Instincts

Early in October, McKay's teacher called me to schedule a parent/teacher meeting.  I found out when I got there that I was meeting with both his home room teacher as well as his Math/Science teacher.  They both had concerns about McKay's lack of focus in the classroom, and the amount of work he has to finish at home because he doesn't complete it in class.  He was never disruptive, but was easily distracted by other kids.  They suggested I talk to his pediatrician and come up with a workable solution to help McKay.  They didn't come right out and say it because I don't think they can legally do that, but I'm pretty sure I read "ADHD concerns" between the lines.  They both said that they have seen this before, that they each had children in their own families who had difficulty staying focused, and that there were definitely ways to make McKay's life a little easier.  (Is his life hard?)  They were kind, non-threatening, and mostly just concerned about how his inattention might magnify in the coming years and make school increasingly more challenging for him, and they didn't want that.  (I didn't either.)

The months of circles that I've run around in since that conference have been exhausting and ridiculous.  I started with our pediatrician, who does not diagnose ADHD in her office.  She referred me to five local child psychologists who only have answering machines.  One of them isn't actually a child psychologist.  One was booked out for three months.  Two never called me back.  I finally got in for an initial visit with the remaining one in November.  I was not impressed.  He spent 10 minutes with me (it was a parent only visit.)  He suggested a battery of assessments to determine what level of ADHD McKay had, if any, then asked if I had any questions.  I had a few.  He gave brief, curt answers and then shooed me out the door.  

We scheduled an assessment appointment for the week after Thanksgiving.  

On the way home from our Thanksgiving week in Utah, the whole family took turns throwing up in the van, so I cancelled McKay's appointment.  

In December, I thought I should call the insurance company just to make SURE that the assessments were covered because I had done some Googling research and found out that those tests can cost up to $6000.  Whoever I talked to at Blue Cross/Blue Shield said, "Yes, any and all psychological assessments are covered as long as the Dr is in network."  He is.  She also said we would only have to pay the office visit co-pay, which is $30.  Relief.

We rescheduled the three hour assessment, and I took McKay out of school one day in January.  It was long and tedious and I took him to lunch afterward because he had been remarkably patient and agreeable.  

They said we would get the results back at the end of that week.  So we waited...for three weeks.  


Before the assessment results arrived, we received a statement from the psychologist's office for $350 which was the amount due AFTER insurance.  I have been on the phone with Blue Cross/Blue Shield since then to remind them of the $30 co pay that we spoke about at the end of last year.  They don't remember that conversation.

Finally, last Friday, the results arrived.  The psychologist called that same day to translate the lengthy document, officially give us the "diagnosis" (mild to moderate attention-based, not behavioral-based, ADHD) and give us some options for "treatment."  He is not any more pleasant on the phone than he is in person.  

So, here are the options:

• We can hold him back in fourth grade for another year.  At first, we thought that might be a good idea, but we came to our senses.  Even the psychologist agreed that holding him back would probably do more harm socially than it would help academically.

• We can get a 504 set up in the school to provide additional, medically necessary assistance in the classroom.  I talked to the school counselor this week and she read through the options that we would have with a 504 in place.  None of them really apply, and because his ADHD isn't severe, there is a chance that some of those options (taking him out of the classroom for testing) might prove to be more disruptive than helpful.  And there really is no sound evidence that his grades are slipping so much that he would benefit from any of that.  

• We can put him on medication.  This is not going to happen.  I have talked to too many people who have said that the trial and error method of finding meds that are effective but don't have undesirable side effects is exhausting and frustrating for both parent and child.  

• We can do nothing.

Here's what I've determined from the time I've spent in the last few months watching my little McKay more closely...

He has good friends.  He has a consistent routine.  He is kind and considerate.  He wants to help.  He procrastinates work.  He negotiates homework, reading, and anything else that sounds like it might not be very fun.  He spends money the instant he gets it.  He occasionally forgets himself and does crazy things like chop up dead snakes, call little girls names, and let the bully on the playground get his way.  He loves scouts.  He is where he is supposed to be 95% of the time.  He wears a helmet when he rides his bike or scooter.  He prefers fruit to cookies.   He is grumpy when he's tired, sick or hungry.  He zones out when I lecture.  He sometimes stuffs the toys and laundry underneath his bad and then tells me his room is clean.  He doesn't make his bed as carefully as I would.  

Here's what else I've determined...

If the entire population of 9 year old boys were tested, I bet half of them would be diagnosed as "mild to moderate ADHD."  Sometimes there is a downside to having a concerned, wonderful, attentive teacher.  Sometimes doing nothing is better than running around in circles considering every voice.  

It has been a long few months of worry, guilt, frustration and stress.  But in the end, it's been a good thing to have to choose my heart over my head.  My instincts are good on this one.  McKay is not slipping down a slope of perpetual frustration and doomed to failure.  He is a pretty normal kid who would rather work than play.  He does not need medication, modification, or treatment.  He just needs attentive parents who keep him accountable and give him opportunities to succeed at working hard.

I'm grateful for good teachers who don't let kids slip through the cracks.  I'm grateful for a village of parents who have helped me sort through all of this.  And for many hours during the day to be quiet and just listen to the voice that isn't the loudest, isn't always the most practical, but is always the better one.