“Your question is painful because while your husband means well, he is unaware of two very important elements”

Q

IF my husband were a kid today, he’d probably be diagnosed with ADHD, ASD, and who knows what else. He’s not, though, and when he was a kid, my in-laws, who had a very large family of rambunctious little ones, just considered him a boy who would never succeed in school and pretty much left him to his own devices.

Now I’m seeing some worrisome behavior in my four-year-old son, and I am desperate to get him evaluated, but my husband refuses. He thinks our son is just like him, and he turned out “fine” without the labels, so our son will as well, and that’s the end of the discussion.

My husband’s idiosyncrasies impact my life in many ways, every day. It’s really hard. And as my son’s mother, I’m terrified of what the future holds — for him, and for his future family. What do I do?

A

Your question is painful because while your husband means well, he is unaware of two very important elements.

1. Because your husband “survived,” and all of the false prophesies that he would never succeed did not materialize, he thinks he’s fine. He is unaware of the difficulties that his challenges present to those close to him. If in fact he has ASD (autism spectrum disorder), he likely has problems with both social relations and communication, making it difficult for him to understand how his disorder affects his personal relationships.
2. Our educational world has also developed and evolved to an unrecognizable state since he was a child. Our schools have become more focused on compliance, regulations, and classifications. Who fits in where, and how? The classroom is a social paradigm as much as an academic construct. Our community has become more aware of learning disabilities, disorders, and emotional challenges. This has brought about the creation of learning centers, resource rooms, and even programs and schools for special education.

Your husband survived in a different school system, a much-less-regulated atmosphere. Even if he was only ADHD, the culture of medicating students has changed drastically over the past 20 years. There is more awareness, and educators have developed progressive responses to children with challenges.

Your son is going to school in this new world of identification and intervention. If you are not on top of your son’s development, the indicators will trigger red flags, and he will likely not survive in school without collateral damage. Of course, the consequences of not taking care of him will extend far beyond just school.

Shlomo Hamelech says in Mishlei 16:2, “All the ways of a man are pure in his eyes.” Rabbeinu Yonah explains this to mean that we all think our inborn tendencies are “normal,” which makes it very difficult to make changes in our middos and character. We do not necessarily perceive our shortcomings as wonderful, but at least as within the range of normal.

At this point, your husband might not be aware of how education has changed, but if he is intelligent and capable of recognizing that his son lives in a different world than the one he grew up in, it is time to share this information with him. If you are concerned that he will not respond favorably, I suggest that you speak with someone reliable in your son’s school. If you give the hanhalah a heads-up before your son’s behaviors become overly troublesome, the school can demand intervention at an early stage, and you will have a partner.

A few words about making a determination. As a mother, you need to trust your gut that there is a real issue; however, it is imperative that you not diagnose your son based on your very reliable mother’s sense. According to the CDC, almost 10 percent of all children in the US are being medicated — over six million children. While medication is often very effective, there is no question that it is too often seen as the easiest way out.

It is essential that the evaluation be very professional. In the United States today, any psychiatrist, pediatrician, primary care physician, neurologist, psychologist, nurse practitioner, licensed mental health counselor (LMHC), licensed professional counselor (LPC), licensed marriage and family therapist (LMFT), or licensed social worker (LSWs) is allowed to diagnose ADD and ADHD.

It is your job as a parent to not rely on just any professional who is authorized to diagnose ADD, but to find a child psychiatrist or child neurologist with extensive experience in this particular area of mental health development who can make the determination. I hope some professionals will forgive me, but I would not rely on a social worker or even a pediatrician.

The doctor needs to determine if it is best for your child to be medicated, and if so, to try medications and follow the outcomes until the right drug and dosage are found. Many children react adversely to one medication but very well to another. Getting the medication and dosage right is a serious undertaking.

If you are concerned about ASD, the determination is even more difficult. Again, today, according to the NIMH, one out of 36 children in the US is diagnosed with ASD. Because the autism spectrum has been broadened, the “benefits” of caring for people on the spectrum have been broadened as well. You must choose a neurologist or psychiatrist who is an expert in determining if a child is on the spectrum. We have become too quick to diagnose mental illness, and we must not be afraid of finding the truth, but at the same time, we must not be trigger-happy in making these determinations.

You are a good mother. Do not compromise on getting your child the correct help, while making sure that your husband feels respected and a part of the process as much as possible.

(Originally featured in Mishpacha, Issue 997)