The Acronym Train

I can’t believe it is happening again. But it is.

I have been aboard the Acronym Train stopping at each station for a new set of letters for years now. We have visited stations like OCD, ODD, SPD, GAD, PDD-NOS, MD-NOS, BP and now my train is heading to a new station: ADHD.

Yes, the day has come for a new stop at yet ANOTHER letter station. It is time for me to take Gabriel to get evaluated for ADHD (Attention Deficit Disorder – He is not hyper, but who knows what the test will show).

This isn’t a revelation – that Gabe has ADD, I have always known this. And I have always said that actually having that diagnosis would only benefit him if we were to medicate for it. Unfortunately, it looks like we may just have to.

As I am sure you have heard, ADHD shares many of the same overlapping indicators as SPD, which makes distiguishing between ADHD and SPD challenging, but not impossible. 

Dr. Roya Ostovar, in her book The Ultimate Guide to Sensory Processing Disorder says, "The area of motor functioning may be helpful in making the distinction between SPD and ADHD.  Most children with SPD have clinically significant weakness in motor coordination, balance, and movement.  The opposite is true for most children with ADHD."

Ironically, Gabriel has always had a good motor coordination, balance and movement.  Gabriel learned to ice skate, in full hockey gear, in less than an hour at age 5.  He learned to ride a two wheeler on time, and can literally climb barefoot up the light pole in our front yard unassisted (much to the neighbor's chagrin).

However, he has a number of other challenges that are impairing his daily living.  Gabriel struggles to find something to do. Not just choose an activity that is of interest to him, but spend more than 30 seconds deciding whether or not it is worth pursuing. And then actually doing it.

Let’s be honest here – he struggles to do things that he likes, not just things that his teachers or I want him to do.

That is challenging.

Add to that he can’t stay on task for more than maybe 3-5 minutes without flat out losing interest and you have a child that literally wanders around our home for hours while we have this conversation:

“Gabriel, I need you to find something to do.”

“I don’t know what to do.”

“OK, check the list of ‘activity ideas’ inside the pantry door.”

“I don’t want to do any of those things.”

(Please imagine at this point that Gabriel is crying, and whining, and most likely throwing himself on the floor, with even perhaps the quintessential fit throwing body language of kicking his feet and pounding his fists – then please remember he is 9. NINE.)

“Ok, then I will give you some choices: Lego’s, Bionicles or go out back.”

“No, I HATE Lego’s!"

“Choose Bioniccles or go out back.”

“OUT BACK!” He yells at me.

And out he goes.

And I look out back.

“Gabriel, you can’t just lay on the table, you need to actually DO SOMETHING.”

“OH! I hate the swings!”

“Ok, then don’t swing.”

“There’s nothing to do!”

“OK, get inside, and do Lego’s – I don’t care if you like them, but you are doing them for 30 minutes. If you don’t want to do it, then you can just look at them.”

“UGHHH!! I HATE LEGO’S!!”

REPEAT. REPEAT. REPEAT.

All day long. And he does NOTHING. Unless I stand over him and force him to comply. He cannot and does not just go play – you know like when we were kids? In his room or in the yard, he can’t just entertain himself. EVER.

We have worked endlessly on play skills, and providing things he actually is good at (this is hard, becaues he is under the impression he sucks at everything), but many of those include being out front and he cannot be out front unsuperivsed.  Safety issue.

So, assuming I don’t follow him around making sure he is doing something, he will be found laying on one of the two couches, laying on the dog bed, laying in a chair out back, laying in his bed. Pretty much laying around waiting for me to invent a new activity that he is dying to do.

If I come up with an activity that he is interested in, revolves around one of his stuffed lions, or that he has no choice but to do (chores), he stays occupied. Usually crying (chores) while he does it, or threatening to quit, before following through on the threat, and finally quitting.  He just cannot sustain his attention span for more than a few minutes.

Nick has handled this great over summer – and has engaged in playing with Gabriel in a dozen or so different games, but I have had to put an abrupt halt (after less than two weeks of trying) on them doing anything together unsupervised or Gabe gets distracted, uninterested, or simply deems the game “unwinnable” and quits. Often with a throw of the said game into the air.

Not fun.

Here are the ‘symptoms’ of ADHD (formerly ADD) from the website WebMD:

A person with ADHD may have some or all of the following symptoms:

• difficulty paying attention to details and tendency to make careless mistakes in school or other activities; producing work that is often messy and careless
• easily distracted by irrelevant stimuli and frequently interrupting ongoing tasks to attend to trivial noises or events that are usually ignored by others
• inability to sustain attention on tasks or activities
• difficulty finishing schoolwork or paperwork or performing tasks that require concentration
• frequent shifts from one uncompleted activity to another
•  procrastination
• disorganized work habits
• forgetfulness in daily activities (for example, missing appointments, forgetting to bring lunch)
• failure to complete tasks such as homework or chores
• frequent shifts in conversation, not listening to others, not keeping one's mind on conversations, and not following details or rules of activities in social situations

Dr. Roya Ostovar, in her book The Ultimate Guide to SPD, talks about how SPD and ADHD share similar behavioral characteristics, but warns, "Some children may have just SPD or just ADHD, but some children may have both. A single symptom does not make a syndrome, and does not necessarily lead to a diagnosis."

But, Gabe displays all of these indicators. And this isn’t new info. But like I said at the beginning, I just didn’t see the need to diagnosis this since it was so low on the totem pole of issues that need to be addressed.

But now, I am worried that it is getting in the way of him functioning as well as he could.

Although I am not a fan of more medication, or more diagnosis, or more labels, or more whatever, I am already on this Acronym Train and I just need to keep on chugging along until I get on the right track(s). 

Next station: ADHD

All aboard!
H