Child Caring

First grade boy can't focus. Is it ADHD?

I have a 6.5 yo son in First Grade. Reports from teachers uniformly say that he is "bright" or "intelligent"... but they also _always_ say that he is slow to do his work.

Kindergarten started well last year, but the second half was torture -- in the end the teacher felt so unsuccessful with him that she recommended he retake kindergarten with a different teacher.

We had him tested for grade level over the summer and he was on track so we did not hold him back. The beginning of 1st grade was great. The teacher agreed he was in the right class and though he worked slowly, he was doing things well. The second half of the school year started a few weeks ago and tonight I got an email from his teacher saying that his working speed appears to be slowing down and she's looking for ideas to get him back on track. She's concerned that if he doesn't figure out how to complete all of his work this year, that he's going to have a difficult time succeeding next year when there is less free time built into the school day. She is not concerned that he is not learning the material (he is still on track in terms of knowledge gained), she is just concerned that he is not completing the worksheets and written evaluations.

At home, he never has a hard time answering the questions on his homework, but *doing* his homework almost seems painful sometimes. (Think of the feeling you get when you're filing taxes. You have all of the information and it's not that hard to work through. But sometimes it takes a herculean effort to push through -- and the temptation to check facebook or get up and see if there's something worth eating in the refrigerator is so distracting that you find yourself in the kitchen before you know you've left your computer. Substitute spelling for taxes and Legos for a snack and you have what I see some days when he's doing his homework.)

Lack of focus is a problem in other areas of his life as well. At both swim lessons and tae kwondo we get reports about him being distracted easily. At home, we've built in generous transition and distraction times to our schedule. We've talked with our pediatrician and a developmental pediatrician and both of them offer ADHD meds and reminders to use positive reinforcement, but not much else. We make sure he gets between 10 and 11 hours of sleep, he eats a balanced diet with plenty of vegetables and I've started adding a daily vitamin in case the midwinter burnout is related to vitamin D.

I was wondering if you have any suggestions for helping a child of this age learn to own his work and complete it quickly. How do we make the decision of whether or not to medicate? Is this pattern of burnout midway through the year common at this age? Should we be looking into other schooling options where there might be less focus on worksheets and other written feedback? Is there any hope that he will mature out of this?

Thank you for your help!
From: Rosa, Portland, OR

Continue Reading Below

Dear Rosa,

It sounds like you are early in your journey, so I want to stress that my blog is a starting point only; there are many sites that are dedicated to the topic and I'm hoping readers will weigh in with some.

But let me start by saying I'm wondering about your expectations: "Own his work and do it quickly"? This is first grade! But that description did make me think about the possibility of an executive function issue.

Because, let's face it, ADHD does seem to be the diagnosis du jour, and (some) doctors are quick to offer medication. Here's another avenue to explore: psychologist LInda Budd coined the term "active/alert" to describe what's going on for some kids.

Meanwhile, if two doctors have offered ADHD meds and positive reinforcement strategies, I'm assuming they have tested him before coming to this conclusion, right....?. You don't mention that. A child does not typically "mature out of" an ADHD diagnosis, but rather learns to to accommodate his/her specific needs.

To medicate or not? I absolutely do not have an answer but, if you haven't seen it yet, this PBS FrontLine program might help you. Ditto for this from the New York Times. And of course you should read my felllow Boston Globe blogger, Dr. Claudia Gold, on this subject.

Discovering what's going on with any child takes time and resources, and I mean emotional as well as financial. It sounds to me like you're doing a great job so far. I hope that some of my recommendations -- and more likely, those from readers -- will be helpful.