Pediatrician update

We went into the appointment not really knowing what to expect. This was a new doctor that we've never seen and all we knew was that it was a woman. She was a lovely lady, in her late 50s. She came out to call Liam in on her own and immediately engaged him in a conversation. Hilary and I just trailed behind, looking like sherpas, carrying all of our coats and knapsacks.

She spent the first 25 minutes of the appointment completely focused on Liam. Getting him to talk to her, asking him questions, having him write out his name, numbers, drawing shapes and pictures. She didn't even acknowledge either Hilary or I for the first ten minutes, when she quietly whispered that she would talk to us after. She wasn't being rude, but just giving her full attention to Liam. She did a physical exam (he's gained 5 pounds since Christmas! Yeah tonsillectomy and dental surgery - my boy is eating again!)

After her time with Liam she turned her attention to us. She wanted to know what prompted the appointment, what we saw at home, what our concerns were. Her "unofficial diagnosis" is "He is PERFECT and ready to start school and I don't see why his teachers should have any concerns." Her outlook is that if his behaviors (fidgety, not focusing, not listening) are interfering with his learning, then yes, we will need to look at doing something about it, but if they are not interfering, then she doesn't care, that is just who he is. Since it was the teachers that first raised the concerns, she did send home the Connor's rating scale questionnaires for both us and the teachers to complete, and she will do some follow up appointments with us to ensure that there is nothing interfering with his ability to thrive next year.

Her suggestions were for us to continue to work at home to help Liam develop concentration skills and working methods. To ensure that he has lots of physical outlets, to always try and do any "desk" work after a physical activity and to start with small increments of time, like 5 minutes, before letting him go do something physical for 5 minutes. Gradually we can increase the time that he is sitting and doing work. She says that if the school can incorporate something similar that he will have even better chances of excelling. Both us and the school have already recognized that he does his best after recess, or after playing hard, so this was not a big surprise, and I think the school will be very open to helping him work out these strategies while he is there to.

March 17, 2008 - Today's the day

that we see the pediatrician to determine our next steps. We are looking into having Liam evaluated for things like auditory processing disorder or possibly ADD, if he isn't too young. We have seen some improvements, both at home and at school, but I think a lot of that is because we have all been using techniques to help Liam work through things. Like getting right in his face to talk to him, having him repeat things back to us, having him do jumping jacks to get the "wiggles" out, having him close his eyes and count to 10 with deep breathing to trying and center himself when he seems "wired".

What we are hoping for today is to find out if we are going down the right path, what steps we should take next and how to ensure that we (and his teachers) are using the best tools and techniques to help him succeed. He has 3 months of pre-school left, off for 12 weeks of summer vacation and then he will be going into the kindergarten programme. We are so glad that we made the decision to not put him in kindergarten this year. I think he would have been too frustrated to be able to give it his "best work".

We just want to make sure that he does the best he can and that we do whatever me need to to help him.

Parent – Teacher meeting

Last night was our quarterly parent-teacher meeting. We got to see samples of Liam’s work, including his “self assessment”. He feels that he is good at listening, that he needs to work on “work” and that his favorite thing to do is to play outside.

The teacher’s had expressed concerns back in November that they felt he wasn’t progressing the way they thought he should be. At that time we discussed 2 possibilities:

1) he had only had his glasses since September, so reading, drawing and writing would almost be brand-new for him, since the previous year he couldn’t see to do it.

2) We all felt that he just didn’t understand that school was a place to WORK and not just a giant play-date that he got to go to everyday.

So Hilary and I talked to him about school being for work time, and that yes, he still gets to play, but he has to do his best work first. And the teachers reinforced this with him as well. And that did seem to be making a difference. Then he was off for an extra week of Christmas to have his tonsils out and after going back in January for 1 week he was off again to have his dental work done. It’s really only been 6 weeks that he’s been back into the swing of a regular routine.

The teachers (whom we LOVE!!) have notice that there has been a lot of improvement. His pencil grip is better, he is now working with both upper and lower case letters (where as in November he was struggling to get through a sheet of just upper case), and his pictures are becoming more detailed. He frequently surprises them (and us) with remembering different facts that they have covered weeks ago. But they are still struggling to keep him focused. In order to get him to do his self assessment, which included 3 pictures and copying 3 lines of text, Alana had to sit beside him the whole time and keep “bringing him back to the task” They are wondering if there is the potential for ADD. They are not thinking ADHD as he does not show any hyperactive tendencies, but they did mention that he does his best work after he has played outside and had that physical release. One of their examples is that if they are talking directly to him, he only seems to get ½ of what is being said. Either the first half because they got his attention when they started talking, but then his mind wanders off part way through and he stops listening, or the second half because his mind has been wandering and all of a sudden he realizes that someone is talking to him and he pays attention. Both Hilary and I agree that we see this at home too.

From everything I have read, 5 and a half is still too young for a definitive ADD diagnosis. We do have a referral to a pediatrician next month to see about having various evals done, mostly to rule out other possibilities like auditory processing disorders, sensory issues, receptive language delays.

For now, I will keep reading, trying to see if there are techniques or exercises we can do at home to help Liam focus.