How was he diagnosed? By whom? When? These are questioned often asked by those parents wondering and waiting to those of us who think we know.
My son was almost 5 years old when he was finally diagnosed with ADHD and, tentatively, with an autism spectrum disorder - maybe Aspergers- by a Developmental Pediatrician. Around a year or so later, I took him to a Psychiatrist who confirmed the diagnosis and made the autism spectrum thing official, calling it PDD(NOS).
I say he was FINALLY diagnosed because when we brought him home from China at age 3 1/2, I knew there was a little something more going on than attachment issues, post-institutional issues, and adjustment issues. The aformentioned list of "somethings" is a lot to deal with, so everyone else seemed to think I was a little crazy for saying "something's wrong". SEVERAL somethings were obviously "wrong"! I knew that. You don't bring home a neglected, undernourished boy who spent the first 3 1/2 years of his life in an orphanage (through no fault of his own) and who has been adopted and ripped away from everything he knew -good and bad - and I mean EVERYTHING - familiar routine, people, food, smells, language, sounds, country - and expect him to behave as if nothing is "wrong". I KNEW THAT. But we had gone through something like this two years prior when we brought his sister home. She was only 1 1/2 but came from the same orphanage and had a very similar history. The adjustment period is difficult and it can be difficult for a long time.
But there was just something more. This little boy was very cute and I had this sneaky feeling that he was really very bright (maybe even brilliant), but there was little evidence of that fact at first. He was so poorly socialized that he seemed more like a monkey than a boy. His intelligible language was very limited even in Mandarin. He did seem to understand more language than he could express, but he did not seem to be able to interpret gestures and demonstrations. It was difficult to communicate with him in any way.
He regressed away from his potty training and didn't seem to be familiar with crayons, pencils, paint, scissors, and, of course, he didn't know what to do with a fork; but he wasn't even very adept at using a spoon.
I had to watch him constantly because he seemed to have no fear, no pattern to his behavior or play, and no intention of interacting in a friendly way with his new siblings. He had a bad habit of whacking and banging his head on various corners and home furnishings. When left alone in the playroom, he would fairly well trash it in about 5 minutes. If I scolded him in any way he would cower and scream in terror.
After he had been home about 6 months, I decided that he MUST have ADHD at the very least. I suspected there was a learning disability of some sort also. Somewhere around that time I read about Asperger's. The description of an "Aspie" made me think of our "monkey-boy" for some reason I couldn't put my finger on at the time.
I asked around and someone recommended Dr. Y, a Developmental Pediatrician. I made an appointment and my DH and I took the boy to see her. She ended up canceling two subsequent appointments and spending 2 1/2 hours with us. She declared our son to be "an interesting case". He really obliged us by acting very monkeyish - hyper and using very few intelligible words. He scrambled around fiddling with everything he could get his hands on. However, she asked him to do several tasks and copy some little drawings she made and he did these tasks quickly and almost perfectly- all the while wiggling, rocking, and grinning maniacly. These little tasks and drawings turned out to be developmental tests. He seemed to be cognitively ahead of his chronological age in several areas, but developmentally delayed in his language, social, and motor skills. She also noticed his strong "flinching" reflex and total lack of eye contact. After some other tests and questionnaires for us, Dr. Y concluded that he definiteley had ADHD and probably a history of some abuse. She thought also we were seeing something like Aspergers, but couldn't be sure because of his history and young age.
We started little monkey-boy on Concerta (timed release Ritalin) within a few days.
MIRACULOUS! He immediately became more focused. He had been only scribbling when given crayons and paper, and he rarely even scribbled for more than a handful of minutes. Four days after starting Concerta, he sat at his little table and made a line drawing of a simple sailboat and wrote his name at the top! He had never written out his name before. I went back through all his preschool sheets from that year and saw no more than two letters of his first name on any of them. I had no more worries about medication being right for him.
So that's basically how we started on the path to helping our son become a real boy!
There was more to come and there will be more to come, but he IS rather brilliant after all.