My son has just been diagnosed as having a learning disability and “borderline” ADHD. I have been reading articles on the web that say there is no such thing as borderline ADHD, that would be like being borderline pregnant…you either are or not. The neurologist said that the decision to medicate is up to me ( I am a single mom, dad is not involved at all in this). I have been agonizing over making such a decision, how can I be sure that I’m right? Anyone have advise, who maybe went through a similar situation? Thanks!
there is no clear diagnosis for anyone really...
its not like there is a blood test. So, in a way, every dx is nothing more than a clinician’s opinion.
To me borderline means ‘not classic’-the little picture one has in their heads of the ADHD kid. When a learning disability is involved it is very hard to determine which characteristic is due to the LD and which comes from elsewhere.They overlap.
With my son, who is not at all hyperactive but has Ld and problems in school, I took the’ try the medication for a few months and see’ approach. Some disagree with that as these are strong stimulants but, for us, that was a good approach. Someone once mentionned on these boards that they were finding ADD meds work with kids with CAPD-who knows-there may be other conditions the medication works with but the medical field isnt sure enough to prescribe them for anything but borderline ADD.
Good luck
Re: "Borderline?" Is there such a thing?
ADHD is mainly diagnosed by using rating scales that assign a certain number of points to particular behaviors associated with the various types of ADHD. If a child exhibits certain classic behaviors “usually” or “always,” then it is easier to make the diagnosis. If the child only shows the behaviors “often” or “sometimes,” it can be harder. A borderline reading may mean that there is another cause for the behaviors or it may simply mean that the child has ADHD but has other mechanisms in place that mask or control the behaviors. This is especially true for inattentive ADHD kids. In my son’s case, his rating scales were always at the borderline. For that reason, we avoided medication for several years. When he continued to spiral downward, despite an appropriate educational setting, we finally did try a stimulant. For my son, it made all the difference. Although we had always thought that his LD was the biggest issue, it turned out that his ADHD was the larger problem. With medication he was more able to persevere with difficult and boring tasks. As a result, we were better able to remediate his multiple LDs to the point where he no longer requires special education. As Sara points out, whether you try medication depends on your comfort level and on the degree of difficulty your child is experiencing.
Andrea
Re: "Borderline?" Is there such a thing?
Jen -
Our pediatrician gave us this medication “measuring stick” for our 2nd grade child diagnosed with mild to moderate ADHD.
- Is the child’s work on grade level?
- Is the child socializing successfully?
- Does the child have a good sense of self-esteem?
Given that criteria, we decided medication was not necessarily the right way to go in our son’s case. Things went relatively smoothly using that strategy for the about six years. But after the last two years, I think we may need to revisit the medication issue again. The work has gotten considerably harder in high school and his lack of attention is a real problem now. But our son doesn’t think he has an attention problem (since it’s not his fault that school is so boring and not worth the effort!).
Our second child was diagnosed ADHD-inattentive at the beginning of middle school. Using the same measuring stick we decided that we needed to try the medication. The results were amazing.
Best wishes on your decision.
Correct...
and some people still have the mistaken idea that giving stimulants to kids who do not really have ADHD will make them “hyper”. This is not true. Think about how adults use caffeine— when we find our energy and attention lagging, we get a cup of coffee or a soda.
Re: "Borderline?" Is there such a thing?
Thanks for the advise everyone. I’m still thinking this over carefully,taking into consideration that my son really struggles in school, can’t do his homework without me to keep him on task, and was retained in 1st grade. At this point I’m leaning toward saying yes to medication.
Re: "Borderline?" Is there such a thing?
When you administer the rating scales, essentially “not significant (or whatever they call it when the trait is not present), borderline significant and significant. Borderline is not as definitive, but nonetheless I have seen children who had very obvious traits rate “borderline.” It comes from the scale itself, not from the professional.
Re: "Borderline?" Is there such a thing?
Hi Jen,
It was really hard for me to decide to medicate my son, but he was having problems with his school work, homework, social skills, etc. We did medicate and it has made a world of difference for him. He really CAN be independent and focused, with meds.
Often, when people find out I medicate my son (he takes Wellbutrin and Ritalin) they look at me funny. But when I tell them it was a very hard decision, not something I ever thought I’d do, but it has made the world a much better place for my son, they say “Oh!” and become very supportive of the decision.
One thing to remember is that you may have to try several different meds, and/or dosages of meds to get the right medication for your son. It has taken us 4 different meds/combinations of meds and about a year to finally find what works for him. When I started, I thought I’d give it up if we hadn’t found the right combination by 6 months - but we kept going and I’m glad we did. He is a very much happier and brighter child now.
Another good site to go to for more discussion is:
http://forums.delphiforums.com/ab-add/start
Best wishes to you and your son,
Lil
Re: "Borderline?" Is there such a thing?
Actually ADHD can be divided into three groups: mild, moderate, and severe ADHD.
One of the benefits of a correct diagnosis of ADHD can be to see if the ADHD meds (the stimulants/alerting agents) work at all. The ADHD meds do not work for everyone. There is no guarantee that even someone with 100% ADHD will respond well to any of the ADHD meds. Sometimes there can be a correct diagnosis but the meds don’t work at all; other approaches are used.
That’s just the real world.
That’s my understanding. Good luck.
The phrase borderline ADHD or borderline ADD is one I see offered more and more lately. I think it represents a ‘safe’ statement for the evaluator to make. By saying borderline, they’re allowing the parent to make the decision fully on their own. I have seen some parents say, “My child is borderline therefore I don’t need to do anything” and other parents say, “My child is borderline so I’d better do something”.
Will the child respond to medication is the question and is the parent comfortable exploring that?
How is your child doing in school? At home? If things are working out fairly well for your child, medication might seem unnecessary. If though he is having problems at school, medication might be helpful to helping him manage school.