Comorbidity Conundrum

anxious child

I can’t help but question the professionals in my sons life.  Both the ones who are there by chance and the ones we’ve invited to peer at him with a giant magnifying glass.  I have read a fair bit about child development and most recently ADHD and all the comorbidity that tends to tag along.  The more I read about the high incidence of misdiagnosis, the sheer absence of these attentional deficit “disorders” in other environments (less than 0.5% of pop in France), the multitude of natural therapies that help so many, and how often “underlying” learning differences can often be the real driver of symptoms, the less patience I have for theories.

My son is nearly terrified of returning to school.  He would not let me leave him today.  It was all I could do not to cry.  I could feel his stress and anxiety and I struggled to see what was causing it.  He never had this anxiety in preschool.  Even last year in kindergarten he was confident in the same building and while he bounced around the room and halls like Tigger, he seemed happy.  Today and last Thursday he was red and blotchy faced, crying and clinging to my leg, asking me (telling me) repeatedly that we would be leaving in 15 minutes because he was done with school.

Our aid was late and it was another new person, an older gentleman who did not seem quite sure what he was supposed to do.  One sweet boy said hello to little man.  Another asked why he was back.  As class proceeded, little man slumped on the floor, squirming and playing with anything to avoid being drawn into class activities.  He gripped his big square timer and leaned in to me, “I love you, mom.”

I sat there for nearly two hours and had to ask why we are doing this to him?  Is it really that important that he “integrate” with 23 other meandering bodies and brains who are barely learning to “hold up a quiet hand” and “keep your hands to yourself”?  46 little hands, feet and elbows all exploring the boundaries of individual and group space, tracing the walls of the hall on hourly treks between transitions.  Each little soul observing what’s the same and what’s different, who fits and who doesn’t.

Little man says he doesn’t fit in there.  In school.  He has told several people (including me) that school is too big, too loud, too many kids, too much for him to handle.  We know from his IQ assessment that it’s not the material that is hard, but how it is all delivered.  The structure of school.  Three first grade classes all bumping into each in one pod area, followed by three of each grade on up into the really big “middle school” where he knows his big sister attends class.  He knows his job is school and it’s stressing him out.  He knows we all believe he can do it and yet he can’t.  So he feels like a failure.  No one is really listening to him.

As I sat in our first full meeting with our “team” at school today, I couldn’t help but feel that the most important voice in his “educational plan” was missing.  Some how all the adults there and by proxy were going to throw out theories and ideas for what is best for him.  But no one really knows what’s going on with him.  We only have theories.  Even the latest science on the ADHD brain is still a theory.  It sounds really convincing, that the brain cannot manage to deliver dopamine efficiently.  Like a structural defect, if only we could rewire it to function like a normal brain than all these problems would just disappear.

Right?

During this meeting, I heard the teacher’s review of everything she observed since the first day of school.  Unfortunately, she has no experience with ADHD and did not see his signs or signals.  I am afraid she inadvertently contributed to his anxiety about school and his spiraling negative self image.  It is entirely understandable and yet, telling a child that he won’t have any friends to invite to his birthday party unless he can stop impulsive behaviors is rather harsh, especially when you learn that ADHD brains can’t help it.  I got the feeling she is now very remorseful about it.  She and I have a lot in common.  We love deeply and wear our hearts on our sleeves.  And sometimes we make mistakes because we just don’t know.

As I sit here with all the puzzle pieces we know about, the ADHD diagnosis, the sensory integration troubles, the peer rejection, the school anxiety, I have to admit I have no idea what to do.  I am living his anxiety every single day as he talks to me, gets himself ready for school and then totally falls apart.  They want me to drop him off at the door tomorrow and not go in.  I haven’t seen a regular aid and the teacher is maxed out.  How do I know the aid tomorrow will be able to help him and not just inadvertently contribute to more stress for him?  Plus the aid can only come tomorrow and not the next day.  The school is trying to find one person but it’s a tough sell as it’s a temporary position.

We all agreed today that going full court press to help him integrate and feel good about himself and school is the top priority.  I see all the effort.  But it’s like saying you’ll build a house for winter with temporary labor you have to pick up at the corner recycle center.  I am losing confidence.  Good intentions are not enough.

Are they?

Am I over-reacting?

And for my friends who have urged me to home school, that option is dancing on the table like a big piece of humble pie.  As my concern for his emotional well-being escalates, it is looking like the only option.  One friend said that stress and anxiety is a well-known confounding factor in many ADHD/learning disability cases (though our neuropsych and the so-called ADHD expert drug doc did not mention it at all).  And like ADHD, anxiety disorder is probably genetic.  I am definitely susceptible to anxiety (only when stressed, like now) and I know my MIL is, too.

I just read that anxiety can be the primary condition and present like ADHD.  What if he IS just anxious?  His most problematic behaviors do not happen in a calm, quiet environment.  He’s fine for hours at home when it’s just us.  As soon as the doorbell rings, random people show up, he gets squirrely.  I asked the school how they plan to help with the anxiety because if we don’t get that one relieved quickly, nothing else will likely improve his performance in the classroom or with peers.

I can tell you that we have a very serene home.  I like order and calm colors.  We have a routine every day with four kids that keeps us all on schedule, including dinner as a family every evening.  I am very organized but not uptight.  I like to give my kids a couple of acceptable choices when possible so they have some feeling of control.  While the siblings do sometimes fight, my husband and I rarely raise our voices at each other.  Yes, as parents we do raise our voices but often because of the logistics of kids in various parts of the house, time constraints and immediacy of some issue or problem, etc.  I’ve been working on a positive reward system to smooth out some of that so we no longer raise our voices at all (I’ll share it if I can actually get it implemented beyond the first week).  While I’m sure there is always room for improvement, our home life is extremely stable, calm and loving.

So, of course I am going to scrutinize the school environment when one of my children is struggling.  And right now, I just don’t know if we are doing our son a service by forcing him to cope with an environment which has been getting worse over the last year, and which all by itself may be confounding or even causing his symptoms!  I do not fault the school because I have two other children thriving there and I see primarily very happy kids and teachers.  It is a wonderful school.  But perhaps my son just isn’t ready for it?

His own words, “I need a small school where I don’t feel so small.”

From my utterly exhausted seat this afternoon, I have to ask why no one is listening to little man.  Do adults and experts always know best?  And to answer the inevitable question of why not just home school, because my husband and I are not in total agreement.  He wants to give school integration a try.  I just don’t know if I can take another week or two of this stress and uncertainty.  Something has got to give.

xo

Links:

IS IT ANXIETY OR ADHD?

3 thoughts on “Comorbidity Conundrum

    1. Hi Enchanted, Thanks. Yes, we can homeschool. I’ve done it once before when we were traveling. It can be really hard on the parent-child relationship if they are unwilling or difficult. However, there are many resources in our town, plus online programs to make it even easier than it was several years ago. I’ve also been recommended to check out Virtual Academy as they have a special education specialist to help families find exactly the right method/curriculum. If this partial day integration just isn’t going to work right now I will definitely pursue that option for a while, until he matures and we can figure out exactly what he’s dealing with.

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