Tuesday, December 4, 2012

ADHD update

Jax had his developmental pediatrician appointment this morning at the Child Development Center (1 of 4 appts). The doctor does not think ADHD is a factor for the boys (event though Brady isn't his official patient until Thursday morning's appointment). We're looking into learning issues, but ADHD does not seem to be at play. The boys took turns sharing the IPad and their stuffed Mario Bro toys for 90 mins during the appointment and were super good. The doctor said there is no way an ADHD kid could do that. He said we're all allowed to have ADHD moments in our lives, and of course little boys (especially when they can bounce off each other) will have them often, but it would've shown up in a 90 minute session of a boring room for sure. He said there would've been boredom, jealousy and/or some sort of multiple disruptions, needs for different toys, and even then, they'd have to be evaluated further. But the fact they were SO content and chilled out, it just didn't even seem like an issue.

He showed me the charts that they created from the paperwork I filled out and then the charts from the teacher and speech therapist. They were all very similar and not one thing went into the red zone. So even with THEIR reports (the ones who suspect it), there were zero red flags. I asked if it's something we should just watch for and he smiled saying, "It's a medical condition. They either have it or they don't. At age 4 there are signs that can progress for a more accurate diagnosis later, or there aren't any of significance. They can't just appear later. So no, this is more than likely never going to be their problem." He admitted that preemies are at high risk for it, but this just isn't their case.

He sees Brady Thursday, but the same result will come I'm sure. Then the boys see a Pediatric Psychologist who will evaluate each of them at one session and then test at another (so she knows what to test for). That will give us some clues as to their learning/behavior I'm sure. Jax didn't see the speech lady yet, but I assume that will similar to Brady, just a bit more advanced with the 'language' part.
This doc believes the boy's IUGR (intrauterine growth restriction), aka - low blood flow, is the reason for their severe tininess, and not the result of a growth disorder. He said that their birth length indicates they were stunted while growing in the belly and it set the tone for their size as people in general. Jax was 14" at birth, and he said that he was already below the curve for his birth week. Brady wasn't much better off with only an extra half inch. He pretty much said they're going to be short, but to work on the food/calories (this was just jax) with a dietician to work through the feeding disorder (Jay and I were slightly bored through this whole speech because he spoke at length about condencing calories into smaller volumes - which we already try so hard to do for the kiddo), but happy, healthy is more important than tall. (They see an Endocrinologist this month just to be sure.)

He does think that the school issue may be that they understand at one level, and the school is teaching at another, so they're distracted. Like sitting through a college course with a teacher who speaks broken English. It's not that you have an attention ISSUE, so much as you're uninterested because you only understand half of it. Which is what they'll look into I guess with further testing. The doctor said that I made a powerful statement to him by saying that the boys will understand most requests, but they have a hard time understanding explanations of things. 

Like tonight we talked about how old they were. They each hold up their entire hand and Jax always says FIVE! I explained to them that they are 4 yrs old, showed them the correct number of fingers and they stared at me. I asked Jax if he remembered his birthday party with all the people, he said yes, so I told him he turned 4 and next summer he'll be 5. He starred at me smiling and then counted to 10. Almost like, no one was home for the explanation part, but he knew we were counting and that's what he was going to do. The boys are super bright, so I wonder where the disconnect is??
Then Jax spilled his milk and said, "oopsie daisy!" and we laughed hysterically - where does he get this stuff??

The doc made Jax run around with no pants on observing his legs and all that (because of his muscle tone/braces) and really did a lot of math with his height/weight from birth to now. His height is that of a 3 yr old and his weight of a 2 yr old (26lbs with all his clothes on). He said we just need to get a handle on the weight part, but we already see the feeding clinic, so he had no referrals for us - finally! ha! He said he'd like his weight to also be that of a 3 yr old, and if it were that of a 4 yr old, he'd be obese since he's short! Obviously.
He told us he thought they were 'sweet' and so well behaved and he'll be gathering the reports and seeing us later.
I'll TAKE IT! (one sigh of relief for this mom, finally)


June said...

So glad you got good news! Kinda makes me sad that the teachers made you worry for nothing. I think the Dr.'s explanation makes perfect sense. Enjoy the good news :-)

Little Wonders said...

Just catching up on your blog, Annie! Thanks for taking the time to share all this info. I have gained so much insight into the girls (much smaller!) issues by everything you guys are discovering these days! Liana was 14 inches at birth (Amaya half an inch longer) - even though the boys were a week or so farther along gestationally? But in any case, she's 26 lbs now, with all the clothes on, and she's only 9 months younger than your boys. They both are a full head shorter than their peers - and it's interesting to hear that IUGR can have a life-long impact on weight and height.
I'm always cheering for your two little guys, and I just think they're doing fabulously ... despite it all :)!