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ADHD in a child of two


Wendy123
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I have a child in my care that is current 2 and will be there on 1st September. Is Mother is convinced that there is something wrong with him.

 

He behaves really well at playgroup and as been assessed by Salt, AENCO, And VI team. His HV is involved.

Mother has said she doesnt like him as he never behaves ( what 2 year old does toe the line for mum) that he doesnt show her affection but I have seen her push him away when he has gone for a kiss.

At our leaving party in Jully she arrived to see him get his presents and certificates. He went to greet her and she pushed him away and greeted her friends llittle girlllllll.

 

There is a lot more going on then I could write here.

 

Can ADHD be diagnosed in a 2 year old and can a child with ADHD change their behaviour for different places??

 

Help!!!

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Sounds like there could be some attachments issues. You are lucky to have had involvement from all those other professionals already. Has anyone actually given a diagnosis for him? Any family support in place?

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You sound like your describing one of my ex families, mum was convinced he had issues, she would list symptoms which you could tell were from Mr Google with wording wtc used. He behaved and engaged well for us and grandmar just not mum, mum would as you say not show the 'normal' behaviour when collecting him and watching their interactions have is a great insight into home life. We had to do lots of extra observations to evidence how he interacted, engaged and behaved within setting to show that we wasn't dampening it down, we got mast in to support mum who in turn agreed with us on parenting, we tried to get mum to come in at drop off and stay for 30mins to do a stay n play with child and key worker! This was fantastic to watch as it showed mum couldn't and didn't know how to play. His behaviour towards mum was all attention led, we worked with mum to provide techniques in dealing with attention behaviour. Unfortunately we was fighting a loosing battle not for want of trying in end all we could do was be mums regulator, I got phone calls, long chats with mum constantly but I was just there for her. I had to be an ear, a regulator to try and support her and him, in end he went to school agencies still involvea. She tried for ASD, ADHD, ADD, Global Delay!

Our area generally will not diagonse ADHD until the child reaches 5 years old, if they are in child care they will get our views but if not in childcare this is where it goes a little wrong in assessment I feel.

It's hard to help but support is key even if it's just acknowledging mums emotions that morning, for our previous possible ADHD children we carry out time observations, small group, 1:1 activities to gauge an understanding of concentration levels along with watching for impulses/twitches during the time and eye movement if you still feel at this point you have no concerns then If mum still wants to look further into it, ask mum if she wants a mtg between her, health visitor and you then HV could do a a few home vistis or you can offer to do home visit to see how he is at home and make it so you can see it more through mums eyes and the things you can do to support x

 

Oopps waffled on :)

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.Can ADHD be diagnosed in a 2 year old and can a child with ADHD change their behaviour for different places??

 

A child with ADHD must show the same behaviours in at least two different places. In my area diagnosis doesn't take place until children are 6......2 seems very young and very strange you are not seeing the same things as mum.

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Sounds like there could be some attachments issues. You are lucky to have had involvement from all those other professionals already. Has anyone actually given a diagnosis for him? Any family support in place?

Yes he has an eye condition which doesnt affect his sight and thats all.

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Thanks all. He seems to only display these behaviours at mums but we have seen her push him away when he goes to greet him..She has stated that she doesnt want him and she does favor the younger child who is a girl. SS and HV involved but mum is always calling SS and HV.Mum has kept a massive file on her childdetailing everytime he misbehaves...appointments..every time she goes to docs etc..

 

She constantly finding something wrong with him that I am becoming concerned that she maybe displaying Munchaussens by proxy.

 

I feel so sorry for this little boy..

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It does sound more like a mum needing some help, and of course if this little one is being pushed away by mum, it snot surprising he does things that will gain her attention, (which then reinforces her 'dislike' of him or her belief that something is wrong). and so also not surprising that he quite different with mum and at nursery. Do you know what his eye problem is?

 

Munchausens (or Fabricated or induced illness as it now tens to be called in the UK) is extremely rare, and I would have thought (not an expert though so others may have better experiences), that the mum (usually) shows herself as deeply loving and caring, which doesn't appear to be what you have described.

However, if you are genuinely concerned, with the wider range of information you have yourself, then this would be a child protection issue and you would need to take action. FII can lead to mums who physically make their child ill and so it would need dealing with.

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Reading a bit between the lines..

 

I have been wondering if it is more about mum and either she really did not bond well with her son,has some mild post natal depression or once she had her daughter tended to spend more time with the baby and the little boy is trying to gain more of the attention back in the only way he knows how.. All she sees is negative behaviour and to her it is continual.. but if she does not give this child equal attention or even a bit of extra for him to feel less pushed out it is not likely to improve.

 

It is difficult as it sounds like mum needs support to learn how to deal with the issues . it is easy to try to see a medical reason when she may be well aware but unwilling to accept that it could be due to the way he is being sidelined a bit for the baby. He is still only a baby himself and could be finding it very hard at home with a younger sibling . Maybe her expectations of what a 2 year old is expected to achieve/do are unrealistic.

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It is possible for a child with ASD who masks their symptoms in an educational setting to also have ADHD and mask those symptoms too. Our local CAMHS has diagnosed a child with exactly this.

 

There are lots of possible explanations for what you've observed some of which could be due to parenting and others neurodevelopmental. It could even be a combination of the two.

 

I would suggest to the mother that she asks her HV or GP for a referral to a community paediatrician who can trigger a full neurodevelopmental assessment for this child. This would include a close look at his home experiences,and his developmental history from conception. Hopefully a range of professionals observing this little one in a range of situations will be able to make some recommendations for how best he can be supported. They may also come to the conclusion that a diagnosis of a neurodevelopmental disorder is appropriate.

 

I wouldn't mention Munchausen's by proxy. That is a very serious and incredibly rare condition and it's far more likely that this little one's difficulties are down to something much less sinister.

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  • 2 weeks later...

Whatever is going on here, there is a child in need and a parent in need and this should be addressed. Has anyone asked mum what she wants to happen or what she thinks her child needs? If so many professional are involved, I wonder if a multi disciplinary meeting has taken place which mum attended, hopefully with a friend or member of the family to offer her some support.

 

It's all too easy for professionals to fly in and out of a family, do their "bit" then leave and nobody is taking the lead and thinking about what the family really needs. Ideally, the Health Visitor should be pulling everything together but many of them are extremely overworked so this might not be happening.

 

Like Upsy Daisy, I've known children who have behaved perfectly well within a setting and been completely different at home, for a wide range of reasons, some of which led to a diagnosis. Unless one person is taking responsibility for looking at all the evidence and building a trusting relationship with mum, it's unlikely that things will change.

 

 

 

 

 

 

 

 

 

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