that can go along with ADD/ADHD or look like it. I would want blood work for thyroid, anemia, blood sugars, etc. Then if there is any problem with sleep/snoring, I would see an ENT about tonsils and adenoids. If there are learning issues, you might want a neuropsychologist.

[elizam]

neither--neither is available where I live. We see a pediatrician only. I think it might be more helpful to see someone who specializes in ADHD, but it isn't an option.

[Mariann]

Actually, just to confuse you even more, we initially began with a child psychologist 2 years ago - completely certain that we were just the most incompetent parents on this planet. The Child Psych's first observation was that the twins should be seen by a child Psychiatrtist as she thought they demonstrated ADD/ADHD. POOHEY! We thought. and then for another 15 months, we banged our heads against the wall as things went from bad to worse. We made incredible nutrition/dietary changes (we now eat as organically and whole as possible), we did employ techniques from the book "The Explosive Child" which did help. Finally, having hit a brick wall, I asked around and was given the name of a Child Psychiatrist - we saw him June 2007. We met with him a couple of times and then decided on meds with which to start. It IS hit and miss, unfortunately; and when you find something that works (if that's how the issue is best treated), you stick with it as long as it lasts.
After 6 months of outrageously high (not covered by insurance) doctor bills, we switched to a pediatric practice that addresses the issue of ADHD and meds - we had a 2 hour consult with the practice and were quite comfortable switching from the Child Psychiatrist to their practice (our former peds practice was beginning to give me a hard time about vaccinations, flu shots, and the ADHD issue was the straw that broke the camel's back).
We continue to use the prescription meds with the twins -- we did switch for a week from a stimulant (which most of the meds are) to a non-stimulant and then switched back as the non-stimulant was not effective or positive. We continue to monitor diet, nutrition, sleep, routine on a CONSTANT basis --we have noticed that WHOLE Organic milk is best for them - Whole goat's milk would be better (raw), but they are really resistant to it. Also, we are having ENORMOUSLY positive results with a product I purchased on Amazon.com called "ATTEND" by Vaxa. It is a 'support product' for ADD/ADHD. We have been able to lower DS' dose of the Vyvanse (which both twins take) to 30 mg/day from 50 mg a day. As a result, his appetite is wonderful, he is sleeping well, and waking in a good mood. He had needed 50 mg/day to get through the day with meltdowns usually occuring at the end of the dose. With the ATTEND, he takes it 8 hours after he takes the Vyvanse and the results have been positive.
We are also getting ready to see an Osteopathic Doctor as DS had 'torticolis' when he was an event, and did have a traumatic birth and is always complaining of back and neck pain (odd for a 7 year old) -- The D.O. thinks that with OMT, we may also see positive results in his behavior and again be able to decrease the prescription meds.
I'm sorry this is so long -- I hope this helps -- the whole thing is like trying to navigate a minefield. Mariann

[Elisabeth in IL]

You guys are great and have given me a lot to think about. My head is about ready to explode.

My ds had his tonsils and adnoids removed when he was 3, he had speaking delays and currently is going through speech therapy. J is also being tutored in reading where the tutor thought that he may have either auditory or visual processing issues. I had our family doctor swab his nose today because I think that he has, once again, an infection or strep in his nose. J is also very uncoordinated and looks funny when attempting basic calisthentics. It sounds like a neuro doctor is where I should begin.

Thank you everyone for your thoughts. If there are any others, I'd like to hear them. :bigear: