Yesterday was the last day of school for Jenny and Anna... so Jenny is now a senior and Anna will be going into 2nd grade this fall. Dominic finished up preschool a couple of weeks ago and will be starting kindergarten in the fall. He had a very hard time in preschool; his behavior was too difficult for the first two preschools and he went through two teachers at his third. Right before spring break, his teacher and the director had a one hour, closed door meeting with me to discuss his behavior. They weren't sure they could meet his needs there.
The teacher would modify her curriculum to try to accomodate Dominic, but he still struggled to start and complete any academic work. He couldn't sit still during circle time, bumping into his neighbors and continually interrupting the teacher. He would color/scribble/paint on his neighbor's papers during table time. He would knock down block towers that the boys would build. He drove his peers crazy. At recess, no one wanted to play with him; that hurt his feelings and he would lash out in anger and frustration. When he got too physically aggressive, the director wasn't sure he could return.
So we started some intensive behavioral modifications then. We've had two months of trying our new approach and it has helped somewhat. We act out scenarios of how to appropriately play, taking turns, not being first all the time, raising our hands, etc. We also instituted a sticker reward chart for good choices and chores. The chart has 4 rows of 5 stickers... after one row is filled, each child gets 30 minutes of one-on-one time with mommy or daddy... when the entire chart is filled, they get a toy or prize that is chosen ahead of time (about a $20 item).
During this meeting with Dominic's teacher and preschool director, we talked about ADHD as a possible diagnosis. Dominic is also very, very bright and may be gifted. I decided to schedule an appointment with Anna's neurologist for Dominic to get evaluated. We received the new patient packet with an ADHD parent and teacher evaluation. It was clear after completing the paperwork that my boy definitely has nearly every symptom of ADHD.
The appointment was yesterday and our neuro is very kind. We talked about family history (Curtis was most likely ADHD as a child and has adult ADD tendencies) and what we've done so far in terms of behavioral modification. We talked about medication, the pros and cons, dosing, duration, etc. After nearly an hour with him, we have a game plan.
Dominic started today on Focalin XR, 5 mg, once a day with room to go up to 10 mg/day. We will keep him on it every day since his impulsivity and hyperactivity adversely affects his ability to form appropriate social relationships with his peers and also causes a great deal of anxiety for Anna. I've started a medication journal for him where I will note the time of day, dose, and side effects as well as positive behavior changes so that we can decide what will ultimately be the best medicine and dose for him.
I guess I'm explaining all of this in detail because I did not make the decision to medicate lightly. Our neuro feels that we did all we could do with behavioral modifications and since Dominic is continuing to struggle with making friends and having Anna reject him, this was the logical next step. The medication is easy to stop at any point and he may outgrown the extreme impulsivity and hyperactivity within a few years. Also, Anna has had some severe reactions to anti-seizure medications, so we are especially wary to try Dominic on medicine. I don't want to seem defensive about this decision; I am fully confident in my parenting ability to handle this challenge and I feel I have Dominic's best interests in mind.
So my next step is to schedule an appointment with a child psychologist who specializes in ADHD. I want to get an IQ test for him as well. The elementary school administration is already aware of Dominic's challenges and will place him with a kindergarten teacher who can handle his needs. We may need a 504 plan. At Anna's last team meeting (I think there were 11 people in attendance), we all talked about Dominic so the entire special education and resource department is ready for him. It helps that I am the campus representative for SEPAC (special education parent advisory council). :)
Now it is summer. We have no plans, no camps, no vacations, and no help hired. I have been dreading the summer... it seems endless. On the recommedation of our pediatrician and behavior specialist, I've come up with a detailed summer schedule which I'm going to put on poster board and post on the wall. I spent all morning modifying the schedule and reorganing our play area. Here it is (and I'm sharing this here in case it could help someone else):
7:00-8:00 ~ wake up, have breakfast, watch TV
8:00-8:30 ~ chores, free play
8:30-9:30 ~ get dressed and play together, mommy showers
9:30-10:00 ~ arts and crafts
10:00-10:30 ~ school activities, reading, writing, math
10:30-10:45 ~ snack, TV
10:45-12:00 ~ outside play, pool, park, or pond
12:00-1:00 ~ lunch, TV
1:00-1:30 ~ independent quiet time
1:30-3:00 ~ errands, store, bank, shopping
3:00-4:00 ~ outside play
4:00-4:30 ~ snack, TV
4:30-5:30 ~ free play, computer, outside, imaginary play
5:30-7:00 ~ time with Daddy, pool, errands, outside
7:00-7:30 ~ dinner, TV
7:30-7:45 ~ clean up, chores, family game
7:45-8:00 ~ bath
8:00 ~ bedtime
Dominic already likes the schedule and I'm already seeing a positive change in his behavior on his first day of Focalin. I'm hopeful... tired, but hopeful.